1
|
VidhiChaudhary, Puri M, Kukreti P, Chhapola V, Kanwar D, Tumpati A, Jakhar P, Singh G. Postpartum depression in Covid-19 risk-stratified hospital zones: A cross-sectional study from India. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6:100269. [PMID: 34725651 PMCID: PMC8550899 DOI: 10.1016/j.jadr.2021.100269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 11/19/2022] Open
Abstract
Objective To determine point prevalence of postpartum depression (PPD) and whether quarantine policies required in postpartum COVID-19 suspects increased the risk of depressive symptoms when compared COVID -19 non suspects in early postpartum period. Methods A cross-sectional study conducted in the postnatal ward of Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, New Delhi from August 2020 to February 2021 using Edinburgh Postnatal Depression Scale (EPDS) to estimate point prevalence of postpartum depression (PPD) in the stratified zones (suspect and nonsuspect) of the hospital. Results Total of 408 postpartum women,204 each (COVID-19 suspects, and nonsuspects zone) were enrolled. Prevalence of Postpartum depression using an EDPS score of >9 was 11.9%. Prevalence of depression (17.9%; vs 4.85%, p <0.001) and level of depression (5.01±3.41 vs 4.14± 2.54, p 0.004) was significantly higher in mothers in isolated quarantine wards of COVID-19 suspect zone as compared to nonsuspect zones. Anhedonia was reported significantly higher (p <0.001) in suspect zone mothers. Multivariate analysis showed 'stay in COVID-19 suspect zone' and 'COVID-19 Suspect status' as a significant predictor of PPD. Conclusion Covid -19 postpartum suspects are at increased risk of developing postpartum depressive symptoms due to isolation and quarantine measures required in suspect zones to mitigate viral transmission. Limitations - Due to the cross-sectional nature of the study long-term impacts on mental health due to isolation could not be assessed. Factors such as marital relationship, COVID -19 related risk factors weren't assessed which may have bearing on the risk of developing PPD.
Collapse
Affiliation(s)
- VidhiChaudhary
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi 110001, India
| | - Manju Puri
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi 110001, India
| | - Prerna Kukreti
- Department of Psychiatry, Lady Hardinge Medical College, New Delhi 110001, India
| | - Viswas Chhapola
- Department of Paediatrics, Lady Hardinge Medical College, New Delhi 110001, India
| | - Divya Kanwar
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi 110001, India
| | - Anujna Tumpati
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi 110001, India
| | - Poonam Jakhar
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi 110001, India
| | - Geetanjali Singh
- Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi 110001, India
| |
Collapse
|
2
|
Nkire N, Mrklas K, Hrabok M, Gusnowski A, Vuong W, Surood S, Abba-Aji A, Urichuk L, Cao B, Greenshaw AJ, Agyapong VIO. COVID-19 Pandemic: Demographic Predictors of Self-Isolation or Self-Quarantine and Impact of Isolation and Quarantine on Perceived Stress, Anxiety, and Depression. Front Psychiatry 2021; 12:553468. [PMID: 33597900 PMCID: PMC7882620 DOI: 10.3389/fpsyt.2021.553468] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 01/07/2021] [Indexed: 12/31/2022] Open
Abstract
Introduction: With the sudden onset and global dispersal of the SARS-CoV-2 virus, many nations including Canada attempted to reduce spread of the resultant COVID-19 syndrome with self-isolation and quarantine, while seeking a cure or vaccine for this disease. Understanding impacts of self-isolation and self-quarantine on stress, anxiety, and depression will help us to mitigate these issues through appropriate development of mental health services. Methods: The sample was drawn from individuals who self-subscribed to Text4Hope, a service that delivers text messages based on a cognitive behavioral therapy framework. Text4Hope was developed to support Albertans during the COVID-19 pandemic. Subscribers were asked for demographic information and if they had to self-isolate or self-quarantine during the pandemic via a survey link. Mental health was assessed using the validated instruments: Perceived Stress Scale (PSS), Generalized Anxiety Disorder-7 item scale (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9). Descriptive statistics and Chi-Square test results were derived using Statistical Package for Social Sciences (SPSS) version-26. Results: 6,041 of 32,805 Text4Hope subscribers (18.4%) completed the survey. Of these respondents, 19.2% had self-isolated or self-quarantined in Alberta as of March 31, 2020 during the COVID-19 pandemic. Post-hoc analysis using adjusted residuals suggested that individuals aged 60 years of age or older, and retirees had a higher likelihood of self-isolation or self-quarantine, compared to respondents with other age or employment characteristics. One-week prevalence rates for self-reported measures of moderate to high stress, likely Generalized Anxiety Disorder (GAD), and likely Major Depressive Disorder (MDD) were 84.9, 46.7, and 41.4%, respectively. Respondents who had to self-isolate or self-quarantine during the COVID-19 pandemic were significantly more likely to present with moderate to high stress, significant anxiety symptomatology, and significant depressive symptomatology. Conclusions: Older age and employment status were significantly associated with the likelihood of self-isolation or self-quarantine. We found elevated self-reported levels of anxiety and depression associated with self-reported COVID-19 pandemic-related self-isolation and self-quarantine activity. These findings have mental health implications both during and after the pandemic and demonstrate the need for greater focus on psychological complications of self-isolation and self-quarantine, and development of optimal ways to manage these pandemic consequences.
Collapse
Affiliation(s)
- Nnamdi Nkire
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Kelly Mrklas
- Strategic Clinical Networks™, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Marianne Hrabok
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - April Gusnowski
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Wesley Vuong
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Shireen Surood
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Adam Abba-Aji
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Liana Urichuk
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Andrew J. Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| |
Collapse
|
3
|
Nash TJ. Development, Testing, and Psychometric Qualities of the Nash Duty to Care Scale for Disaster Response. J Nurs Meas 2017; 25:314-331. [DOI: 10.1891/1061-3749.25.2.314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: Although nurses struggle with the decision to report for work during disaster events, there are no instruments to measure nurses’ duty to care for disaster situations. The purpose of this study was to describe the development, testing, and psychometric qualities of the Nash Duty to Care Scale. Methods: A convenience sample of 409 registered nurses were recruited from 3 universities in the United States. Results: Exploratory factor analysis resulted in a 19-item, 4-factor model explaining 67.34% of the variance. Internal consistency reliability was supported by Cronbach’s alpha ranging from .81 to .91 for the 4-factor subscales and .92 for the total scale. Conclusions: The psychometrically sound instrument for measuring nurses’ perceived duty to care for disasters is applicable to contemporary nursing practice, institutional disaster management plans, and patient health outcomes worldwide.
Collapse
|
4
|
Yeager VA, Hurst D, Menachemi N. State barriers to appropriating public health emergency response funds during the 2009 H1N1 response. Am J Public Health 2015; 105 Suppl 2:S274-9. [PMID: 25689213 PMCID: PMC4355722 DOI: 10.2105/ajph.2014.302378] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined state-specific administrative barriers to allocating 2009 H1N1 influenza public health emergency response (PHER) funds. METHODS We conducted a qualitative review of PHER grants management reports to identify and code barriers reported by states in allocating funds. Using linear regression, we examined the relationship between the percentage of funds allocated and each individual barrier and, separately, the cumulative effect of multiple barriers. RESULTS States reported 6 barrier types, including regulatory issues (n = 14, or 28%), contracting issues (n = 14, or 28%), purchasing issues (n = 6, or 12%), legislative issues (n = 5, or 10%), staffing issues (n = 5, or 10%), and issues transferring funds between state and local health departments (n = 4, or 8%). In multivariate models, having experienced a purchasing barrier was associated with a significant decrease in PHER allocation (B = -26.4; P = .018). Separately, the cumulative effect of having 3 barriers was associated with a decrease in PHER allocation (B = -16.0; P = .079). CONCLUSIONS Purchasing barriers were associated with delayed use of PHER funds. Moreover, the cumulative effect of any 3 barriers hampered the allocation of funds. Understanding barriers to using funds can inform future funding guidance for improved efficiency of response efforts.
Collapse
Affiliation(s)
- Valerie A Yeager
- Valerie A. Yeager is with the Department of Global Health Systems and Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. David Hurst is with the Applied Science and Evaluation Branch, Division of State and Local Readiness, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA. Nir Menachemi is with the Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham
| | | | | |
Collapse
|
5
|
Nathawad R, Roblin PM, Pruitt D, Arquilla B. Addressing the gaps in preparation for quarantine. Prehosp Disaster Med 2013; 28:132-8. [PMID: 23356554 PMCID: PMC7113027 DOI: 10.1017/s1049023x1200180x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 08/22/2012] [Accepted: 03/25/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In the event of an outbreak of a communicable respiratory illness, quarantine may become necessary. The New York Institute for All Hazard Preparedness (NYIAHP) of the State University of New York (SUNY) Downstate Medical Center, in cooperation with the New York City Department of Health and Mental Hygiene's Healthcare Emergency Preparedness Program, (NYC DOHMH-HEPP) quarantine working group, has developed a series of clinical protocols to help health care facilities respond to such an event. PROBLEM Two full-scale exercises (FSEs) were designed and conducted a year apart in the quarantine unit at Kings County Hospital Center (KCHC) to test the efficacy and feasibility of these quarantine protocols. The goal of these exercises was to identify the gaps in preparedness for quarantine and increase hospital readiness for such an event. METHODS Evaluators monitored for efficient management of critical physical plants, personnel and material resources. Players were expected to integrate and practice emergency response plans and protocols specific to quarantine. In developing the exercise objectives, five activities were selected for evaluation: Activation of the Unit, Staffing, Charting/Admission, Symptom Monitoring and Infection Control, and Client Management. RESULTS The results of the initial FSE found that there were incomplete critical tasks within all five protocols: These deficiencies were detailed in an After Action Report and an Improvement Plan was presented to the KCHC Disaster Preparedness Committee a month after the initial FSE. In the second FSE a year later, all critical tasks for Activation of the unit, Staffing and Charting/Admission were achieved. Completion of critical tasks related to Symptom Monitoring and Infection Control and Client Management was improved in the second FSE, but some tasks were still not performed appropriately. CONCLUSION In short, these exercises identified critical needs in disaster preparedness of the KCHC Quarantine Unit. The lessons learned from this logistical exercise enabled the planning group to have a better understanding of leadership needs, communication capabilities, and infection control procedures. Kings County Hospital Center performed well during these exercises. It was clear that performance in the second exercise was improved, and many problems noted in the first exercise were corrected. Staff also felt better prepared the second time. This supports the idea that frequent exercises are vital to maintain disaster readiness.
Collapse
Affiliation(s)
- Rita Nathawad
- SUNY Downstate Medical Center, Brooklyn, New York USA
| | | | - Darrin Pruitt
- Department of Health and Mental Hygiene, New York, New York USA
| | | |
Collapse
|