Search

Introduction: Health personnel work under highly stressful conditions with long work hours, frequent night work, and shift duties resulting in sleep problems. Sleep problems lead to a decline in performance, cognition, memory, decision-making, medical errors and mental disorders. The study aimed to find out the prevalence of poor quality of sleep among healthcare workers in a tertiary care centre. Methods: This is a descriptive cross-sectional study conducted among healthcare workers (doctors, nurses, paramedics) of a tertiary care centre after obtaining ethical approval from the Institutional Review Committee. Data was collected from 1 October to 1 December 2023. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 127 healthcare workers, the prevalence of poor quality of sleep was seen in 61 (48.03%) (39.34-56.72, 95% Confidence Interval). A total of 31 (50.82%) were female and 30 (49.18%) were male. Conclusions: The prevalence of poor sleep quality was found to be higher than that of other studies done in similar settings. There is a need to enhance institutional support like incorporating flexible work schedules, and regular wellness programs to alleviate poor sleep quality among healthcare workers.

Abstract Background Pathways to care studies are feasible and tested means of finding the actual routes taken by patients before reaching proper care. In view of the predominance of nonprofessional service providers and the lack of previous large studies on pathways in Nepal, this multicenter study is needed. The aim of the study was to trace the various pathways and carers involved in mental health care; assess clinical variables such as the duration of untreated illness, clinical presentation and treatment; and compare geographically and culturally diverse landscapes. Methods This was a cross-sectional, convenience sampling study performed at 14 centers where new cases were being taken. The World Health Organization Study of the Pathways-to-Care Schedule was applied. The Nepali version of the encounter form was used. The data were collected between 17 September and 16 October 2020 and were analyzed using the Statistical Package for the Social Sciences (SPSS). Additionally, perspectives from local investigators were collected and discussed. Results Most of the first carers were native/religious faith healers (28.2%), followed by psychiatrists (26%). The median duration for the first psychiatric consultation was 3 weeks. The duration of untreated illness was 30.72 ± 80.34 (median: 4) weeks, and the time taken for this journey was 94.99 ± 274.58 (median: 30) min. The longest delay from the onset of illness to psychiatric care was for epilepsy {90.0 ± 199.0 (median: 25.5)} weeks, followed by neurotic illness {22.89 ± 73.45 (median: 2)} and psychotic illness {10.54 ± 18.28 (median: 2)} weeks. Overall, most patients with severe mental illnesses (SMIs) had their first contact with faithhealers (49%), then met with medical doctors (13%) or psychiatrists (28%). Marked differences in clinical presentation surfaced when hilly centers were compared with the Terai belt. Conclusions Faith healers, general practitioners and hospital doctors are major carers, and the means of educating them for proper referral can be considered. The investigators see several hindrances and opportunities in the studied pathways. The employment of more mental health professionals and better mental health advocacy, public awareness programs and school education are suggested strategies to improve proper mental health care.

Abstract Background Mental health problems among medical students are highly prevalent internationally. There have been very few studies however in Nepal. This study aimed to assess the frequency of mental health problems and burnout in Nepalese medical students. Results A total of 169 students responded to the questionnaire. Half (50%) of the surveyed students had some form of mental health problem according to the GHQ-12, while the OLBI showed that 85% students were disengaged and 65% were exhausted. The CAGE screening tool was positive in 14%, and 11% described illicit drug use. Sixty-four percent of students identified their academic studies as their major source of stress. Conclusions Timely recognition of mental health problems is imperative to avert psychiatric illness. Training on early identification and management of stress would be helpful. Further studies are required to identify the factors associated with poor mental health.

Introduction: Health personnel working in the frontline to deal with COVID 19 outbreak are at increased risk of developing psychological problems. This study aims to find out the prevalence of depression, anxiety and stress among Nepalese health care workers. Methods: This is a hospital based descriptive cross-sectional study conducted from July 10 2020 to September 10, 2020. All health care workers (total 280) were included in the study. HADS-14 item was used to measure anxiety and depression. Perceived stress scale was used to measure stress. Data was analyzed with Statistical Package for the Social Sciences software version 24.0. Statistical data was analyzed by percentage, mean and standard deviation. Results: Out of total 270 respondents the prevalence of anxiety, depression and stress was found to be 112 (41.4%), 65 (24.1%) and 203 (74%) respectively. Females accounted for 148 (54.8%) and males 122 (45.2%). More than one third 96 (35.6%) of the health workers were working in front line. Conclusions: Prevalence of anxiety, depression and stress is higher among health workers when compared to similar studies. Effective strategies toward improving the mental health like adequate rest, supply of protective equipments, frequent breaks, ensuring safety issues of their family members, training on management of stress might be helpful in reducing stress.

Introduction: Patients with thyroid disorders are more prone to develop depressive symptoms and conversely depression may be accompanied by various subtle thyroid abnormalities. The aim of the study was to estimate the prevalence of thyroid dysfunction in depression. Methods: This is a descriptive cross-sectional study conducted at Devdaha Medical College and Research Institute employing a simple random sampling technique during the period of August 2019-January 2020. The research was approved by the Ethical Committee of the Institutional Review Board of Devdaha Medical College and Research Institute. The protocol approval number is 009/019. Data analysis was done in Statistical Package for the Social Sciences (Version 23). Results were presented as frequencies and percentages where required. Results: Among 263 patients with depression, 69 (26.2%) had abnormal thyroid status with most common being subclinical hypothyroidism 32 (12.2%), 13 (4.9%) overt hypothyroidism and 7 (2.7%) overt hyperthyroidism. Conclusions: The prevalence of thyroid dysfunction is high among patients with depression. We recommend to conduct routine thyroid function tests for all the patients with depression.