Perceived Occupational Stressors and the Health Software Professionals in Bengaluru, India

There is limited research on occupational stress and its relation to health from developing countries such as India. This study was done to evaluate work conditions of professionals in two highly productive sectors: the information technology (IT) sector, also known as software development, and Information Technology Enabled Services (ITES), also known as call centers. The study employed thirty-two in-depth interviews. The results indicate the presence of nine stress domains: job control, autonomy, time pressure, length of experience in industry, night shifts, income, appreciation of work, physical environment, work-environment and affective or emotional factors. Global drivers of demand, and local supply of a skilled workforce and the work force regulatory environment in India determine the work culture in Indian IT companies. Apart from affecting health of the professionals, these determinants influence workforce policies, priorities, goals and management practices

Challenges and opportunities in mixed method data collection on mental health issues of health care workers during COVID-19 pandemic in India

Background: The present paper describes the key challenges and opportunities of mixed method telephonic data collection for mental health research using field notes and the experiences of the investigators in a multicenter study in ten sites of India. The study was conducted in public and private hospitals to understand the mental health status, social stigma and coping strategies of different healthcare personnel during the COVID-19 pandemic in India.Methods: Qualitative and quantitative interviews were conducted telephonically. The experiences of data collection were noted as a field notes/diary by the data collectors and principal investigators.Results: The interviewers reported challenges such as network issues, lack of transfer of visual cues and sensitive content of data. Although the telephonic interviews present various challenges in mixed method data collection, it can be used as an alternative to face-to-face data collection using available technology.Conclusions: It is important that the investigators are well trained keeping these challenges in mind so that their capacity is built to deal with these challenges and good quality data is obtained

Factors associated with stigma and manifestations experienced by Indian health care workers involved in COVID-19 management in India: A qualitative study

Healthcare personnel who deal with COVID-19 experience stigma. There is a lack of national-level representative qualitative data to study COVID-19-related stigma among healthcare workers in India. The present study explores factors associated with stigma and manifestations experienced by Indian healthcare workers involved in COVID-19 management. We conducted in-depth interviews across 10 centres in India, which were analysed using NVivo software version 12. Thematic and sentiment analysis was performed to gain deep insights into the complex phenomenon by categorising the qualitative data into meaningful and related categories. Healthcare workers (HCW) usually addressed the stigma they encountered when doing their COVID duties under the superordinate theme of stigma. Among them, 77.42% said they had been stigmatised in some way. Analyses revealed seven interrelated themes surrounding stigma among healthcare workers. It can be seen that the majority of the stigma and coping sentiments fall into the mixed category, followed by the negative sentiment category. This study contributes to our understanding of stigma and discrimination in low- and middle-income settings. Our data show that the emergence of fear of the virus has quickly turned into a stigma against healthcare workers

Need for developing unified workplace mental health screening tool for the Indian population: Commenting on the Tool to assess and classify work (TAWS-16)

Workplace mental health has gained importance in the recent days. However, its assessment is challenging considering the complexity involved in it. The earliest and highly cited Indian research on the workplace mental health listed 12 workplace factors viz. role overload, role ambiguity, role conflict, unreasonable (group & political) pressure, individual responsibility, under participation, powerlessness, poor peer relations, intrinsic impoverishment, low status, strenuous working condition and unprofitability. However, in view of the deficiency, the workplace factors have been rephrased by subsequent investigators. Numerous investigators have attempted to develop or partially use the pre-existing tool for assessing the workplace stress. These primary observations are often heterogeneous, difficult to interpret, and contribute to the challenges during drafting guidelines / policies. Therefore, a tool validated for larger population perhaps after amalgamation of the existing validated tools is recommende

Development and validation of tool for screening occupational mental health and workplace factors influencing it

Introduction: Occupational mental health is one of the key entity for ideal work place. Earlier studies have identified certain workplace factors to influence the mental health of the worker. “Workload”, “Reward”, “Community”, “Control”, “Values” and “Fairness” are the key areas identified in occupational psychology that determine the mental health of the worker. An imbalance in these factors may lead to negative occupational mental health, i.e. burnout. The burnout, a psychological syndrome is combination of emotional exhaustion, depletion of compassion and sense of reduced accomplishment. To note, the concept of occupational mental health in nation with second largest workforce is nascent. Further, the utility of existing western tools in Indian context is limited by multiple factors such as less comprehensibly, culturally inappropriate, patented and other factors. Hence, a tool was developed to screen the occupational mental health and workplace areas. Methods and results: Conventional steps involved in psychological tool development, viz. construct identification, drafting of pertinent questions, content validation, field testing of questions and others were adopted. After series of steps, a tool for screening the occupational mental health consisting of 21 questions and screening the key constructs influencing the mental health at workplace (workplace assessment) consisting of 25 questions were developed. Each of these questions sought responses using a 3-point scale i.e. “Never”, “Sometimes” and “Always”. As intended, the questions were relatively simple, shorter, comprehensible and compliant (no rejections) as observed by the feedback obtained during the pilot (feasibility) study involving 58 consenting volunteers. The tool was explored on larger sample involving workforce from various occupational background in addition to screening of the general mental health using general health questionnaire 5 (GHQ 5). The screening tool exhibited adequate test - retest reliability, internal consistency / reliability (cronbach’s α > 0.73) and correlation (correlation coefficient > 0.6) with the general mental health in larger evaluation of 153 consenting workers. Conclusion: Present study attempted to develop tool for screening adverse occupational mental health (burnout) and workplace factors that are known to be detrimental for mental health. Considering the magnitude of workforce and relatively naïve the concept of occupational mental health in the country, a tool (such as the one reported in the study) for screening the mentioned constructs are need of the hour. Hence, the proposed simple and easy to administer tool, would aid in recognizing the burnout and aid in early diagnosis and management of those requiring intervention

Psychosocial impact of COVID-19 pandemic on healthcare workers in India & their perceptions on the way forward - A qualitative study

Background & objectives: The healthcare system across the world has been overburdened due to the COVID-19 pandemic impacting healthcare workers (HCWs) in different ways. The present study provides an insight into the psychosocial challenges faced by the HCWs related to their work, family and personal well-being and the associated stigmas. Additionally, the coping mechanisms adopted by them and their perceptions on the interventions to address these challenges were also explored. Methods: A qualitative study was conducted between September and December 2020 through in-depth telephonic interviews using an interview guide among 111 HCWs who were involved in COVID-19 management across 10 States in India. Results: HCWs report major changes in work-life environment that included excessive workload with erratic timings accentuated with the extended duration of inconvenient personal protection equipment usage, periods of quarantine and long durations of separation from family. Family-related issues were manifold; the main challenge being separated from family, the challenge of caregiving, especially for females with infants and children, and fears around infecting family. Stigma from the community and peers fuelled by the fear of infection was manifested through avoidance and rejection. Coping strategies included peer, family support and the positive experiences manifested as appreciation and recognition for their contribution during the pandemic. Interpretation & conclusions: The study demonstrates the psychological burden of HCWs engaged with COVID-19 care services. The study findings point to need-based psychosocial interventions at the organizational, societal and individual levels. This includes a conducive working environment involving periodic evaluation of the HCW problems, rotation of workforce by engaging more staff, debunking of false information, community and HCW involvement in COVID sensitization to allay fears and prevent stigma associated with COVID-19 infection/transmission and finally need-based psychological support for them and their families

Psychological distress and burnout among healthcare worker during COVID-19 pandemic in India-A cross-sectional study.

BackgroundCOVID-19 has inundated the entire world disrupting the lives of millions of people. The pandemic has stressed the healthcare system of India impacting the psychological status and functioning of health care workers. The aim of this study is to determine the burnout levels and factors associated with the risk of psychological distress among healthcare workers (HCW) engaged in the management of COVID 19 in India.MethodsA cross-sectional study was conducted from 1 September 2020 to 30 November 2020 by telephonic interviews using a web-based Google form. Health facilities and community centres from 12 cities located in 10 states were selected for data collection. Data on socio-demographic and occupation-related variables like age, sex, type of family, income, type of occupation, hours of work and income were obtained was obtained from 967 participants, including doctors, nurses, ambulance drivers, emergency response teams, lab personnel, and others directly involved in COVID 19 patient care. Levels of psychological distress was assessed by the General health Questionnaire -GHQ-5 and levels of burnout was assessed using the ICMR-NIOH Burnout questionnaire. Multivariable logistic regression analysis was performed to identify factors associated with the risk of psychological distress. The third quartile values of the three subscales of burnout viz EE, DP and PA were used to identify burnout profiles of the healthcare workers.ResultsOverall, 52.9% of the participants had the risk of psychological distress that needed further evaluation. Risk of psychological distress was significantly associated with longer hours of work (≥ 8 hours a day) (AOR = 2.38, 95% CI(1.66-3.41), income≥20000(AOR = 1.74, 95% CI, (1.16-2.6); screening of COVID-19 patients (AOR = 1.63 95% CI (1.09-2.46), contact tracing (AOR = 2.05, 95% CI (1.1-3.81), High Emotional exhaustion score (EE ≥16) (AOR = 4.41 95% CI (3.14-6.28) and High Depersonalisation score (DP≥7) (AOR = 1.79, 95% CI (1.28-2.51)). About 4.7% of the HCWs were overextended (EE>18); 6.5% were disengaged (DP>8) and 9.7% HCWs were showing signs of burnout (high on all three dimensions).ConclusionThe study has identified key factors that could have been likely triggers for psychological distress among healthcare workers who were engaged in management of COVID cases in India. The study also demonstrates the use of GHQ-5 and ICMR-NIOH Burnout questionnaire as important tools to identify persons at risk of psychological distress and occurrence of burnout symptoms respectively. The findings provide useful guide to planning interventions to mitigate mental health problems among HCW in future epidemic/pandemic scenarios in the country