Psychological Impact of COVID-19 Pandemic on Nurses in Kerala and Maharashtra States, India: A Mixed-methods Study

This observational study assessed the psychological impact of COVID-19. 520 nurses (263 not involved in COVID-19 care and 257 involved) responded to an online survey. 24 nurses in Maharashtra (19 women and 5 men) were interviewed by telephone. Depression, anxiety and stress were measured using the Depression Anxiety Stress Scales (DASS-21)-short version PTSD with the Impact of Event Scale-Revised (IES-R). Descriptive, bivariate analyses and logistic regression were conducted. For the qualitative component, a qualitative-phenomenological approach was used. Higher mean DASS-21 depression, anxiety and stress subscale scores, and higher total IES-R and subscale scores were observed among nurses involved in COVID-19 care compared to those not involved. Qualitative findings indicate increased workload, longer distance from family and constant fear of infection and transmission, along with coping strategies. Screening and support mechanisms for nurses in COVID-19 care in India are needed to manage immediate and long-term psychological outcomes.