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Table of Contents
ORIGINAL ARTICLE
Year : 2022  |  Volume : 8  |  Issue : 2  |  Page : 121-125

Perceived fear and anxiety as an after effect among coronavirus disease-2019 patients and their treating doctors


1 Professor, Clinical Psychology, SMCH, Ghaziabad, Uttar Pradesh, India
2 Professor, Medicine, SMCH, Ghaziabad, Uttar Pradesh, India
3 Assistant Professor, Psychiatry, SMCH, Ghaziabad, Uttar Pradesh, India
4 Professor Surgery and VC of Santosh Deemed to be University, Pratap Vihar, Ghaziabad, Uttar Pradesh, India
5 Counsellor, Department of Clinical Psychology, SMCH, Ghaziabad, Uttar Pradesh, India
6 MBBS (2015-2021)-SMCH, Ghaziabad, Uttar Pradesh, India

Date of Submission31-May-2022
Date of Acceptance24-Nov-2022
Date of Web Publication11-Jan-2023

Correspondence Address:
Rani Srivastava
SMCH, Ghaziabad, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sujhs.sujhs_28_22

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  Abstract 


Introduction: Coronavirus disease-2019 (COVID-19) represented a human tragedy among the general population and has been an unprecedented challenge for patients, treating doctors, and the entire world. This fact has created continuous fear, anxiety, and many more psychological discomforts such as impairment in healthy happy life, drug abuse, increased religiosity, and hopelessness, and it is also being noticed that women and women-treating doctors are found to be more prone to catch psychological disturbances.
Objective: Considering all the above challenges, this study was intended to test the general health, level of fear, anxiety, and general well-being of COVID afflicted individuals and their treating doctors.
Methodology: Here, the general well-being, level of anxiety, stress, and fear of COVID-19 patients and their treating doctors are examined. This study has been counducted online for COVID-19 patients (with Telephonic calls) and direct interview of treating doctors. The patient's details were taken from hospital records to contact them online. On the other side, the faculty of their treating doctors who have been physically involved in this project were examined for psychological testing. This study has been conducted in the Department of Clinical Psychology in collaboration with Medicine, Santosh Medical College, Hospitals, Ghaziabad, UP.
Results and Discussion: Out of 1325 total cases, only 34% of cases took interest to provide us feedback after recovery. Approximately the similar proportion of cases, i.e., 35% did not respond but rather gave silly rationales as if they did not want to be recognized. One of the smartest groups of such population was who were proved to be highly fake as they furnished all fake identities even during their admission. It was very shocking. COVID patients did not reveal any serious psychopathology. Now if we compare the psychological profile of treating doctors (faculty and PG), their overall health has shown remarkable concerns means their mental health is affected.
Conclusion: Therefore, this study concludes that the knowledge and perception about this pandemic and factors associated with anxiety/depression among frontline physicians are needed to be taken care of because it is marked among the doctors of Santosh Hospital.

Keywords: Anxiety, coronavirus disease-2019, fear, treating doctors


How to cite this article:
Srivastava R, Kumar A, Saran B, Bhagat T, Bansal S, Tyagi A, Srivastava Y. Perceived fear and anxiety as an after effect among coronavirus disease-2019 patients and their treating doctors. Santosh Univ J Health Sci 2022;8:121-5

How to cite this URL:
Srivastava R, Kumar A, Saran B, Bhagat T, Bansal S, Tyagi A, Srivastava Y. Perceived fear and anxiety as an after effect among coronavirus disease-2019 patients and their treating doctors. Santosh Univ J Health Sci [serial online] 2022 [cited 2023 Feb 1];8:121-5. Available from: http://www.sujhs.org/text.asp?2022/8/2/121/367562




  Introduction Top


The coronavirus disease-2019 (COVID-19) represents a human tragedy in relation to the general population as well as to treating doctors.[1]This pandemic has rapidly and profoundly affected every part of the daily life of human beings such as their working, their living, shopping, socialization, and planning the future.[2] It is highly astonishing that people are continuously suffering from pandemic-related anxiety and fear even after being treated for this disease, is making them stressed and mentally imbalanced throughout,[3] even the concerned suicidal rate is also becoming reportable.[4]

In number of COVID-affected patients and among their treating doctor various psychological changes have been noticed such as impairment in healthy happy life, drug abuse, increased religiosity, and hopelessness, and it is also being found that women and women-treating doctors are found to be more prone to catch psychological disturbances.[2]

The number of cases (general population as well as their treating doctors) owning to social isolation and economic stresses have reduced excess community support and the uncertainty and reduced help-seeking mental and physical ill health are dragging them toward serious mental health issues. This challenging situation is providing treating doctors to face burnout, moral injury, and various disorders.[4],[5]

The past research on previous global disease outbreaks has shown that people suffering from such pandemic (COVID-19) tend to exhibit elevated levels of posttraumatic stress, fear, social stress, anxiety, health anxiety, and suicidality.[3],[6] Therefore, the Coronavirus Anxiety Scale (CAS; Lee, 2020)[7] was recently developed to identify those particularly affected by the fear and uncertainty of this growing pandemic crisis. It is important to note that coronavirus anxiety has also been referred to as “corona phobia” in this emerging line of research.[8]

Considering all these unavoidable changes, this study was intended to test the general health, level of fear, level of anxiety and well-being, and how the pains and difficulties of COVID-afflicted individuals and treating doctors are reported.

COVID-19 has stigmatized the entire society in terms of social stigma. Social stigma in the context of health is the negative association between a person or group of people and doctors who share certain characteristics and a specific disease. In an outbreak, this may mean people are labeled, stereotyped, discriminated against, treated separately, and/or experience loss of status due to a perceived link with a disease. Such treatment can negatively affect those with the disease, as well as their caregivers (including doctors), family, friends, and communities. People who do not have the disease but share other characteristics with this group may also suffer from stigma.[9] Considering such facts, the treating doctors have also been included in this project. It is assumed that people who do not have the disease but share other characteristics with this group may also suffer such stigma even.

The level of stigma associated with COVID-19 is based on three main factors:

(1) It is a disease that is new and unknown, (2) People are often afraid of the unknown, (3) Unknowns are easily found to be associated with fear of others, and (4) One more additional factor is afflicted people during post-COVID condition they remain confused whether they should report about their past complications/not?

One of the studies[10] analyzed health-care workers (HCWs) knowledge, practices, and attitudes regarding coronavirus disease-2019 (COVID-19). A cross-sectional survey was conducted in February 2020, involving a total of 1357 HCWs across 10 hospitals in Henan, China. Of those surveyed, approximately 85% fear of infection with the virus regarding COVID-19. Besides anxiety is a common response to any stressful situation. This study attempted to assess the knowledge, attitude, anxiety experience, and perceived mental health-care need among the adult Indian population during the COVID-19 pandemic. In addition to the level of knowledge, some risk factors including work experience and job category influenced HCWs' attitudes and practice concerning COVID-19. Measures must be taken to protect HCWs from risks linked to job category, work experience, working hours, educational attainment, and frontline HCWs.

Those while working frontline treating the infected patients, the HCWs have high rates of depression and anxiety.[11] It is observed that these professionals are not only suffering from anxiety of caring for sick patients – while facing a dire lack of personal protective equipment and rapidly changing hospital protocols – but also forgoing the calming companionship of their partners and children. It is a whole different level of loneliness from what most of us are facing. Hence, it should come as no surprise that the mental well-being of HCWs is in serious jeopardy. A new study, published recently in the Journal of the American Medical Association, quantifies that risk. The survey-based study examines the mental health outcomes of 1,257 HCWs attending to COVID-19 patients in 34 hospitals in China. The results are not comforting. A large proportion of them reports experiencing symptoms of depression (50%), anxiety (45%), insomnia (34%), and psychological distress (71.5%).

Women and nurses report, especially severe symptoms – perhaps not surprising, given that they are often called on to do extra emotional labor, such as keeping up a steady stream of reassurances while suppressing their own feelings, which is known to take a toll. Frontline workers and those in Wuhan, the epicenter of the original outbreak, exhibit a greater psychological burden than Chinese HCWs farther from the epicenter.

The study notes that during the 2003 SARS outbreak, HCWs feared they would infect their family or friends and felt stigmatized because they were known to be in close contact with sick patients. They experienced significant long-term stress. Similar fears are probably contributing to HCW's distress now, in addition to the obvious concern that they are at higher-than-average risk of contracting COVID-19, the authors say.

“Protecting HCWs is an important component of public health measures for addressing the COVID-19 epidemic,” the study concludes. “Special interventions to promote mental well-being in HCWs exposed to COVID-19 need to be immediately implemented, with women, nurses, and frontline workers requiring particular attention.”


  Methodology Top


Aim

Since the after effect of corona has affected the perception of patients and doctors in many ways and too also has precipitated lots of unpleasant and disabling consequences, therefore, the present study has the intention to detect the problems in relation to the above psychological variables as an after effect so that such people can be provided a required help.

Objectives

To see the after effects the following objectives have been formed.

  1. To assess the general health of COVID-19-affected patients and their treating doctors
  2. To check the level of fear among COVID-19 patients and their treating doctors
  3. To check the level of anxiety among COVID-19 patients and their treating doctors
  4. To check the mental well-being among COVID-19 patients and their treating doctors.


Sample and sampling

As per hospital records from July/August 2020 to till November/December 2020, 1325 patients were enrolled for COVID-19 treatment. All these registered cases based on purposive sampling were taken for the study.

Purpose

The entire sample consists of two groups:

  1. COVID-19-affected individuals who were treated properly at Santosh Hospital GZB under the admitted condition
  2. Treating doctors (45 males and females) who were frontline professionals.


Study process

This study has been conducted on online and offline basis, based on available details of the In-patient patient department (IPD) COVID-19 patients mentioned in the hospital records (under the Department of Medicine, Santosh Medical College, Ghaziabad, UP) from July/August 2020 to till November/December 2020.

On the other side, the faculty of their treating doctors who have been physically involved for these patients have undergone psychological analysis on offline basis. Under this analysis, their general health status, level of fear, anxiety, stress, and general well-being have been examined during the said period.

Rating Scales

For data collection, following standardized test measures were used on both groups (COVID patients and doctors):

  1. General Health Questionnaire (GHQ)
  2. Fear of Corona Virus-19 Scale (FCVS)
  3. CAS
  4. Self-Reporting questionnaire (SRQ).



  Results Top


The results are analyzed on the basis of the mean, standard deviation, t-test, and Pearson's correlations.

Out of 1325 total cases, only 34% of cases took interest to provide us feedback after recovery. Approximately the similar proportion of cases, i.e., 35% did not respond but rather gave silly rationales as if they did not want to be recognized. One of the smartest groups (5th) of such population who were proved to be highly fake as they furnished all fake identities even during their admission. It was very shocking.

Since this period was of full-blown state of COVID-19, so hospital was in a rushing mode of incoming patients, therefore, it became mandatory to refer the cases to the other hospitals which was 16% so that they may get immediate help.

There were 54 doctors comprising seniors, juniors (faculty), and PGs together but out of them, 32 doctors and 13 PGs gave their consent for this study as shown in [Graph 2]. Distribution of treating doctors who came forward for the study. As the [Table 2] shows the total doctors responded including 12 senior faculty and 20 junior faculty and rest 13 were junior resident doctors.
Table 2: Distribution of treating doctors who came forward for the study

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The psychological profile of COVID-19 [Table 3] and [Graph 3] patients revealed that regarding fear they have a neutral feeling. As far as coronavirus-related anxiety is concerned these patients have rarely reflected anxiety. On health status, there was no serious pathology during such period. Moreover, this study was conducted at the time when they were in the recovery stage so maybe whatever anxiety and fear was there might have been overcome by the time of assessment.
Table 3: Psychological profile of coronavirus disease 2019-patients

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On the self-reporting questionnaire for the presence of psychiatric complaints, they had the least complaints. Now if we compare the psychological profile of treating doctors (faculty and PG), their overall health [Table 4] has shown substantial concerns means their mental health is affected. On CAS TABLE NO -03 as such no serious anxiety is reflected while FCVS is being reported at moderate level, even their well-being is also significantly affected. Such a level of fear is sounding a bit pathological because while remaining in contact with PG patients on a regular basis they were carrying a fear of being infected which was proved true afterward, as almost 90% of doctors were infected while delivering their services.
Table 4: Psychological profile of treating doctors

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This fear was not only related to being infected rather was related to their family members being infected during such a pandemic. Besides the anxiety related to being in isolation and apprehension was adding discomfort further.


  Conclusion Top


This pandemic has rapidly and profoundly affected every part of human beings. This study is a sort of small drop in the ocean through which we have tried to check the mental well-being of corona-afflicted individuals and their treating doctors. As far as COVID - afflicted patients are concerned their perception is not afflicted of poor physical well-being, fear, and anxiety because whatever psychological disturbances were there, they had already gone through this phase when they were diseased but the perception of their treating doctors[12] is still affected due poor physical well-being, fear, and anxiety, for which they are in the need of counseling. Since the said pandemic is still continued and treating doctors cannot escape from their duties, therefore, they need to be under regular counseling moreover they need to be appraised with better safety knowledge and resources which can alleviate their anxiety and stress.

Limitation

Social stigma in the context of health is the negative association between a person or group of people who share certain characteristics and a specific disease. In an outbreak, this may mean people are labeled, stereotyped, discriminated against, treated separately, and/or experience loss of status because of a perceived link with a disease.

Such treatment can negatively affect those with the disease, as well as their caregivers, family, friends, and communities. People who do not have the disease but share other characteristics with this group may also suffer from stigma. The current COVID-19 outbreak has provoked social stigma and discriminatory behaviors against people of certain ethnic backgrounds as well as anyone perceived to have been in contact with the virus. This is what is the reason as in this study about 230 approximately (17%) [Table 1] and [Graph 1] patients reported wrongly about their where about.
Table 1: Distribution of cases as per their participation

Click here to view



Stigma[9] can drive people to hide the illness to avoid discrimination, prevent people from seeking health care immediately, and discourage them from adopting healthy behaviors, all these are also suspected with our results.

Difference in the findings of patient's and doctor's responses – Has reported health complications and fear to coronavirus

COVID-19 is a global pandemic and a major public health burden worldwide. With poor health-care facilities and health-care systems, it is developing long-lasting effects in developing countries. Outbreaks especially a pandemic situation evoked fear-related behaviors among health-care professionals[13] and there is always an increased risk of mental health disorders. Therefore, this study concludes that the knowledge and perception about this pandemic, its prevalence, and factors associated with anxiety/depression among frontline physicians are needed to be taken care of because it is marked in this Santosh Hospital.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Romo V. NYC Emergency Room Physician Who Treated Coronavirus Patients Dies by Suicide. NPR; 2020. Available from: https://www.npr.org/sections/coronavirus-live-updates/2020/04/28/847305408/nycemergency-room-physician-who-treated-coronaviruspatients-dies-by-suicide?t=1588799220486. [Last accessed on 2020 May 05].  Back to cited text no. 1
    
2.
Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry 2020;7:228-9.  Back to cited text no. 2
    
3.
Chong MY, Wang WC, Hsieh WC, Lee CY, Chiu NM, Yeh WC, et al. Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital. Br J Psychiatry 2004;185:127-33.  Back to cited text no. 3
    
4.
Reger MA, Stanley IH, Joiner TE. Suicide mortality and coronavirus disease 2019-a perfect storm? JAMA Psychiatry 2020;77:1093-4.  Back to cited text no. 4
    
5.
British Psychological Society. The Psychological Needs of Healthcare Staff as a Result of the Coronavirus Outbreak; 2020. Available from: https://www.bps.org.uk/sites/www.bps.org.uk/files/News/News%20-%20Files/Psychological%20needs%20 of%20healthcare%20staff.pdf. [Last accessed on 2020 May 08].  Back to cited text no. 5
    
6.
Wheaton MG, Abramowitz JS, Berman NC, Fabricant LE, Olatunji BO. Psychological predictors of anxiety in response to the H1N1 (swine flu) pandemic. Cognit Ther Res 2012;36:210-8.  Back to cited text no. 6
    
7.
Samuel S. Doctors and Nurses Treating COVID-19 Patients Experience Mental Health Issues. Giving Compass 2020. https://givingcompass.org/article/doctors-and-nurses-treating-covid-19-patients-experience-mental-health-issues. [Last accessed on 2022 Dec 27].  Back to cited text no. 7
    
8.
Asmundson GJ, Taylor S. Coronaphobia: Fear and the 2019-nCoV outbreak. J Anxiety Disord 2020;70:102196.  Back to cited text no. 8
    
9.
WHO. Social stigma associated with COVID-19 n.d. https://www.who.int/publications-detail-redirect/social-stigma-associated-with-covid-19 [Last accessed on 2022 Dec 27].  Back to cited text no. 9
    
10.
Zhang M, Zhou M, Tang F, Wang Y, Nie H, Zhang L, et al. Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China. J Hosp Infect 2020;105:183-7.  Back to cited text no. 10
    
11.
Samuel S. Doctors and Nurses Treating COVID-19 Patients Experience Mental Health Issues. Giving Compass 2020. https://givingcompass.org/article/doctors-and-nurses-treating-covid-19-patients-experience-mental-health-issues. [Last accessed on 2022 Dec 27].  Back to cited text no. 11
    
12.
Amin F, Sharif S, Saeed R, Durrani N, Jilani D. COVID-19 pandemic- knowledge, perception, anxiety and depression among frontline doctors of Pakistan. BMC Psychiatry 2020;20:459.  Back to cited text no. 12
    
13.
Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID-19 scale: Development and initial validation. Int J Ment Health Addict 2022;20:1537-45.  Back to cited text no. 13
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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