Prevalence and correlates of cyberchondria among professionals working in the information technology sector in Chennai, India: A cross-sectional study.

Background: Cyberchondria is the excessive searching of online health information that leads to anxiety and distress. There is scarce information about its prevalence in low and middle-income country settings. Objectives: The objective of the study was to assess the prevalence and factors influencing cyberchondria among employees working in the information technology sector in India. Methods: An emailed questionnaire-based cross-sectional survey was conducted among 205 employees working in various information technology firms in and around Chennai. The data were analyzed using nonhierarchical k-means cluster analysis to group participants with and without cyberchondria on its four subdomains. The association of cyberchondria with general mental health as measured by the General Health Questionnaire 12 was studied using independent sample t-test. Logistic regression analysis was performed to study the association between general mental health and cyberchondria after adjusting for sociodemographic covariates. Results: The prevalence of cyberchondria was 55.6%. The dominant pattern was excessiveness of online searching, requirement of reassurance followed by distress due to health anxiety, and compulsivity. Cyberchondria was negatively associated with general mental health (adj. OR 0.923; 95% CI 0.882-0.967) after adjusting for age, sex, education, and years of service. Conclusions: Cyberchondria is an emerging public mental health problem in India. Since it is associated with poor mental health, measures need to be adopted to evaluate, prevent, and treat it at the population level.

Social capital, trust in health information, and acceptance of Measles-Rubella vaccination campaign in Tamil Nadu: A case-control study.

Background: Parents' decision about vaccination of children is influenced by social relationships and sources of information. The aim of this study was to assess the influence of social capital and trust in health information on the status of Measles-Rubella (MR) vaccination campaign in Tamil Nadu. Materials and Methods: This was a case-control study carried out in Kancheepuram district in Tamil Nadu where the MR vaccination campaign offered by Government of Tamil Nadu had poor acceptance. Cases were parents of children who had refused the MR vaccine and controls were parents having children in the same age group who had accepted the vaccine. Data on social capital and trust in health information were collected by using social capital scale developed by the researchers and trust in the source of information was measured by using simple questions on the level of trust in the information source. Results: Nonadministration of MR vaccine was high among young parents and parents of younger children. Vaccine acceptance was higher when it was offered at school (P < 0.000) and also among parents who trusted school teachers (P < 0.003) and other school children (P < 0.014) as source of information. MR vaccine acceptance was less among parents who trusted social media and WhatsApp information. Greater levels of health-related physical social capital led to greater vaccine hesitancy. Multivariate analysis revealed that greater the age of the child, better parental attitudes toward vaccination, poorer health-related physical social capital, and greater trust in health information provided by school teachers led to overall greater acceptance of the MR vaccine. Conclusion: Strong homogeneous bonding social capital had a negative influence on MR vaccine acceptance. Schools and school teachers played a vital role in influencing parental decision to vaccinate.

Purpose in life and its association with stress among persons living in a semi-urban area of Tamil Nadu.

BACKGROUND: Purpose in life (PIL) is defined as the question concerning the significance or importance of life or one's existence. PIL is closely associated with spirituality and, hence, is an important determinant of health. This, in turn, leads to lower stress response and good mental health. OBJECTIVES: To assess the PIL and perceived psychosocial stress and to develop a conceptual understanding of the relation between the two. MATERIALS AND METHODS: A questionnaire was developed to understand the PIL in the cultural context of semi-urban Tamil Nadu. Its internal consistency was checked and it was administered to 227 conveniently selected individuals between 15 and 70 years of age. RESULTS: The questionnaire on PIL developed for this study had an acceptable internal consistency with a Cronbach's alpha of 0.883. Some common purposes in life mentioned by the people were recognition and acknowledgment for their roles and responsibilities, to be a part of a society that is higher class than their current frame, acceptance by people in society, to show people who disagree with them that they are wrong, to be treated with respect, to be known as a person with integrity, love for others, to be beneficial to others at the cost of themselves, to bring equity in the society, and to help others. It was also found that adherence to social norms as a PIL was associated with lower perceived stress. CONCLUSION: This study provides a conceptual understanding on the purposes in people's lives in the context of semi-urban Tamil Nadu and their association with perceived psychosocial stress.

Patient-physician trust among adults of rural Tamil Nadu: a community-based survey.

BACKGROUND: Trust is the acceptance of a vulnerable situation in which the truster believes that the trustee will act in the truster's best interests. The cornerstone of the patient-physician relationship is "trust". Despite the intensity and importance of trust relationship of patients toward their physician, the phenomenon is rarely studied in developing countries. OBJECTIVE: Our study aimed to explore the concept of patient-physician trust among adults of rural Tamil Nadu to assess the factors affecting patient-physician trust relationship and patient satisfaction. MATERIALS AND METHODS: A cross-sectional descriptive household survey was carried out on 112 individuals selected by a multistage random sampling method. Men and women aged above 40 years who have visited a health care service at least once during the last 5 years were included in the study. Thom et al's modification of the Anderson and Dedrick Physician Trust scale was used to measure patient trust in physician. RESULTS: Trust is a one-dimensional construct in the surveyed population as revealed by an exploratory factor analysis which extracted one component explaining 50% of the overall variance. Trust influences patient's self-reported satisfaction (ß coefficient of 0.048; P < 0.001) and remains independent of all the other factors assessed in the study such as, age, gender, education, self-reported health status, time spent with the physician, physician's gender, physician's age, and medical specialty that the physician belongs to. Physician's gender, physician's age, self-reported health status, and time spent with the physician were significantly associated with satisfaction with the physician. CONCLUSION: Trust in physicians seems to not depend on any of the assessed factors and largely seems to be implicit in the physician-patient relationship. Trust in physician is associated with patient satisfaction. Further studies are needed to assess trust in physicians in developing country settings.

Diabetes self-care activities: a community-based survey in urban southern India.

BACKGROUND: Diabetes is a lifestyle disease and can be successfully managed by good self-care activities such as diet, exercise, monitoring and drug adherence. Adequate baseline information about the prevalence of good self-care activities is not available from India. We aimed to estimate the existing self-care behaviours and factors influencing these behaviours among adult patients with type 2 diabetes in urban southern India. METHODS: A cross-sectional survey was conducted using a cluster design in an urban community in southern India. The Summary Diabetes Self-Care Activities questionnaire was used to collect information on diet, exercise, monitoring of blood sugars and adherence to drugs. Risk factors such as marital status, socioeconomic status, depression, benefit-finding and duration of illness, which are likely to influence self-care behaviour, were assessed. RESULTS: Good dietary behaviour was present in 29% (95% CI 20.8%-37.2%), good exercise behaviour in 19.5% (95% CI 17.4%-21.6%), regular blood sugar monitoring in 70% (95% CI 62.2%-77.8%) and drug adherence in 79.8% (95% CI 75.1%-84.5%). Being male (OR 3.38; 95% CI 1.541-7.407) and married (OR 5.60; 95% CI 1.242-25.212) significantly favoured good exercise behaviour. Being married (OR 2.322; 95% CI 1.104-4.883) and belonging to the higher socioeconomic status (OR 2.713; 95% CI 1.419-5.190) were significantly associated with monitoring of blood sugars. CONCLUSIONS: Self-care activities with respect to diet and exercise are poor in the population studied. The self-care activities relating to blood sugar monitoring and drug adherence are good. Improving self-care behaviour among patients with diabetes in India should start with adequate targeted health education.

Household food security in urban Tamil Nadu: a survey in Vellore.

BACKGROUND: Food security has been a matter of concern in recent years due to the global food crisis and rising food prices. We aimed to study the level of food security in a densely populated urban area in southern India. METHODS: A door-to-door survey of 130 households in an urban area in Vellore district, Tamil Nadu was done and information on food security status was collected using the United States Department of Agriculture Household Food Security Scale, on socioeconomic status using the modified Kuppuswamy scale and demographic details. RESULTS: Of the 130 households surveyed, food insecurity with hunger was present in 61.5% (95% CI 52.98%-70.02%), food insecurity without hunger in 13.1% (95% CI 7.2%-19%) and food security in 25.4% (95% CI 17.8%-33%) of the households. Prevalence of any form of food insecurity was present in three-fourths of the households (74.6%; 95% CI 67%-82.2%). Only 76 (58.5%) households used the public distribution system for buying rice-the staple food, and 63 (82.9%) households in the lower socioeconomic strata used the public distribution system for buying rice. CONCLUSIONS: Despite good penetration of the public distribution system in Tamil Nadu, the prevalence of food insecurity in urban areas is high. Nationwide and regional urban-rural food security data need to be studied to influence policy regarding the means to reduce food insecurity in India.