Perceived stressors and outcomes among professionals working from home during COVID-19 pandemic in India

INTRODUCTION

At the end of 2019, Wuhan city in China also an evolving business hub of China been through an outbreak of a novel coronavirus due to which many people lost their lives and infected thousand individuals within the first fifty days of the epidemic.¹ Novel coronavirus is also known as severe acute respiratory syndrome human Coronavirus 2 (SARS-CoV-2). Its primary host were considered to be Bats in Wuhan, China. WHO declared it a public health emergency of international concern on 30^th January 2020. On 11^th February, WHO announced a name for the new corona virus disease COVID -19, On the 11^th of March, WHO declared COVID-19 a pandemic as by then about 114 countries were affected via human-to-human transmission by droplet nuclei. Its incubation period ranges up to 14 days and the main symptoms of COVID-19 disease noticed as atypical pneumonia, fever, difficult breathing, decreased SPO2 level and ultimately death due to respiratory failure depending upon immune status of the patients.² Government of India is taking all obligatory steps to safeguard the country and is effective and adopting various measures to face the challenge and menace postured by the growing pandemic of COVID-19 the Corona Virus.³

COVID-19 pandemic is having a profound effect on all aspects of society, including mental health and physical health. Although a rise in symptoms of anxiety and coping responses to an anxiety expected during these extraordinary circumstances, there is a risk that prevalence of clinically relevant numbers of people with anxiety, depression, and engaging in harmful behaviors (such as suicide and self-harm) might increase. ⁴ There is a massive transmission of fake news about COVID-19 over social media sites (WhatsApp, Twitter, Facebook) and this has created an anxious atmosphere all over the world. This anxious atmosphere is affecting the daily lives of people all around the world. “It is now crystal clear that mental health needs must be treated as a core element of our response to and recovery from the COVID-19 pandemic,” “There is also a need of collective responsibility of governments of all countries and public society, with the backing of United Nations, said Dr. Tedros Adhanom Ghebreyesus. WHO-director general.”⁵

As we know that, COVID-19 virus is highly contagious and have enforced countries for complete shut-down to prevent its transmission, this has led to an immense public reaction in the history ever, which have also impacted mental health a lot among individuals. In these testing times anxiety and concerns about pandemic in society are affecting every individual globally to inconstant level.⁶ Government and concerned authorities all over the world have urged people to remain calm and take all precautions while keeping them isolated inside their homes, Government of India is also updating information on about COVID-19 on its official website, ‘https://www.mygov.in/covid-19/’ which provides all the necessary and relevant information related to the pandemic to prevent and control anxiousness over these times. The website has videos and readable material about the infection and measures which needs to be undertaken to control the transmission. This is helping citizens to know factual information only rather than panicking over false information. Due to this lockdown, most of the professions have opted for work from home to keep the world of work and regular life going. This is not the first time where people are working from home but complete lockdown have very first time enforced all professionals to work from home, especially in India. Professionals like IT personnel’s, engineers, human resource professionals, school teachers, college professors taking classes online, are working from home. Evidently, work from home enables to comply with the guidelines issued by WHO as well as government of India in terms of social distancing and keeping isolation from the outer world. Work from home has been instrumental in maintaining the social distancing norms which would have been impossible otherwise.

As, this crisis phase is an entirely a new experience for people around the world and most of the people who are working from home are going through lot of changes resulting into negative as well as positive outcomes too. Recent studies have also revealed that Coronavirus disease 2019 (COVID-19) pandemic is the most stressful time of entire professional career of some people, which has leads to stark increase in new prescriptions of antidepressants, antianxiety, and anti-insomnia medications. While many people and professionals have picked upon their lost interests or developed some new skill.⁷ The mental health issues are one of the major health concerns, which are also expected to increase day by day during this pandemic. Although it’s been around three months now in this new normal, professionals are working from home, they have experienced a range of emotions from affected job satisfaction, adjusting to work from home environment to incorporating some new behaviors in this time, which might turn in to new habits hopefully. During this time, generally many of us are constantly monitoring news and social media feeds, which might turn compulsive and counterproductive in some people resulting in increasing anxiety rather than easing it.⁸

Many articles on social media and personal experiences of professionals have also revealed that, they developed effectiveness in work from home and found great joy in newly developed life skills. Eventually many organizations and human resource departments are also planning and conducting webinars for professionals working from home to increase and update their knowledge about online work and for teachers about online classes management and also about how to relieve stress and remain anxiety free during these times. Many organizations have adopted for virtual Yoga teachings and engaging professionals in fun activities to keep them engaged with their colleagues and office environment. Professionals are also overly afraid over reopening of firms and workplace, therefore concerned government authorities and firms are advising people who are having anxiety over these uncertain times while working from home to limit social media consumption to a specific time frame and time of day to keep mental health intact in this lockdown period and testing times of pandemic Narayan et al.⁹

It is now evident that professionals have gone through a range of emotions and experiences that they have experienced very first time in life altogether, which include stressors related to Job, related to social life, physical changes and then fortunately there are some positive outcomes too.¹⁰ Bearing in mind, all above mentioned to points, this study was solely planned and conducted for the professionals who are working from home to know and study about the impact of working from home on their mental and physical health. The study has focused on knowing and analyzing all experiences and interventions can be planned in future for a better work from home experience and be ready such times in future. In this study, we have assessed the stressors that are perceived while working from home, negative as well as positive outcomes since one has to manage work home life simultaneously in such times.

METHODS

This was a quantitative approach, cross-sectional study carried out in India. A convenient and snowball sampling technique was used to include participants. Professionals who were working from home are the participants of study. An online self-reporting structured questionnaire was developed by using google for and a consent to participate in study was affixed to it. The link of google form questionnaire was generated and sent through emails, WhatsApp and other social media to the contacts of the researchers/investigators. As, it is an online study, this is the link, https://forms.gle/j2vCKZNQWCZtdR767, that has been shared along with a message explaining about research study. All the participants were requested and encouraged to roll out the survey to as many people as possible. Therefore, the google form link was forwarded to professionals apart from the first point of contact and so on. The professionals who are participants got auto directed to information about study and informed consent too on receiving and clicking the link of google form. Once they accepted and gave consent to be part of this survey, they filled up the asked socio-demographic details and then consecutively, a set of questionnaires appeared, containing questions under following four main domains: job stressors, social stressors, physical stressors and positive outcomes, which the participants were to answer. Participants with age 20 years or more, able to understand English and willing to give informed consent were included. The data collection was initiated on 27^th May 2020 at 9.30 am IST and closed on 4^th June 2020 at 4 PM IST. We were able to collect data from across various states of India specially from North India.

The tool contained two main sections, section 1 is socio-demographic variables which included age, gender, occupation, area of residence, zone of residence according to GOI and working from home (hours in a day). Section II contained perceived stressors and outcomes under four main domains: job stressors contained seven items (productivity during lockdown, job satisfaction, insecurity related to job and salary, delay in work, ineffective concentration, worry about hacking and phishing while working online, network issues), Social stressors contained five items (missing out regular life, increase exposure to screen, excessive use of social media, information overload, ineffective personal and professional roles), physical stressors contained eight items (eyes sight affected, gained weight, sleep cycle disturbed, pains, episodes of increased heart rate, difficulty to concentrate, procrastination, feeling of being disconnected from your friends and extended family), positive outcomes (learnt new dishes, new hobby, self-time, comfortable work from home, technical skills improved, physical issues diminished, better time management, new life skill, quality time with family, better home care, healthy eating, concentrating on new ideas and life goals), While working from home during pandemic of the novel coronavirus. The respondents/participants were asked to answer or choose as Yes, No and uncertain about any change or perceived stressor or outcome. Descriptive statistics have been used in the study to analyse the findings. Inferential statistics also used to find out whether there is any association of any stressors or outcome with selected demographic variable.

RESULTS

This is one-of-a-kind studies during this lockdown due to pandemic which focussed only on professionals working from home. This study is an online survey done exclusively to assess perceived stressors and outcomes while working from home was conducted among professionals in the Indian population. A total of 284 responses were recorded. All the participants were above 20 years age and of Indian origin. The study included only those participants who are working from home be it of any profession. The respondents of study included professionals working from home Professionals working from home whether of university, school, IT Firms, as lawyers, HR personnel’s, lawyers, engineers, administration departments etc.

Frequency and percentage of socio demographic variables

In this study, as shown in Figure 1, majority of respondents working from home were 123 in age group of 26-30 followed by 55 (41.2%) participants in age group 31 to 35 years. Among respondents, females were 172 (60.4%) and males were 112 (39.4%). Study includes respondents from most of professions who have worked from home, in which majority belonged to any other group and that were 96 (33.8%) which included human resource department professionals, receptionists, own firm or business, content creators on social media. Followed by, 82 (28.9%) participants were lecturers and so on. Most of the respondents were residing in urban area were 235 (82.7%) and 49 (17.3%) in rural area. As per zone of area of residence during pandemic according to no. of COVID cases set by government, 61 participants were in red zone (21.5%), 93 participants in orange (32.7%), 16 participants (5.6%) in green and containment zone respectively. 161 (56.7%) participants were working for 8-11 hours a day, 101 (35.6%) participants were working for 4-7 h a day and 22 (7.7%) participants for 12 h and above a day during work from home.

Frequency and percentage of job-related stressors

As shown in Table 1, many respondents have experienced stressors related to their job during work from home, in which 130 (45.8%) participants/respondents agreed that their productivity reduced during work from home and 35 (12.3%) participants were uncertain about it. Job satisfaction has been affected in 161 (56.7%) and 102 (35.9%) said No. Most of the professionals were not delaying their work during work from home as 164 (57.7%) participants said No, 104 (36.6%) participants agreed that they started delaying work while working from home. 108 (38.8%) respondents were not able to concentrate effectively in online meetings and most of them were able to concentrate 138 (47.2%) participants said yes and 42 (14.8%) participants were not certain. 138 (48.6%) participants were worried about hacking and phishing scams as lot of apps are being used like zoom, web ex, etc., 110 (38.7%) were not worried at all and 36 (12.7%) were uncertain about hacking or phishing. 167 (48.5%) participants were facing network issues while working or attending any meeting online, 94 (33.1%) participants were not facing and issue and 23 (9.1%) were not clearly certain about it.

Frequency and percentage of social stressors

As shown in Table 2, While working from home, professionals have experienced many social stressors within and around, 222 (78.2%) participants have said that they are missing out on regular life like hanging out. Exposure to screen has increased due to working online among 247 (87%) participants whereas 25 (8.8%) were not affected by exposure to screen. 202 (71.1%) participants were using excessive social media during working from home and 17 (22.2%) were not certain about use of social media. 165 (58.1%) participants have experienced anxiety due to information overload about COVID-19. 150 (52.8%) professionals have experienced ineffective personal and professional roles during work from home and 86 (30.3%) were able to manage their roles well.

Frequency and percentage of physical stressor

In Table 3, while working from home, most people experience some sedentary lifestyle, physical stressors have also been assessed. Among professionals, 155 (54.6%) had agreed that their eye sight is being affected during work from home maybe because of excessive exposure to screen time. 141 (49.3%) have gained weight, 191 (673%) participants have gone through disturbed sleep cycle while 3 (1.1%) are uncertain about it. There are some who have also gone through episodes of increased heart rate, stomach upset, fatigue, or other uncomfortable sensations may be due to information overload about COVID everywhere on social media, 99 (34.9%) participants said yes to have experienced this. Since home environment seems to increase urge to rather relax frequently, 110 (38.7%) participants agreed to procrastinate during this time whereas most of them were able to efficiently work without procrastination, 127 (44.7%) disagree to procrastination. 143 (50.4%) were not able to concentrate/focus on one thing at a time while working from home. Majority of them (174) were having a feeling of being disconnected from friends and extended family members during these times.

Frequency and percentage of positive outcomes

As shown in Table 4, Apparently, lockdown and work from home have enable people time to recreate, reorganize, re think and re learn. So, this survey also assessed positive outcomes also to focus on the positive side of work from home and lockdown. 211 (74.3%) professionals said yes to have learnt new dishes during this time. 171 (60.2%) participants started with a new hobby and 177 (62.3%) participants giving more time to themselves in a long time. 145 (51.1%) have developed comfort in working from home and 187 (65.8%) improved their technical skills while working online from home. 125 (44%) participants improved their time management skills too. 174 (61.3%) have learnt and started Practicing any new life skill in these times and 204 (71.8%) participants have agreed that they are now spending quality time with their respective families. Home care is better than before now among 208 (73.2%) professionals and 220 (70.8%) are now eating healthy. And 201 (70.3%) participants have been able to concentrate and plan on new ideas and life goals now as they are getting more time for self.

DISCUSSION

Preparing for a pandemic is challenging because of a multiple factors and threat it may cause.¹¹ This once in a century crisis situation due to pandemic has affected people all over the world both physically and mentally. Its contagious nature has forced for complete shutdown and impacted direct human to human communication, which have been perceived as gloomy by most of the world.

There are studies conducted to assess stress and anxiety on general population, such as Zhang et al. evaluated the immediate impact of the COVID-19 pandemic on mental health and quality of life among local Chinese residents aged ≥18 years in Liaoning province, mainland China using an online survey between January and February 2020. Study is based on a total of 263 participants and majority of participants, 52.1% of participants felt horrified and apprehensive due to the pandemic.¹² Odriozola-González et al evaluated the psychological impact of COVID-19 in the university community during the first weeks of using an online survey with 2530 members of the university of Valladolid, in Spain. A total of 50.43% of respondents presented moderate to severe impact of the outbreak.¹³ Roy et al conducted study to assess the knowledge, attitude, anxiety experience, and perceived mental healthcare need among adult Indian population during the COVID-19 pandemic. The anxiety levels identified in the study were high. More than 80% of the people were preoccupied with the thoughts of COVID-19, in their study, sleep difficulties, paranoia about acquiring COVID-19 infection and distress related social media were reported in 12.5, 37.8 and 36.4% participants respectively.¹⁴

Consistent findings were presented in our study where participants were affected with many kind of stressors, 130 (45.8%) respondents’ productivity reduced during work from home. 222 (78.2%) participants have said that they are missing out on regular life like hanging out. 202 (71.1%) participants were using excessive social media during working from home. 143 (50.4%) participants were not able to concentrate or focus on one thing at a time and 174 participants were having a feeling of being disconnected from friends and extended family members during these times.

To our knowledge, our study is one first one to investigate the stressors professionals going through during this time. The study findings have analysed that most of the professionals while working from home need coping strategies while working from home and here are some following tips to cope with those stressors in these unprecedent times for professionals: practice self-care, get enough sleep, regular exercise (maybe simple indoor exercises), eat well and drink plenty of water (hydrated), try mindfulness apps, find ways to focus, establish a routine, take breaks and be kind to yourself, take your time to grieve and don’t lose hope for future. Be hopeful, don’t get anxious about “what next?”, have meals on time, take a bath in the first half of day and keep your day as normal working day, take 10 minutes a day, turn off smart phone, power down television, and simply be, practice deep breathing as deep breaths are helpful and help us to centre our thoughts, stay hydrated, avoid excessive caffeine, talk about your feelings and have a good deep conversations with family, sit with your elders and learn new life skills, don’t medicate yourself on your own, keep in touch with workers, create a regular work schedule and a mini home office space, Follow guidelines given by govt during lockdown and educate everyone around you, enhance immunity by having immunity booster natural foods and drinks, Educate and help in seeking information for everyone around, seek help when needed.^15,16

The findings of our study might help in raising awareness and address the mental health issues of people during this COVID-19 pandemic. The results of the research study focus on to develop intervention plan to relieve anxiety among professionals as well as general public. The right step at right time with right support can help in fostering resilience among professionals, and encourage them to know their ability to manage stressors in during such times of crisis. Our health care experts should also focus on to expand mental health support and widen the in scope for easy access to general public and address general public about keeping mental health intact. A mass awareness, acceptance of public reaction during such unique crisis and working in this direction is the need of the hour.

Limitations

The study could not be done a larger sample size and limited to mostly north Indian states. The investigators didn’t use Likert scale for assessment of stressors which would have been more appropriate to assess exact feelings of professionals.

CONCLUSION

India, right now is going through a perplexing situation, number of infected/positive cases is increasing day by day. Most of the IT firms, private companies, schools and college teachers/lecturers are working from home. With strict preventive measures and restrictions by government in the form of nationwide lockdown, the citizens have experienced a range of psychological reactions and the present study focused on assessing those stressors and outcomes. Indeed, it is extremely important to have intact mental health to focus and work from home without panicking in these times of crisis. This is the only study that assessed the factors that are impacting mental health of professionals and also assessed some positive outcomes, professionals were able to experience and inculcate new life skills in their life.

ACKNOWLEDGEMENTS

The authors would like to thanks all the participants who agreed to be part of this study.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

REFERENCES

1. 1. Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res. 2020;24:91-8.
2. 2. Yadav D, Yadav R. Review of Novel Coronavirus Disease (COVID-19) in India on. Eurasian J Med Investig. 2020;4(3):284-8.
3. 3. Maheshwari S, Kumar Gupta P. Knowledge, attitude, and practice towards coronavirus disease 2019 (COVID-19) among medical students: A cross-sectional study. J Acute Dis. 2020;9(3):100-4.
4. 4. Varshney M, Thomas Parel J. Initial psychological impact of COVID-19 and its correlates in Indian Community: An online (FEEL-COVID) survey. Plos one. 2020.
5. 5. Xiang Y-T, Yang Y, Li W, Zhang L. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7:228-9.
6. 6. Erick T, Baloran. Knowledge, Attitudes, Anxiety, and Coping Strategies of Students during COVID-19 Pandemic. J Loss Trauma. 2020;25(8):635-42.
7. 7. Yeen H, Ning Z. Chinese mental health burden during the COVID-19 pandemic. Asian J Psychiatry. 2020;51:102052.
8. 8. Praveen M. Work from home stressful for most, finds survey. The Hindu.2020 June 02. Available from: https://www.thehindu.com/news/cities/Kochi/work-from-home-stressful-for-most-finds-survey/article31726942.ece. Accessed on 14 Oct, 2020.
9. 9. Narayan J. Work from home taking a toll on you? Here’s how people and firms are tackling it. The Indian Express. 2020 May18. Available from: https://indianexpress.com/article/lifestyle/life-style/coronavirus-lockdown-work-from-home-household-chores-stress-anxiety-panic-mental-health-cope-6351708/. Accessed on 14 Oct, 2020.
10. 10. De Oliveira Araújo FJ, De Lima LSM, Cidade PIM, Nobre CB, Rolim Neto ML. Impact of Sars-Cov-2 And Its Reverberation in Global Higher Education and Mental Health. Psychiatry Res. 2020;288:112977.
11. 11. Singhal T. A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediat. 2020;87(4):281-6.
12. 12. Zhang Y, Feei Ma Z. Impact of the COVID-19 Pandemic on Mental Health and Quality of Life among Local Residents in Liaoning Province, China: A Cross-Sectional Study. Int J Environ Res Public Health. 2020;17(7):2381.
13. 13. Odriozola-González P, Planchuelo-Gómez A, Irurtia MJ, De Luis-Garcíab R. Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university. Psychiatry Res. 2020;290:113108.
14. 14. Roy D, Tripathy S, Kar SK, Sharma N, Verma SK, Kaushalb V. Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic. Asian J Psychiatry. 2020;51:102083.
15. 15. Dickerson D. Seven tips to manage your mental health and well-being during the COVID-19 outbreak. Nature. 2020.
16. 16. Hirematha P, Suhas Kowshika CS, Manjunath M, Shettar M. COVID 19: Impact of lock-down on mental health and tips to overcome. Asian J Psychiatry. 2020;51:102088.