Psychosocial Morbidity Among Doctors Working in Intensive Care Unit in Tertiary Care Hospitals in Chennai - A Cross Sectional Study

P Vinothkumar; Shanthi  Edward; Anantha Eashwar VM

doi:10.55489/njcm.130820222186

Authors

P Vinothkumar Sree Balaji Medical College and Hospital, Chennai, India
Shanthi Edward Sree Balaji Medical College and Hospital, Chennai, India
Anantha Eashwar VM Sree Balaji Medical College and Hospital, Chennai, India

DOI:

https://doi.org/10.55489/njcm.130820222186

Keywords:

Depression, stress, Mental health, Intensivists, Poor sleep quality

Abstract

INTRODUCTION: Intensivists routinely works in a demanding, highly complicated environment where mortality and morbidity are common events and errors can lead to series situation in the working place. Doctors and other health care workers used to work in high stressful condition which affects their own physical as well mental health.

AIM &OBJECTIVE: The aim was to assess psychological factors such as mood status (anxiety, depression and stress) as well as to find out the various influencing factors on psychological health among doctors working in Intensive Care Unit (ICU).

METHODS: The list of tertiary care hospitals in Chennai were collected and Ten hospitals were selected randomly by lottery method and 15 doctors who were working in Intensive Care Units (ICU) were selected from each hospital by systematic random sampling to arrive at the calculated sample size of 150. The Data was collected using the Pretested semi structured questionnaire and validated Depression, Anxiety and Stress (DASS-21) Scale. Data was entered in MS Excel and analysed by SPSS version 22.

RESULTS: The prevalence of Depression, Anxiety and Stress was found to be 78.6%, 86% and 60.6% respectively among ICU doctors. It was found that, having a history of either diabetes or hypertension was an important predictor for depression with an adjusted odds ratio of 3,48 (95% CI – 1.3-8.8) and person who were working more than 8 hours per day was statistically associated(p<0.05) with stress with an adjusted odds ratio of 2.21 (95% CI – 1.1-5.49).

CONCLUSIONS: Routine screening of physical health and mental health for doctors involved in the diagnostic as well as treatment aspects of work towards patients in Intensive Care Unit (ICU) should be conducted periodically.

References

Coomber S, Todd C, Park G, Baxter P, Firth-Cozens J, Shore S. Stress in UK intensive care unit doctors. Br J Anaesth. 2002 Dec;89(6):873-81. Doi: https://doi.org/10.1093/bja/aef273 PMid:12453932

Kumar S. Burnout and Doctors: Prevalence, Prevention and Intervention. Healthc Basel Switz. 2016 Jun 30;4(3):E37. Doi: https://doi.org/10.3390/healthcare4030037 PMid:27417625 PMCid:PMC5041038

Gopalakrishnan S. Prevalence of hypertension and its association with psychosocial factors among old age home inmates in an ur-ban area of Kancheepuram district, Tamil Nadu. International Journal of Community Medicine and Public Health. 2017 Oct;4(10):3712. Doi: https://doi.org/10.18203/2394-6040.ijcmph20174238

Javadekar A, Javadekar S, Chaudhury S, Saldanha D. Depression, anxiety, stress, and sleep disturbances in doctors and general popu-lation during COVID-19 pandemic. Ind Psychiatry J. 2021 Oct;30(Suppl 1):S20-4. Available from: Doi: 10.4103/0972-6748.328783

Rajasekar G, Krishnan R. Mental Health of Medical Practitioner. Indian J Psychol Med. 2021 Jul;43(4):279-85. Doi: https://doi.org/10.1177/02537176211006874 PMid:34385719 PMCid:PMC8327874

Elbay RY, Kurtulmuş A, Arpacıoğlu S, Karadere E. Depression, anxiety, stress levels of physicians and associated factors in Covid-19 pandemics. Psychiatry Res. 2020 Aug;290:113130. Doi: https://doi.org/10.1016/j.psychres.2020.113130 PMid:32497969 PMCid:PMC7255248

Saravanabavan L, Sivakumar M, Hisham M. Stress and Burnout among Intensive Care Unit Healthcare Professionals in an Indian Tertiary Care Hospital. Indian J Crit Care Med Peer-Rev Off Publ Indian Soc Crit Care Med. 2019 Oct;23(10):462-6. Doi: https://doi.org/10.5005/jp-journals-10071-23265 PMid:31749555 PMCid:PMC6842838

Mosheva M, Hertz-Palmor N, Dorman Ilan S, Matalon N, Pessach IM, Afek A, et al. Anxiety, pandemic-related stress and resilience among physicians during the COVID-19 pandemic. Depress Anxiety. 2020 Oct;37(10):965-71. Doi: https://doi.org/10.1002/da.23085 PMid:32789945 PMCid:PMC7436709

Grover S, Sahoo S, Bhalla A, Avasthi A. Psychological problems and burnout among medical professionals of a tertiary care hospital of North India: A cross-sectional study. Indian J Psychiatry. 2018;60(2):175-88. Doi: https://doi.org/10.4103/psychiatry.IndianJPsychiatry_254_17 PMid:30166673 PMCid:PMC6102958

Salari N, Khazaie H, Hosseinian-Far A, Khaledi-Paveh B, Kazeminia M, Mohammadi M, et al. The prevalence of stress, anxiety and de-pression within front-line healthcare workers caring for COVID-19 patients: a systematic review and meta-regression. Hum Re-sour Health. 2020 Dec 17;18(1):100. Doi: https://doi.org/10.1186/s12960-020-00544-1 PMid:33334335 PMCid:PMC7745176

Sandi C, Haller J. Stress and the social brain: behavioural effects and neurobiological mechanisms. Nat Rev Neurosci. 2015 May;16(5):290-304. Doi: https://doi.org/10.1038/nrn3918 PMid:25891510

Aly HM, Nemr NA, Kishk RM, Elsaid NMAB. Stress, anxiety and depression among healthcare workers facing COVID-19 pandemic in Egypt: a cross-sectional online-based study. BMJ Open. 2021 Apr 30;11(4):e045281. Doi: https://doi.org/10.1136/bmjopen-2020-045281 PMid:33931409 PMCid:PMC8098284

Kumari A, Kaur T, Ranjan P, Chopra S, Sarkar S, Baitha U. Workplace violence against doctors: Characteristics, risk factors, and miti-gation strategies. J Postgrad Med. 2020;66(3):149-54.

Anand T, Grover S, Kumar R, Kumar M, Ingle GK. Workplace violence against resident doctors in a tertiary care hospital in Delhi. Natl Med J India. 2016 Dec;29(6):344-8.

Chakraborty S, Mashreky SR, Dalal K. Violence against physicians and nurses: a systematic literature review. Z Gesundheitswissen-schaften J Public Health. 2022 Jan 22;1-19. Doi: https://doi.org/10.1007/s10389-021-01689-6 PMid:35096514 PMCid:PMC8783572

Uvais NA, Shihabudheen P, Hafi NAB. Perceived Stress and Stigma Among Doctors Working in COVID-19-Designated Hospitals in India. Prim Care Companion CNS Disord. 2020 Jul 30;22(4):20br02724. Doi: https://doi.org/10.4088/PCC.20br02724

Depression Anxiety Stress Scales - DASS [Internet]. [cited 2022 Mar 29]. Available from: http://www2.psy.unsw.edu.au/dass//

Elhadi M, Khaled A, Malek AB, El-Azhari AE, Gwea AZ, Zaid A, Elturki SM, Aburgegah A, Ageila MA, Alhadi A, Albashkar HA. Prevalence of anxiety and depressive symptoms among emergency physicians in Libya after civil war: a cross-sectional study. BMJ open. 2020;10(8):e039382. Doi: https://doi.org/10.1136/bmjopen-2020-039382 PMid:32859667 PMCid:PMC7454180

Embriaco N, Hraiech S, Azoulay E, Baumstarck-Barrau K, Forel JM, Kentish-Barnes N, Pochard F, Loundou A, Roch A, Papazian L. Symptoms of depression in ICU physicians. Annals of intensive care. 2012 Dec;2(1):1-8. Doi: https://doi.org/10.1186/2110-5820-2-34 PMid:22839744 PMCid:PMC3543176

Lee MJ, Nho WY, Jung H, Cho JW, Seo JS, Lee HM, Cho KH, Kim YJ, Kim JK. High prevalence of depression and sleep-wake disorders among female emergency medicine residents in South Korea. Annals of medicine. 2022 Dec 31;54(1):846-55. Doi: https://doi.org/10.1080/07853890.2022.2053568 PMid:35348012 PMCid:PMC8967212

Peng X, Meng X, Li L, Hu C, Liu W, Liu Z, Ma X, Xu D, Xing Z, Zhu Z, Liu B. Depressive and anxiety symptoms of healthcare workers in in-tensive care unit under the COVID-19 epidemic: an online cross-sectional study in China. Frontiers in Public Health. 2021;9. Doi: https://doi.org/10.3389/fpubh.2021.603273 PMid:33748059 PMCid:PMC7973083

Wozniak H, Benzakour L, Moullec G, Buetti N, Nguyen A, Corbaz S, Roos P, Vieux L, Suard JC, Weissbrodt R, Pugin J. Mental health outcomes of ICU and non-ICU healthcare workers during the COVID-19 outbreak: a cross-sectional study. Annals of Intensive Care. 2021 Dec;11(1):1-0. Doi: https://doi.org/10.1186/s13613-021-00900-x PMid:34245380 PMCid:PMC8271328

Greenberg N, Weston D, Hall C, Caulfield T, Williamson V, Fong K. Mental health of staff working in intensive care during COVID-19. Occupational Medicine. 2021 Mar;71(2):62-7. Doi: https://doi.org/10.1093/occmed/kqaa220 PMid:33434920 PMCid:PMC7928568

Amte R, Munta K, Gopal PB. Stress levels of critical care doctors in India: A national survey. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2015 May;19(5):257. Doi: https://doi.org/10.4103/0972-5229.156464 PMid:25983431 PMCid:PMC4430743

Chatta HA, Zafar A, Amin F. Measurement of stress among doctors in surgical intensive care unit (ICU) of Lahore General Hospital, Lahore. Pakistan Journal of Medical & Health Sciences. 2017 Jul 1;11(3):874-7.

Chen Y, Shen X, Feng J, Lei Z, Zhang W, Song X, Lv C. Prevalence and predictors of depression among emergency physicians: a national cross-sectional study. BMC Psychiatry. 2022 Dec;22(1):1-8. Doi: https://doi.org/10.1186/s12888-022-03687-8 PMid:35090424 PMCid:PMC8795725

Saracoglu KT, Simsek T, Kahraman S, Bombaci E, Sezen Ö, Saracoglu A, Demirhan R. The psychological impact of COVID-19 disease is more severe on intensive care unit healthcare providers: a cross-sectional study. Clinical Psychopharmacology and Neuroscience. 2020 Nov 30;18(4):607. Doi: https://doi.org/10.9758/cpn.2020.18.4.607 PMid:33124593 PMCid:PMC7609209

Yap Y, Slavish DC, Taylor DJ, Bei B, Wiley JF. Bi-directional relations between stress and self-reported and actigraphy-assessed sleep: a daily intensive longitudinal study. Sleep. 2020;43(3):zsz250. Doi: https://doi.org/10.1093/sleep/zsz250 PMid:31608395 PMCid:PMC7066487