BACKGROUND
Depression, anxiety and somatization are the most common mental disorders in primary care as well as medical specialty populations; each is present in at least 5-10% of patients and frequently comorbid with one another. An efficient means for measuring and monitoring all three conditions would be desirable.


METHODS
Evidence regarding the psychometric and pragmatic characteristics of the Patient Health Questionnaire (PHQ)-9 depression, generalized anxiety disorder (GAD)-7 anxiety and PHQ-15 somatic symptom scales are synthesized from two sources: (1) four multisite cross-sectional studies (three conducted in primary care and one in obstetric-gynecology practices) comprising 9740 patients, and (2) key studies from the literature that have studied these scales.


RESULTS
The PHQ-9 and its abbreviated eight-item (PHQ-8) and two-item (PHQ-2) versions have good sensitivity and specificity for detecting depressive disorders. Likewise, the GAD-7 and its abbreviated two-item (GAD-2) version have good operating characteristics for detecting generalized anxiety, panic, social anxiety and post-traumatic stress disorder. The optimal cutpoint is > or = 10 on the parent scales (PHQ-9 and GAD-7) and > or = 3 on the ultra-brief versions (PHQ-2 and GAD-2). The PHQ-15 is equal or superior to other brief measures for assessing somatic symptoms and screening for somatoform disorders. Cutpoints of 5, 10 and 15 represent mild, moderate and severe symptom levels on all three scales. Sensitivity to change is well-established for the PHQ-9 and emerging albeit not yet definitive for the GAD-7 and PHQ-15.


CONCLUSIONS
The PHQ-9, GAD-7 and PHQ-15 are brief well-validated measures for detecting and monitoring depression, anxiety and somatization.

Iconography : The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review

Readiness for Online Learning during COVID-19 pandemic: A survey of Pakistani LIS students

Introduction In present days, the use of information technology (IT) in education is unquestionable. The mounting advancement of IT has changed the scenario of education. With the emergence of the current COVID-19 situation, it has undoubtedly provided a solution to most of our educational needs when all educational institutions remained closed due to the pandemic. This study aims to identify the nursing students' attitude towards the practice of e-learning amidst COVID-19. Methods A descriptive web-based cross-sectional study was conducted among nursing students with a sample size of 470. A self-administered validated questionnaire along with a standard tool to measure the attitude was used for data collection. Data were analyzed using SPSS. Results The mean ± SD age of the respondents was 20.91± 1.55 years. The majority (76.4%) of the respondents used mobile for their study and 90.4% used Wi-Fi for the internet source. The main advantage of e-learning was stated as the ability to stay at home (72.1%) followed by the reduced cost of accommodation and transport (51.3%) whereas the internet problem (81.7%) was the major disadvantage followed by technical issues (65.5%). Only about 34% of the students found e-learning as effective as traditional face-to-face learning. The mean scores for the domains: perceived usefulness, intention to adapt, distant use of e-learning, ease of learning, technical support, and learning stressors were 3.1, 3.1, 3.8, 2.9, 2.9, and 2.5 respectively. Overall, 58.9% had a favorable attitude regarding e-learning. There was no significant association of overall attitude regarding e-learning with selected socio-demographic variables whereas it was positively associated with all of its six domains. All the domains were positively correlated with each other except for ease of learning with technical support and distant use, and technical support with learning stressor and distant use. Learning stressor versus distant use was negatively correlated with each other. Conclusion Though e-learning was implemented as a substitute during the pandemic, almost half of the nursing students showed a positive attitude regarding e-learning. The majority of the students had internet problems and technological issues. If e-learning can be made user-friendly with reduced technical barriers supplemented with programs that can enhance practical learning abilities, e-learning can be the vital alternative teaching method and learning in the nursing field.

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Nursing students' attitude on the practice of e-learning: A cross-sectional survey amid COVID-19 in Nepal.

With the advent of COVID-19 arose the need for social distancing measures, including the imposition of far-reaching lockdowns in many countries. The lockdown has wreaked havoc on many aspects of daily life, but education has been particularly hard hit by this unprecedented situation. The closure of educational institutions brought along many changes, including the transition to more technology-based education. This is a systematic literature review that seeks to explore the transition, in the context of the pandemic, from traditional education that involves face-to-face interaction in physical classrooms to online distance education. It examines the ways in which this transition has impacted academia and students and looks at the potential long-term consequences it may have caused. It also presents some of the suggestions made by the studies included in the paper, which may help alleviate the negative impact of lockdown on education and promote a smoother transition to online learning.

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Analytical study on the impact of technology in higher education during the age of COVID-19: Systematic literature review.

The outbreak of COVID-19 affected almost every sector, including higher education institutions across the world particularly Afghanistan educational system. For this purpose, the researcher aimed to investigate the effects of COVID-19 on the academic performance of Afghan students and their level of satisfaction with online teaching. It also explored the significant difference in academic performance of students along with their satisfaction level with online teaching across gender. There were 1231 respondents, including 867 males and 364 females, from public and private universities of Afghanistan. Descriptive and inferential statistical analyses were employed. The findings of the study revealed that COVID-19 has negatively affected the academic performance of Afghan students and the students were highly dissatisfied with online teaching during this critical moment. Besides, the study revealed significant differences in the academic performance of students and their level of satisfaction with online teaching across gender. A strong positive correlation was found between the academic performance of Afghan students and their level of satisfaction with online teaching during the COVID-19 outbreak. According to the findings of the study, several implications and recommendations have been provided. © 2021 The Author(s). This open access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.

https://www.tandfonline.com/doi/pdf/10.1080/23311983.2021.1933684

Effects of COVID-19 on the academic performance of Afghan students’ and their level of satisfaction with online teaching

Background:: Online learning can play a vital role in the process of teaching and learning during Corona Virus Disease 2019 (COVID-19) pandemic However, learners' satisfaction is extremely important in effective implementation of the online learning, especially at institutions where it is newly adopted

Online learning in the face of COVID-19 pandemic: assessment of students' satisfaction at Chitwan Medical College of Nepal. (COVID-19 special issue.)

Background Online learning can play a vital role in the process of teaching and learning during Corona Virus Disease 2019 (COVID-19) pandemic. However, learners' satisfaction is extremely important in effective implementation of the online learning, especially at institutions where it is newly adopted. Objective To assess satisfaction towards online learning and its predictors among students at Chitwan Medical College, Bharatpur. Method A web-based cross-sectional survey was undertaken among 434 undergraduate and postgraduate students from various academic programs who had participated in the online classes started during this COVID-19 pandemic. A structured questionnaire consisting of 31 items (5-point Likert scale) covering four major student satisfaction domains (learners' dimensions, technological characteristics, instructors' characteristics and course management and coordination) was distributed to the students using Google Form. Result More than half (53.5%) of the students were satisfied with the online learning, while 29.7% gave neutral views. Bivariate analyses found that all four domains scores were positively correlated with each other as well as with the students' overall satisfaction towards learning. In multivariate analysis, female gender [aOR: 2.72, p = 0.013], WiFi as internet modality for learning [aOR: 3.36, p = 0.001) and learners' dimension score [aOR: 1.27, p<0.001] were the significant predictors of students' satisfaction. Conclusion Although recently adopted, the satisfaction of the students towards online classes appears good, and prioritizing the identified predictors and working on the weak links could assist in enhancing students' satisfaction and better outcomes.

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Online learning in the face of COVID-19 pandemic: Assessment of students’ satisfaction at Chitwan medical college of Nepal

The prevalence of depression and anxiety disorders is common among people with diabetes mellitus. Coexistence of diabetes and depression/anxiety increases the risk of diabetes complications and reduces the overall quality of life. Hence, this study aimed to assess the depression and anxiety among patients with type 2 diabetes mellitus in Chitwan. Descriptive survey was carried out among 296 purposively selected clinically diagnosed type 2 diabetes patients admitted in the Chitwan Medical College Teaching Hospital from 15th June 2018 to 17th September 2019. Patients were interviewed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7). Data were analyzed using descriptive and inferential statistics. Of 296 diabetic patients, 48.6% were 60 years and above, 59.5% female and 61.5% literate; their common occupation was agriculture (38.2%) followed by household work (26.4%). Nearly two-thirds (62.8%) of diabetes patients had other chronic comorbid conditions. Depression and anxiety were observed among 57.8% and 49.7% of diabetes patients, respectively. While observing the severity, 27.4%, 19.6%, 8.4%, and 2.4% of patients had mild, moderate, moderately severe, and severe depression, respectively. Likewise, 24.7%, 20.3%, and 4.7% of patients had mild, moderate, and severe anxiety, respectively. Current living status, educational status, medicine adherence, satisfaction toward current treatment, and history of mental illness in the family were found to be significant factors associated with the anxiety of patients with diabetes. Further, educational status, smoking habit, satisfaction towards current treatment, and history of diabetes in family were the factors associated with depression. Prevalence of depression and anxiety is high among admitted patients with diabetes mellitus, and many factors are associated with it. Hence, regular screening services are essential along with diabetes management plan for timely identification and treatment of the vulnerable groups in the healthcare centers.

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Depression and Anxiety among Patients with Type II Diabetes Mellitus in Chitwan Medical College Teaching Hospital, Nepal

Background: Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and has a significant impact on an individual’s quality of life.

Objective: To assess the quality of life of patients suffering from chronic obstructive pulmonary disease in Chitwan, Nepal.

Materials and Methods: A cross-sectional hospital-based study was conducted in a private hospital among 40 patients with chronic obstructive pulmonary disease. Data were collected from August 6, 2014, to August 7, 2014, using a pretested instrument (α = 0.954) with 56 items answered on five-point rating scales. The total score varied from 0 (worst) to 100 (best). The data were analyzed using descriptive and inferential statistics.

Result: The mean score of the total quality of life was 54.97 ± 13.83, while 47.80 ± 16.66 was for physical, 59.26 ± 12.69 for social, and 59.51 ± 15.17 for psychological domains, which showed a higher impairment on physical health. In subscales, the mean score of quality of life was higher on social support (67.34 ± 12.30), whereas lower on symptoms (45.76 ± 19.09) and activities (48.44 ± 18.0 for social and 49.32 ± 16.84 for physical). The quality of life was significantly higher among the patients aged 60–69 years, literate, absence of comorbidity, absence of hospital admission, and not on regular medicine, whereas the quality of life was not associated with sex, marital status, residence, income, duration of diagnosis, and smoking status.

Conclusion: Patients with chronic obstructive pulmonary disease have an impaired quality of life on physical health compared with psychological and social health because of frequent symptoms and limitations on physical activities. Hence, physical health and factors affecting the quality of life need to be considered while planning interventions to improve the quality of life of patients.

Quality of life of patients with chronic obstructive pulmonary disease in Chitwan, Nepal: a pilot study report

Psychiatric morbidity such as anxiety and depression is common among patients with coronary artery disease (CAD). The coexistence of psychiatric morbidity negatively affects the outcome of treatment and increases the overall burden of disease in CAD patients. The objective of the study was to identify the level of anxiety and depression among patients with CAD. Descriptive, cross-sectional research design and purposive sampling were used and a total of 168 patients having coronary artery disease were selected purposively for the study from the patients attending cardiac outpatient department of Sahid Gangalaal National Heart Center, Kathmandu, Nepal. Data was collected on 2017 by using pretested semistructured interview schedule, Hospital Anxiety and Depression Scale. The findings showed that 27.4% of the respondents had anxiety caseness and 23.8% of the respondents had depression caseness. Bivariate analysis showed that patient’s level of anxiety was significantly associated with sex, family income, occupation status, and self-esteem. Higher level of anxiety (42.4%) was found in female than male patients. Likewise, level of depression was significantly associated with education status, occupation status, presence of comorbidities, physical exercise, and self-esteem of the patients. There was significant positive relationship between anxiety and depression score. Thus anxiety and depression were common among patients with CAD. Hence, anxiety and depression in CAD patients need be monitored regularly, provide regular counseling services, and refer the patients for the treatment when needed.

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Kalpana Sharma

Papers

Online learning in the face of COVID-19 pandemic: assessment of students' satisfaction at Chitwan Medical College of Nepal. (COVID-19 special issue.)

Online learning in the face of COVID-19 pandemic: Assessment of students’ satisfaction at Chitwan medical college of Nepal

Depression and Anxiety among Patients with Type II Diabetes Mellitus in Chitwan Medical College Teaching Hospital, Nepal

Quality of life of patients with chronic obstructive pulmonary disease in Chitwan, Nepal: a pilot study report

Anxiety and Depression Among Patients With Coronary Artery Disease Attending at a Cardiac Center, Kathmandu, Nepal