Psychological impact on people Due to Pandemic of Covid-19 in selected Areas of Mumbai

 

Christine Michael

Holy Family Institute of Nursing Education, Premier Road, Kurla West, Mumbai -400070.

*Corresponding Author Email: chrismic27@yahoo.com

 

 

ABSTRACT:

Coronavirus disease 2019 (COVID-19) is defined as an illness caused by a novel coronavirus, now called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2; formerly called 2019-nCoV). COVID-19 is an emerging respiratory infection that was first discovered in December 2019, in Wuhan city, Hubei Province, China.1 The 2019-nCoV has close similarity to bat coronaviruses, and it has been postulated that bats are the primary source. While the origin of the 2019-nCoV is still being investigated, current evidence suggests spread to humans occurred via transmission from wild animals illegally sold in the Huainan Seafood Wholesale Market.2 SARS-CoV-2 belongs to the larger family of ribonucleic acid (RNA) viruses, leading to infections, from the common cold, to more serious diseases, such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).1 The main symptoms of COVID-19 have been identified as fever, dry cough, fatigue, myalgia, shortness of breath, and dyspnoea.1 COVID-19 is characterized by rapid transmission, and can occur by close contact with an infected person.1 COVID-19 has spread widely and rapidly, from Wuhan city, to other parts of the world, threatening the lives of many people 1. By the end of January 2020, the World Health Organization (WHO) announced a public health emergency of international concern and called for the collaborative effort of all countries, to prevent its rapid spread. Later, the WHO declared COVID-19 a “global pandemic” 1. It is mainly transmitted through respiratory and close contact, which leads to the phenomenon of clustering infection in families and hospitals. Because of the sudden nature of the outbreak and the infectious power of the virus, it will inevitably cause people anxiety, depression and other stress reactions.3 It is necessary to understand and investigate the public psychological states during this tumultuous time.3 The results of the survey are of great practical significance to the information provision, cognition, behavior guidance and psychological support of governments at all levels.3 Understanding and investigating the public psychological states during this tumultuous time is of practical significance.3 Social and family attention and mental health support are essential. 3However, we think that the psychological impact of this pandemic like stress and anxiety among the general population is also a grave concern. Hence, this study attempted to find the psychological impact of COVID 19 on people in selected areas in Mumbai. Objectives: (1) To assess the psychological impact on people due to the pandemic of COVID-19 (2) To find the association between psychological impact and their selected demographic variables (age, gender, religion, marital status, educational status, occupation, family type, income, area of residence, and housing type). Review of literature: 3 sections (1) Studies related to psychological impact of COVID 19 on general population (2) Studies related to psychological impact of COVID 19 on health professionals (3) Studies related to psychological impact of COVID 19 on students. The Conceptual framework for the study was based on Health Promotion Model. Methodology: The Research Design used was descriptive study. The sample size was 200 people from selected areas of Mumbai. The samples were selected by using snow ball method. The data were collected by using self- administered 4 point Likert scale which was developed by the investigators. The tool was validated by 5 experts. Reliability was established by split half method. (r = 0.8). The main study was conducted in selected areas of Mumbai. The data collected were tabulated, analysed and interpreted using statistical test such as chi square. Findings of the study: The findings of the study revealed that there was severe psychological impact due to the pandemic of COVID-19 among the people. There was no significant association between psychological impact and age, sex, religion, marital status, family type, income, area of residence, and housing type except educational status and occupation which were significant (chi square values 21.03) for the psychological impact on the people and the rest of the demographic variables are found to be non-significant. Conclusion: The study concluded by stating the fact that, the psychological impact of people due to the pandemic of covid-19 was severe. The findings, recommendation and conclusion were stated adequately.

 

KEYWORDS: Psychological Impact, Pandemic, COVID-19, People.

 

INTRODUCTION:

Coronavirus disease 2019 (COVID-19) is defined as an illness caused by a novel coronavirus, now called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS- CoV-2; formerly called 2019-nCoV). COVID-19 is an emerging respiratory infection that was first discovered in December 2019, in Wuhan city, Hubei Province, China.1 The 2019-nCoV has close similarity to bat coronaviruses, and it has been postulated that bats are the primary source.1 While the origin of the 2019-nCoV is still being investigated, current evidence suggests spread to humans occurred via transmission from wild animals illegally sold in the Huainan Seafood Wholesale Market.2 SARS-CoV-2 belongs to the larger family of ribonucleic acid (RNA) viruses, leading to infections, from the common cold, to more serious diseases, such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).1 The main symptoms of COVID-19 have been identified as fever, dry cough, fatigue, myalgia, shortness of breath, and dyspnoea .1 COVID-19 is characterized by rapid transmission, and can occur by close contact with an infected person.1 COVID-19 has spread widely and rapidly, from Wuhan city, to other parts of the world, threatening the lives of many people 1. By the end of January 2020, the World Health Organization (WHO) announced a public health emergency of international concern and called for the collaborative effort of all countries, to prevent its rapid spread. Later, the WHO declared COVID-19 a “global pandemic”.1 It is mainly transmitted through respiratory and close contact, which leads to the phenomenon of clustering infection in families and hospitals.3 Because of the sudden nature of the outbreak and the infectious power of the virus, it will inevitably cause people anxiety, depression and other stress reactions.3 It is necessary to understand and investigate the public psychological states during this tumultuous time.3

 

The results of the survey are of great practical significance to the information provision, cognition, behavior guidance and psychological support of governments at all levels.3 Understanding and investigating the public psychological states during this tumultuous time is of practical significance. Social and family attention and mental health support are essential. 3However, we think that the psychological impact of this pandemic like stress and anxiety among the general population is also a grave concern. Hence, this study attempted to find the psychological impact of COVID 19 on people in selected areas in Mumbai.

 

In Indian subcontinent, as of 30th march 2020, according to the Ministry of Health and Family Welfare (MOHFW), a total of 1071 COVID-19 positive cases (including 49 foreign nationals) were reported in 27 states/union territories. These include 99 cases that were cured/ discharged, one person who has migrated and 29 deaths. Hospital isolation of all confirmed cases, tracing and home quarantine of the contacts is on-going. In India, spread of the initial disease could be traced mainly to the foreign nationals who visited the country as tourists from the disease affected countries and secondly due to the mass immigration of Indian nationals from abroad; due to the fear of infection. As the pandemic outbreak in India was on-going, the Government of India took stringent measures to limit the cases by far in that stage only, by initiating a major lockdown pan-India and also by shifting the Immigrants to the special quarantine facilities prepared by the Indian military directly from the airports and seaports for a minimum of 14 days. Community health teams were also launched to spread awareness about the chances of spread and precautionary measures that one can use to protect themselves and others.

 

During the early stages of the pandemic in India, this study was focused mainly to assess its psychological impact on the patient who recovered and was cured from the COVID 19. The lives of people were drastically affected with lockdown and fear related to the disease’s potential effects and transmission. The fear due to the contraction of COVID 19 is on the rise because of the death tolls and global spread. Hence, this study

attempted to find the psychological impact of COVID 19 on people in selected areas in Mumbai.

 

NEED FOR THE STUDY:

The COVID-19 pandemic in India is part of the worldwide pandemic of coronavirus disease 2019(COVID-19) caused by severe acute respiratory syndrome coronavirus 2(SARS-coV-2). The first case of COVID-19 in India, which originated from china, was reported on 30th January 2020.India currently has the largest number of confirmed case in Asia, and has the second highest number of confirmed cases in the world after the united states with more than 10.3 million reported cases of COVID-19 infection and more than 150,000 deaths as of January 06,2021.The per day cases peaked mid- September in India with over 90,000 cases reported per day and have since come down to below 40,000 in December.4

 

In July 2020, India’s Ministry of Information and Broadcasting claimed the country’s case fatality rate was among the lowest in the world at 2.41% and “steadily declining”. By mid-May 2020, six cities accounted for around half of the reported cases in the country-Mumbai, Delhi, Ahmedabad, Chennai, Pune and Kolkata. As of 10 September 2020, Lakshadweep is the only region which has not reported a case. On 10th June, India’s recoveries exceeded active cases for the first time. Infection rates started to drop significantly in September, and the number of daily new cases and active cases started to decline rapidly. A Government panel on COVID-19 announced in October that the pandemic had peaked in India, and may come under control by February 2021. India has over 30 anti-COVID Vaccines in various stages of development and the first of these is expected to be introduced in early 2021.22

 

The coronavirus disease 2019(COVID- 19) pandemic has caused enormous psychological impact worldwide. We conducted a systematic review and Meta -analysis on the psychological and mental impact of COVID-19 among the general population higher COVID-19 risk published between 1 Nov 2019 to 25 May 2020.

 

A study conducted in China during the initial outbreak of covid-19 found that 53.8% of rated psychological impact of the outbreak, 16.5% reported moderate to severe depression, 28.8% reported severe anxiety & 8.1% reported moderate to severe anxiety to severe stress level. A review of existing literature revealed that symptoms of anxiety and depression (16to28%) and self-reported stress (8%) are common psychological reactions to the COVID-19 pandemic.

 

We conducted literature research using Embase, PubMed and WHO COVID-19 databases. Among the initial search of 9207 studies, 62 studies with 162,639 participants from 17 countries were included in the review. The pooled prevalence of anxiety and depression was 33% (95% confidence interval- 28%-38%) and 28% respectively. The prevalence of anxiety and depression was the highest among patients with pre-existing conditions and COVID-19 infection. Studies from China, Italy, Turkey, and Spain reported higher-than-pooled prevalence among health care workers and the general public. Common risk-factors included having sufficient medical resources, up-to-date and accurate information and taking precautionary measures. Psychological interventions targeting high risk populations with heavy psychological distress are in urgent need.

 

Psychological impact may include anxiety, irritability and excessive feeling of stress or anger in the COVID-19. In older patients with cognitive decline may become much more anxious, agitated and socially withdrawn thus their specific needs demand specific attention.

 

For people bereaved from the death of dear friends, colleagues and loved one due to COVID-19 and cremation can result in anger, psychological trauma and long-term psychiatric sequelae. Religious, misbelief, disbelief and community disharmony are major which may tarnish the pandemic in India.

 

The Researcher having interacted with people during this dreadful period of the pandemic felt the need to explore the stress and anxiety levels of the people so that they could be helped with measures to handle their situations through counselling and other stress relieving steps.

 

STATEMENT OF THE PROBLEM:

A descriptive study to assess the psychological impact on people due to the pandemic of COVID-19 in selected areas in Mumbai.

 

OBJECTIVES:

1.       To assess the psychological impact on people due to the pandemic of COVID-19

2.       To find the association between psychological impact and their selected demographic variables (age, gender, religion, marital status, educational status, occupation, family type, income, area of residence, and housing type).

 

HYPOTHESES:

H1: There will be a severe psychological impact on people due to the pandemic of COVID-19.

 

H2: There will be a significant association between psychological impact on people due to the pandemic of COVID-19 and their demographic variables.

 

OPERATIONAL DEFINITIONS:

1.       ASSESS: Assess refers to the process of estimating the psychological impact on people.5

2.       Psychological Impact: -Psychological impact is defined as the stress and anxiety caused by COVID-19 on people in selected areas in Mumbai.

3.       Pandemic:-A pandemic is defined as “an epidemic occurring worldwide or over a very wide area, crossing international boundaries and usually affecting a large number of people”.

4.       Covid-19: -covid-19 is a disease caused by a new strain of coronavirus “co” stands for corona, “vi” for virus and “d” for disease. Formerly, this disease was referred to as 2019. Novel coronavirus or ‘2019-ncov’ the covid-19 virus is a new virus linked to the same family of virus as severe acute respiratory syndrome (SARS) and some types of common cold.7

5.       PEOPLE: -People of age group of 20 years and above male and female, all religions, illiterates and literates of all educational background, and of all occupations.

 

Assumptions:

1.       COVID-19 is a pandemic affecting people physically and psychologically.

2.       Majority of the people are at risk of COVID-19.

3.       There will be an increased prevalence of COVID-19 people with co-morbid conditions.

 

DELIMITATION:

The study is delimited to people in selected areas of Mumbai.

 

REVIEW OF LITERATURE:

Review of literature of the present study is organized and presented under the following headings.

1.       Studies related to psychological impact of COVID 19 on general population

2.       Studies related to psychological impact of COVID 19 on health professionals.

3.       Studies related to psychological impact of COVID 19 on students.

 

I.        Studies Related to Psychological Impact of Covid 19 On General Population

Mohammad Ali Fardin, Zahedan- The advent of coronavirus disease 2019 (COVID-19) has caused confusion, changed people’s living conditions, including commuting restrictions, fear of disease transmission, and closure of schools and businesses, and brought about devastating psychological impacts, like anxiety. However, most studies only have focused on clinical data.10 The current study was carried out to indicate that COVID-19 has negative psychological problems other than mortality. A review of the studies performed in other parts of the world showed that COVID-19 has caused several psychological impacts, including increased anxiety. By an increase in the prevalence rate of COVID-19 and its resulted restrictions, the level of anxiety increases, as well; therefore, raising public awareness of the disease and providing positive psychological programs in the media aimed at controlling stress can reduce anxiety in society.

 

Sijia Li, Yilin Wang, JiaXue 4conducted a study to explore the impacts of COVID-19 on people’s mental health, to assist policy makers to develop actionable policies, and help clinical practitioners (e.g., social workers, psychiatrists, and psychologists) provide timely services to affected populations.11 We sample and analyse the Weibo posts from 17,865 active Weibo users using the approach of Online Ecological Recognition (OER) based on several machine-learning predictive models.11 We calculated word frequency, scores of emotional indicators (e.g., anxiety, depression, indignation, and Oxford happiness) and cognitive indicators (e.g., social risk judgment and life  satisfaction) from the collected data. The sentiment analysis and the paired sample t-test were performed to examine the differences in the same group before and after the declaration of COVID-19 on 20 January, 2020. 11 The samples in this study were from the original Weibo data pool. The data pool contained more than 1.16 million active Weibo users. Weibo is a popular platform to share and discuss individual information and life activities, as well as celebrity news in China. The retrieved data included (1) user’s profile information, (2) network behaviours, and (3) Weibo messages. Privacy was strictly protected during the procedure, referring to the ethical principles. In this study, we used Online Ecological Recognition (OER) [20], which referred to the automatic recognition of psychological profile (e.g., anxiety, well-being, etc.) by using predictive models based on ecological behavioural data from Weibo. We employed Text Mind system developed by the Computational Cyber Psychology Laboratory at the Institute of Psychology, Chinese Academy of Sciences to extract content features, including Chinese word segmentation tool, and psychoanalytic dictionary. We used the Chinese word segmentation tool to divide users’ original microblog content into words/phrases with, linguistic annotations, such as verbs, nouns, adverbials, and objects, and then extracted psychologically meaningful categories through the simplified Chinese LIWC (Language Inquiry and Word Count) dictionary. These lexical features were data sources for word frequency analysis. After feature extraction, we used the psychological prediction model obtained from the preliminary training to predict the psychological profile of these active Weibo users. Procedures of feature extraction from online Weibo data and psychological indicators predicted by dynamic features. We calculated word frequency, scores of negative emotional indicators (i.e., anxiety, depression, and   indignation), positive emotional indicators (i.e., Oxford happiness), and cognitive indicators (i.e., social risk and life satisfaction) of the collected messages. We then compared the differences of psychological characteristics before and after the declaration of outbreak of COVID-19 on 20 January, 2020 through the paired sample t-test by using SPSS (Statistical Product and Service Solutions) 22, which is published by IBM (International Business Machines Corporation), New York, USA. In this study, we compared the difference before and after 20 January on both linguistic categories and psychological profile. We found an increase in negative emotions (anxiety, depression, and indignation) and sensitivity to social risks, as well as a decrease in positive emotions (Oxford happiness) and life satisfaction after declaration of COVID-19 in China. What’s more, people show more concern for health and family, and less concern for leisure and friends. Using social media data may provide timely understanding of the impact of public health emergencies on the public’s mental health during the epidemic period.

 

Michael L. Teea B., et. al. conducted a study which examined the prevalence of psychiatric symptoms and identified the factors contributing to psychological impact in the Philippines.12 A total of 1879 completed online surveys were gathered from March 28-April 12, 2020. Collected data included socio-demographics, health status, contact history, COVID-19 knowledge and concerns, precautionary measures, information needs, the Depression, Anxiety and Stress Scales (DASS-21) and the Impact of Event Scale-Revised (IES-R) ratings. The IES-R mean score was 19.57 (SD=13.12) while the DASS-21 mean score was 25.94 (SD=20.59). In total, 16.3% of respondents rated the psychological impact of the outbreak as moderate-to-severe; 16.9% reported moderate-to-severe depressive symptoms; 28.8% had moderate-to-severe anxiety levels; and 13.4% had moderate-to-severe stress levels. Female gender; youth age; single status; students; specific symptoms; recent imposed quarantine; prolonged home-stay; and reports of poor health status, unnecessary worry, concerns for family members, and discrimination were significantly associated with greater psychological impact of the pandemic and higher levels of stress, anxiety and depression (p<0.05). Adequate health information, having grown-up children, perception of good health status and confidence in doctors’ abilities were significantly associated with lesser psychological impact of the pandemic and lower level of stress, anxiety and depression (p<0.05). During the early phase of the pandemic in the Philippines, one-fourth of respondents reported moderate-to-severe anxiety and one-sixth reported moderate-to-severe depression and psychological impact. The factors identified can be used to devise effective psychological support strategies.12

Deeksha Pandey , et. al. conducted a study which aimed to explore the degree of psychological distress in terms of-Depression, Anxiety and Stress among the adult population in India during the strict 21 days mandatory lockdown. This assessment might also help in future to keep targeted services in place, to cope up with the psychological distress of the quarantined population. A cross sectional survey design was adopted to assess the psychological state of general population in India, during the COVID-19 mandatory lockdown period, with the help of a validated questionnaire. The reported prevalence of depression was around 30.5%, which was the highest among the variables of psychological health. Anxiety was reported by 22.4%, followed by stress which was seen in 10.8% of respondents. In the third week the incidence of depression (37.8% versus 23.4%; p<0.001), anxiety (26.6% versus 18.2%; p<0.001) and stress (12.2% versus 9.3%; p<0.045) was reported to be significantly higher as compared to second week. Our results suggest a progressively detrimental impact of lockdown on various aspects of psychological health. We noticed around eight to ten fold increase in the prevalence of depression (30.5%) and anxiety (22.4%) during lockdown, as compared to baseline statistics in Indian population (3·1-3·6% for depressive disorders and 3·0-3·5% for anxiety disorders.13

 

II.      Studies Related To Psychological Impact Of Covid 19 On Health Professionals:

Sardar Muhammad et. al. conducted a study which aimed to assess prevalence and influencing factors of anxiety and depression during the pandemic in our Pakistani population, including healthcare professionals, undergraduate medical students, and general public. An online cross sectional survey was conducted; with a questionnaire having demographic profile, COVID-19- related knowledge/awareness, self-rating anxiety scale (SAS), and self-rating depression scale (SDS). A total of 1014 people responded to the survey. Chi square test was used to compare different groups, and logistic regression models were used to explore influencing factors for anxiety and depression symptoms. Of the 1014 respondents, 92.6% were aware of COVID-19, and the prevalence rate of anxiety and depression symptoms was 4.6% and 14.3%, respectively. Healthcare professionals had more awareness about COVID-19 as compared to medical students and general public (p<0.001). Logistic regression models showed females, and people who were not aware of COVID-19 (≤ 6 points score) were more likely to have both anxiety and depression symptoms (p<0.05), the general public had more anxiety than healthcare professionals (p<0.05), while undergraduate medical students and young people had only depression (p<0.05). Although major mental health burden is not present in Pakistan, but there is a dire need to pay more attention to vulnerable groups like young people, undergraduate medical students, and women. Psychological interventions are required to reduce the psychological impact of COVID-19 pandemic.14

 

Benjamin Y.Q. Tan, et. al. examined the psychological distress, depression, anxiety, and stress experienced by health care workers in Singapore in the midst of the outbreak, and compared these between medically and non–medically trained hospital personnel. From 19 February to 13 March 2020, health care workers from 2 major tertiary institutions in Singapore who were caring for patients with COVID-19 were invited to participate with a self-administered questionnaire. In addition to information on demographic characteristics and medical history (Table 1), the questionnaire included the validated Depression, Anxiety, and Stress Scales (DASS-21) and the Impact of Events Scale–Revised (IES-R) instrument (2, 3). Health care workers included “medical” (physicians, nurses) and “nonmedical” personnel (allied health professionals, pharmacists, technicians, administrators, clerical staff, and maintenance workers). The primary outcome was the prevalence of depression, stress, anxiety, and posttraumatic stress disorder (PTSD) among all health care workers. Secondary outcomes were comparison of the prevalence of depression, anxiety, stress, and PTSD, and mean DASS-21 and IES-R scores between medical and nonmedical health care workers. The Pearson 2 test and Student t test were used to compare categorical and continuous outcomes, respectively, between the 2 groups. Multivariable regression was used to adjust for the a priori defined confounders of age, sex, ethnicity, marital status, presence of comorbid conditions, and survey completion date. Our study highlights that nonmedical health care personnel are at highest risk for psychological distress during the COVID-19 outbreak. Early psychological interventions targeting this vulnerable group may be beneficial.15

 

Anae lle Cailleta, et. al. aimed at assessing the psychological impact of COVID-19 on the caregivers at the peak of the “crisis period”. A survey using the Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale – Revised (IES-R) was proposed to the persons working in 5 ICUs of a French teaching hospital (8th of April to the 21st of April 2020). Logistic regression was performed to find independent risk factors for anxiety and post-traumatic stress disorder (PTSD). A value of p < 0.05 was considered significant. The incidence of anxiety and depression were 48% and 16%, respectively. PTSD symptoms were present in 27% of respondents. The independent risk factors for developing anxiety syndrome were being assigned in COVID-19 + ICU (OR = 2.081 [95% confident interval (CI), 1.035-4.184)], and not be trained in intensive care medicine, OR = 2.570 [95% CI, 1.344-4.901].  The independent risk factors for PTSD are having a history of burn-out (OR = 4.591 [95% CI, 1.464-14.397] and not being trained in ICU, (OR = 2.155 [95% CI, 1.047- 4.440]). COVID-19 could have a strong impact on ICU workers. 16 M. Tasdik Hasan, et. al. conducted a cross-sectional study using an online survey between April 21 and May 10, 2020. Outcomes assessed included demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS). The survey was completed by 412 Bangladeshi physicians. The findings revealed that, in terms of standardized HADS cut-off points, the prevalence of anxiety and depressive symptoms among physicians was 67.72% and 48.5% respectively. This study identified a real concern about the prevalence of anxiety and depressive symptoms among Bangladeshi physicians and identifies several associated factors during the COVID-19 pandemic. Given the vulnerability of the physicians in this extraordinary period whilst they are putting their own lives at risk to help people infected by COVID-19, health authorities should address the psychological needs of medical staff and formulate effective strategies to support vital frontline health workers.17

 

III.        Studies Related To Psychological Impact of Covid 19 On Students:

Antonio J. et. al. conducted this study to analyse the levels of fear of COVID-19, stress, anxiety, and depression during lockdown among undergraduates from Ecuador, and to test these possible predictors of depression using a model taken from our study of the scientific literature. A total of 640 undergraduates (72% women) between 18 and 47 years old (M = 21.69; S.D = 4.093) were surveyed. The resulting mean levels found for stress, anxiety, and depression were above levels considered non-pathological. Women showed higher levels of fear of COVID-19 than men. The statistical prediction for depression showed a good fit. This depression could be related: both directly and positively by fear of COVID-19 and stress, and indirectly, as a result of these two factors, positively mediated by anxiety. Our study concludes by highlighting the important role that the complex relationships between fear, stress, and anxiety can play in the development of depression symptoms and how they can be taken into account in programs aimed at preventing and alleviating this disorder. The population consisted of 78,059 students from four universities from the province of Manabí (Ecuador): Universidad Laica Eloy Alfaro de Manabí, Universidad Técnicadel Litoral, Universidad Técnica de Manabí, and Universidad Estatal Del Sur de Manabí. The sampling was incidental, due to the accessibility. A total of 640 undergraduates took part in the research. Of the full sample, 72% were women (n =461) and 28% men (n = 179). The age of the participants ranged from 18 to 47 years (M = 21.69; S.D = 4.093). The results of the Mann-Whitney U test of independent samples showed the existence of significant differences between men and women in the fear of COVID-19 scores. The scores obtained from the FCV-19S were higher for women than for men. However, no statistically significant differences were detected for the levels of stress, anxiety, and depression between men and women studying in Ecuador.18

 

Sreesupria Purushothaman Ravichandran, et. al. conducted a study to assess the prevalence and severity of core symptoms of depression, anxiety and stress in college students across India during the Lock-down; to estimate the impact of lock-down on time spent on their routine activities, domestic violence, eating habits and sleep pattern; to analyse the impact of various factors and the mental health status. A semi-structured questionnaire also containing the 21 items of depression anxiety and stress scale (DASS21) was circulated through social media. College students from different states across India participated. Study period was from April 2020 to May 2020. The responses collected were analysed using chi squared test and logistic regression. Total 53.1%, 37.2% and 24.3% had symptoms of depression, anxiety and stress respectively, with varying severities (n=727). Significant associations of the negative emotional states with decreased time spent with their family and friends and its effects; increased incidence of domestic violence; increased sleep duration; disturbed sleep; financial crisis, etc. were found (p value<0.05). COVID-19 is building psychological distress among vulnerable college students, as they are forced to stay home, along with worsening financial situations, lifestyle changes, family situations and time spent on various activities. Psychological interventions are recommended.19

 

Wenjun Caoa, et. al. conducted a study and assessed the mental health of these students during the COVID-19 outbreak by using structured questionnaires. The target population comprised undergraduates of Changzhi medical college. The respondents in the target population were sampled by cluster sampling. The questionnaires were anonymous to ensure the confidentiality and reliability of data. Finally, 7143 respondents that completed the questionnaires were included in the final analysis (100% response rate). They responded to a questionnaire packet that included the 7-item Generalized Anxiety Disorder Scale (GAD-7) and those inquiring the participants’ basic information. We received 7,143 responses. Results indicated that 0.9% of the respondents were experiencing severe anxiety, 2.7% moderate anxiety, and 21.3% mild anxiety. About 24.9% of college students have experienced anxiety because of this COVID-19 outbreak. Living in urban areas, living with parents, and having a steady family income were protective factors for college students against experiencing anxiety during the COVID-19 outbreak.

Among the sample of 7143 college students, approximately two-third were women 67 (0.94%). The respondents lived in Hubei Province; 43.83% lived in rural areas, 95.4% lived with their parents, and 52.86% of the parents of students did not have a steady income.20

 

Saroni Biswas and Anirban Biswas assessed the psychological pressure on college and university students in India through cluster sampling. The students responded (n = 209) to an online questionnaire following the Generalized Anxiety Disorder Scale (GAD-7) and Hamilton Anxiety Rating Scale (HAM-A) with some other basic information. According to GAD-7 scoring, we found the respondent students had severe anxiety (1.44%), moderately severe anxiety (14.35%), moderate anxiety (36.36%) and mild anxiety (47.85%). Following HAM-A scoring, anxiety level among the students could be scaled as severe (0.96%), high (4.31%), moderate (13.40%) and mild anxiety (34.93%) level. Age of the students was a confounding factor (p = 0.049, HAM-A) of experiencing anxiety, students <20 years of age were more anxious. We found female students to be more anxious than the males following the HAM-A scoring tool. Academic delays (R2 = 0.996, p=0.036) and impact on daily life (R2 = 0.996, p = 0.117) were positively associated with anxiety symptoms, while social support was marginally correlated (R2 = 0.726, p = 0.069) with the anxiety level. As the study found almost all the students are experiencing anxiety because of the current pandemic situation, continuous observation of psychological health for all is recommended as well as establishing psychological intervention during the preparedness phase.21

 

RESEARCH METHODOLOGY:

Research methodology is a way to systematically solve the research problem. In this study it refers to the varied steps that are generally adopted by a researcher in studying the research problem along with logic behind them. The present study was aimed at assessing the psychological impact of COVID 19 of the people.

 

RESEARCH APPROACH:

Quantitative approach was used to assess the psychological impact of COVID 19 on general population.

 

RESEARCH DESIGN:

The essential questions that research design is concerned with how the study subjects will be brought into the research and how they will be employed with the research design. In this study we have used the descriptive design.

 

VARIABLES:

Dependent variable:

Psychological impact of people due to the pandemic of COVID-19.

 

Associate variables:

Age, Gender, Religion, Marital status, Educational status, Occupation, Family type, Income, Area of residence, and Housing type.

 

Setting of The Study:

Setting of the physical location and condition in which data collection takes place. The study was conducted in different areas of the city of Mumbai, Maharashtra, during the COVID 19 pandemic lockdown. The investigator found the setting appropriate to conduct the study because adequate number of people were cooperative and gave permission to conduct study.

 

Population:

Population is the entire group to whom the researcher generalizes the study results. In this present study population are selected people from different areas of Mumbai.

 

Sample and Sampling Techniques:

Sampling is the process of selecting a representative unit of a population for the study in a research. Sample is a subset of the population selected to participate in a research study. The study sample consisted of 200 people from selected areas of Mumbai. Snowball sampling technique was used.

 

SAMPLING CRITERIA:

Sampling criteria are characteristics for selecting samples.

 

Inclusion criteria-

1.       People from selected areas in Mumbai

2.       General population of all ages

3.       People who are willing to participate in the study

 

Exclusion criteria-

1.       People staying outside of Mumbai city.

2.       People who are not willing to participate in the study.

 

Description of The Tool:

Data collection tool used by the researcher is to observe or measure the key variables in the research problem. The study tool consists of the psychological impact of COVID 19 on the people.

 

Selection and Development of the Tool:

The tool used for the study was a 4 point Likert scale. It was prepared on the basis of the objective of the study.

1.       Review of literature which provided adequate content for tool preparation

2.       Information obtained from the general people.

3.       Past experience of the investigator.

This provided relevant data necessary to construct the tool on psychological impact on the people in selected areas of Mumbai.

 

Testing of The Tool:

Content validity

The prepared instruments along with objectives, and criteria submitted to five experts. Changes were made according to their suggestions.

 

Reliability of the Tool:

The reliability was checked by testing on 20 people in the selected areas in Mumbai. The subjects completed the questionnaire within 20 minutes, all the subjects found the test items easy to understand. The reliability of the tools was established by using split half technique which measures the coefficient of internal consistency. The reliability of the tool was found to be r = 0.8, hence the tool was found to be highly reliable.

 

Description of The Tool:

Section A: Demographic Data

It consisted of 10 items such as Age, Gender, Religion, Marital status, Educational status, Occupation, Family Type, Income, Area of residence, Housing Type.

 

Section B: Likert Scale on Psychological impact of Covid 19 on people

It consists of 25 statements, all were personal statements in which 24 were negative and 1 was positive. Total score was 100.

 

Pilot Study:

Pilot study is the study carried out at the end of the planning phase of research in order to explore and test the research elements. The pilot study was conducted in the selected areas in Mumbai, Maharashtra from 4thJanuary to 10th January, and 2021. The written permission to conduct the study was obtained from the Director of the Institution (Appendix-). The data was collected from 20 people in selected areas in Mumbai. A snowball sampling technique was adopted; written consent taken from the participants. The results of the pilot study were analysed. The result of pilot study was appropriate and the tool was finalized. Data analysis was done using descriptive and inferential statistics. The study revealed the mean score. The methodology was found to be feasible, practicable and acceptable. No modification was made in the tool.

 

Data Collection Procedure:

The data collection period extended from 11th January to 4th February, 2021. The purpose of the study was explained to the subjects, and consent was obtained. The subjects were told that confidentiality will be maintained. The subjects under the study were selected through snowball sampling technique. The total numbers of 200 people were selected. Consent was obtained from the subjects. The subjects took one day to complete the Questionnaire. The data collection process was terminated by thanking the subjects. The investigator did not face any difficulty in collection data from the subjects.

 

Plan For Data Analysis:

The data obtained were planned to be analysed using both descriptive and inferential statistics, on the basis of objectives:

·         Demographic data containing sample characteristics would be analysed using frequency and percentage.

·         Psychological impact on people due to the pandemic of COVID-19 would be assessed based on their scores out of 100.

·         The association between the demographic and Psychological impact questionnaires would be done by using Chi Square.

 

ETHICAL CONSIDERATIONS:

The purpose and other details of the study were explained to the subjects and informed consent was obtained. Assurance was given to the study subjects of their anonymity and the confidentiality of the data collected from them.

 

Data Analysis and Interpretation:

This part deals with the analysis and interpretation of data collected to assess the level of psychological impact due to pandemic of COVID-19 on people. The main nursing purpose of this chapter is to evaluate, summarize, and interpretation for the study.

 

The data was analysed based on objectives of the study:

·         To assess the psychological impact on people due to the pandemic of COVID-19

·         To find the association between psychological impact and their selected demographic variables.

 

Organization and representation of the data:

The data collection from the samples were organized and presented as follows:

 

Section I-Description of demographic variables of the people selected for the study.

Section II- Assessment of psychological impact on people due to the pandemic COVID-19.

Section III- Association between psychological impact on people due to the pandemic COVID-19 and their selected demographic variables.

 

Section I-Description of demographic variables of the people selected for the study.

Regarding Age it was found that majority of the population were in the age group of 21-40 years (44%)and the least were above 60 years (6.5%), regarding Gender it was found that majority of the population were females (57.5%) and least were males( 42.5%), regarding Marital Status it was found that majority of the population were married (49.5%) and none were divorcee (0%), regarding Educational status it was found that majority of the population were Graduates(36%) and least had No formal education(4%), regarding Religion it was found that majority of the population were Hindus (63%) and least were Others (0.5%), regarding Occupation it was found that majority of the population were private employees(31%) and the least were Government job holders(9.5%), regarding Family Type it was found that majority of the population belonged to Nuclear family (64%) and the least belonged to Extended family (4%), regarding Income it was found that majority of the  population have income below Rs. 10,000(39%) and least have income Above Rs. 80,000(10.5%), regarding Area of residence it was found that majority of the population are living in City (64.5%) and least were living in the Town (8%), regarding Housing Type it was found that majority of the populations were living in Chawls (38%) and the least in Bungalows (28.5%).

 

Section II- Assessment of psychological impact on people due to the pandemic COVID-19.

For the present study following research hypothesis was formulated:

H1: There will be severe psychological impact on people due to the pandemic of COVID-19.

 

Table No. 1: Depression Anxiety Stress Score (DASS) score.

Sr.

No.

Impact

Score

Frequenc y

Percentage

1.

Mild

21-40

4

2%

2.

Moderate

41-60

44

22%

3.

Severe

61-80

80

40%

4.

Very severe

81-100

72

36%

 

 

Figure 1: The above 3-D Cone diagram shows distribution of sample in relation to level of psychological impact due to COVID- 19 pandemic on people in selected areas of Mumbai.

The data in Figure1 shows that majority of the people (40%) had severe psychological impact due to COVID-19 and least (2%) had Mild psychological impact of COVID 19.

 

It was inferred that majority of the people had severe psychological impact due to COVID-29 and least had mild psychological impact due to COVID-19.

 

Section III- Association between psychological impact on people due to the pandemic COVID-19 and their selected demographic variables.

H2: There will be a significant association between psychological impact on people due to the pandemic of COVID-19 and their demographic variables.

 

Table No. 2:- Association between selected demographic variables and psychological impact on people due to covid-19 in selected areas of mumbai

Sr.

No.

Demographic Variables

Chi Square

Significance

1.

Age

16.92

NS

2.

Sex

7.82

NS

3.

Religion

16.92

NS

4.

Marital Status

12.59

NS

5.

Educational status

21.03

S

6.

Occupation

21.03

S

7.

Family type

16.92

NS

8.

Income

16.92

NS

9.

Area of Residence

12.59

NS

10.

Housing type

12.59

NS

 

 

 

 

 

S- Significant NS- Non- Significant:

Table No. 2 shows that there is an association between the Psychological Impact of people due to COVID-19 and their Educational Status (chi square value 21.03) and Occupation (chi square value 21.03) and rest of the demographic variables were found to be non-significant. Hence it is inferred that educational status and Occupation did influence the psychological impact of people due to COVID-19.

 

FINDINGS:

The major findings of the study were presented based on the objectives of the study:

 

Objective 1: To assess the psychological impact on people due to the pandemic of covid-19.

·         Majority of the population (40%) had severe psychological impact of COVID-19 and least (2%) had Mild psychological impact of COVID 19.

 

Objective 2: To find the association between psychological impact of people due to pandemic of COVID-19 and their selected demographic variables

·         There is an association between the Psychological Impact of people due to COVID-19 and their Educational Status (chi square value 21.03) and Occupation (chi square value 21.03) and rest of the demographic variables were found to be non-significant.

 

LIMITATIONS:

·         The study had covered limited population as we have selected only few areas of Mumbai.

·         Children were not included in the study as they may not be able to make use of the Likert scale.

 

RECOMMENDATIONS:

1.       A longitudinal study can be conducted comparing the COVID-19 waves.

2.       A similar study can be conducted on a larger population.

3.       A similar study can be conducted on the psychological impact related to any other pandemic.

 

CONCLUSION:

The following conclusions were drawn from the findings of the study:

·         Among 200 people 72 persons were very severely affected and 80 persons were severely affected where as 44 persons were moderately affected and 4 were mildly affected.

·         Educational status and Occupation has influenced the psychological impact of people due to COVID-19 Therefore, since majority of the people were severely affected with the pandemic of COVID-19 we as nurses need to help them to manage this unprecedented stressful situation by teaching them stress adaptation techniques.

 

REFERENCE:

1.        Mohammed K. Al-Hanawi, KhadijahAngawi, Noor Alshareef conducted A CrossSectional Study on Knowledge, Attitude and Practice Toward COVID-19 Among the Public in the Kingdom  of Saudi Arabia, https://www.frontiersin.org/articles/ 10.3389/fpubh.2020.00217/full

2.        Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China Dawei Wang, MD1; Bo Hu, MD1; Chang Hu, MD1; et al Fangfang Zhu, MD1; Xing Liu, MD1; Jing Zhang, MD1; Binbin Wang, MD1; Hui Xiang, MD1; Zhenshun Cheng, MD2; Yong Xiong, MD3; Yan Zhao, MD4; Yirong Li, MD5; Xinghuan Wang, MD6; Zhiyong Peng, MD1 https://jamanetwork.com/journals/jama/ fullarticle/2761044

3.        Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China https://doi.org/10.1080/13548506. 2020.1746817

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8.        Definition of complications, https://www.macmillandictionary. com/dictionary/british/complication?q=complicatio ns

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12.      Psychological impact of covid-19 pandemic in the Philippines Michael L. Teea, b, Cherica A. Teec, Joseph P. Anlacand, Katrina Joy G. Aligamd, Patrick Wincy C. Reyese, VipatKuruchitthamf, Roger C. Hog.

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14.      Awareness, anxiety, and depression in healthcare professionals, medical students, and general population of Pakistan during covid-19 pandemic: A cross sectional online survey Sardar Muhammad AlfareedZafar, Muhammad Junaid Tahir, Muna Malik, Muhammad Irfan Malik, Fahd Kamal Akhtar, RubiGhazala

15.      Psychological impact of the covid-19 pandemic on healthcare workers in Singapore Benjamin Y.Q. Tan, Nicholas W.S. Chew, Grace K.H. Lee,

16.      Psychological impact   of   covid-19   on   ICU   caregivers   Anae l̈ leCaillet a, Charlotte Costea, Rocio Sanchez a, Bernard Allaouchiche

17.      The impact of covid-19 pandemic on mental health & wellbeing among home-quarantined Bangladeshi students: a cross-sectional pilot studyAbidHasan Khan, MstSadia Sultana 1, SahadatHossain 2, M TasdikHasan 3, HelalUddin Ahmed 4, MdTajuddinSikder 1

18.      Fear of covid-19, stress, and anxiety in university undergraduate students: a predictive model for depression Antonio J. Rodríguez- Hidalgo, Gisela Pantaleón, Irene Dios and Daniel Falla

19.      Psychological impact of covid-19 lock-down on college students across India: A cross sectional study Sreesupria Purushothaman Ravichandran, Mekhala Kumaravel Palanichami, Kishore Kumar Kalaiselvan, Aarthi Muthukumar, Gautam Mahalingam

20.      The psychological impact of the covid-19 epidemic on college students in China WenjunCaoa, Ziwei Fang, GuoqiangHouc, Mei Hana, XinrongXua, Jiaxin Donga, JianzhongZhenga.

21.      Anxiety level among students of different college and universities in India during lock down in connection to the covid-19 pandemic SaroniBiswas 1, AnirbanBiswas

22.      https://zeenews.india.com/india/live-updates/india-coronavirus- covid-19-live-updates-march-30-indias-coronavirus-cases-jump- to-1251-with-32-deaths-227260

 

Received on 24.06.2021                Modified on 20.07.2021

Accepted on 09.08.2021            ©A&V Publications All right reserved

Asian J. Nursing Education and Research. 2021; 11(4):541-551.

DOI: 10.52711/2349-2996.2021.00128