Psychological and social impact of COVID-19 in Pakistan: Need for Gender Responsive Policies

BACKGROUNDCOVID-19 has rapidly crossed borders, infecting people throughout the world. Women may be especially vulnerable to depression and anxiety due to the pandemic, AIMSThis study attempted to assess how gender impacts risk perceptions, anxiety levels behavioral responses to the COVID 19 pandemic in Pakistan in order to recommend gender responsive health policies METHODSA cross-sectional online survey was conducted. Participants were asked to complete a sociodemographic data form, the Hospital Anxiety and Depression Scale (HADS), and questions on their risk perceptions, preventive behavior and information exposure. Regression analysis was used to assess effects of factors such as age, gender and household income on anxiety levels. RESULTSOf the 1390 respondents, 478 were women, and 913 were men. Women considered their chances of survival to be relatively lower than men (59 % women vs 73% men). They were also more anxious (62% women vs 50% men), and more likely to adopt precautionary behavior, such as avoiding going to the hospital (78% women vs. 71% men), not going to work (72% women and 57% men), and using disinfectants (93% women and 86% men). Men were more likely to trust friends, family and social media as reliable sources of COVID-19 information, while women were more likely to trust doctors. CONCLUSIONWomen experience a disproportion burden of the psychological and social impact of the pandemic compared to men. Involving doctors in healthcare communication targeting women, might prove effective. Social media and radio programs may be effective in disseminating information related to COVID among men.

Perceived Risk and Distress related to COVID-19: Comparing Healthcare versus non-Healthcare Workers of Pakistan

BackgroundHealthcare workers (HCWs) find themselves susceptible to contracting COVID-19 or being the source of exposure for their family members. This puts them at a high risk of psychological distress which may compromise patient care. In this study we aim to explore the risk perceptions and psychological distress between HCWs and non-healthcare workers (NHCWs) in Pakistan. MethodsA cross-sectional study was conducted in Pakistan using an online self-administered questionnaire. Respondents were categorized into HCWs (completed or aspiring to complete education in Medicine or allied fields) and NHCWs. HCWs were further categorized into front-line (direct patient care) and back-end HCWs. ResultsData from 1406 respondents (507 HCWs and 899 NHCWs) was analyzed. No significant difference was observed between HCWs and NHCWs perception of susceptibility and severity towards COVID-19. Healthcare graduates perceived themselves (66% students vs. 80% graduates, p-value 0.011) and their family (67% students vs. 82% graduates, p-value 0.008) to be more susceptible to COVID-19 than the healthcare students. Frontline HCWs perceived themselves (83% frontline vs. 70% back-end, p-value 0.003) and their family (84% frontline vs. 72% back-end, p-value 0.006) as being more susceptible to COVID-19 than back-end healthcare professionals. Over half of the respondents were anxious (54% HCWs and 55% NHCWs). Female gender, younger age and having COVID-19 related symptoms had a significant effect on the anxiety levels of both HCWs and NHCWs. ConclusionFrontline HCWs, healthcare students, young people, females and individuals with lower income were at a higher risk of psychological distress due to the pandemic. Government policies should thus be directed at ensuring the mental well-being of frontline HCWs, and improving their satisfaction in order to strengthen health care delivery system.

Social distancing: A non-pharmacological intervention for COVID-19.

Social distancing is one of the non-pharmacological measures to contain the infection of COVID-19. At this point in time, no vaccine is available to prevent the infection, no effective drugs are available to prevent and treat the disease, and none of the communities have acquired herd immunity. Various models have shown positive impact of social distancing, provided its implementation on vast majority of the population over a long period of time. Its effect is manifold. Besides flattening the curve, it impacts the political, fiscal, social, economic aspects of the society, along with socially vulnerable and economically underprivileged population. It becomes obsolete after the population develops herd immunity subsequent to widespread infection in the community, or after effective mass immunisation or specific drugs for its control, cure and prevention are available widely.

Assessment of structured physical examination skills training using a retro-pre-questionnaire / 보건의료교육평가

PURPOSE: The effectiveness of physical examination skills (PES) training is very rarely assessed using the "post-then-pre" approach. In this study, a retro-pre-questionnaire was used to study the effect of structured physical examination skills training (SPEST) imparted to second-year undergraduate medical students. METHODS: KIST Medical College (KISTMC) affiliated to Tribhuvan University Nepal admitted its first batch of MBBS students in November 2008. The university curriculum recommends the involvement of Medicine and Surgery Departments in PES training, but the methods for teaching and assessment are not well defined. KISTMC has made training more structured and involved the Medicine, Surgery, Gynaecology and Obstetrics, Orthopaedics, ENT, Ophthalmology, Paediatrics, and Family Medicine Departments. SPEST includes the teaching/learning of basic PES for 210 minutes once a week for 28 weeks. Self-assessment is done by using a retro-pre-questionnaire at the end of the last session of training, and these data are analysed using SPSS. RESULTS: Out of 100 students, 98 participated in the objective structured clinical examination (OSCE); 82 completed the retro-pre-questionnaire. Forty-six skills representing various systems were selected for inclusion in the retro-pre-questionnaire from among the many skills taught in different departments. The average perceived skills score (maximum score, 46x4=184) before training was 15.9 and increased to 116.5 after training. The increase was statistically significant upon the application of a paired t-test. CONCLUSION: The students perceived that their level of skills improved after the training. The retro-pre- instrument seems to be useful for assessing the learners' self-reported changes in PES after training if a large number of skills need to be assessed. However, it should be noted that although a retro-pre-questionnaire may reveal valuable information, it is not a substitute for an objective measure or gold standard.