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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 6  |  Page : 1414-1417  

Impact of Covid pandemic and working strategies on private practitioners


1 Senior Lecturer, Department Of Prosthodoctics, Dental College and Hospital, Itaura, Azamgarh, Uttar Pradesh, India
2 Senior Resident, Department Of Dentistry, Patna Medical College, Patna, Bihar, India
3 Dental Officer, ECHS Polyclinic station HQ, Gopalpur, Cantonment, Odisha, India
4 Senior Lecturer, Department of Conservative Dentistry and Endodontics, Dr. B. R. Ambedkar Institute of Dental Sciences and Hospital, Patna, Bihar, India
5 Senior Lecturer, Department of Oral and Maxillofacial Pathology and Microbiology, ITS CDSR Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
6 Senior Lecturer, Dept. of Public Health Dentistry, People's College of Dental Sciences and Research Center, Bhopal, Madhya Pradesh, India

Date of Submission23-Mar-2021
Date of Decision10-Apr-2021
Date of Acceptance09-May-2021
Date of Web Publication10-Nov-2021

Correspondence Address:
Saurav Kumar
Department of Oral and Maxillofacial Pathology and Microbiology, ITS CDSR Dental College and Hospital, Ghaziabad, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.jpbs_231_21

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   Abstract 


Background: The COVID-19 pandemic is badly affecting more than 2 million population of 213 countries and has caused 1,952,976 deaths till January 12, 2020. India has also suffered a great loss in terms of economy and people. Furthermore, owing to the complete lockdown enforced in India, restricting humanitarian movement also affected day-to-day life of Indians with a huge impact. Objectives: The present clinical trial was carried out to evaluate the impact of the COVID-19 pandemic on private practitioners. Furthermore, changes in their practice pattern were evaluated along with the perspective of their health, role, and response to the pandemic. Materials and Methods: The study includes a total of 120 health-care professionals of either gender. The stress and mental health of the participants was assessed using Depression Anxiety Stress Scale-21 in English format, also included the questions related to the demographic characteristics, use of technologies for providing virtual health care, changes in the working during the pandemic, and an opinion of their experiences during that period. The data collected were subjected to the analysis and were kept confidential and anonymous. Results: 16.6% of participants preferred virtual consultation before the pandemic in contrast to 83.3% during the pandemic. The most preferred method remained the phone call by 15.8% (n = 19) patients. Depression was seen severely in 35% of study participants (n = 42) and 13.3% of participants extremely severe depression was seen (n = 16). Severe and extremely severe anxiety was noticed in 31.66% (=38) and 15% (18) study participants respectively, whereas severe and extremely severe stress was found in 30% (n = 36), and 12.5% (n = 15) private practitioners. The most common factor that can be considered responsible for compromised mental health in private practitioners was the possibility of infecting the society seen in 59.1% (n = 71) participants. Conclusion: During the pandemic breakout, private practitioners suffered a great challenge both financially and mentally, especially during the lockdown. Furthermore, a significant increase was seen in the virtual consultation methods during the pandemic breakout.

Keywords: Anxiety, COVID-19, depression, pandemic, private health care, stress, telemedicine, virtual consultation


How to cite this article:
Yadav RS, Singh P, Askari M, Sinha S, Kumar S, Mehta V. Impact of Covid pandemic and working strategies on private practitioners. J Pharm Bioall Sci 2021;13, Suppl S2:1414-7

How to cite this URL:
Yadav RS, Singh P, Askari M, Sinha S, Kumar S, Mehta V. Impact of Covid pandemic and working strategies on private practitioners. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Aug 10];13, Suppl S2:1414-7. Available from: https://www.jpbsonline.org/text.asp?2021/13/6/1414/330027




   Introduction Top


The novel coronavirus is also known as COVID-19 causing coronavirus disease was first detected in the Wuhan city of China in November 2019. It is a rapidly spreading, deadly, and contagious disease that soon after its detection in China spread worldwide affecting a large population globally. The WHO declared COVID-19 as a pandemic due to the spread globally.[1]

The lockdown affected the mental status of people along with the business, economy, and access to health-care facilities. Along with the mentioned parameters, health-care practices were also affected on a large scale. The regular practice of the government, as well as private practitioners, is also badly affected by the pandemic.[2]

Being a standard model in the pandemic, lockdown is enforced in various regions to restrict the spread of the contagious disease, detection of the new cases, and mortality rate. Although safety measures are usually followed completely by the general population, health-care personnel are usually the ones to be at the frontline and are usually exposed to the ailments.[3] With the previously available resources, various health-care professionals are faced with an increase in work load owing to the great number of patients to be seen. Due to the use of extra precautions such as personal protective equipment (PPE) kits, they also feel discomfort physically under stressed working conditions. Added to this, with very limited availability of information regarding coronavirus and disease, no standard protection protocols are available to be instilled in the practice. Health-care professionals are also subjected to fear of the unintentional spread of disease to the society and family leading them to isolation, which imposes a further risk of mental trauma.[4]

Previous diseases such as Severe Acute Respiratory syndrome in 2003 and Middle East respiratory syndrome in 2015 had shown a great impact on the working and mental status of the health-care professionals during and after the disease breakout. These impacts of the diseases are long-lasting including post-traumatic stress disorders and a decrease in working efficiency.[5]

Private practice in the health-care sector involves a huge part including 81% doctors, 58% of hospitals, and 40% of total births making private practice an important aspect to be taken care of. Furthermore, private practice setups and hospitals continued to treat patients in the middle of the pandemic. Among the guidelines issued by the Government of India in March 2020, there was information regarding isolation wards and treatment of COVID-19 in private sectors as well.[6] However, despite the crucial role of private practitioners during COVID, the fear of disease led to the sharp decline in their practice leading to the increased financial burden, and hence stress.[7]

The present clinical trial was carried out to evaluate the impact of the COVID-19 pandemic on private practitioners. Furthermore, changes in their practice pattern were evaluated along with the perspective of their health, role, and response to the pandemic.


   Materials and Methods Top


The present trial was carried out and included the private practitioners who worked during the lockdown and did not close their clinics in the year 2020. The study included a total of 120 health-care professionals. The informed consent was signed by all the participants for their voluntary participation in the trial. The stress and mental health of the participants was assessed using the Depression Anxiety Stress Scale-21[8] in English format. Along with these various predisposing factors that could lead to the development of stress, anxiety, and depression were also assessed.

To be included in the study, the participants had to be a qualified health-care professional who worked during the pandemic from March 2020 till the completion of the study in January 2021 and had internet access to fill the questionnaire form assigned to them. The participants who were not qualified but practiced during the mentioned period were excluded from the study along with participants with no internet. The link for the survey was shared with all the participants.

The survey was kept as an internet-based survey to allow no-contact completion of the study. The mean time taken by participants to complete the survey was 12 min. The questionnaire apart from the depression anxiety stress scale-21, also included the questions related to the demographic characteristics, use of technologies for providing virtual health care, changes in the working during the pandemic, and an opinion of their experiences during that period. The data collected were subjected to the analysis and were kept confidential and anonymous.


   Results Top


The study included 120 private practitioners from both genders with 17.5% females (n = 21) and 99 males (82.5%). The demographic characteristics of the study participants are summarized in [Table 1]. These characteristics include the age of the participants, their years of private practice, and location whether in a rural or urban location.
Table 1: Demographic characteristics of the study subjects

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Before the pandemic, personal meetings were preferred over virtual consultations. These parameters are described in [Table 2] where only 16.6% of participants preferred virtual consultation before pandemic in contrast to 83.3% during the pandemic. The most preferred method remained the phone call by 15.8% (n = 19) patients.
Table 2: Comparison of virtual consultations before and after COVID-19 pandemic

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Depression Anxiety Stress Scale-21 was also assessed for all the included private practitioners. The factors exposing practitioners to compromise in their mental health were also evaluated, and the results are summarized in [Table 3] and [Table 4]. Depression was seen severely in 35% of study participants (n = 42) and 13.3% of participants extremely severe depression was seen (n = 16). Severe and extremely severe anxiety was noticed in 31.66% (=38) and 15% (18) study participants, respectively, whereas, severe and extremely severe stress was found in 30% (n = 36), and 12.5% (n = 15) private practitioners. The most common factor that can be considered responsible for compromised mental health in private practitioners was the possibility of infecting the society seen in 59.1% (n = 71) participants.
Table 3: Depression, anxiety, and stress in study participants

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Table 4: Possible factors responsible for stress, anxiety, and depression

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   Discussion Top


In the period of the COVID pandemic of 2020, there are higher chances of disease transmission from health-care professionals to patients and from patients to professionals. Hence, private-care practitioners are shifting their practice toward virtual consultations like telemedicine as shown in the present study. These findings were following the studies by Ashique and Kaliyadan[9] in 2020, Lee and English[10] in 2018, Landow et al.[11] in 2014 where teleconsultations were considered as an effective means of not only providing consultation but also for research and monitor condition of the patients. Furthermore, it is an effective method to educate patients.

As shown in the present study, before the pandemic, virtual consultation was used by only 16.6% (n = 20) practitioners, which drastically increased to 83.33% (n = 100) private practitioners during the COVID-19 era. More than 60% of practitioners admitted that they would like to continue the same practice even after the disease is controlled. The most commonly preferred method by the practitioners was phone calls (15.8%, n = 19) compared to Whatsapp, zoom meetings (5.83%, n = 7), and other means of communication. These results were in agreement with the study by Li et al.[12] in 2020 where the phone call was preferred over other modes of virtual consultations.

In the present study, various factors that lead to the development of stress, anxiety, and depression in private practitioners were fear of getting infected and in turn infecting the family and society (59.1%, n = 71) fear of isolation, and no control over the pandemic condition. Other additive factors were no medicine/vaccine, shortage of N-95 mask and PPEs, and an exponential increase in the new cases. These factors were similar to the previous reports by Huang et al.[13] in 2020, Kang et al.[14] in 2020, and Wong et al.[15] in 2005 where similar factors were documented by the authors.

In the results of the present study, it was seen that depression was seen severely in 35% of study participants (n = 42) and 13.3% of participants extremely severe depression was seen (n = 16). Severe and extremely severe anxiety was noticed in 31.66% (=38) and 15% (18) study participants, respectively, whereas severe, and extremely severe stress was found in 30% (n = 36), and 12.5% (n = 15) private practitioners. The most common factor that can be considered responsible for compromised mental health in private practitioners was the possibility of infecting the society seen in 59.1% (n = 71) participants. These results were in accordance with the study conducted by Lai et al.[16] in 2020.


   Conclusion Top


During the pandemic breakout, private practitioners suffered a great challenge both financially and mentally, especially during the lockdown. Furthermore, a significant increase was seen in the virtual consultation methods during the pandemic breakout. Furthermore, the prevalence of virtual consultations has drastically increased and serves as an effective model to provide contactless treatment to needy subjects.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

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Gopalan HS, Misra A. COVID-19 pandemic and challenges for socio-economic issues, healthcare and National Health Programs in India. Diabetes Metab Syndr 2020;14:757-9.  Back to cited text no. 2
    
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Arab M, Rafiei H, Safarizadeh MH, Ahmadi JS, Safarizadeh MM. Stress, anxiety, and depression among medical university students and its relationship with their level of happiness. IOSR-JNHS 2016;5:44-7.  Back to cited text no. 8
    
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Ashique KT, Kaliyadan F. Teledermatology in the wake of COVID -19 scenario: An Indian perspective. Indian Dermatol Online J 2020;11:301-6.  Back to cited text no. 9
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Landow SM, Mateus A, Korgavkar K, Nightingale D, Weinstock MA. Teledermatology: Key factors associated with reducing face-to-face dermatology visits. J Am Acad Dermatol 2014;71:570-6.  Back to cited text no. 11
    
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Li Z, Ge J, Yang M, Feng J, Qiao M, Jiang R, et al. Vicarious traumatisation in the general public, members, and non-members of medical teams aiding in COVID-19 control. Brain Behav Immun 2020;1591:30303-9.  Back to cited text no. 12
    
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Huang JZ, Han MF, Luo TD, Ren AK, Zhou XP. Mental health survey of 230 medical staff in a tertiary infectious disease hospital for COVID-19 [article in Chinese]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2020;38:192-5.  Back to cited text no. 13
    
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Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry 2020;7:14.  Back to cited text no. 14
    
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Wong TW, Yau JK, Chan CL, Kwong RS, Ho SM, Lau CC, et al. The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope. Eur J Emerg Med 2005;12:13-8.  Back to cited text no. 15
    
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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