International Journal of Science Annals, Vol. 4, No. 1, 2021 ╤Аrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa SOCIAL AND BEHAVIORAL SCIENCES. Health Care Sciences ORIGINAL RESEARCH Psychological Well-Being of COVID Positive Patients During Quarantine in a South Indian Private Hospital AuthorтАЩs Contribution: A тАУ Study design; Chakrabarti S.1 ABCDEFG B тАУ Data collection; C тАУ Statistical analysis; 1 Saveetha Medical College and Hospital, Chennai, India D тАУ Data interpretation; E тАУ Manuscript preparation; F тАУ Literature search; Received: 11.02.2021; Accepted: 11.05.2021; Published: 30.06.2021 G тАУ Funds collection Abstract Background and The Coronavirus disease 2019 (COVID-19) pandemic has led to unparallel Aim of Study: hazards to mental health globally. Many countries around the world have introduced quarantine measures. Quarantine has changed not only the plans of most people, but also their way of life. The greatest impact of quarantine is experienced by COVID positive patients who are isolated in a hospital. The aim of the study: to explore psychological well-being of COVID positive patients during quarantine in a private hospital. Material and Methods: In this study, 100 patients who were COVID positive were requested to fill the Quality of Life Questionnaire. A pre-validated questionnaire was used to assess the depression score amongst COVID positive patients. The analysis of the answers and respondent opinions was conducted using the Pearson method, which produced statistically relevant results. Results: The studied aspects of mental health patients: sleep, appetite, crying spells; happiness and hope for the future; ability to concentrate and focus and getting disturbed easily by trivia; support received from family and friends; overall outlook of life and ability to stay happy in solitude. As a result, qualitative indicators of the patientsтАЩ mental health during quarantine in a private hospital were obtained. Conclusions: The data obtained showed that patients managed to stay happy and eat well but they talked less, had disturbed sleep and did not look forward towards a hopeful future. Some were able to shake away the blues with family, friends on Online Media but some got depressed and got crying spells and thought that their life was a failure. The study concluded that patients on quarantine were often depressed. Many patients might benefit if psychological counselling and support are employed during quarantine measures. Keywords: mental health, psychological well-being, quarantine, pandemic, COVID-19 Copyright: ┬й 2021 Chakrabarti S. Published by Archives of International Journal of Science Annals DOI and UDC DOI https://doi.org/10.26697/ijsa.2021.1.5 UDC 159. Conflict of interests: The author declares that there is no conflict of interests Peer review: Double-blind review Source of support: This research did not receive any outside funding or support Information about Chakrabarti Sudakshina тАУ https://orcid.org/0000-0003-1344-8317; the author: sudhianat@gmail.com; Doctor of Medicine, Associate Professor of Anatomy, Covid Duty Doctor, Saveetha Medical College and Hospital, Chennai, India. 34 International Journal of Science Annals, Vol. 4, No. 1, 2021 ╤Аrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Introduction the questionnaire. This study was approved by the In December 2019 there was a sudden rise in cases of Ethical and Research Board. Voluntary written informed pneumonia in Wuhan city, China which was later consent was obtained in all cases. Permission was designated as Coronavirus disease by the World Health obtained from the Ethical Committee at Saveetha Organization (WHO) on February 11, 2020. This Medical College and Hospital, Chennai, India. A Coronavirus is identified as a novel strain of coronavirus validated questionnaire was used to assess the that shares 79% of genetic similarity with SARS-CoV depression score amongst COVID-19 positive patients. from the SARS outbreak 2003. On March 11, 2020, the This study was conducted from May 2020 to September WHO declared the outbreak a global pandemic (Anand 2020. et al., 2020). This outbreak has changed various aspects Sample Size and Collection of the economy resulting in vast decline in tourism, A total of 100 COVID-19 positive patient in age group aviation, agriculture and financial sectors of the country 18-60 years by RTPCR who underwent quarantine were (Nicola et al., 2020). The consequences of this pandemic requested to fill the Google questionnaire form affected the physical and mental health of individuals тАЬPsychosocial Impact of COVID-19 PandemicтАЭ after more than the world anticipated (Brooks et al., 2020; written informed consent in local language. The Fiorillo & Gorwood, 2020; Hanna et al., 2018; Lima et participation was voluntary. A total of 68 responses al., 2020). Resulting COVID-19 has required many were received and were obtained in the study. The pre- countries across the globe to implement early quarantine validated DSM 4 (ICDS) questionnaires were used to measures as the fundamental disease control tool. assess the depression score amongst COVID-19 positive Mental disorders, such as anxiety, depression, are patients and data was analyzed using automated Google attributed to risk factors including loneliness, pie charts and Percentages. Patients with a pre-existing frustration, which is inevitable in the majority of the psychiatric illness those who are not willing to be a part population during quarantine (Kang et al., 2020; of the study were excluded from the study. Shigemura et al., 2020; Park, S.-C., & Park, 2020). Data Analysis Altruistic behavior towards self-isolation and voluntary Data was analyzed for calculating the percentage of quarantine should be encouraged after proper patient with different depression score. Automated clarification through mass communication to minimize Graphs were used to analyze the data. distress and long-term complications of imposed The analysis of the answers and respondent opinions quarantine. was conducted using the Pearson method, which The aim of the study. To explore psychological well- produced statistically relevant results. being of COVID positive patients during quarantine in a private hospital. Results Questionnaires were sent to 100 patients out of whom Materials and Methods 68 responded. The summary results of the respondentsтАЩ In this study 100 patients who were COVID-19 answers according to the developed questionnaire are diagnosed as positive by RTPCR, were requested to fill shown in Table 1. Table 1 Summary Results of RespondentsтАЩ Answers According to the Developed Questionnaire Distribution of the participants number according to the responses Queries for participants (people/%) A B C D Total 1. I was bothered by things that really donтАЩt bother me 31/47.0 19/28.8 7/10.6 9/13.6 66/100.0 2. I could not get going 29/44.6 24/36.9 6/9.3 6/9.2 65/100.0 3. I felt like people dislike me 43/65.2 16/24.2 3/4.5 4/6.1 66/100.0 4. I felt sad 28/41.8 19/28.4 12/17.9 8/11.9 67/100.0 5. I had crying spells 48/73.8 10/15.4 6/9.2 1/1.6 65/100.0 6. I enjoyed life 11/16.6 7/10.6 10/15.2 38/57.6 66/100.0 7.People were unfriendly 42/63.6 19/28.8 4/6.5 1/1.1 66/100.0 8. I felt lonely 31/46.3 20/29.9 7/10.4 9/13.4 67/100.0 9. I had trouble keeping my mind on what I was doing 31/47.0 21/31.8 5/7.6 9/13.6 66/100.0 10. I did not feel like eating; my appetite was poor 34/51.5 17/25.8 7/10.6 8/12.1 66/100.0 11. I felt that I could not shake off the blues with the 47/71.2 13/19.7 3/4.2 3/4.9 66/100.0 help from my family or friends 12. I felt I was just as good as other people 3/4.4 5/7.3 4/5.9 56/82.4 68/100.0 13. I felt that everything I did was an effort 20/30.3 11/16.6 5/7.6 30/45.5 66/100.0 14. I talked less than usual 28/41.8 15/22.4 7/10.4 17/25.4 67/100.0 15. I was happy 11/16.7 4/6.0 7/10.6 44/66.7 66/100.0 16. My sleep was restless 25/37.3 23/34.3 11/16.5 8/11.9 67/100.0 17. I felt fearful 38/56.7 15/22.4 6/9.0 8/11.9 67/100.0 18. I thought my life had been a failure 52/78.8 5/6.9 4/6.7 5/7.6 66/100.0 19. I felt hopeful about the future 6/8.8 10/14.7 8/11.8 44/64.7 68/100.0 20. I felt depressed 49/73.1 5/7.5 4/6.0 9/13.4 67/100.0 35 International Journal of Science Annals, Vol. 4, No. 1, 2021 ╤Аrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Figures 1 to 20 show the graphical representation of Figure 3 number of patients with different dimensions of mental Distribution of RespondentsтАЩ Answers to Query 3 health. The aspects of sleep, appetite, crying spells were recorded. The dimensions of happiness and hope for the future were analyzed. Ability to concentrate and focus and getting disturbed easily by trivia was also studied. The support received from family and friends was documented. Overall outlook of life and ability to stay happy in solitude was assessed. According to Figure 1 a total of 47.0% respondents rarely felt that they were bothered by the things that really donтАЩt bother them; 28.8% тАУ sometimes felt such a state; only 13.6% respondents were bothered by the things that usually donтАЩt bother them. Figure 1 Distribution of RespondentsтАЩ Answers to Query 1 The respondents answered about the sad feeling as follows (Figure 4): rarely тАУ 41.8%, sometimes тАУ 28.4%, occasionally тАУ 17.9%, most of the time тАУ 11.9%. Figure 4 Distribution of RespondentsтАЩ Answers to Query 4 Figure 2 shows that respondents felt as they could not get going: rarely тАУ 44.6%, sometimes тАУ 36.9%, occasionally тАУ 9.3%, most of the time тАУ 9.2%. Figure 2 Distribution of RespondentsтАЩ Answers to Query 2 Figure 5 shows that 73.8% respondents rarely had crying spells, 15.4% тАУ sometimes had such a state. Figure 5 Distribution of RespondentsтАЩ Answers to Query 5 A total of 65.2% respondents felt that people rarely disliked them, only 6.1% respondents felt such a state most of the time (Figure 3). 36 International Journal of Science Annals, Vol. 4, No. 1, 2021 ╤Аrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Most of the respondents (57.6%) answered to have A lot of people occupied themselves with other activities enjoyed their life during the quarantine period, but 16.6% like WhatsApp, Twitter, Facebook and other online rarely enjoyed their life in the quarantine period social media. Figure 9 shows that 13.6% respondents (Figure 6). were unable to concentrate whatever they were doing Figure 6 most of the time; 47.0% respondents rarely had trouble Distribution of RespondentsтАЩ Answers to Query 6 keeping their mind on what they were doing. Figure 9 Distribution of RespondentsтАЩ Answers to Query 9 About 63.6% respondents rarely felt that people were unfriendly to them, 28.8% of respondents felt that people sometimes were unfriendly to them (Figure 7). Figure 7 Figure 10 shows that 51.5% respondents had a good Distribution of RespondentsтАЩ Answers to Query 7 appetite, but 12.1% respondents had poor appetite most of the time. Figure 10 Distribution of RespondentsтАЩ Answers to Query 10 A total of 13.4% respondents felt lonely for most of the time; 46.3% тАУ rarely felt lonely; 29.9% тАУ sometimes felt lonely (Figure 8). Figure 8 Distribution of RespondentsтАЩ Answers to Query 8 Figure 11 shows that 71.2% respondents rarely felt that they could not shake off the blues with the help from family and friends, and 19.7% respondents agreed that they were able to shake away the blues with the help of family and friends sometimes. 37 International Journal of Science Annals, Vol. 4, No. 1, 2021 ╤Аrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Figure 11 A total of 41.8% respondents rarely felt that they talked Distribution of RespondentsтАЩ Answers to Query 11 less than usual, 25.4% respondents тАУmost of the time felt such a state (Figure 14). Figure 14 Distribution of RespondentsтАЩ Answers to Query 14 A total of 82.4% respondents felt that they were just as good as other people, but 4.4% respondents rarely felt that they were just as good as others (Figure 12). Figure 12 Figure 15 shows that most of the respondents (66.7%) felt Distribution of RespondentsтАЩ Answers to Query 12 happy most of the time, but 16.7% тАУ were unhappy. Figure 15 Distribution of RespondentsтАЩ Answers to Query 15 Figure 13 shows that 45.5% respondents felt that everything they did was an effort most of the time, 30.3% According to Figure 16 37.3% respondents rarely, 34.3% respondents rarely felt such a state. respondents sometimes had restless sleep. Figure 13 Figure 16 Distribution of RespondentsтАЩ Answers to Query 13 Distribution of RespondentsтАЩ Answers to Query 16 38 International Journal of Science Annals, Vol. 4, No. 1, 2021 ╤Аrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa Figure 17 shows that 11.9% respondents felt fearful most Figure 20 shows that a few respondents (13.4%) actually of the time, 56.7% тАУ rarely felt fearful. felt depressed, while 73.1% тАУ rarely felt depressed. Figure 17 Figure 20 Distribution of RespondentsтАЩ Answers to Query 17 Distribution of RespondentsтАЩ Answers to Query 20 Despite the fact that the study was conducted in India, its A total of 78.8% respondents rarely thought that their life results can be useful to scientists for research on the had been a failure, but 7.6% тАУ thought that their life had COVID problem around the world. been a failure most of the time (Figure 18). Figure 18 Discussion Distribution of RespondentsтАЩ Answers to Query 18 Our study explored the mental health status of the general population amidst the COVID-19 pandemic. Generally, there is a higher prevalence of symptoms of adverse psychiatric outcomes among the public when compared to the prevalence before the pandemic (Huang et al., 2019). The quarantine imposed due to the coronavirus outbreak adversely influenced peopleтАЩs economy because of an increase in the rate of unemployment. This led to an increased financial crisis among people and decrease in the quality of life. All these factors can put individuals at greater risk for developing adverse psychological symptoms. Xiong et al. (2020) found that there are relatively high rates of symptoms of anxiety depression and post- traumatic stress disorders, psychological distress and stress in the general population during the COVID-19 pandemic in China. But in our study, most of the people Figure 19 shows that 64.7% respondents most of the time (13.4%) felt depressed and 11.9% had sleep disturbances were hopeful about the future, but 8.8% тАУ rarely felt most of the time. hopeful. According to a study by Brooks et al. (2020), the severity Figure 19 of stress related symptoms will depend upon the Distribution of RespondentsтАЩ Answers to Query 19 quarantine duration and extent, the fear of being infected, feeling lonely. In our study, we found 11.6% of people felt fearful most of the time and 13.4% of people felt lonely most of the time. According to Zhang and Ma (2020), they found a higher prevalence of insomnia, anxiety, depressive symptoms, somatization, and obsessive-compulsive symptoms in mental health staff. A systematic review and meta-analysis (including studies from 2000 to 2014) showed an impact of an epidemic/pandemic on the mental health of health care professionals, as тАЬprobableтАЭ percentage of cases (Vyas et al., 2016). In this review, psychological distress was assessed in 13 studies, with an average rate among exposed HCPs of approximately 40% (range: 11тАУ75%). Insomnia was assessed in four studies, with an average 39 International Journal of Science Annals, Vol. 4, No. 1, 2021 ╤Аrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa rate among exposed HCPs of approximately 39% (range: Health anxiety is the term used by some authors which is 30тАУ52%). Posttraumatic stress disorder (PTSD) a state of mind where certain body functioning symptoms were assessed in 19 studies, with an average mechanisms can be misinterpreted as symptoms of rate of approximately 21% (range: 10тАУ33%), of whom infectious pandemic disease. With COVID-19 media 40% reported persistently high PTSD symptoms 3 years coverage, misinformation and exaggerated information after exposure. Meta-analytic results showed effects were can result in excessive health anxiety not only in COVID small, (SMD = 0.12, 95% CI = -0.23 to 0.47), but not patients but also among general population. This can significant. Depression symptoms were measured in 8 result in maladaptive behaviors among masses like studies, with an average rate of approximately 46% hoarding items, refusing treatments or making multiple (range: 23тАУ74%), of whom up to 9% reported severe visits to health care facilities etc. (Asmundson & Taylor, levels. 11% were clinically diagnosed 1 month after the 2020a; 2020b). disease outbreak. Meta-analytic results showed effects were moderate (SMD = 0.40, 95% CI = 0.24тАУ0.51) and Conclusions significant. Anxiety symptoms were assessed in fourteen The present study suggests that there is an increased studies. The average rate was approximately 45% (range: stress during isolation and quarantine during pandemics. 19тАУ77%). Meta-analytic results showed effects were Patients manage to stay happy and eat well but they talk small, (SMD = 0.08, 95% CI = -0.09 to 0.25) and not less, have disturbed sleep and do not look forward significant. In our study 67.7% of the people felt happy towards a hopeful future. Some are able to shake away and 75% of the people were hopeful about the future. the blues with family, friends on Online Media but a few One systematic review (Brooks et al., 2018) synthesizing do get depressed and get crying spells and think that their the social and occupational factors affecting the mental life is a failure. Patients often realize that the disease is health of HCPs covered the literature up to 2015 and difficult to cure and whatever they do is just an effort and included 22 studies, all of which had investigated the not a cure. Many patients might benefit if psychological SARS epidemic. Brooks et al. (2018) identified six counselling and support are employed during quarantine organizational and four social factors as showing an measures. influence on mental health outcomes. For this rapid Acknowledgements review, no further evidence of social and organizational The author acknowledges the management of Saveetha factors published after 2015 was identified amongst our Medical College and Research Associates in helping out accepted papers. Below is a brief summary of the with data collection. organizational and social factors found by Brooks et al. (2018) and associated data can be found in the study Ethical Approval (Brooks et al., 2018). Further predictors, beyond The present study was approved by the Institutional organizational and social factors, may also influence the Human Ethics Committee, Saveetha Medical College impact of epidemics/pandemics on mental health. and Hospital, Chennai, India (SMCH/07/116/20 from In another review it was observed that subsyndromal 03.07.2020). psychological states were common during COVID pandemic. 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International Journal of Science Annals, 4(1) , 34тАУ41. https://doi.org/10.26697/ijsa.2021.1.5 The electronic version of this article is complete. It can be found online in the IJSA Archive https://ijsa.culturehealth.org/en/arhiv and in the KRPOCH Publishing Repository https://ekrpoch.culturehealth.org/handle/lib/71 This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/deed.en). 41