Stress, anxiety, and depression among call handlers employed in international call centers in the national capital region of Delhi.

BACKGROUND: Call handlers employed in call centers repeatedly undergo stress in their day-to-day lives and this can have deleterious effects on their health. OBJECTIVES: The objectives were to study the levels of stress, anxiety, and depression, and their predictors among call handlers employed in international call centers in the National Capital Region (NCR) of Delhi. MATERIALS AND METHODS: A cross-sectional questionnaire-based survey was conducted among 375 call handlers aged 18-39 years. Depression Anxiety Stress Scale- 42 (DASS-42) was used to measure stress, anxiety, and depression along with a pretested sociodemographic questionnaire. Univariate analysis was done to find out the association of stress, anxiety, and depression with various factors. Variables with P < 0.25 were included in multiple logistic regression and three models were developed each for stress, anxiety, and depression. RESULTS: The prevalence of stress, anxiety, and depression among call handlers was 46.7%, 57.1%, and 62.9% respectively. Abnormal sleep quality, prolonged travel time, and lack of relaxation facilities at the office were predictors of stress and depression. The presence of physical ailments, the absence of hobbies, temporary/part-time employment, and traveling long-distance to office were significant predictors of anxiety among call handlers. CONCLUSION: Call handlers face a high burden of stress, anxiety, and depression. Public health specialists need to pay adequate attention to their health problems.

Resurrecting social infrastructure as a determinant of urban tuberculosis control in Delhi, India.

BACKGROUND: The key to universal coverage in tuberculosis (TB) management lies in community participation and empowerment of the population. Social infrastructure development generates social capital and addresses the crucial social determinants of TB, thereby improving program performance. Recently, there has been renewed interest in the concept of social infrastructure development for TB control in developing countries. This study aims to revive this concept and highlight the fact that documentation on ways to operationalize urban TB control is required from a holistic development perspective. Further, it explains how development of social infrastructure impacts health and development outcomes, especially with respect to TB in urban settings. METHODS: A wide range of published Government records pertaining to social development parameters and TB program surveillance, between 2001 and 2011 in Delhi, were studied. Social infrastructure development parameters like human development index along with other indicators reflecting patient profile and habitation in urban settings were selected as social determinants of TB. These include adult literacy rates, per capita income, net migration rates, percentage growth in slum population, and percentage of urban population living in one-room dwelling units. The impact of the Revised National Tuberculosis Control Program on TB incidence was assessed as an annual decline in new TB cases notified under the program. Univariate linear regression was employed to examine the interrelationship between social development parameters and TB program outcomes. RESULTS: The decade saw a significant growth in most of the social development parameters in the State. TB program performance showed 46% increment in lives saved among all types of TB cases per 100,000 population. The 7% reduction in new TB case notifications from the year 2001 to 2011, translates to a logarithmic decline of 5.4 new TB cases per 100,000 population. Except per capita income, literacy, and net migration rates, other social determinants showed significant correlation with decline in new TB cases per 100,000 population. CONCLUSIONS: Social infrastructure development leads to social capital generation which engenders positive growth in TB program outcomes. Strategies which promote social infrastructure development should find adequate weightage in the overall policy framework for urban TB control in developing countries.

A study on infant and young child feeding practices among mothers attending an urban health center in East Delhi.

A cross sectional study was conducted to study the diet pattern of children less than 2 years with regard to certain infant and young child feeding (IYCF) indicators. A total of 374 children less than 24 months of age coming to the immunization clinic were studied using a standard pretested and prevalidated questionnaire. Exclusive breastfeeding was followed by 57.1% of children under 6 months of age. Minimum dietary diversity, minimum meal frequency, and minimum acceptable diet were seen adequate in 32.6%, 48.6%, and 19.7% of children between 6 months and 2 years of age, respectively.

Diabetes self-efficacy strongly influences actual control of diabetes in patients attending a tertiary hospital in India.

A cross-sectional survey of 507 in- and out-patients, with diagnosed Type 2 diabetes mellitus (T2DM) was undertaken to study the relationships between personal, disease and treatment-related factors and diabetes control in a tertiary care hospital. On multivariate logistic regression analysis, self-efficacy (odds ratio (OR) =2.94; 95% confidence interval (CI) =1.92-4.54); P<0.001) was the single most important determinant of current diabetes control (HbA1c ≤7%), along with absence of hyperglycemic symptoms in the past year (OR=1.83; 95% CI=1.15-2.93, P<0.01), current treatment with oral medication (OR=1.77; 95% CI=1.17-2.66; P<0.007), and adherence to dietary restrictions (OR=2.7; 95% CI=1.28-5.88; P<0.009). Self-efficacy was itself influenced by educational status, employment, availability of family support, and positive mental attitudes. Our findings suggest that health care delivery inputs, patients' personal characteristics including education and attitude, and family support for care are complexly processed to determine patients' ability to manage their disease, which ultimately influences disease outcomes.

A Study of the Swine Flu (H1N1) Epidemic Among Health Care Providers of a Medical College Hospital of Delhi.

BACKGROUND: Influenza viruses cause annual epidemics and occasional pandemics that have claimed the lives of millions. Understanding the role of specific perceptions in motivating people to engage in precautionary behavior may help health communicators to improve their messages about outbreaks of new infectious disease generally and swine flu specifically. OBJECTIVES: To study the knowledge and practices of health care providers regarding swine flu and to study the attitudes and practices of health care providers toward the prevention of the swine flu epidemic. MATERIALS AND METHODS: The present study was a cross-sectional (descriptive) study and was conducted in the month of September, 2009, among doctors and nurses. A maximum of 40% of the total health care providers of GTB Hospital were covered because of feasibility and logistics, and, therefore, the sample size was 334. RESULTS: Around 75% of the health care providers were aware about the symptoms of swine flu. Mostly, all study subjects were aware that it is transmitted through droplet infection. Correct knowledge of the incubation period of swine flu was known to 80% of the doctors and 69% of the nurses. Knowledge about high-risk groups (contacts, travelers, health care providers) was observed among 88% of the doctors and 78.8% of the nurses. Practice of wearing mask during duty hours was observed among 82.6% of doctors and 85% of nurses, whereas of the total study population, only 40% were correctly using mask during duty hours. CONCLUSIONS: Significant gaps observed between knowledge and actual practice of the Health Care Provider regarding swine flu need to be filled by appropriate training. Data indicate that the health care providers are very intellectual, but they do not themselves practice what they preach.