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SHORT COMMUNICATION
Year : 2021  |  Volume : 30  |  Issue : 1  |  Page : 187-190  Table of Contents     

The impact of working in a COVID hospital on sexual functioning in male nurses: A study from North India


1 Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Nursing, GMCH, Chandigarh, India
4 Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
5 Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Submission07-Mar-2021
Date of Acceptance06-Apr-2021
Date of Web Publication30-Jun-2021

Correspondence Address:
Dr. Shubh Mohan Singh
Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ipj.ipj_55_21

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   Abstract 


Introduction: The COVID-19 pandemic has spread to almost all the countries and regions in the world. The fear of getting infected while serving COVID patients and the stress due to separation from family during the quarantine period may impact over sexual functioning of healthcare workers (HCWs). Methodology: The study protocol was approved by the institutional ethics committee. This was a nonfunded, cross-sectional, observational study. All participants provided written informed consent. This study was carried out in a multispecialty tertiary teaching hospital in North India. The participants were drawn from married and living with partner male nurses. Sexual functioning was assessed using the changes in sexual functioning questionnaire short-form (CSFQ-14). Results: The study found that the prevalence of global sexual dysfunction was significantly higher in male nurses who had completed their rotations in the COVID hospital when compared to those who had not. There were no statistically significant differences between the groups on sociodemographic profiles and the profile of their spouses. Discussion: HCWs working in COVID situations are known to suffer from stress, depression, and anxiety. This may impact the sexual functioning of the HCWs, especially when they have been in an infectious environment and the marital dyad may have doubts of the transmission of the infection. Conclusion: Male nurses who have worked in a COVID care setting are likely to report higher levels of sexual dysfunction

Keywords: COVID-19, depression, hospital, male, nursing, pandemic, personal protective equipment, sexuality


How to cite this article:
Kumar M, Mohindra R, Sharma K, Soni RK, Rana K, Singh SM. The impact of working in a COVID hospital on sexual functioning in male nurses: A study from North India. Ind Psychiatry J 2021;30:187-90

How to cite this URL:
Kumar M, Mohindra R, Sharma K, Soni RK, Rana K, Singh SM. The impact of working in a COVID hospital on sexual functioning in male nurses: A study from North India. Ind Psychiatry J [serial online] 2021 [cited 2021 Aug 1];30:187-90. Available from: https://www.industrialpsychiatry.org/text.asp?2021/30/1/187/320370



The COVID-19 pandemic has spread to almost all the countries and regions in the world. There has been a disproportionate psychosocial impact of COVID-19 on healthcare workers (HCWs).[1] Many studies have shown that there is an increased prevalence of psychological morbidity in the form of anxiety and depressive symptoms.[1] As coronaviruses and COVID-19 are not known to have any direct impact on psychological functioning, it is presumed that much of this morbidity is explainable based on the stress of working in a COVID environment.[2],[3] This stress could be due to various factors such as the fear of death and disease, the stigma associated with COVID-19, and the fear of spreading the infection to family members among others.[4]

It is known that psychosocial stress concerning the working environment may impact sexual functioning.[5] Working in a COVID care setting is likely to represent significant stress and may impact sexual functioning. As per current evidence, COVID-19 is unlikely to have any direct impact on sexual functioning. Sexual dysfunction that is observed in these individuals is likely to be due to psychosocial distress.[6] There is some previous evidence to suggest that stress at the workplace (non-COVID environment) can impact sexual functioning in both men and women.[7],[8] Thus, HCW who has worked in a COVID environment may experience an impact on sexual functioning. A review of literature in this area suggested that while there are studies that have assessed sexual functioning in various populations, the impact of working in a COVID environment on sexual functioning in HCWs has not been studied.[9],[10]

This study was conducted to assess sexual functioning in a population of HCWs who had worked in a COVID hospital in North India.


   Methodology Top


The study protocol was submitted and approved by the institutional ethics committee. This was a nonfunded, cross-sectional, observational study. All participants provided written informed consent.

Setting

This study was carried out in a multispecialty tertiary teaching hospital in North India. A separate wing of the hospital has been designated a COVID hospital for the district. This is staffed by all categories of the HCWs of the hospital. The usual schedule followed in the COVID hospital is that HCW is withdrawn from their usual place of work and sent to work in the COVID hospital for 1 week which is followed by a period of quarantine of 5 days. During the period of work in COVID hospital and quarantine, the HCWs stay at a designated accommodation provided by the hospital and are not allowed to meet family members, and movement is restricted. At the end of the quarantine, HCW are tested for COVID-19 and on being tested negative are allowed to go back to their families and workplace.

Participants

The participants were drawn from married and living with partner male nurses. One group (cases) had been posted in the COVID hospital, had completed quarantine, and had tested negative. Assessments were done 2–4 weeks after their being tested negative for COVID-19 and allowed to go back to their usual places of work and accommodation. The control population consisted of married male nurses who had not yet been posted to the COVID hospital. There were 100 participants in each group.

Instruments

We used a sociodemographic profile sheet for recording sociodemographic details. Sexual functioning was assessed using the changes in sexual functioning questionnaire short-form (CSFQ-14).[11] This is a commonly used instrument for assessing global sexual dysfunction in a variety of clinical situations. We also assessed the participants for depressive symptoms using the patient health questionnaire-9 (PHQ-9).[12] Both of these are self-rated instruments.

Procedure

Male nurses who had completed their COVID hospital rotation, had mandatory quarantine, and had been tested negative were approached for participation in the study. The controls were also approached for participation. All those who provided written informed consent were assessed on the three instruments mentioned above. We recruited 100 participants in each group. Data were analyzed statistically. Confidentiality was assured.


   Results Top


The mean age of the respondents was 32.02 years (standard deviation [SD] = 3.99) in the COVID group and 32.32 years (SD = 4.07) in the non-COVID group. There were no statistically significant differences between the groups on sociodemographic profiles and the profile of their spouses. There was no reported physical comorbidity in the participants and their partners in the two study groups.

[Table 1] presents the scores on the CFSQ-14 and PHQ-9 in the two groups.
Table 1: The scores on the changes in sexual functioning questionnaire-14 and patient health questionnaire-9inthetwogroups

Click here to view


The prevalence of global sexual dysfunction (score <48) was 31 in the COVID group and 16 in the non-COVID group (P << 0.05). The prevalence of moderate and above severity of depressive symptomatology (PHQ score >10) was 24 in the COVID group and 11 in the non-COVID group (P = 0.01). The severity of depression was found to be inversely correlated with the CSFQ-14 score in both groups (overall Pearson's correlation coefficient = −0.48, P << 0.05).


   Discussion Top


Male sexual dysfunction is often associated with systemic illnesses and depression.[13] There is also evidence that stress may impact sexual functioning and marital satisfaction.[14] HCWs working in COVID situations are known to suffer from stress, depression, and anxiety.[15] This may impact the sexual functioning of the HCWs, especially when they have been in an infectious environment and the marital dyad may have doubts about the transmission of the infection. This study was planned to examine the above question by assessing sexual dysfunction in male nurses who have been working in a COVID hospital.

We found that the prevalence of global sexual dysfunction was significantly higher in male nurses who had completed their rotations in the COVID hospital when compared to those who had not. Further, the COVID hospital group had a small significantly higher mean score on global sexual dysfunction. This mean global score was inversely correlated with the severity of depression. The prevalence of depressive morbidity was higher in the COVID hospital group.

While our study was not designed to assess the direction and causality of these phenomena, it is possible that working in a COVID hospital may be associated with sexual dysfunction due to psychological distress as indicated by the depressive symptoms. The possible reasons for psychological morbidity may be the working environment characterized by the danger of infection, morbidity, and mortality in patients, the physical discomfort of wearing personal protective equipment, and staying away from family during the rotation and quarantine. It is also possible that after return from quarantine, the possibility of infection may persist in some and lead to a reduction in or abstinence from sexual activity. Our study suggests that more research is needed into the sexual health, marital adjustment, and emotional impact of working in a COVID environment among HCW.

The study has certain limitations; first, purposive sampling was used to get the sample size which can add bias in the results, which limits it for projections. Second, the study was done exclusively in male nursing officers, which do not determine the sexual dysfunction perspective of female nursing officers.

As health systems globally are overwhelmed by coronavirus disease 2019 (COVID-19), health workers must be protected as “every country's most valuable resource.” Measures to support the enormous psychological burden faced by frontline health workers worldwide are urgently needed.


   Conclusion Top


Male nurses who have worked in a COVID care setting are likely to report higher levels of sexual dysfunction. This may have a bearing on their overall functioning and psychological health. Impairment in sexual functioning should be factored into wellness initiatives for this group of personnel.

Acknowledgment

We acknowledge all participants.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun 2020;89:531-42.  Back to cited text no. 1
    
2.
Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar-Poli P, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: A systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry 2020;7:611-27.  Back to cited text no. 2
    
3.
Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3:e203976.  Back to cited text no. 3
    
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Mohindra R, Rakavi R, Suri V, Bhalla A, Singh SM. Issues relevant to mental health promotion in frontline health care providers managing quarantined/isolated COVID19 patients. Asian J Psychiatr 2020;51:102084.  Back to cited text no. 4
    
5.
Mokarami H, Toderi S, Rahimi Pordanjani T, Taban E. Role of psychosocial job stressors on sexual function of male nurses: The mediator role of work ability. Am J Mens Health 2018;12:1908-15.  Back to cited text no. 5
    
6.
Abbas AM, Fathy SK, Khamees AA, Salem AS, Ahmed L. Focused review on the genital and sexual affection of COVID-19 patients. Gynecol Obstet Hum Reprod 2020;49:101848.  Back to cited text no. 6
    
7.
Hamilton LD, Meston CM. Chronic stress and sexual function in women. J Sex Med 2013;10:2443-54.  Back to cited text no. 7
    
8.
Papaefstathiou E, Apostolopoulou A, Papaefstathiou E, Moysidis K, Hatzimouratidis K, Sarafis P. The impact of burnout and occupational stress on sexual function in both male and female individuals: A cross-sectional study. Int J Impot Res 2020;32:510-9.  Back to cited text no. 8
    
9.
Yuksel B, Ozgor F. Effect of the COVID-19 pandemic on female sexual behavior. Int J Gynaecol Obstet 2020;150:98-102.  Back to cited text no. 9
    
10.
Schiavi MC, Spina V, Zullo MA, Colagiovanni V, Luffarelli P, Rago R, et al. Love in the time of COVID-19: Sexual function and quality of life analysis during the social distancing measures in a group of Italian reproductive-age women. J Sex Med 2020;17:1407-13.  Back to cited text no. 10
    
11.
Keller A, McGarvey EL, Clayton AH. Reliability and construct validity of the changes in sexual functioning questionnaire short-form (CSFQ-14). J Sex Marital Ther 2006;32:43-52.  Back to cited text no. 11
    
12.
Kroenke K, Spitzer RL, Williams JB, Löwe B. The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. Gen Hosp Psychiatry 2010;32:345-59.  Back to cited text no. 12
    
13.
DeLay KJ, Haney N, Hellstrom WJ. Modifying risk factors in the management of erectile dysfunction: A review. World J Mens Health 2016;34:89-100.  Back to cited text no. 13
    
14.
Morokqff PJ, Gillilland R. Stress, sexual functioning, and marital satisfaction. J Sex Res 1993;30 Suppl 1:43-53.  Back to cited text no. 14
    
15.
Maben J, Bridges J. COVID-19: Supporting nurses' psychological and mental health. J Clin Nurs 2020;29:15-6.  Back to cited text no. 15
    



 
 
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