Mental distress among healthcare workers due to COVID-19 during second wave in a tertiary care center of South Karnataka: A cross-sectional study

Background: Healthcare workers (HCWs) in India are facing physical and psychological pressure. The pandemic has significant psychological impacts. Hence, we wanted to assess the mental stress and social stress among HCWs during the second wave of COVID-19. Aim and Objectives: Assessment of the mental distress among HCWs of tertiary care level institution during second wave of COVID-19 with the following objectives: (1) To know the sociodemographic characteristics of the HCWs of tertiary care center and (2) to assess the psychological stress among healthcare workers of a tertiary health center. Material(s) and Method(s): It is a cross-sectional and observational study conducted in hospital setting, in a tertiary care setting. Data were collected from 196 HCWs of the institute. Institutional ethical clearance was taken before the study. Structured questionnaire included sociodemographic variables, work-related variables, and variables to assess social stress. We used hospital anxiety and depression scoring questionnaire to assess anxiety and depression. Data were collected through personal interviews and online through Google forms after taking informed consent. Descriptive statistics and Chi-square tests are used analyzed using Statistical Package for the Social Sciences Version 21 for Statistical analysis. Result(s): A total of 196 HCWs, 121 doctors, 74 nursing staff, and one ward staff participated in the study. Nursing staff were at higher risk for anxiety and depression, that is, 29% and 25% than others. Females were slightly more anxious (29%) and depressed (17%) than males. HCWs who are Muslim by religion were at more mental distress. Media exposure of more than 3 h had increased risk of mental distress. HCWs with other frontline COVID warrior as a partner were both anxious (40%) and depressed (20%). Anxiety (35%) was more among those who's family members got COVID positive. About 25% of them faced social stigma, 55% of them faced issue of isolation with in the community, and 14% of them faced acts of violence which is unacceptable. Conclusion(s): Although its second wave HCWs are still having psychological distress which needs to be addressed. Social stress that they are facing is significant and is associated with higher anxiety and depression, which has to be taken seriously.Copyright © 2023, Mr Bhawani Singh. All rights reserved.

Challenges faced in biomedical waste management by waste handlers amidst the COVID-19 pandemic in a tertiary care hospital: a qualitative study

Introduction : Coronavirus disease 2019 (COVID-19) saw an overhaul in the biomedical waste management (BMWM) practices. Waste handlers were at the brunt of these changes. If the challenges pertaining to BMWM at the ground level are better understood, more effective measures to overcome them can be formulated. Objectives: 1. To identify myths and concerns regarding BMWM in the context of COVID-19 pandemic. 2. To explore the challenges faced in BMWM amidst the COVID-19 pandemic. 3.To explore opportunities and future perspectives of BMWM. Method: In-depth interviews were conducted among 17 purposively selected Class IV health care workers during August to November 2021 in a tertiary care institute in Mumbai. Data was reported using thematic analysis. Results: Three major themes - challenges and concerns faced by BMW handlers, enablers/motivators, opportunities and future practices were generated from the transcripts. Various challenges faced by waste handlers were- difficulties in segregation and transport of BMW, exhaustion from PPE usage and fear of acquiring and spreading COVID-19 from work, stigma faced from public, and handling COVID-19 deaths. Support from family and colleagues, incentives and a positive change in public perception enabled them to work. Forming redressal committees, addressing job security concerns and timely provision of good quality equipment can improve hospital waste management measures in the future. Conclusion: It is of utmost importance to address challenges faced by waste handlers in BMWM. Onus should also be on periodic training in BMWM.

The many shades of violence against women: a call to action

Confronting gender-based violence is a key area of concern and one that calls for urgent action. These debates have become particularly relevant in light of the Covid-19 pandemic and the unveiling of underlying inequalities. Amongst the many unintended consequences of the pandemic lies the increased risk of domestic violence for vulnerable women who have been required to self-isolate. There is increasing evidence that we are facing more than one pandemic with quite worrying and widespread problems in global systems, whether they relate to public health or to human rights. As academics, we can contribute by theorizing with intersectionalities, translating research into practice, engaging with our local communities and creating non-stigmatized environment. But most of all, we can advocate for victims.

Separation and Discrimination: The Lived Experience of COVID-19 Survivors in Philippine Isolation Centers

Social isolation in times of pandemic can affect the well-being of individuals infected with a contagious disease. This study explores the lived experience of the 12 COVID-19 survivors placed in community-based isolation centers in Cebu City, Philippines and whose cases were mild and asymptomatic. In describing their lived experience, we employed Max van Manen's phenomenology of practice. Results show that the COVID-19 survivors have suffered more from the consequences of separation and discrimination than the disease's physiological effects. Educating the whole community about social responsibility and ethical behavior in dealing with COVID-19 survivors is essential to minimize social stigma and discrimination.

The effects of responsibility frames and stigmatizing headlines in news on support for covid-19 policies in korea

This study examined the mechanisms through which responsibility frames and stigmatizing headlines influence support for governmental policies to address the pandemic. Based on a factorial design experiment, we examined the effects of 2 responsibility frames (individual vs. societal responsibility) and 4 headline types (non-stigmatized vs. name-stigmatized vs. characteristic-stigmatized vs. both-stigmatized). The results showed that the individual responsibility frame increased individual attribution of responsibility for the cause and spread of COVID-19 whereas reducing societal attribution of responsibility, compared to the societal responsibility frame. The headline that detailed both the stigmatized characteristic and name increased individual attribution of responsibility compared to the non-stigmatized headline. Furthermore, the effects of frames and headline types on policy support were sequentially mediated by attribution of responsibility and emotions. Individual attribution of responsibility led to anger whereas societal attribution of responsibility led to sympathy. Subsequently, anger increased support for punitive policies while sympathy increased support for assistive policies. This study contributes to the literature on news framing of pandemics by integrating cognitive and emotional mechanisms in forming policy attitudes. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The Impact of the COVID-19 Pandemic on Female Domestic Workers in an Urban Setting

This paper focuses on the increasing marginalisation and vulnerability of female domestic workers in urban India in the wake of the COVID-19 pandemic. It analyses the impact of the pandemic on the livelihood and the physical, mental and emotional well-being of women domestic workers through a primary survey conducted in Lucknow city in 2020 and 2021. The paper highlights the effect of lockdown on their livelihoods, savings, food security, family life and mental health. It also analyses the effectiveness of the outreach of government support to this vulnerable segment of the urban informal sector. Given the vulnerability of this group to various forms of exploitation, the authors suggest that policy interventions aimed at providing welfare and social protections will need to be coupled with strong political will and increased social consciousness to have an enduring impact. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

Navigating visibility and risk: disabled young women's self-presentation practices on social media

Visibility is a requirement of neoliberal postfeminist girlhood and social media is often attributed with the capacity to provide disabled young women with visibility that they lack elsewhere. While some attention has been paid to the intersections of gender and disability through the self-presentations of disabled young women who are known as disabled content creators, such as bloggers and YouTubers, this article goes beyond this to examine how disabled young women represent themselves on social media as part of their everyday practices. Using a combination of discursive textual analysis of Twitter and Instagram accounts and semi-structured interviews with five disabled young women, I explore how affordances such as Twitter retweets play a key role in how disabled young women navigate their visibility online as part of their self-presentation practices. I argue that visibility is potentially risky and disabled young women's social media use is shaped by concerns about harassment and questions about the 'legitimacy' of their disabled identities that operate at the intersections of gender, disability and race, stemming from their experiences of 'systemic disbelief'. Finally, I situate these self-representation practices within the context of the COVID-19 pandemic.

The Earthquake Disaster in Turkiye: A Review from Child and Adolescent Psychiatry Perspective

The earthquake has long-lasting various mental and behavioral effects on children and adolescents. The aim of this review was to discuss the nature and extent of psychiatric problems, management options, and the process of organizing psychological interventions for affected children. Individuals show a range of physically, emotionally, and cognitively healthy responses that can help them cope with the aftermath of a disaster. Psychiatric symptoms such as acute stress reactions, post-traumatic stress disorder, depression, anxiety disorder, increased risk of suicide, sleep disorders, substance use disorders, and psychotic disorders may develop in some children. Comorbidities and sub-clinical syndromes are also common. There are many risk factors and protective factors in the development of mental disorders. Close follow-up of children at high risk and interventions for psychosocial support may prevent the development of mental disorders. It is very important to start the intervention at the earliest period. The psychological impacts of young disaster victims can be addressed by skilled local volunteers, medical professionals, and educators in primary health care programs. With the nation's overall social and economic recovery, children can recover more quickly from traumatic experiences.Copyright © 2023, Duzce University Medical School. All rights reserved.

THE RELATIONSHIP OF NURSE STIGMA DURING THE COVID-19 PANDEMIC TO NURSE PERFORMANCE AT HOSPITAL IN KUPANG

During the COVID-19 pandemic, these professions that are at high risk of contracting COVID-19 can trigger ongoing fear, anxiety, stress, fatigue, and emotional trauma that is exacerbated by the stigma of being a carrier of the disease. This can have an impact on nursing services that are not optimal and decrease in performance. The purpose of this study was to determine the relationship of nurses' stigma during the COVID-19 pandemic to the performance of nurses working at Bhayangkara Drs Hospital. Titus Uly and S. K. Lerik Regional General Hospital, Kupang City. This study was designed using a quantitative study with a Cross Sectional design with Chi Square statistical test. A sample of 67 people was taken using Simple Random Sampling. From the results of the study, it was found that most nurses (98.5%) had a negative stigma during the COVID-19 pandemic and had good performance as much as 81.5%. There is a significant relationship (p value = 0.038) between nurse stigma during the COVID-19 pandemic and nurse performance. This research can be input for hospital leadership regarding attention to nurses and making policies to improve performance that is free of stigma and for nurses themselves to continue to have strong self-coping so as not to cause anxiety and not reduce performance in nursing services/providing care. [ FROM AUTHOR] Copyright of Devotion: Journal of Research & Community Service is the property of Green Publisher and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

RED-EMAR - A Chilean pilot initiative of early detection and intervention in clinical high-risk subjects

The COVID-19 crisis has had a significant impact on the mental health of adolescents and young adults in South America. As a result, the appearance of a higher incidence of anxiety and depressive disorders in these countries have been documented and could lead to the appearance of severe mental health disorders. In this context, the prevention and early intervention in mental health is a current challenge in Central and South America. Since the last decade, the existence of initiatives in this field has been mapped in Mexico, Brazil, Chile and Argentina, mostly in first episode psychosis programs. However, Chile is the only country in South America with a multicentre prospective initiative for early detection and intervention in clinical high-risk subjects (called RED-EMAR). The aim of RED-EMAR is disseminate the value of the at-risk mental state concept (abbreviated to EMAR in Spanish), establish agreed therapeutic strategies in this field, and establish potential new evidence-based local interventions. The successful experiences of this network include the monitoring and discussion of clinical cases in telemedicine and the development of mental health psychoeducation guidelines. However, Insufficient resources, stigma, and the lack of mental health public policies are some of the weaknesses of this initiatives in South America. The development and access to early detection and intervention services in South America could be a window of opportunity to reduce the impact of severe mental health disorders such as psychosis and related disorders and move towards an approach aimed at prevention or delaying its onset.

Unveiling stigma: Exploring mental health literacy in the time of COVID-19 pandemic

In the present chapter, an attempt is made to explore the persisting Mental Health stigma and its association with the aforementioned construct from a quantitative perspective. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Regional consultation on enhancing the capacity of Member States to implement anti-stigma programmes in the Eastern Mediterranean Region

[...]the economic downturns, social polarization, public health emergencies, widespread humanitarian emergencies, forced displacement, climate crises, and even COVID-19 are major threats to mental health in the Eastern Mediterranean Region. The Comprehensive Mental Health Action Plan 2013-2030 (8), the Regional Framework to Scaleup Action on Mental Health in the Eastern Mediterranean Region (9), the World Mental Health Report (10), and the associated tools and resources published by WHO provide strategic directions for addressing stigma and discrimination. Recommendations Through outreach activities and advocacy at national and subnational levels, Member States are to strengthen multisectoral partnerships, including with people who experience mental health disorders and their support networks, to leverage scarce resources for mental health and integrate anti-stigma actions into mental health law, policies, and interventions.

Social and cultural determinants

Mental health problems often have their onset early in life, with about 50% of people having an onset by the age of 14 and 75% by the age of 24. Even before the current COVID-19 pandemic, there was a crisis in terms of access to mental health care for youth worldwide. We know that early identification and intervention for all medical conditions leads to better outcomes. However, not all youth who need early mental health support are able to access it, with early access even less likely in middle- and lower-income countries. There are clearly multiple international barriers in terms of services, resources, workforce, and stigma that impact the ability of young people to access mental health support. Here, we present international approaches from several diverse cultures, countries and communities working to meet the early mental health needs of youth and families in terms of education and access to resources.

Stigma and health inequality experienced by ethnic minorities during the COVID-19 pandemic in a Chinese community: an implication to health policymakers.

Introduction: Ethnic minorities are considered one of the most vulnerable groups during the COVID-19 pandemic. However, the explanatory pathway of how their disadvantaged experiences during epidemics are related to the embedded and longstanding stigmas against them and how these embedded stigmas can affect their resilience in disease outbreaks are not well understood. This study investigated the experiences of ethnic minorities in the COVID-19 pandemic, and how their experiences were related to the embedded stigma toward them. Methods: This study adopted a qualitative approach, interviewed 25 individuals (13 women and 12 men) from ethnic minority groups residing in Hong Kong from August 2021 to February 2022 in a semi-structured format. Thematic analysis was conducted to analyze the data. Results: The participants were isolated and stereotyped as infectious during the COVID-19 pandemic at community and institutional levels. Their experiences did not occur suddenly during the pandemic but were embedded in the longstanding segregation and negative stereotypes toward ethnic minorities in different aspects of life before the pandemic. These negative stereotypes affected their resilience in living and coping with the pandemic. Conclusion: The participants' experiences during the COVID-19 pandemic were mostly disadvantageous and predominantly initiated by the mainstream stigmatization toward them by the local Chinese residents and government. Their disadvantaged experiences in the pandemic should be traced to the embedded social systems, imposing structural disparities for ethnic minorities when accessing social and medical resources during a pandemic. Because of the preexisting stigmatization and social seclusion of ethnic minorities in Hong Kong, the participants experienced health inequality, which stemmed from social inequality and the power differential between them and the Chinese locals. The disadvantaged situation of the participants negatively affected their resilience to the pandemic. To enable ethnic minorities better cope with future epidemics, merely providing assistance to them during an epidemic is barely adequate, but a more supportive and inclusive social system should be established for them in the long run.

Social stigma and discrimination faced by COVID-19 patients in an industrial unit: Findings of survey from rural Maharashtra.

Introduction: Uncertain situation of the coronavirus disease 2019 (COVID-19) pandemic has led to fear, stigma, and discrimination across all strata of society in varying proportions. Stigmatization increases the suffering of people or those who are at risk of getting the disease and make it harder for public health authorities to control the disease. Material and Methods: The present study is a questionnaire-based cross-sectional survey conducted over a period of four weeks in the month of July 2021 in a food industry in rural region of western Maharashtra among COVID-19 positive patients. A total of 152 participants were included in the study. The data was analyzed using SPSS software (version 20). Descriptive statistics were used which included frequencies and percentages. Results: 64.5% of the participants were males and 35.5% were females. Approx. 85% of the participants were in age group 15-58 years. 100% of them reported to have faced fear on being tested COVID-19 positive. However, only approx. 2-5% individuals hid their illness from family and friends and 7.9% of them were afraid of getting hospitalized. Conclusion: It was found that fear was prevalent among all survivors but stigma was found to be minimal which is likely due to widespread awareness through media, IEC campaigns, and active involvement of administration in implementing policies.

A multi-country study of the associations between HIV vulnerability status, perception of COVID-19 related stigma and post-traumatic stress symptoms during the first wave of the pandemic.

BACKGROUND: This study investigated the associations between COVID-19 related stigma and post-traumatic stress symptoms (PTSS); and the associations between PTSS and COVID-19 related stigma, HIV status, COVID-19 status and key HIV population status. METHODS: This was a secondary analysis of data of 12,355 study participants generated through an online survey that recruited adults from 152 countries between July and December 2020. The dependent variables were COVID-19-related stigma and PTSS. The independent variables were HIV status (positive/negative), transaction sex (yes/no), use of psychoactive drugs (yes/no), and vulnerability status (transaction sex workers, people who use psychoactive drugs, living with HIV, and COVID-19 status). The confounding variables were age, sex at birth (male/female), level of education, sexual minority individuals (yes/no) and country income level. Multivariable logistic regression analyses were conducted to determine associations between the dependent and independent variables after adjusting for confounders. RESULTS: There were 835 (6.8%) participants who experienced COVID-19 related stigma during the pandemic and 3,824 (31.0%) participants reported PTSS. Respondents who were living with HIV (AOR: 1.979; 95%CI: 1.522-2.573), tested positive for COVID-19 (AOR: 3.369; 95%CI: 2.692-4.217), engaged in transactional sex (AOR: 1.428; 95%CI: 1.060-1.922) and used psychoactive drugs (AOR: 1.364; 95%CI: 1.053-1.767) had significantly higher odds of experiencing COVID-19 related stigma. Individuals with vulnerability status (AOR:4.610; 95%CI: 1.590-13.368) and who experienced COVID-19 related stigma (AOR: 2.218; 95%CI: 1.920-2.561) had significantly higher odds of PTSS. CONCLUSION: Individuals with vulnerability status may be at increased risk for COVID-19 related stigma. Key and vulnerable populations who were living with HIV and who experienced stigma may be at a higher risk of experiencing PTSS. Populations at risk for PTSS should be routinely screened and provided adequate support when they contract COVID-19 to reduce the risk for poor mental health during COVID-19 outbreaks and during future health crisis with similar magnitude as the COVID-19 pandemic.

Stigma Scale Adaptation and Validation for Measuring COVID-19 Stigma.

BACKGROUND: The current coronavirus disease 2019 (COVID-19) pandemic has been found to be associated with increased psychosocial problems such as depression, anxiety, stress, and stigma. Many health-related stigma instruments that have been developed are condition-specific; these should be adapted and validated for generic use, across different health conditions. This study was conducted to measure stigma, stress, anxiety, and depression using the COVID-19 Stigma Scale-Modified (CSS-M), a modified version of the HIV Stigma Scale, among the Indian population. METHODS: A weblink-based online survey was conducted using the adapted CSS-M, along with the Depression, Anxiety, and Stress Scale-21. Collected data were analyzed with correlation analysis, reliability analysis, exploratory factor analysis, and convergent and divergent validity. RESULTS: With a sample size of 375, the modified scale for COVID-19 stigma showed internal consistency and a good inter-item correlation (Cronbach's alpha 0.821). Principal axis factoring with varimax rotation along with alternative parallel analysis established the two factorial structure and had valid composite reliability, discriminate validity, and partial convergent validity. CONCLUSION: We found that COVID-19 Stigma Scale-Modified is a valid measure to assess COVID-19-related stigma. The scale was found to be internally consistent with a good inter-item correlation, composite reliability, valid discriminate validity, and partial convergent validity. Specific COVID-related validated scales for stigma should be developed in the future.

Navigating responsible bio-political citizenship: Cross-country comparison of stigma in Covid-19 illness narratives in Germany, Japan, the UK and the USA.

This paper aims to further understanding of discourses of responsible bio-political citizenship during the first year of the Covid-19 pandemic. This was an interview-based qualitative study comparing experiences of 103 people who were ill with Covid for the first time across 2020 in Japan, Germany, the USA and the UK. Comparative thematic analysis explored discussion of responsibility in relation to Covid illness, experiences of social fracture and stigma, and the strategies employed to resist or mitigate stigma. This comparative analysis highlighted significant similarities across countries. We identified three mysteries of Covid illness experiences that impacted the work of navigating biopolitical citizenship. First, the mystery of how people caught Covid. There was an inherent paradox of following guidance yet nonetheless falling ill. Disclosure of Covid to minimise onward transmission was held in tension with accusations of irresponsibility. Second, the mystery of onward transmission. Uncertainty about transmission placed participants in a liminal space of potentially having caused harm to others. Third, the mystery of how long illness should last. Uncertainty about ongoing infectiousness made social re-entry difficult, particularly in instances of persistent symptoms. We demonstrate the instability of certainty in the context of new and emerging forms of biopolitical citizenship. Guidance and emerging scientific evidence sought to demystify Covid through providing certainty that could guide responsible actions, but where citizens experienced paradoxes this had the potential to exacerbate stigma.

"We do it ourselves": strengths and opportunities for improving the practice of harm reduction.

BACKGROUND: Unprecedented increases in substance-related overdose fatalities have been observed in Texas and the U.S. since the onset of the COVID-19 pandemic and have made clear there is considerable need to reduce harms associated with drug use. At the federal level, initiatives have called for widespread dissemination and implementation of evidence-based harm reduction practices to reduce overdose deaths. Implementation of harm reduction strategies is challenging in Texas. There is a paucity of literature on understanding current harm reduction practices in Texas. As such, this qualitative study aims to understand harm reduction practices among people who use drugs (PWUD), harm reductionists, and emergency responders across four counties in Texas. This work would inform future efforts to scale and spread harm reduction in Texas. METHODS: Semi-structured qualitative interviews were conducted with N = 69 key stakeholders (25 harm reductionists; 24 PWUD; 20 emergency responders). Interviews were transcribed verbatim, coded for emergent themes, and analyzed using Applied Thematic Analysis with Nvivo 12. A community advisory board defined the research questions, reviewed the emergent themes, and assisted with interpretation of the data. RESULTS: Emergent themes highlighted barriers to harm reduction at micro and macro levels, from the individual experience of PWUD and harm reductionists to systemic issues in healthcare and the emergency medical response system. Specifically, (1) Texas has existing strengths in overdose prevention and response efforts on which to build, (2) PWUD are fearful of interacting with healthcare and 911 systems, (3) harm reductionists are in increasing need of support for reaching all PWUD communities, and (4) state-level policies may hinder widespread implementation and adoption of evidence-based harm reduction practices. CONCLUSIONS: Perspectives from harm reduction stakeholders highlighted existing strengths, avenues for improvement, and specific barriers that currently exist to harm reduction practices in Texas.

Fear of COVID and Physical Health Among People Living with HIV in China: Mediation Effects of HIV Stigma, Social Support, and Substance Use.

The COVID-19 pandemic has uniquely impacted people living with HIV (PLWH) worldwide. The negative impacts on PLWH's mental health from fear of COVID-19 are labeled as "a double stress." The association between fear of COVID-19 and HIV (internalized) stigma has been found among PLWH. Studies that explore the relationships between fear of COVID-19 and physical health outcomes are few, especially among PLWH. In this study, we explored the relationship between fear of COVID-19 and physical health among PLWH and the mediated effects of HIV stigma, social support, and substance use. A cross-sectional online survey of PLWH (n = 201) from November 2021 to May 2022 was carried out in Shanghai, China. The data on socio-demographics, fear of COVID-19, physical health, HIV-related perceived stigma, social support, and substance use were gathered and analyzed by structure equation modeling (SEM). In SEM analysis, fear of COVID-19 showed a significant and indirect effect on physical health (ß=-0.085) which was primarily mediated by HIV stigma. In SEM analysis, the final model had a good fit. Fear of COVID-19 showed a significant effect on HIV stigma (ß = 0.223) with the majority being direct effects (ß = 0.262) and a small indirect effect via substance use (ß=-0.039). Furthermore, HIV stigma showed a significant effect on physical health (ß=-0.382), the majority of which was direct (ß=-0.340), and a small indirect effect via social support (ß=-0.042). This is one of the first studies to explore how fear of contracting COVID-19 can affect PLWH's coping behaviors (e.g., using substances and obtaining social support) used to combat HIV stigma as well as to achieve better physical health in China.