I have never seen a patient from far: Narratives of Doctors during the Covid-19 Pandemic in India

Volume 6, Issue 6, December 2021     |     PP. 709-725      |     PDF (219 K)    |     Pub. Date: November 30, 2021
DOI: 10.54647/cm32705    83 Downloads     5479 Views  

Author(s)

Megha Dhillon, Department of Psychology, Lady Shri Ram College, University of Delhi, New Delhi, India
Vaidehi Mishra, Department of Psychology, University of Delhi, South Campus, New Delhi, India

Abstract
The present study is a qualitative investigation of the lived experiences of Indian doctors in the context of the Covid -19 situation in the country. Data was collected through in-depth interviews with ten participants including two female doctors and eight male doctors. The data obtained from the interviews was analysed using the technique of thematic analysis. Results indicated that doctors perceived the situation in the country as one fraught with a large number of challenges. These ranged from poor public compliance with safety measures and shortages in personal protective equipment to lack in the availability of health infrastructure. In addition to these, doctors also reported impacts of the pandemic on their personal lives. These included persistent anxiety over not only acquiring the virus but also passing it on to their families and some doctors reported changes in their interactional styles with their family members. The doctors missed being able to enjoy the little things in life and socialising with their loved ones. Family and faith emerged to be the most common ways of dealing with the stresses created by the situation. Alongside a desire for things to come back to normal, doctors looked for greater support from the government for the provision of better infrastructure. There was dissatisfaction over the government’s ability to protect doctors from harassment and this was another area within which doctors sought a positive change. Implications of the study and future directions have been discussed.

Keywords
doctors, covid-19, lived experiences, coping, psycho-social impacts, India

Cite this paper
Megha Dhillon, Vaidehi Mishra, I have never seen a patient from far: Narratives of Doctors during the Covid-19 Pandemic in India , SCIREA Journal of Clinical Medicine. Volume 6, Issue 6, December 2021 | PP. 709-725. 10.54647/cm32705

References

[ 1 ] Tam, C. W., Pang, E. P., Lam, L. C., & Chiu, H. F. (2004). Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: stress and psychological impact among frontline healthcare workers. Psychological medicine, 34(7), 1197–1204. https://doi.org/10.1017/s0033291704002247
[ 2 ] Raven, J., Wurie, H., & Witter, S. (2018). Health workers' experiences of coping with the Ebola epidemic in Sierra Leone's health system: a qualitative study. BMC health services research, 18(1), 251. https://doi.org/10.1186/s12913-018-3072-3
[ 3 ] Chong, M. Y., Wang, W. C., Hsieh, W. C., Lee, C. Y., Chiu, N. M., Yeh, W. C., Huang, O. L., Wen, J. K., & Chen, C. L. (2004). Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital. The British journal of psychiatry : the journal of mental science, 185, 127–133. https://doi.org/10.1192/bjp.185.2.127
[ 4 ] Su, T. P., Lien, T. C., Yang, C. Y., Su, Y. L., Wang, J. H., Tsai, S. L., & Yin, J. C. (2007). Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: a prospective and periodic assessment study in Taiwan. Journal of psychiatric research, 41(1-2), 119–130. https://doi.org/10.1016/j.jpsychires.2005.12.006
[ 5 ] Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., Wu, J., Du, H., Chen, T., Li, R., Tan, H., Kang, L., Yao, L., Huang, M., Wang, H., Wang, G., Liu, Z., & Hu, S. (2020). Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA network open, 3(3), e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
[ 6 ] Giusti, E. M., Pedroli, E., D'Aniello, G. E., Stramba Badiale, C., Pietrabissa, G., Manna, C., Stramba Badiale, M., Riva, G., Castelnuovo, G., & Molinari, E. (2020). The Psychological Impact of the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study. Frontiers in psychology, 11, 1684. https://doi.org/10.3389/fpsyg.2020.01684
[ 7 ] Kapoor, C. (2020, June 10). Covid-19: Is Indian healthcare system heading for collapse? Anadolu Agency. https://www.aa.com.tr/en/asia-pacific/covid-19-is-indian-healthcare-system-heading-for-collapse/1871871#:~:text=In%20the%202019%20Global%20Health,seen%20a%20high%20number%20of
[ 8 ] Kaul, R. (2019, November 1) India’s public spending on healthcare continues to remain lowest globally. Hindustan Times. https://www.hindustantimes.com/india-news/india-s-public-health-spending-lagging-behind/story-6YPZFSfWMVlHGipDXyUEFO.html
[ 9 ] Khanam, A., Dar, S. A., Wani, Z. A., Shah, N. N., Haq, I., & Kousar, S. (2020). Healthcare Providers on the Frontline: A Quantitative Investigation of the Stress and Recent Onset Psychological Impact of Delivering Health Care Services During COVID-19 in Kashmir. Sage journals, 42(4), 359-367. https://doi.org/10.1177/0253717620933985
[ 10 ] Sarkar, K. (2020, June 4). As Covid-19 cases rise, makeshift hospitals need to be set up: Centre tells SC. Hindustan Times. https://www.hindustantimes.com/india-news/as-covid-19-cases-rise-makeshift-hospitals-need-to-be-set-up-centre-tells-sc/story-N6WmtOIv68PsfKMdHEEvpK.html
[ 11 ] Wu, P., Fang, Y., Guan, Z., Fan, B., Kong, J., Yao, Z., Liu, X., Fuller, C. J., Susser, E., Lu, J., & Hoven, C. W. (2009). The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 54(5), 302–311. https://doi.org/10.1177/070674370905400504
[ 12 ] Chen, N., Wang, P., Hsieh, M., Huang, C., Kao, K., Chen, Y., & Tsai, Y. (2007). Impact of Severe Acute Respiratory Syndrome Care on the General Health Status of Healthcare Workers in Taiwan. Infection Control & Hospital Epidemiology, 28(1), 75-79.  https://doi.org/10.1086/508824
[ 13 ] Soni, P. (2020, May 21). Doctors fighting COVID-19 got upto 50% pay cut — and some of them haven’t been paid yet. Business Insider. https://www.businessinsider.in/india/news/doctors-fighting-covid-19-got-upto-50-pay-cut-and-some-of-them-havent-been-paid-yet/articleshow/75838969.cms
[ 14 ] Sakhadeo, D. (2020, April 2). Healthcare workers attacked as fears about coronavirus take hold of India. Global Voices. https://globalvoices.org/2020/04/02/healthcare-workers-attacked-as-fears-about-coronavirus-take-hold-of-india/#
[ 15 ] Ellis-Peterson, H. & Rahman, S. A. (2020, March 30). Indian doctors being evicted from homes over coronavirus fears. The Guardian. https://www.theguardian.com/world/2020/mar/30/indian-doctors-being-evicted-from-homes-over-coronavirus-fears
[ 16 ] Biswas, S. (2020, July 19). India coronavirus: 'Our neighbours made us Covid-19 pariahs'. BBC News. https://www.bbc.com/news/world-asia-india-53418762
[ 17 ] Clarke, V. & Braun, V. (2013). Teaching thematic analysis: Overcoming challenges and developing strategies for effective learning. The Psychologist, 26, 120-123.
[ 18 ] Complaints from states that people becoming lax in taking Covid-19 precautions: Health ministry. (2020, September 8). The Times of India. https://timesofindia.indiatimes.com/india/complaints-from-states-that-people-becoming-lax-in-taking-covid-19-precautions-health-ministry/articleshow/77998692.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst
[ 19 ] Weinstein N. D. (1987). Unrealistic optimism about susceptibility to health problems: conclusions from a community-wide sample. Journal of behavioral medicine, 10(5), 481–500. https://doi.org/10.1007/BF00846146
[ 20 ] McKenna, F. P., Horswill, M. S., & Alexander, J. L. (2006). Does anticipation training affect drivers' risk taking?. Journal of experimental psychology. Applied, 12(1), 1–10. https://doi.org/10.1037/1076-898X.12.1.1
[ 21 ] Sharf, B. F., Stelljes, L. A. & Gordon, H. S. (2005). 'A little bitty spot and I'm a big man': patients' perspectives on refusing diagnosis or treatment for lung cancer. Psychooncology, 14(8), 636-46. https://doi.org/10.1002/pon.885
[ 22 ] Thacker, T. (2020, September 1). Indian Medical Association urges PM Modi to give government jobs to children of 'martyr' doctors. The Economic Times. https://economictimes.indiatimes.com/news/politics-and-nation/indian-medical-association-urges-pm-modi-to-give-government-jobs-to-children-of-martyr-doctors/articleshow/77878501.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst
[ 23 ] Ahmedabad: Doctors at SVP strike work over N95 masks. (2020, May 13). The Times of India. https://timesofindia.indiatimes.com/city/ahmedabad/gujarat-doctors-at-svp-strike-work-over-n95-masks/articleshow/75706834.cms
[ 24 ] Acharya, R. & Porwal, A. (2020). A vulnerability index for the management of and response to the COVID-19 epidemic in India: an ecological study. The Lancet Global Health, 8(9), 1142-1151. https://doi.org/10.1016/S2214-109X(20)30300-4
[ 25 ] Facing 'Social Boycott', Himachal Man Hangs Self Day After Testing Negative for Coronavirus. (2020, April 5). News18 India. https://www.news18.com/news/india/facing-social-boycott-himachal-man-hangs-self-to-death-day-after-testing-negative-for-coronavirus-2565349.html
[ 26 ] No posters outside houses of isolated patients will help reduce COVID-19 stigma: Experts. (2020, October 9). The Economic Times. https://economictimes.indiatimes.com/news/politics-and-nation/no-posters-outside-houses-of-isolated-patients-will-help-reduce-covid-19-stigma-experts/articleshow/78574180.cms?from=mdr
[ 27 ] Cabinet okays ordinance to protect frontline workers. (2020, April 22). The Economic Times Bureau. https://economictimes.indiatimes.com/news/politics-and-nation/govt-brings-ordinance-making-attack-on-doctors-paramedic-staff-punishable-up-to-7-years/articleshow/75291953.cms?from=mdr
[ 28 ] Scenes from Indian Air Force flypasts around the country to thank frontline health workers. (2020, March 3). Scroll. https://scroll.in/video/960902/watch-scenes-from-indian-air-force-flypasts-around-the-country-to-thank-frontline-health-workers
[ 29 ] McAbee R. (1991). Occupational stress and burnout in the nursing profession. A model for prevention. AAOHN journal: official journal of the American Association of Occupational Health Nurses, 39(12), 568–575. PMID: 1747166.
[ 30 ] Philip, J. & Cherian, V. (2020). Factors Affecting the Psychological Well-being of Health Care Workers during an Epidemic: A Thematic Review. Indian Journal of Psychological Medicine, 42(4), 323-333. https://doi.org/10.1177/0253717620934095
[ 31 ] Maunder, R. G., Lancee, W. J., Balderson, K. E., Bennett, J. P., Borgundvaag, B., Evans, S., Fernandes, C. M., Goldbloom, D. S., Gupta, M., Hunter, J. J., McGillis Hall, L., Nagle, L. M., Pain, C., Peczeniuk, S. S., Raymond, G., Read, N., Rourke, S. B., Steinberg, R. J., Stewart, T. E., VanDeVelde-Coke, S. & Wasylenki, D. A. (2006). Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerging infectious diseases, 12(12), 1924–1932. https://doi.org/10.3201/eid1212.060584.
[ 32 ] Wong, T. W., Yau, J. K., Chan, C. L., Kwong, R. S., Ho, S. M., Lau, C. C., Lau, F. L., & Lit, C. H. (2005). The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope. European journal of emergency medicine: official journal of the European Society for Emergency Medicine, 12(1), 13–18. https://doi.org/10.1097/00063110-200502000-00005