A qualitative study of factors affecting mental health amongst low-income working mothers in Bangalore, India

Career women's mental wellbeing in the era of population decline: the effects of working environment and family environment on the mental wellbeing

Introduction

In recent years, it has become increasingly evident that the population in many countries has been declining. China, which was previously the world's most populous nation and is often categorized as an emerging economy, officially entered an era of population decline in 2022. The advent of this era has make China's economic development more uncertain and aging of population more pronounced. To address the population decline, the Chinese government implemented the "Three-Child Policy" to encourage childbirth, aiming to reverse the negative population growth. However, this policy has not achieved the expected goals. Instead, it has increased the pressure on women to bear children, particularly for career women, where such pressure may conflict with their existing work and family environments, subsequently affecting their mental wellbeing.

Methods

A survey was conducted to investigate the mental wellbeing status of career women in Changchun City, Jilin Province, Northeast China. It analyzes the impact of working and family environments on the mental wellbeing of these women.

Results

Based on the survey, this study draws five conclusions: A. The mental wellbeing status of career women varies across different ages, industries, and childbirth statuses. B. The perceived adverse impact of childbirth on the working environment may negatively affect the mental wellbeing of career women. C. The perceived adverse impact of childbirth on the family environment may negatively affect the mental wellbeing of career women. D. Career women are not satisfied with the effectiveness of current policies in protecting women's rights. E. Compared to working environments, there is a greater demand for career women in the family environments, particularly in reducing various family burdens.

Discussion

The pro-natalist policies introduced in response to negative population growth can worsen the mental wellbeing of career women, while the deterioration of their mental wellbeing could further accelerate population decline. Given the current challenges, this study suggests that effectively improving the mental wellbeing of career women requires building psychological resilience among childless career women, reducing the burden of family on career women, and continuously improving policies and regulations that protect the rights of career women.

Prevalence and risk factors of depression, anxiety, and stress among the Bangladeshi construction workers: A cross-sectional study

BACKGROUND

Construction workers are a population that is at risk for mental illnesses such as depression, anxiety, and even suicide due to the high stress and physical demands of their work. This study aimed to determine the prevalence and risk factors for depression, anxiety, and stress among Bangladeshi construction workers.

METHODS

From February 2022 to June 2022, community-based cross-sectional research was conducted among construction workers. Survey data was gathered using interviewer administered questionnaires with 502 participants from the construction sites. Data were collected based on the information related to socio-demographics, lifestyle, occupation, health hazards, and mental health (i.e., depression, anxiety, and stress). The results were interpreted using the chi-square test and logistic regression utilizing SPSS statistical software.

RESULTS

The study revealed the prevalence rates of depression, anxiety, and stress among construction workers to be 17.9%, 30.3%, and 12%, respectively. Key findings indicate that construction workers who maintained a healthy sleep duration were 64% less likely to be depressed compared to those with poor sleep (AOR = 0.36; 95% CI: 0.21-0.61, p<0.001). Workers who did not experience breathing issues upon starting construction work had a 45% lower likelihood of experiencing depression (AOR = 0.55; 95% CI: 0.32-0.97, p = 0.037) and an 82% lower likelihood of experiencing anxiety (AOR = 0.18; 95% CI: 0.11-0.30, p<0.001). Bricklayer construction workers were 72% less likely to experience stress (AOR = 0.28; 95% CI: 0.08-0.95, p = 0.041), and workers without breathing issues after starting construction work were 66% less likely to experience stress (AOR = 0.34; 95% CI: 0.17-0.66, p = 0.001).

CONCLUSIONS

The study found that depression, anxiety, and stress are prevalent among construction workers in Bangladesh, with breathing issues as a significant risk factor. Thus, there is a need for effective measures to reduce these problems and provide a safe working environment for construction workers to ensure their productivity and the country's overall growth.

Adverse childhood experiences, HIV and sexual risk behaviors - Five sub-Saharan countries, 2018-2020

BACKGROUND

Adverse childhood experiences (ACEs) have been shown to have negative, lasting effects on health including increasing the likelihood of engaging in sexual risk behaviors.

OBJECTIVE

This study aimed to identify associations between exposures to ACEs and sexual risk behaviors and HIV service utilization among young people.

PARTICIPANTS AND SETTING

A sample of 8023 sexually active young people (19-24 year olds) from five sub-Saharan African countries participated Violence Against Children and Youth Surveys (VACS).

METHODS

Descriptive analysis of demographic variables, individual ACEs, cumulative ACEs, sexual risk behaviors, HIV testing, antiretroviral treatment (ART) and Antenatal Care (ANC) attendance were completed. Bivariate and multivariable logistic regression analyses were conducted to assess the associations between both individual and cumulative ACEs, sexual HIV risk behaviors, and service utilization while controlling for important covariates such as demographic, having ever been pregnant, had an STI, and used contraception.

RESULTS

Exposure to three or more ACEs was higher among males (26.1 %) compared to females (21.3 %); p = 0.003. The most prominent sexual risk behavior for females was having sexual partners who were at least 5 years older (45.7 % compared to males 3.7 %; p < 0.0001) whereas in males it was no or infrequent condom use (45.3 % compared to females 30.1 %; p < 0.0001). Males and females exposed to childhood sexual violence had seven and four times the odds of engaging in transactional sex (aOR = 7.34, 95 % CI: [3.5-15.0]) and (aOR =3.75, 95 % CI: [2.3-6.2], respectively. Females exposed to three or more ACEs were four times more likely to engage in transactional sex (aOR = 4.85, 95 %, CI: [1.6-14.4]) compared to those who did not experience any ACEs. Males exposed to three or more ACEs were two times more likely to engage in early sexual debut (aOR = 2.2, 95 % CI: [1.3-3.4]),]) compared to those who did not experience any ACEs. Females who had witnessed IPV or violence in the community had significantly higher odds of getting tested for HIV (aOR = 2.16, 95 % CI: [1.63-2.87]) and (aOR = 1.36, 95 % CI: [1.03-1.81]), respectively.

CONCLUSIONS

This study demonstrated that experiencing ACEs during childhood is associated with higher HIV risk behaviors in sub-Saharan Africa (SSA) with unique differences between males and females.

Psychological Distress in Low-Income and Economically Marginalized Populations in India: Protective and Risk Factors

Studies at the juncture of development economics and public health take on considerable responsibility in addressing inequality and related mental health distress. Mental healthcare in economically marginalized populations requires depicting the linkages between socioeconomic status and psychological distress. In the present work, a sequential mixed-methods design was used to study 190 people in such communities in India. Gender-dependent psychological distress was found according to the Kessler Psychological Distress Scale (K-10) with moderate distress in women (M = 26.30, SD = 9.15) and mild distress in men (M = 21.04, SD = 8.35). Regression analysis indicated that gender significantly predicted psychological distress, followed by age, marital status, and the level of education of the head of the family. The Interpretative Phenomenological Analysis of semi-structured interviews of the six women who scored the highest on the distress scale unveiled three master themes: (1) manifestation of psychological distress, (2) contextual challenges, and (3) sources of strength and resilience. Overall, participants reported a lack of resources, community violence, gender discrimination, and widespread substance use as major contributors to the ongoing distress. These findings can pave the way for future studies to expand beyond independent economic indicators and curate clinical interventions for culturally competent mental healthcare.

Amelioration and deterioration: Social network typologies and mental health among female domestic workers in China

Previous quantitative studies on the effects of social network types on mental health have obtained inconsistent or conflicting results, due to problems such as sample selection bias or crude measurement of variables. In this study, we avoided these problems by using appropriate statistical methodology to examine the effect of various forms of social network on the mental health of a sample of 987 Chinese female domestic workers. Thus, we measured social network types in terms of both network attributes (friend networks and family networks) and interaction channels (face-to-face, telephone, and WeChat/QQ channels, where the latter are two popular online messaging platforms in China), and used the coarsened exact matching method to obtain a balanced sample. The results showed that social network typologies had positive and negative effects on the mental health of this sample of domestic workers, as evidenced by (1) In terms of network attributes, family networks were associated with improved mental health and friend networks were associated with worsened mental health; (2) In terms of interaction channels, the significant amelioration in mental health from family networks came from face-to-face interactions, the significant deterioration in mental health from friends networks came from telephone interactions, and in terms of other interaction channels, family networks and friends networks had no significant effect on mental health. Robustness tests indicated that these conclusions are reliable. We discuss the possible mechanisms of which different types of social networks influence mental health.

Corona was scary, lockdown was worse: A mixed-methods study of community perceptions on COVID-19 from urban informal settlements of Mumbai

The COVID-19 pandemic has magnified the multiple vulnerabilities of people living in urban informal settlements globally. To bring community voices from such settlements to the center of COVID-19 response strategies, we undertook a study in the urban informal settlements of Dharavi, Mumbai, from September 2020-April 2021. In this study, we have examined the awareness, attitudes, reported practices, and some broader experiences of the community in Dharavi with respect to COVID-19. We have used a mixed-methods approach, that included a cross-sectional survey of 468 people, and in-depth interviews and focus group discussions with 49 people living in this area. Data was collected via a mix of phone and face-to-face interviews. We have presented here the descriptive statistics from the survey and the key themes that emerged from our qualitative data. People reported high levels of knowledge about COVID-19, with television (90%), family and friends (56%), and social media (47%) being the main sources of information. The knowledge people had, however, was not free of misconceptions and fear; people were scared of being forcefully quarantined and dying alone during the early days of COVID-19. These fears had negative repercussions in the form of patient-related stigma and hesitancy in seeking healthcare. A year into the pandemic, however, people reported a shift in attitudes from 'extreme fear to low fear' (67% reported perceiving low/no COVID risk in October 2020), contributing to a general laxity in following COVID-appropriate behaviors. Currently, the community is immensely concerned about the revival of livelihoods, that have been adversely impacted due to the lockdown in 2020 as well as the continued 'othering' of Dharavi for being a COVID hotspot. These findings suggest that urban informal settlements like Dharavi need community-level messaging that counters misinformation and denial of the outbreak; local reinforcement of COVID-appropriate behaviours; and long-term social protection measures.

Domains of Psychosocial Risk Factors Affecting Young Construction Workers: A Systematic Review

Despite being a key provider of employment, construction work significantly contributes to poor mental health among young construction workers worldwide. Although there are studies on the psychosocial risk factors (PRFs) that make young construction workers susceptible to poor mental health, the literature is fragmented. This has obscured a deeper understanding of PRFs and the direction for future research, thus making it challenging to develop appropriate interventions. To address this challenge, we systematically reviewed the literature on young construction workers’ PRFs using meta-aggregation, guided by the PICo, PEO, and PRISMA frameworks. We sought to synthesize the domains of PRFs that affect young construction workers’ mental health, and to determine the relationships between the PRF domains, psychological distress, and poor mental health. A total of 235 studies were retrieved and 31 studies published between 1993 and 2020 met the inclusion criteria. We identified 30 PRFs and categorized them into ten domains, which were further classified into personal, socio-economic, and organizational/industrial factors. The findings of this review contribute to achieving an in-depth understanding of young construction workers’ PRF domains and their patterns of interaction. The findings are also useful to researchers and policymakers for identifying PRFs that are in critical need of attention.

Effects of Physical Activity and Counselling Interventions on Health Outcomes among Working Women in Shanghai

Working women in Shanghai are a high-risk group of suffering work stress and burnout. Women have been found to be affected by work-family conflicts, which results in lower health-related quality of life (HRQoL), higher job stress, and burnout. This study evaluated the potential physical activity and counselling intervention effects on health outcomes of working women in Shanghai. Participants were randomly recruited from eight communities of Shanghai using the stratified cluster sampling method. A total of 121 female workers took part in this study, who were randomly divided into three groups: a control group and two intervention groups (individual-based and group-based intervention). The first intervention involved a moderate physical activity program and an individual based counselling intervention, while the second included the same physical activity program, but with a group counselling approach. Both interventions lasted 12 weeks. Subjective perceptions of work stress, burnout, and HRQoL were measured before and after the intervention. In the control group, the HRQoL value decreased after the intervention, with the mean value falling from 91.59 to 87.10, while there was no significant difference found between participants for stress (p = 0.752) and burnout (p = 0.622) before and after the intervention. After the intervention, the value of stress and burnout decreased, and the value of HRQoL increased in the two intervention groups. At the intervention's completion, there were significant differences compared between the two intervention groups and the control group separately regarding changes in burnout and HRQoL (all p = 0.000). For stress, the group-based intervention group exhibited a significant difference compared to the control group (p = 0.000), while the individual-based intervention group did not (p = 0.128). A Physical activity and counselling intervention delivered either in a group or individual format could reduce stress, burnout, and improve HRQoL of working women in Shanghai, and the group interventions were potentially more effective than those targeted at individuals.

Social determinants of mental health of women living in slum: a systematic review

OBJECTIVE

With the rise of urbanization globally, the problem of living in slums has become a problem for the civil society. As a vulnerable segment, women make up half of the population in these regions; therefore, women's mental health has always been a concern. The purpose of this study was to review the social determinants of mental health in women living in slum areas.

METHODS

We systematically reviewed articles published between 2009 and 2019 on the social determinants of women's mental health in SID, Magiran, Google scholar, PubMed, Scopus, Science Direct, Embase, MEDLINE, PsychINFO, and PsychARTICLES databases using MeSH keywords according to PRISMA guidelines. The quality of the studies was assessed depending on the type of study using Ottawa Newcastle" scale and Joanna Briggs Institute quality assessment tools. Finally, 23 studies were analyzed.

RESULTS

Different social determinants influenced the mental health of women living in slum areas. Among the structural determinants, the socioeconomic level had the highest frequency, and gender was in the second rank with the highest correlation with poorer women's mental health status. Among the intermediate determinants, living conditions, food insecurity, social capital, and social support were most frequently associated with mental health status.

CONCLUSION

Women living in slum areas are prone to developing mental disorders and poorer mental health; therefore, supporting these women and creating job opportunities to raise their incomes and, subsequently, improve their social, economic, and living conditions should be taken into consideration. In addition, this requires careful planning and comprehensive social support.

Antenatal Depression and Generalized Anxiety Disorder in a Tertiary Hospital in South India

BACKGROUND

Antenatal depression is associated with several adverse maternal outcomes, perinatal outcomes, lower academic achievements in adolescence, and future mental health problems for the mothers. Early identification and effective treatment of depression in antenatal women can also improve perinatal outcomes.

AIM

This study aims to understand the prevalence of antenatal depression and anxiety disorder, along with associated factors, among antenatal women attending the outpatient clinic of the obstetrics department in a tertiary care hospital.

METHODS

A cross-sectional design was employed for determining the prevalence, while a case-control framework was used for analysis of the associated factors. Semi-structured sociodemographic pro forma, Patient Health Questionnaire (PHQ-9) Tamil version, and Generalised Anxiety Disorder (GAD-7) Tamil version were administered to antenatal women after obtaining informed consent. Those who scored above 10 points on the PHQ-9 or above 9 points on the GAD-7 were interviewed using the Mini-International Neuropsychiatric Interview (MINI) diagnostic interview schedule, by a psychiatrist, for confirming the diagnosis.

RESULTS

In our sample, 22% of the participants were diagnosed with depression, and 23% with generalized anxiety disorder (GAD). Twenty-eight participants (13.4%) had both depression and GAD. Antenatal depression was associated with alcohol use in the spouse (P < 0.015), physical violence (P < 0.026), low perceived social support from the in-laws (P < 0.039), and pressure to have a male child (0.001). Antenatal GAD was associated with low perceived social support from the in-laws (P < 0.039) and pressure to have a male child (P < 0.041).

CONCLUSION

The occurrence of depression and generalized anxiety disorder is high in antenatal women. Our study identified relevant psychosocial factors that may be potential targets to develop effective interventions.

Depressive Symptoms, Suicidal Ideation, and Mental Health Service Use of Industrial Workers: Evidence from Vietnam

Background: Depressive symptoms and suicidal ideation substantially reduce industrial workers' productivity and performance. This study was performed to examine the prevalence of depressive symptoms and suicidal ideation and identify associated factors among industrial workers in different provinces of Vietnam. Materials and Methods: We performed a cross-sectional study in industrial zones of four provinces of Vietnam. The Patient Health Questionnaire (PHQ-9) was employed to screen depressive symptoms and suicidal ideation. Multivariate logistic regression was performed to determine factors related to depressive symptoms and suicidal ideation. Results: Of 1200 industrial workers, 30.5% and 33.6% industrial workers had positive depressive symptoms and suicidal ideation in the last two weeks, respectively. There were 38.3% ever using mental health services in the last 12 months. High school education (OR = 0.64, 95% CI = 0.44-0.95); living in dormitory (OR = 3.07, 95% CI = 1.51-6.24), living with siblings (OR = 2.98; 95% CI = 1.32-6.75), having two children or more (OR = 1.45, 95% CI = 1.03-2.03), high years of experience (OR = 0.94; 95% CI = 0.89-0.98), suffering from burnout, alcohol use disorder (OR = 2.38; 95% CI = 1.72-3.28), and smoking status (OR = 0.38, 95% CI = 0.23-0.61) were associated with positive depressive symptoms. Living with children, working in mechanical/metallurgy/electronics factories, completely exhausted and often thinking of quitting, and alcohol use disorder were positively related to suicidal ideation. Conclusions: This study found a high prevalence of depressive symptoms and suicidal ideation among industrial workers in Vietnam. Regular screening and detecting high-risk groups, along with interventions to reduce health risk behaviors, burnout and on-site medical service quality improvement, are recommended to alleviate the burden of depression in industrial workers.

Rethinking health systems in the context of urbanisation: challenges from four rapidly urbanising low-income and middle-income countries

The world is now predominantly urban; rapid and uncontrolled urbanisation continues across low-income and middle-income countries (LMICs). Health systems are struggling to respond to the challenges that urbanisation brings. While better-off urbanites can reap the benefits from the 'urban advantage', the poorest, particularly slum dwellers and the homeless, frequently experience worse health outcomes than their rural counterparts. In this position paper, we analyse the challenges urbanisation presents to health systems by drawing on examples from four LMICs: Nigeria, Ghana, Nepal and Bangladesh. Key challenges include: responding to the rising tide of non-communicable diseases and to the wider determinants of health, strengthening urban health governance to enable multisectoral responses, provision of accessible, quality primary healthcare and prevention from a plurality of providers. We consider how these challenges necessitate a rethink of our conceptualisation of health systems. We propose an urban health systems model that focuses on: multisectoral approaches that look beyond the health sector to act on the determinants of health; accountability to, and engagement with, urban residents through participatory decision making; and responses that recognise the plurality of health service providers. Within this model, we explicitly recognise the role of data and evidence to act as glue holding together this complex system and allowing incremental progress in equitable improvement in the health of urban populations.

Premenstrual Dysphoric Disorder: Ranking the Symptoms and Severity in Indian College Students

Background: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are common conditions causing significant impairment in various domains of life. Both the conditions are associated with physical, emotional, and behavioral symptoms. There is dearth of studies regarding symptomatology and severity of the condition in Indian college students.

Aim: Aim of this study is to categorize and rank the symptoms and severity of PMDD in college students in India.

Materials and methods: A cross-sectional survey was conducted in various colleges of Mysuru. A total of 600 girls were approached over a period of 1 year. Confidentiality was assured and written informed consent was taken. Girls with irregular periods and those who had an absence of menstruation since last 3 consecutive menstrual cycles were excluded. A total of 571 filled up forms were taken for analysis. Data was analyzed using SPSS 22 version software. Chi-square test was used as the test of significance for qualitative data.

Results: The mean age of participants was 21.12 ± 2.6 years. Majority of the subjects were unmarried and were from urban background. The prevalence of PMS/PMDD was 46.1%, out of which 10.2% met the criteria for PMDD. Physical symptoms (91.4%) were the most commonly reported symptom domain in the PMDD category, followed by anger or irritability (84.5%). Almost half of the subjects with no or mild PMS had reported physical symptoms. The least reported symptom was insomnia. PMDD group had reported maximum impairment in the domain of relationship with family members (77.6%), followed by home responsibilities and relationship with coworkers.

Conclusion: This study suggests that the prevalence of clinically relevant PMS/PMDD is higher than widely cited estimates and is a cause of concern for health care authorities in India. Physical complaints are the most commonly reported among all the symptoms in all groups. There is a need to actively assess for premenstrual symptoms in young women for comprehensive treatment and good outcome.

Women's Experiences and Perceptions of Depression in India: A Metaethnography

In India, social determinants of health, including poverty, domestic violence, and inadequate social support disproportionately affect women, leaving them more vulnerable to depression than men. We conducted a metaethnography to synthesize qualitative data from 13 studies (1987-2017) that explored women's experiences and perceptions of depression in India. We used a feminist standpoint to critically examine how gender shapes these experiences and perceptions. Indian women's experiences of depression were embedded in their social worlds. Women perceived interpersonal conflict, caregiving burden, domestic violence, financial insecurity, adverse reproductive events and widowhood as causes of depression. Women used cultural expressions to describe physical, emotional, and cognitive distress. The detrimental impact of discriminatory social conditions, gender inequalities, and traditional gender roles on Indian women's mental health highlights the need for gender-sensitive mental health research and practice that can attend to women's sociocultural context and promote values of gender equality and social justice.

Education Mitigates the Relationship of Stress and Mental Disorders Among Rural Indian Women

BACKGROUND

Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics.

OBJECTIVES

To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics.

METHODS

Cross-sectional survey of 700 women from rural Gujarat, India. CMD screening status was assessed using Self-Reported Questionnaire 20 (SRQ-20). Factors associated with CMD screening status were evaluated using multivariable logistic regression. Effect modification for the relationship of perceived stress and CMD screening status was assessed using interaction terms and interpreted in terms of predicted probabilities.

FINDINGS

The analytic cohort included 663 women, with roughly 1 in 4 screening positive for CMD (157, 23.7%). Poor income, low education, food insecurity, and recurrent thoughts after traumatic events were associated with increased risk of positive CMD screen. Perceived stress was closely associated with CMD screening status. Higher education attenuated the relationship between high levels of stress and CMD screening status (82.3%, 88.8%, 32.9%; P value for trend: 0.03). Increasing income and age attenuated the link between moderate stress and CMD.

CONCLUSIONS

Our findings suggest a high burden of possible CMD among reproductive-aged women from rural western India. Higher education might mitigate the association between elevated stress and CMD. Future efforts to improve mental health in rural India should focus on preventing CMD by enhancing rural women's self-efficacy and problem-solving capabilities to overcome challenging life events and stressors, thereby reducing the risk of CMD.

Socioeconomic patterning of chronic conditions and behavioral risk factors in rural South Asia: a multi-site cross-sectional study

OBJECTIVES

Our aim was to examine relationships between markers of socioeconomic status and chronic disease risks in rural South Asia to understand the etiology of chronic diseases in the region and identify high-risk populations.

METHODS

We examined data from 2271 adults in Chennai, Goa and Matlab sites of the Chronic Disease Risk Factor study in South Asia. We report age-sex adjusted odds ratios for risk factors (tobacco, alcohol, fruit-vegetable use and physical activity) and common chronic conditions (hypertension, diabetes, overweight, depression, impaired lung and vision) by education, occupation and wealth.

RESULTS

Respondents with greater wealth and in non-manual professions were more likely to be overweight [OR = 2.48 (95% CI 1.8,3.38)] and have diabetes [OR = 1.88 (95% CI 1.02,3.5)]. Wealth and education were associated with higher fruit and vegetable [OR = 1.89 (95% CI 1.48,2.4)] consumption but lower physical activity [OR = 0.52 (95% CI 0.39,0.69)]. Non-manual workers reported lower tobacco and alcohol use, while wealthier respondents reported better vision and lung function.

CONCLUSIONS

Ongoing monitoring of inequalities in chronic disease risks is needed for planning and evaluating interventions to address the growing burden of chronic conditions.

Fear of childbirth and depressive symptoms among postnatal women: A cross-sectional survey from Chhattisgarh, India

BACKGROUND

Prevalence rates of Fear of Birth and postnatal depressive symptoms have not been explored in Chhattisgarh, India.

OBJECTIVE

To validate Hindi Wijma Delivery Experience Questionnaire and to study the prevalence of Fear of Birth and depressive symptoms among postnatal women.

METHODS

A cross-sectional survey at seventeen public health facilities in two districts of Chhattisgarh, India among postnatal women who gave birth vaginally or through C-section to a live neonate. Participants were recruited through consecutive sampling based on health facility records of daily births. Data were collected through one-to-one interviews using the Wijma Delivery Experience Questionnaire Version B and the Edinburgh Postnatal Depression Scale. Non-parametric associations and linear regression data analyses were performed.

RESULTS

The Hindi Wijma Delivery Experience Questionnaire Version B had reliable psychometric properties. The prevalence of Fear of Birth and depressive symptoms among postnatal women were 13.1% and 17.1%, respectively, and their presence had a strong association (p<0.001). Regression analyses revealed that, among women having vaginal births: coming for institutional births due to health professionals' advice, giving birth in a district hospital and having postnatal depressive symptoms were associated with presence of FoB; while depressive symptoms were associated with having FoB, perineal suturing without pain relief, and giving birth to a low birth-weight neonate in a district hospital.

CONCLUSION

The prevalence of Fear of Birth and depressive symptoms is influenced by pain management during childbirth and care processes between women and providers. These care practices should be improved for better mental health outcomes among postnatal women.

Common mental disorder and its socio-demographic correlates among married women residing in slum areas of Bhubaneswar, India

The mental health of women residing in slum areas is a neglected and important public health concern. The present cross-sectional study was undertaken during 2012-2013 to assess frequently occurring mental disorders and associated factors among married women 15-45 years of age, residing in slum areas of Bhubaneswar, India. A multistage, cluster, random sampling design was applied to select the study areas. The presence of a mental disorder was determined using a validated, self-reported questionnaire, developed by the World Health Organization. Using a predesigned, pretested schedule, relevant data were collected from 362 eligible, willing women respondents. Eighty women (22.1%) had a mental disorder, 56 (70.0%) of whom never consulted a health-care provider. Results of multiple logistic regression indicated that presence of a mental disorder was positively associated with not being satisfied with managing household financial affairs, not having time to attend social obligations, attending religious services less than four times per month, addiction of a family member to alcohol or drugs, and misunderstandings or quarrels in the family. Policy makers should be encouraged to incorporate such determinants in schemes or programs intended to promote the mental health of married slum women.

Impact of social determinants on well-being of urban construction workers of Hyderabad

BACKGROUND

Hyderabad has witnessed one of the largest labor immigration in recent years and these construction workers are highly vulnerable in terms of health. Social determinants of health (SDH) arise from conditions in which they live and these factors interact with each other to produce direct impact on health.

OBJECTIVES

(1) To evaluate the sociodemographic and job characteristics of the construction workers. (2) To assess the impact of social determinants on well-being.

MATERIALS AND METHODS

A sample size of 135 construction workers working at three sites of HITEC city were interviewed using semi-structured questionnaire. Health perception and the impact on well-being was measured using the Healthy Days Module and Kessler's Psychological Distress Scale. SDH were measured on a 27-item questionnaire with responses on a Likert scale ranging from 0 to 4. Proportions, percentages, P values, and mean scores were obtained.

RESULTS

The mean age of the sample was 35.4 ± 11.94 years. Seventeen (12.6%) of the workers reported a high risk score on the Kessler's Psychological Distress Scale. Binary logistic regression analysis was used to identify significant domains of social determinants independently associated with the well being of construction workers and significant among the nine domains of social determinants were addiction score domain with odds of 2.259 and a P value of 0.015 and the distress domain with odds of 1.108 and a P < 0.001.

CONCLUSIONS

There is a significant impairment of physical and mental health due to various factors including SDH, such as addictive habits and psychological distress, which are amenable to prevention.

Depression in women in Indian context

The estimate of the global burden of disease predicts that depression will be the second-leading cause of disability worldwide by 2020. Depression is widely prevalent in women in all age groups especially in India where 1.2 billion population lives. In the current scenario of underdiagnosed, untreated cases of females suffering from depression, the hurdles faced by Indian women include inadequate number of mental health professionals, lack of awareness, stigma, disadvantaged position of women, multiple roles, increased levels of stress, and domestic violence. The literature search included an electronic database, published materials, and standard textbooks. The authors have provided a brief overview of different types of depression in females. Epidemiology, etiology, clinical presentation, and management linked to the reproductive cycle of women have been covered. Awareness through public education, early detection, organized national mental health programs, comprehensive management, with judicious utilization of the limited resources would tackle the rising number of cases of female depression, in a cost effective manner, thereby preventing suicide.

Cultural adaptation of the Brief COPE for persons living with HIV/AIDS in southern India

Physical and psychological stressors of HIV infection demand adequate coping responses from persons living with HIV/AIDS (PLHA) and coping strategies may vary by cultural context. The Brief COPE is a well validated scale that has been used extensively to assess coping with cancer, depression, and HIV infection in other settings, but never in India. In this study we translated and validated the 28 item Brief COPE among 299 PLHA in South India, assessing reliability, validity, and cultural appropriateness. Although the original scale demonstrated acceptable internal consistency (alpha = 0.70) and good convergent validity with depression, the test-retest reliability was marginal (test-retest = 0.6) and the original factor structure demonstrated poor fit in a confirmatory factor analysis (CFA). An exploratory factor analysis yielded a 16 item scale with five factors (active planning, social support, avoidant emotions, substance use, religion). A second CFA demonstrated good model fit and acceptable reliability (alpha = 0.61) of the adapted scale.

Perception of Iranian middle-aged women regarding moral health concept: a content analysis

Introduction:

The present study aimed at exploring and describing the perception of moral health from middle-aged women standpoints. Women’s decisive role in family is undeniable. In the family which is built upon tradition, faith and ethics, this is women’s principle which is represented in the moral health of the individual and the society, deals with the nature of the vice and virtue. This study attempted to identify the perception of Iranian middle-aged women about the concept of moral health.

Method:

The present study completed through a content analysis method. Twenty two middle-aged women were recruited through purposive sampling. Data were granted by face to face, semi-structured interview.

Result:

Our major categories are devotion, preserving moral values and moral challenges. Devotion category includes subcategories such as prioritizing the health of family members and trying to save marriage. Preserving moral values category includes subcategories such as respecting values and consolidating beliefs over time. Moral challenges category consists of individual and familial challenges subcategories.

Conclusion:

Moral health is of high importance which affects various dimensions of individual, social and familial life. The findings of the present study presented new dimensions of middle-aged women’s health regarding moral health which can finally have different consequences on familial and social moral health.

Psychological well-being of parents and family caregivers of children with hearing impairment in south India: influence of behavioural problems in children and social support

Parents of children with hearing impairment are at increased risk of mental health morbidities. We examined the predictive factors associated with caregiver's strain and psychological morbidities in parents and family caregivers of children with hearing impairment. In total, n = 201 parents and family caregivers of children with and without hearing impairment aged 3 to 16 years were recruited. Caregiver's strain and psychological morbidities were measured using the Zarit Burden scale and the World Health Organization's Self-Reporting Questionnaire (SRQ-20). Presence of behavioural problems in children was measured using the Strengths and Difficulties Questionnaire. After adjustment, low educational attainment and domestic violence were found to be associated with caregiving strain, whereas dissatisfaction with social support from family, behavioural problems in children, and domestic violence strongly predicted psychological morbidities. Addressing the mental healthcare needs of parents may help in downsizing the impact of psychological morbidities on the well-being of children with hearing impairment.