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Medical professionals face high stress due to the type of work they do and the prolonged working hours. Frequent burnout results due to the challenging nature of their work. Added to the stress of work, malpractice lawsuits add to their burden. In India, most doctors work in compromised settings with poor infrastructure and manpower but are expected to follow the best practices. In court, they are judged with the Bolam and Bolitho tests being essential considerations. Several tragic incidents have been reported, including depression, anger issues, and even suicide deaths of healthcare professionals (HCPs) after accusations of negligence and subsequent inquiry. Such incidents demonstrate the multitude of challenges an HCP faces in day-to-day practice. It is crucial to find ways to tackle these problems and enhance the capacity of HCP to handle such demanding circumstances. Malpractice litigation can significantly impact the mental health of HCPs. It is common to experience emotional turmoil when faced with a lawsuit. Second victim syndrome (SVS) is a term used to describe a set of symptoms experienced by HCPs who make an error leading to injury to a patient. However, it also happens if he is traumatized by the consequences of violence during healthcare services or a lawsuit or defamation article in newspaper/social media. Following a litigation crisis in their career, many HCPs go through various stages of grief, including shock, denial, anger, bargaining, depression, and acceptance. At times, death by suicide of the HCPs is well known. SVS is known to profoundly affect the personal, family, economic, professional (defensive practice), and social life of HCPs. HCPs should accept the allegations of negligence as an occupational hazard and prepare for the eventual litigation at least once in a lifetime by knowing about the medical laws, HCP's rights, becoming aware of the emotional turmoil of the lawsuit, preparing to cope with the lawsuit, and seeking help from colleagues and indemnity insurance. Frequent training of the HCPs is strongly recommended to know about the changing laws and also to undergo periodic professional competence enhancement to reduce the incidents of errors amounting to medical negligence. Medical and hospital administration should debrief after any incident and conduct internal investigations to identify systemic flaws and prevent future recurrence, resolve issues within their control at their level, and manage media (mainstream and social media) appropriately. If established, a reporting system with online and offline services will ease the internal administrative investigation process and take appropriate, timely actions. During the crisis, HCPs should have adequate and appropriate insurance or indemnity coverage and mental health support systems. [ABSTRACT FROM AUTHOR]

Context: Empathy and self-esteem are essential in delivering quality health care, particularly for women in labor and giving birth. Aims: The aim of this study was to determine the empathy quotient and self-esteem of the second-year and final-year medical and nursing students and labor room staff. Settings and Design: This cross-sectional study was conducted at a teaching hospital in southern India between September and December 2021. Materials and Methods: The inclusion criteria for the study were (i) nursing or medical students currently in their second or final year and (ii) obstetrician or nursing officer or intern currently posted in the labor room. Empathy quotient and self-esteem were measured using the Cambridge Behavioral Scale and Rosenberg's Self-Esteem Scale, respectively. Statistical Analysis Used: The scale scores were summarized as mean (standard deviation), percentages, and 95% confidence intervals. The association between empathy quotient, self-esteem, age, gender, designation, and experience duration was analyzed. We performed multivariable analysis using binary logistic regression. P <0.05 was considered statistically significant. Results: Of the 400 participants included in the study, 36.8% (42.7% - medical, 26.2% - nursing personnel) had lower than average empathy quotient scores, and 13.3% (18.4% - medical, 4.1% - nursing personnel) had low self-esteem. Self-esteem had a statistically significant, independent effect on empathy quotient, as noted in the multivariable analysis among medical and nursing personnel. There was a significant difference between empathy quotient and self-esteem scores in medical and nursing personnel across various designations (P < 0.05). Conclusion: A third of the participants had empathy quotient ratings that were below average, and one-eighth of participants had low self-esteem. Self-esteem and empathy quotient are interdependent; hence has to addressed together. The empathy quotient and self-esteem vary across different designations emphasising the need to take measures to nurture it. [ABSTRACT FROM AUTHOR]

Across India, there have been multiple studies conducted to address the issues of the mental health of healthcare workers during the COVID-19 pandemic. The present study estimated the pooled prevalence of psychological morbidity among healthcare workers during the early phase of the COVID 19 pandemic in India. We searched the following electronic bibliographic databases: PubMed, ScienceDirect, Wiley online library, and Google scholar for studies conducted from the onset of the COVID 19 pandemic until 25 September 2021. The methodological quality of each study was scored and outcome measures with uniform cut off scores as per various screening measurements were evaluated. According to the current meta analysis, the pooled estimates of depression, anxiety, stress, and insomnia among Indian healthcare workers during the COVID 19 pandemic are 20.1% (95% CI: 15.6 to 24.6%; n = 21 studies), 25.0% (95% CI: 18.4 to 31.6%; n = 20 studies), 36% (95% CI: 23.7 to 48.2%; n = 22 studies) and 18.9% (95% CI: 9.9 to 28.0%; n = 6 studies) respectively. In subgroup analyses, low quality studies based on the JBI checklist (Score < 3/9) and studies using DASS 21 showed a higher pooled prevalence of depression and anxiety. About 20–36% of the healthcare workers in India reported having depression, anxiety, and stress during the early phase of the COVID 19 pandemic. The present study provides a comprehensive review of the overall burden of mental health problems among healthcare workers during the COVID 19 pandemic in India necessitating appropriate intervention strategies to protect these frontline groups before the memory of the pandemic crisis starts to fade. [ABSTRACT FROM AUTHOR]

Background: The unprecedented onset of coronavirus disease 2019 (COVID-19) had a huge impact on health-care facilities, leading to different psychosocial challenges among health-care workers (HCWs) during this pandemic. Aim: This study aimed to explore the impact of COVID-19 on the work, family, and personal life of HCWs engaged in COVID-19 duties during the first wave in India and gain insights on the coping strategies. Materials and Methods: The findings from 12 qualitative in-depth interviews were analyzed and presented in this article. This study is a part of a mix-method design study conducted at two hospitals and one community site in Mumbai, Maharashtra. The present qualitative sample was drawn conveniently from the randomly selected quantitative sample chosen from the three sites. Results: This study highlights that in the early stage of the COVID-19 pandemic, HCWs experienced transition in work life, burnout, disruption in family life, negative emotions such as fear, and experiences of stigma. The findings also reveal that while institutional workers faced discrimination and stigma outside their workplace, noninstitutional workers faced discrimination at multiple sites during traveling and at in their residential places and additionally faced harassment while working in the community. The findings also suggest that despite numerous challenges faced by HCWs, they were driven by a sense of responsibility and displayed resilience. Conclusion: Considering the HCWs as the backbone of the health-care system, it is crucial to boost and maintain the mental well-being of HCWs by providing timely and tailored interventions to sustain their resilience and build better responses to future pandemic. [ABSTRACT FROM AUTHOR]

Background: The contagious coronavirus disease-2019 (COVID-19) pandemic has had a significant psychological impact on healthcare workers. Intensive care unit (ICU) and emergency room (ER) providers have functioned in an environment of fear for their health as well as their family well-being. Aim and objective: The aim and objective of the article was to study mental health disorders (anxiety, depression, stress, post-traumatic stress disorder (PTSD), and sleep quality) in frontliners and to identify factors affecting mental health indices. Materials and methods: A survey of 153 doctors and nurses working in ICU and ER was conducted from December 2020 to January 2021 using questionnaire with clinically validated scales: Acute Stress Disorder Scale, Perceived Stress Scale, Beck's Depression Inventory (BDI), Zung Self-rating Anxiety Scale (SAS), Global Pittsburgh Sleep Quality Index (PSQI), Multidimensional Scale of Perceived Social Support (MSPS), and New General Self-efficacy (NGSE) Scale. Analysis was performed to identify of gender, age, place of work, self-efficacy, and social support using logistic regression. Results: Of the 153 participants, 21.6% had PTSD, 88.6% had moderate to high stress, 16.3% had anxiety, and 59.5% had poor sleep. Of these, the majority were females and those aged ≤30 years. Males had lesser depression, anxiety, and poor sleep compared to females (p <0.05). Participants working in ER reported higher stress as compared to those working in ICU (p <0.05). PTSD, perceived stress, depression, anxiety, and poor sleep were higher in participants with low-to-moderate perceived self-efficacy as compared to participants with high self-efficacy (p <0.05). Conclusion: This study reveals significant psychological distress among ER and ICU frontliners during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, a typical high-acuity environment during the nonpandemic times. [ABSTRACT FROM AUTHOR]

Purpose: Despite the fact that marriage below the age of 18 years is illegal in India, a considerable number of females get married and start childbearing during their adolescent years. There is low prevalence of contraceptive methods and high unmet need for family planning (FP). Realizing this, new government programs have been launched to increase the uptake of sexual and reproductive health services among adolescents. However, evidence specific to this age group remains scarce. Aim and objectives: The present study was conducted to assess the prevalence of modern contraceptives among married adolescents, and to determine its association with sociodemographic variables, health worker outreach, and media exposure to FP messages in India. Methods: Data for this analysis was drawn from the fourth round of the National Family Health Survey (NFHS-4) conducted in India during 2015–16. The sample size is restricted to 13,232 currently married adolescent girls aged 15–19 years, who were not pregnant at the time of the survey. Bivariate and multivariate analysis were conducted to assess the levels of contraceptive use and its predictors among married adolescents. Results: The use of modern contraceptives among married adolescents increased from 4 to 10% between 1992–93 and 2015–16. The uptake of modern contraceptives was found to be low among the uneducated, those residing in rural areas, among backward classes, those practising Hindu religion, women in the poorest wealth quintile, women without children, and those with no exposure to FP messages via media or health care workers. Among those who met health care workers and discussed FP issues with them, 34.11% were using modern contraceptives as compared to 11.53% of those who did not have discussions with health care workers. Conclusions: The evidence suggests that contact with health care workers significantly influences the use of modern contraceptives. Further focus on increasing contact between married adolescents' and health care workers, and improving the quality of counselling will protect adolescents from early marriage and pregnancy. Plain language summary: Complications related to early pregnancies and childbirth are a leading cause of death among adolescent girls. Still, a considerable number of young girls in India get married and start childbearing in adolescence. Data shows that 9% of the girls aged 15–19 years in rural areas and 5% in urban areas have already begun childbearing. The World Health Organisation (WHO) recommends access to high-quality sexual and reproductive health information and services as a fundamental right of adolescents. In recent years, the Indian government has also taken several initiatives to cater to the needs of adolescents. The present study focuses on the levels of contraceptive use and the influence of health care workers and media outreach on the uptake of modern contraceptives among married adolescents in India. Findings from the present study suggest that though there has been an increase in the use of modern contraceptives among married adolescents over time, overall the level of contraceptive use is very low. There is visible variation in the use of modern contraceptives depending on the educational status, residence, religion, caste, and household wealth of adolescent girls. Contact of married adolescents with health care workers positively influences the uptake of modern contraceptives. However, the proportion of married adolescents who had contact with health care workers is very low. [ABSTRACT FROM AUTHOR]