“Study to assess the level of depression among the post COVID recovery clients

aged 16 and above attending in medicine and chest OPD of Midnapore Medical
College & Hospital, Paschim Medinipur, West Bengal.”

By-

Part III

B.Sc Nursing students

Group - A

1. Arpita Roy
2. Anita Bera
3. Jinia Ojha
4. Moubani Roy
5. Moumita Mahanta
6. Somashree Barik
7. Sreta Samnta
8. Sulata Murmu

COLLEGE OF NURSING, MIDNAPORE MEDICAL COLLEGE &

HOSPITAL, PASCHIM MEDINIPUR

WEST BENGAL UNIVERSITY OF HEALTH SCIENCES

2021

1
 Certified that is a genuine work
Of
B.Sc Nursing 3rd year students
Group-A
College of Nursing, MMCH
Paschim Medinipur

Submitted in partial fulfilment of the requirement for the degree of

Bachelor of Science in Nursing from west Bengal university of Health
and Sciences.

...............................
Prof. Aparna Saha
Acting Prinipal
College of Nursing
Midnapore Medical College and Hospital
Paschim Medinipur

2
“Study to assess the level of depression among the post COVID recovery clients
aged 16 and above attending in medicine and chest OPD of Midnapore Medical
College & Hospital, Paschim Medinipur, West Bengal.”

By-
3rd year
B.Sc Nursing, MMCH
Group-A
College of Nursing, M.M.C.H
Paschim Medinipur

Guide..................... Guide.....................
Mrs. Jharna Bag Mrs. S. Mondal
Senior Lecturer Clinical Instructor
College of Nursing College of Nursing
Paschim Medinipur Paschim Medinipur

Submitted in partial fulfilment of the requirement for the degree of

Bachelor of Science in Nursing at the college of Nursing, Midnapore
Medical College and Hospital, Paschim Medinipur.

WEST BENGAL UNIVERSITY OF HEALTH AND SCIENCES

2021

3
 DECLARATION

We hereby declared that the dissertation entitled “Study to assess the level of
depression among the post COVID recovery clients aged 16 and above attending in
medicine and chest OPD of Midnapore Medical College & Hospital, Paschim
Medinipur, West Bengal” is the outcome of original research work undertaken and
aried out by us and the guidance of Mrs Jharna Bag, senior Lecturer of College of
Nursing, Midnapore Medical College and Hospital and Mrs. Shrabani Mondal,
Clinical Instructor of College of Nursing, Midnapore Medical College and Hospital.

We also declare that the material of this dissertation has not been formed
in any way the basis for award and any degree or diploma in this
university or any other universities.

Paschim Medinipur, West Bengal

Group A
1. Arpita Roy
2. Anita Bera
3. Jinia Ojha
4. Moubani Roy
5. Moumita Mahanta
6. Somashree Barik
7. Sreta Samnta
8. Sulata Murmu

4
ABSTRACT

5
 ACKNOWLEDGEMENT
I would like to thanks Madam
The study has been completed under the expert guidance and supervison
of Mrs. Jharna Bag, senior Lecturer of College of Nursing, Midnpore
Medical College, and Hospital and Mrs. Shrabani Mondal, Clinical
Instructor of College of Nursing, Midnpore Medical College and
Hospital.

6
 INDEX
CHAPTER CONTENT Page No.

Chapter- I  Introduction 8-11

 Background of the study
 Need of the study
 Problem statement
 Purpose of the study
 Objective of the study
 Operational definition
 Delimitation
Chapter-II  Review of literature 12-13
Chapter-III  METHODOLOGY 14-17
 Research approach
 Research design

 Development and
description of tools
 Pilot study
 Ethical consideration

Chapter-IV  DATA ANALYSIS 18-23

 Interpretation of tool-I
 Interpretation of tool-II

Chapter -V  DISCUSSION

Chapter - VI  CONCLUSION &
RECCOMENTION
 REFERNCE

 APPENDICES

CHAPTER I
INTRODUCTION
7
COVID-19 is an infectious disease caused by the SARS-COV-2 virus. It is being
increasingly recognized as a serious global health problem and it is declared to be
pandemic.

According to WHO, overall 99% of 736 district reported testing and 71.1% reported
COVID-19 cases.

Mental illness is maladjustment in living. It produces disharmony in the person’s

ability to meet human needs comfortably or effectively & function within a culture.
It actually encompasses numerous psychiatric disorders & can affect person of any
age, race, religion or income. Many people suffering from mental illness may not
look as though they are ill or that something is wrong.

Depression is common mental disorder that presents with mood, loss of interest and
pleasure, feeling of guilt, low self worth, low energy and poor concentration.
Depression is related to old age level of education, occupation, the problem of
everyday living and social problems.

BACKGROUND OF THE STUDY

Depression is likely the oldest and still one of the most frequently diagnosed
psychiatric illness. Symptoms of depression have been described almost as far as
there is evidence of written documentation.

Depression is a medical condition that affects a person’s thoughts and feelings as

well as the body. It can be associated with various physical problems, such as sleep,
appetite, libido and a variety of bodily discomforts.

Relation between COVID- 19 and depression has been integrated by many

researchers. Occurrence of depression among individuals with post COVID-19
recovery varies by age, socio-economic status among developed and developing
nation.

NEED OF THE STUDY

Depression is common problem among post COVID recovery patients. The findings
of present study will help in affective counselling and management of depression
8
among the post COVID recovery patients. The findings of the study will also
provide information for researcher in the area of depression in general.

The present study aims to assess the level of depression among post COVID
recovery patients at outdoor of MMCH, paschim Medinipur.

PROBLEM STATEMENT
“Study to assess the level of depression among the post COVID recovery clients
aged 16 and above attending in medicine and chest OPD of Midnapore Medical
College & Hospital, Paschim Medinipur, West Bengal ”

PURPOSE OF THE STUDY

To assess the level of depression among the post COVID recovery clients aged 16
and above attending medicine and chest outdoor department of Midnapore Medical
College & Hospital.

OBJECTIVES
 To assess level of depression among post COVID recovery clients.
 To assess the COVID vaccination status of the COVID recovery clients.

OPERATIONAL DEFINATIONS
 DEPRESSION
In our study depression is defined as a type of mood disorder where the
individual suffers from alteration in mood that is expressed by feelings of
sadness, despair and pessimism.
Depression is characterized by:
 Loss of interest in usual activities
 Reduced self esteem
 Changes in appetite
 Changes in sleep pattern
 Reduced concentration

 POST COVID CLIENTS

In our study Post COVID condition defined as an individual with a history of
probable or confirmed SARS CoV-2 infection, usually 3 months from the
9
onset of COVID-19 with symptoms and that last for at least 2 months and
cannot be explained by an alternative diagnosis.

DELIMITATION
The study was delimited to –
 Post COVID recovery patients available in the medicine outdoor in
MMCH during the period of data collection.
 Post COVID recovery patients available in the chest outdoor in MMCH
during the period of data collection.

CONCEPTUAL FRAMEWORK

10
 Conceptual framework presents logically constructed concepts to provide general
explanation of the relationship among the concepts of research study without using
a single existing theory.

INPUT PROCESS OUTPUT

Patients with following  Development Normal

demographic variables and validation
of tools
 Age
 Assessment of
 Sex Mild mood
level of
 Education disturbance
depression
 Religion
with
 Occupation administration
 Monthly Borderline
khkhk
of Beck’s
income clinical
Depression
 Type of family depression
Inventory
 Type of
residence Moderate
depression
 Relationship
with family
members
Severe
 Marital status
depression
 Social
relationship
with others
Extreme
 COVID
depression
vaccination

Feedback

Fig no. 1: Conceptual framework based on system model by Ilgen D. R et al

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 CHAPTER II
REVIEW OF LITERATURE
A review of literature is a description and analysis of the literature relevant to a
particular field of topic. It provides an overview of what work already been carried
out, who are the key researchers who did that work, which of the questions are
already answered regarding a particular area or research interest, what methods and
methodologies were used to answer the particular questions and what are the
prevailing theories and hypothesis.

Literature review regarding depression related to COVID

1. Fernandez c et al, (2020), conducted a study on anxiety, depression and poor

sleep quality as long term sequalae in previously hospitalized patients. This was
a multicentre observational study included 1200 hospitalized patients randomly
selected from four public hospitals in Madrid, Spain with a diagnosis of SARS
COV-2 by RT-PCR technique and radiological findings during first wave of the
pandemic. This multicentre study revealed that almost 50% of hospitalized
COVID-19 survivors experienced anxiety or depressive symptoms and poor
sleep quality seven months after hospital discharge.

2. Janiri D et al, (2020), conducted a study on psychological distress after

COVID-19 recovery. The testing was done at the Columbus post COVID
hospital. Among 61 samples 18 subjects (29.51%) reported psychological
distress, there were more women than men in the group with likelihood of
psychological distress.

3. Carlos J et al,(,2020), conducted a study on depression, perceived stress related

to COVID , post-traumatic stress, and insomnia among asthma and COPD
patients during the COVID-19 Pandemic. This was a cross sectional study
conducted on 148 asthma and 144 COPD patients presents similar frequencies of
depression risk, COVID-19 perceived stress, post-traumatic stress risk and
insomnia risk during Colombia lockdown.

4. Anand V et al, (2021), conducted a study on COVID-19 and psychological

distress. This study aimed to identify psychological factors that predicted distress

12
among Indian population during the spread of novel corona virus study confirms
the high prevalence of distress experienced by Indians at the time of COVID-19.

5. Eltman C et al, (2020), conducted a study on prevalence of depression

symptoms in US adults before and during the COVID-19 pandemic. This
nationally representative surveys study used 2 population based surveys of US
adults aged 18 or older. The result shows that prevalence of depression
symptoms in the US was more than 3 folds higher during COVID-19 comparted
with before the COVID-19 pandemic. Individuals with lower social resources,
lower economic resources, and greater exposure to stressor reported a greater
burden of depression symptoms.

6. Gopal A et al (2020), conducted a study on dynamics of psychological

response to COVID-19 in India. This was a longitudinal study. This study shows
that 70.8% of participants reported being mildly anxious, 18.8% moderately
anxious, 10.4% reported severe anxiety symptoms and 14.8% of the participants
reported being depression.

7. Hu Y et al (2020), conducted a study on factors related to mental health of

inpatients with COVID-19 in Wuhan, china. Among the 85 participants, 45.9%
has symptoms of depression, 38.8% had anxiety and 54.1% had insomnia.

13
 CHAPTER III
METHODOLOGY
This chapter deals with methodology of study which includes design of the research
study, research setting, target population, sampling technique & sample size,
development and description of instruments, validity and reliability of research
tools, procedure and time frame of data collection, pilot study, feasibility of the
study and ethical consideration.

RESEARCH DESIGN
Research design is also known as blueprint that researchers select to carry out their
research study.

The schematic diagram of research design for the present study was given below......

Sample
Setting Sample Size
Post COVID clients
Medicine and chest OPD, 30 post COVID clients
attending Medicine and
MMCH, Midnapore
chest OPD, MMCH,
Medical College and
Midnapore Medical
Hospital
College and Hospital

TOOL Data Collection Method

Analysis
Tool-I- sociodemographic Questionnaire
Descriptive analysis tool

Tool-II- Beck’s Depression

Inventory

Interpretation

Study findings Report

Figure No. 2- Research Design

14
Research design includes six major elements which are stated below:

 RESEARCH APPROACH
The approach of the research study is quantitative approach.

 POPULATION, SAMPLE AND SAMPLING

Population include post COVID clients attending medicine and chest OPD,
MMCH.
Sample size was taken 30.
Non probability purposive sampling technique was used.

 TIME, PLACE AND SOURCES OF DATA COLLECTION

The data collection was done during the month of October-November, 2021
at medicine and chest outdoor, MMCH, Paschim Medinipur.
The data collection was done from the post COVID client attending chest and
medicine OPD, MMCH during the data collection period.

 TOOLS AND METHOD OF DATA COLLECTION

The tools which are used for data collection are:

 BECK’S DEPRESSION INVENTORY

Beck’s depression inventory is a 21 item questionnaire for evaluating level

of depression. This tool was developed by the American psychiatrist Aron
Temkin Beck in 1961. This is a standard tool.

 SOCIO DEMOGRAPHIC TOOL

Socio demographic tool was developed to collect the demographic data of

the samples using semi structured interview schedule consisting of 12 item
questionnaires.

 METHOD OF DATA ANALYSIS

Data analysis was descriptive and was done using frequency distribution table
and bar graph.

15
 DEVELOPEMENT AND DESCRIPTION OF RESEARCH
INSTRUMENTS
The tools are divided into two parts, Tool-I & Tool-II
 Tool-I comprises of demographic data such as age, sex, education, religion,
occupation, monthly income, marital status, relationship with family members,
residence, relationship with others, COVID vaccination status.
This structured questionnaire was developed by the researchers and
validated by experts.
 Tool-II is a standard tool that is Beck’s depression inventory which was
developed by the American psychiatrist Aron Temkin Beck in 1961. It is a kind
of rating scale with self-scored questionnaire comprising of 21 questions.
Scores of depressions are calculated by adding up scores for relevant 21 items.
The highest possible score is 63 and the lowest is 0.
Total Scores Levels of Depression
0-10 These ups and downs are considered as normal
11-16 Mild mood disturbance
17-20 Borderline clinical depression
21-30 Moderate depression
31- 40 Severe depression
>40 Extreme depression

TABLE: 1. Scoring of Beck’s Depression Inventory

Semi structured interview schedule method was used to collect data from the
samples using this tool.

PILOT STUDY

16
The pilot study was done on 08/10/21 at the fever clinic, MMCH, Paschim
Medinipur after taking all the ethical permission from the concerned authorities.
The pilot study was done on 10 samples and found that 20% samples are suffering
from mild mood disturbance, 40% are suffering from borderline clinical depression,
10% suffering from moderate depression and 10% from severe depression.

ETHICAL CONSIDERATION

 Administrative permission was taken from the principal of College of nursing,

Midnapore Medical College and Hospital.
 Permission was taken from the Medical superintendent cum vice principal of
Midnapore Medical College and Hospital.
 Permission was taken from the Head of the Department of Medicine OPD of
Midnapore Medical College and Hospital.
 Permission was taken from the Head of the Department of Chest OPD of
Midnapore Medical College and Hospital.

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 CHAPTER IV
DATA ANALYSIS
This chapter deals with the analysis and interpretation of collected data of the final
study. Analysis and interpretation include compilation, editing, coding,
classification and presentation of data.

The analysis makes the raw data into a meaningful data or draw out some result
from it. Thus this chapter will represent the data of 30 samples analysed using
descriptive statistics.

METHODS OF REPRESENTATION

 Frequency distribution table

 Bar graph

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TABLE: 2. Frequency and percentage distribution of sociodemographic tool

Demographic Data Frequencies percentage

1. Age
a. Below 19 years 4 13.33%
b. 19-25 years 6 20%
c. 25-40 years 9 30%
d. Above 40 years 11 36.67%
2. Sex
a. Male 11 36.66%
b. Female 19 63.33%

3. Religion
a. Hindu 24 80%
b. Muslim 6 20%
c. Others 0 0%
4. Education
a. Illiterate 6 20%
b. Primary 11 36.67%
c. Secondary 7 23.33%
d. Higher secondary 3 10%
e. Graduate 3 10%
f. Postgraduate 0 0%
5. Occupation
a. unemployed 16 53.33%
b. Daily labour 10 33.33%
c. Business 2 6.67%
d. Govt. Employee 0 0%
e. private Employee 2 6.67%
6. Monthly income
a. below 5000 6 20%
b. 5000 to 10000 12 40%
c. 10000 to 15000
d. above 15000
7. Type of family
a. Nuclear 16 53.33%
b. joint 11 36.67%

19
c. extended 3 10%

8. Type of residence
a. urban 8 26.67%
b. semi urban 4 13.33%
c. rural 18 60%
9. Relationship with family members
a. Good 25 83.33%
b. average 5 16.67%
c. bad 0 0%

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 10. Marital status
a. unmarried 7 23.33%
b. married 19 63.33%
c. widow 4 13.33%
d. widower 0 0%
e. divorced 0 0%
0 0%
f. separated
11. Relationship with others
a. good 22 73.33%
b. average 8 26.67%
c. poor 0 0%
12. COVID vaccination status
a. Not taken 3 10%
b. 1st dose completed 15 50%
c. 2nd dose completed 12 40%

The data presented in the table show that out of 30 samples of post COVID
patients attending chest and medicine OPD 4(13.33%) patients are of age below
19 years, 6(20%) are of between age of 19 to 25 years, 9(30%) patients are of
age between 25 to 40 years and 11(36.67%) patients are above 40 years of age.

Among 30 patients 11(36.33%) are male and 19(63.33%) are female.

24(80%) of them are Hindu and 6(20%) are Muslim.

6(20%) patients are illiterate, 11(36.67%) of them completed their primary

education,7(23.33%) of them completed their secondary, 3(10%) of them
completed their higher secondary education and 3(10%) of them completed
their graduation.

16(53.33%) patients were unemployed, 10(33.33%) were daily labour,

2(6.67%) were business person, 2(6.67%) were private employees.

6(20%) patients had their monthly income below Rs 5000, 12(40%) patients has
monthly income between Rs 5000 to 10,000.

16(53.33%) patients live in nuclear family,11(36.67%) patients live in joint

family and 3(10%) patients live in extended family.

8(26.67%) patients live in urban area, 4(13.33%) patients live in semi urban
area and 18(60%) patients live in rural area.

25(83.33%) of them had good relationship with their family member and
5(16.67%) of them has average relation with their family member.

21
7(23.33%) patients were unmarried, 19(63.33%) were married and 4(13.33%)
were widow.

22(73.33%) patients had good relationship with others and 8(26.67%) had
average relation with others.

3(10%) of them had not taken COVID vaccine, 15(50%) patients had taken 1st
dose and 12(40%) had taken their 2nd dose.

22
TABLE 3. Frequency and percentage distribution table
Scores of depressions are calculated by adding up scores for relevant 21 items. The highest
possible score is 63 and the lowest is 0.

Total Scores Levels of Depression Frequency percentage

0-10 These ups and downs are considered as normal 8 26.67%
11-16 Mild mood disturbance 9 30%
17-20 Borderline clinical depression 2 6.67%
21-30 Moderate depression 3 10%
31- 40 Severe depression 4 13.33%
>40 Extreme depression 4 13.33%

The data represented in the table shows that out of 30 post COVID patients 8
(26.67%) had normal mood disturbance, 9(30%) patients had mild mood
disturbance, 2(6.67%) patients had borderline depression, 3(10%) patients had
moderate depression, 4(13.33%) patients had severe depression and 4(13.33%)
patients had extreme depression.

23
 n=30
35.00%
30%
30.00% 27%
25.00%
20.00%
15.00% 13% 13%
FREQUENCIES

10%
10.00% 7%
5.00%
0.00%

LEVELS OF DEPRESSION

Figure No. 3- Bar graph showing levels of depressions

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 CHAPTER V
DISCUSSION
This chapter deals with the major findings, discussion to other studies,
conclusion and implication for nursing practice, nursing education, nursing
administration and nursing research. The limitation of the study had been stated.
It also attempted to give an account of suggestion and recommendations for
further research in the field of nursing.

MAJOR FINDINGS

A. findings related to demographic variables.

 Most of the respondents (36.67%) were above 40 years of age.
 Majority of the respondents (63.33%) were female.
 Majority of the respondents (80%) were Hindu.
 Most of the respondents (33.67%) had completed their primary
education.
 Majority of the respondents (53.33%) were unemployed.
 Majority of the respondents (63.33%) were female.
 Majority of the respondents (53.33%) live in nuclear family.
 Majority of the respondents (60%) live in rural area.
 Majority of the respondents (83.33%) had good relationship with
their family member
 Majority of the respondents (63.33%) were married.
 Majority of the respondents (73.33%) had good relationship with
others.
 Majority of the respondents (50%) had taken their 1st dose of
COVID vaccination.

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B. findings related to measurement of level of depression.
 Majority of the respondents (30%) had mild mood disturbance
 26.67% of respondents has normal ups and downs of mood.
 6.67% of respondents had borderline clinical depression.
 10% of respondents had moderate mood depression.
 13.33% of respondents had severe depression.
 13.33% of respondents had extreme depression.

26
 CHAPTER VI
CONCLUSION AND RECCOMENDATION

CONCLUSION

In light of this research, it can be concluded the post COVID patients aged
above 16 years come under category of mild mood disturbance according to
Beck’s Depression Inventory.

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APPENDIX

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