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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Assessment of Stress and Resilience in the General Population during COVID-19: A Cross-sectional Study
Correspondence Address :
S Gopinath,
No. 16/28, Jayaraman Street, Pazhavanthangal, Chennai-600061, Tamil Nadu, India.
E-mail: gopi4863@gmail.com
Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic, which began in Wuhan, China, in December 2019, has quickly spread worldwide, causing numerous challenges for people, such as lockdowns, isolation, and subsequent mental stress. Developing mental resilience is crucial for handling stress effectively. Understanding the impact of the COVID-19 pandemic on stress and the resilience of the Indian population enables insight and facilitates thoughtful reformation in aiding the community.
Aim: To assess the stress and resilience among the general population during the COVID-19 pandemic and to find the association between demographic variables and stress and resilience. Additionally, the study aimed to evaluate the correlation between stress and resilience among these subjects.
Materials and Methods: A cross-sectional study was conducted Department of Psychiatry, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India, from February 2021 to April 2021. A total of 740 willing respondents affected by the COVID-19 pandemic participated in the study. A snowball sampling method was used in which participants were approached via a Google form circulated through their known contacts. The study encompassed those who had experienced either direct or indirect effects of the COVID-19 pandemic. The user-friendly Google form collected essential demographic information such as gender, marital status, and employment type. The stress and resilience levels were measured using the Perceived Stress Scale (PSS) and Resilience Scale. The statistical analysis of sample characteristics with frequency distributions and categorical variables was done with the application of Chi-square tests. Correlation analysis was done using the Spearman’s test. A p-value of <0.05 was considered statistically significant.
Results: The research demonstrated remarkably low resilience levels and heightened stress levels among female participants (p<0.001, p<0.001) as well as single individuals (p=0.001, p<0.001). Conversely, a significant number of married men exhibited greater resilience (p=0.013) and reduced stress levels (p<0.001) compared to the rest of the population. Individuals in formal employment experienced less stress compared to those in informal employment (p=0.008). Notably, there was a moderate negative correlation between perceived stress and resilience which was significant (r=-0.562, p<0.001).
Conclusion: The COVID-19 pandemic has greatly affected mental health and coping mechanisms; factors such as gender, social connections, and financial stability play significant roles. The study found that women, single individuals, and those working in informal sectors faced increased stress during these challenging times. Hence, psychological interventions targeting the pandemic crisis need to be planned considering the highlighted biological, socio-economic, and occupational factors.
Coronavirus disease-2019, Employment, Pandemic, Perceived stress scale, Resilience scale
The COVID-19 pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), began in China’s Wuhan region in December 2019 and rapidly spread across the globe (1). This unprecedented crisis caught the world off guard, as countries grappled with a severe health emergency and individuals faced lockdowns, isolation, and resulting mental health challenges (2). Studies consistently show that people experienced significantly higher levels of stress during this period of uncertainty (3),(4). Common reactions to this heightened stress include anxiety, irritability, insomnia, difficulty concentrating, decreased productivity, and relationship conflicts. A systematic review by Mahmud S et al., found a markedly increased prevalence of stress, anxiety, insomnia, and depression (5), with reported rates of depression ranging from 24.4% to 64.1% and anxiety ranging from 12.9% to 72.7% (6),(7).
Limited coping flexibility leaves individuals more vulnerable to serious psychological issues such as stress, anxiety, and depression (8). Meanwhile, mental resilience serves as a mediator between stigma and mental health for COVID-19 survivors (9) and is crucial in dealing with the widespread repercussions of the pandemic (10),(11). Resilience encompasses the ability to effectively navigate, manage, and adapt to significant stressors or traumatic events. This adaptive capacity is shaped by an individual’s personal assets and resources found within their life and environment, enabling them to recover and rebound in the face of adversity (12). Evaluating and strengthening mental resilience is vital for effective resource distribution and the development of targeted interventions to address the mental health consequences of this global crisis (13).
The intensity of mental symptoms is influenced by factors such as social isolation, feelings of loneliness, societal stigma, and employment status (14). This became particularly evident when the unemployment rate in India soared to 23.5%, more than double the rate of the previous year’s same quarter (7.2%), according to a report by the Centre for Monitoring Indian Economy Pvt. Ltd. (CMIE), due to the nationwide lockdown from late March to May 2020 (15). Despite cultural differences and varying levels of social support, the present research provides fresh insights and enhances the current body of knowledge.
The present study stands out because it focuses on assessing the relationship between stress and mental resilience among the general population amidst the COVID-19 pandemic and evaluates the impact of employment type alongside other socio-demographic factors that have been thoroughly examined.
The aim of the study was to assess stress and resilience among the general population.
The objectives of the study were:
• To assess the association between demographic variables and stress and resilience.
• To assess the correlation between stress and resilience among the general population.
This cross-sectional study took place at Department of Psychiatry, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India during the second wave of the pandemic, from February 2021 to April 2021. The study was conducted in accordance with the principles of the Declaration of Helsinki, 2013.
Sample size calculation: The sample size was calculated using the previously reported 82.6% population proportion of perceived stress (moderate and high) during the COVID-19 pandemic (16). The snowball sampling method was employed to select the participants.
The formula used to calculate the sample size is:
n={z2 * p*(1–p)}/ε2
n=(1.962 * 0.826 * (1-0.826))/0.0272
n=740
Therefore, 740 participants who were impacted by the COVID-19 pandemic and willing to participate in the study were included, in order to achieve a 95% confidence level with a margin of error within ±2.73% of the measured value. These individuals willingly provided their informed consent, displayed at the beginning of a Google form, before submitting their responses.
Inclusion criteria: The study encompassed those who experienced either direct or indirect effects of the COVID-19 pandemic. The direct impacts of COVID-19 encompass a diverse range of disease severities, while indirect consequences involve elements such as social distancing, apprehension associated with the pandemic, and concerns related to employment and finances stemming from lockdowns or societal restrictions imposed due to the global health crisis.
Exclusion criteria: Individuals unable to read or write in English and those under 18 years of age were excluded from the research.
Study Procedure
The principal investigator, a psychiatry resident, drafted a semi-structured Google form-based questionnaire that underwent review by all co-authors. After obtaining agreement from all investigators, the Google form was disseminated online to compile crucial information such as gender, marital status, religion, income, and employment type.
In 2003, the 17th International Conference of Labour Statisticians at the International Labour Organisation (ILO) introduced informal employment as any paid work without registration, regulation, or protection from legal frameworks. Additionally, unpaid work in income-generating businesses is seen as informal. Unfortunately, informal workers don’t receive stable contracts, benefits, social security, or representation (17). The research categorised jobs into two types: formal and informal employment. Formal employment referred to jobs in the government and private sectors that were registered and had established rules for their employees. Informal employment, on the other hand, referred to jobs in the unorganised sector, which lacked proper registration and regulations for its workers.
The authors evaluated stress and resilience levels using the self-reported Perceived Stress Scale (PSS) and Resilience Scale, respectively, which were included in the Google form. According to Cohen S et al., the PSS serves as a prevalent tool for assessing stress levels (18).
The study employed the 10 item Perceived Stress Scale (PSS-10) due to its clear-cut inquiries and easily understandable replies. Participants shared their emotions and thoughts from the past month through a 10-question survey, marked on a 5-point Likert scale ranging from 0 (never) to 4 (very often). PSS scores can range from 0 to 40, with elevated scores signifying increased perceived stress. In their 1988 study, Cohen S et al., revealed that the PSS-10 scores exhibited satisfactory internal consistency reliability (α=0.78), alongside moderate concurrent criterion validity and an acceptable level of convergent validity (18). Scores ranging from 0 to 13, 14 to 26, and 27 to 40 were taken as low, moderate, and high perceived stress, respectively, for analysis (19).
The PSS holds unique value as it underscores an individual’s interpretation of their experiences. Differing perceptions of stress may arise among two individuals exposed to the same events, resulting in variations in their accumulated scores and PSS categorisation.
The Brief Resilience Scale (BRS), crafted by the expert team of Smith BW et al., stands as a highly acclaimed resilience scale and was diligently utilised in the research (20). This innovative scale delves into an individual’s subjective ability to rebound and recuperate from stress, thoroughly examining a singular resilience construct which consists of both affirming and opposing statements. The BRS scores range from 6 (depicting low resilience) to 30 (indicating high resilience) on an intricate 6-question scale. This scale offers five distinct response options: strongly disagree, disagree, neutral, agree, and strongly agree, uniformly presented across all six thought-provoking questions.
Statistical Analysis
The statistical analysis was conducted utilising the epi.info 7.2 software. To showcase the characteristics of the sample, frequency distribution was employed. Associations between categorical variables were analysed through the Chi-square (χ2) test. As the variables didn’t follow a normal distribution, the Spearman’s test was applied to assess the correlation. A p-value below 0.05 signifies a noteworthy statistical significance.
The frequency distribution of the sample characteristics is displayed in (Table/Fig 1). The investigation uncovered a substantial link between perceived stress and independent variables such as gender, marital status, and employment type, as depicted in (Table/Fig 2). A larger proportion of women 62 (16.58%) and single individuals 60 (16.35%) experienced significantly more stress compared to men 28 (7.65%) and married individuals 30 (8.04%) (χ2=20.291, p<0.001; χ2=20.753, p<0.001), respectively. Likewise, formally employed individuals 105 (17.8%) tended to perceive less stress than those informally employed 15 (10%), which was statistically significant (χ2=9.759, p=0.008).
Upon further examination of marital status and its impact on gender regarding perceived stress, the authors found that single men 22 (12.4%) were more inclined to feel higher stress levels than married men 6 (3.2%), displaying a statistically significant connection (χ2=23.390, p<0.001) as shown in (Table/Fig 3).
As portrayed in (Table/Fig 4), a significant relationship between mental resilience and independent factors such as gender and marital status was observed. A substantial percentage of women 138 (36.9%) and single individuals 124 (33.8%) exhibited significantly lower resilience compared to men 77 (21.04%) and married individuals 91 (24.4%) (χ2=25.260, p<0.001; χ2=14.027, p=0.001), respectively. Nonetheless, the authors found no association between employment type and a person’s resilience (p=0.191). Similarly, when analysing the influence of marital status on gender in terms of mental resilience, married men 20 (10.6%) demonstrated a higher likelihood of possessing strong resilience compared to single men 7 (4%), which was statistically significant (c2=8.620, p=0.013), as presented in (Table/Fig 5).
During the examination of the correlation between perceived stress and mental resilience, a moderate negative relationship (r=-0.562, p<0.001) was uncovered, which was significant as depicted in (Table/Fig 6). This finding suggests that individuals experiencing high levels of stress tend to exhibit lower resilience capacities.
During the COVID-19 outbreak, a study involving 740 participants was conducted amid the chaos of the pandemic’s second wave. At this time, knowledge about the virus was limited, and the global population grappled with its detrimental effects. Overwhelmed by increasing patient numbers, hospitals faced bed and oxygen shortages, resulting in substantial death rates. Vaccinations were scarce, and a prevailing atmosphere of uncertainty led to widespread stress (21). The interruption of everyday life and mounting concerns over individual safety and economic stability exacerbated psychosocial stress. Moreover, travel restrictions and limited physical contact separated friends and family, contributing to even greater stress levels (22).
The study reaffirms that females tend to experience higher stress levels than males, a finding consistent with earlier studies (23),(24). Consequently, gender is a key factor in the psychological impact of the COVID-19 pandemic, with women facing greater risks than men (23).
During pandemic crises, stress-related responses are expected. A person’s mental resilience is of utmost importance in managing the sudden, unprecedented stress brought on by the COVID-19 pandemic and adjusting to new norms. The present study emphasises that gender significantly influences resilience, as evidenced by lower resilience levels among females compared to males, which, in turn, makes them more susceptible to stress. Despite earlier studies yielding mixed results, the study presents substantial evidence supporting the notion that women report low resilience and encounter greater psychological turmoil than men. Additionally, psychological resilience has been found to exhibit negative correlations with depression, anxiety, and stress symptoms (24).
The research uncovered a notable connection between marital status and its impact on stress and resilience. A significant portion of single individuals, who may have limited social and emotional support, demonstrated lower resilience and perceived higher stress compared to their married counterparts. Contemporary international studies endorse the notion that the positive facets of marriage, such as collaboration in everyday tasks and a supportive partnership, contribute to reduced perceived stress (25),(26),(27),(28),(29).
As a result, the present study signifies that gender, mental resilience, and social support serve as reliable predictors of stress and other psychological disorders (30). Enhanced baseline resilience, coupled with increased social support, can effectively reduce perceived stress during COVID-19 (31). The pandemic has indisputably reshaped the work environment for all. This research unveiled a fascinating observation: those employed in formal sectors experienced reduced stress levels in comparison to their counterparts in informal sectors. The latter faced heightened stress owing to job and income uncertainties during lockdown (32). Conversely, individuals with formal employment tended to enjoy steadier income and livelihoods. Basyouni SS et al., identified a robust connection between financial worry and job insecurity among workers in both the formal and informal sectors (33). Intriguingly, work-related flow exhibited an adverse association with fiscal unease, serving as a bridge between job uncertainty and financial concerns (33). Additionally, the investigation highlighted an opposite relationship between resilience and stress- greater resilience enables people to endure lower stress levels. This discovery is consistent with prior research conducted by Barzilay R et al., on the correlation between resilience and pandemic-induced stress (34). Prolonged pandemic-induced stress can negatively impact one’s well-being, potentially leading to physical and mental health complications (35).
Limitation(s)
Though an extensive sample size was utilised, which is a definite advantage, the absence of direct interaction with participants and an examination of specific confounding variables constitutes notable limitations of the investigation.
In summary, stress levels tend to be higher among women, single individuals, those in informal employment, and people with lower resilience. It is crucial to note the inverse connection between perceived stress and a person’s resilience. The importance of promoting mental well-being through physical activity and proper nutrition is increasingly recognised. Besides maintaining healthy habits, the present study suggests that empowering individuals with effective adaptive stress coping techniques can be incredibly beneficial. There is an underlying need for a comprehensive approach to building resilience, not only focusing on managing stress but also encompassing sufficient social and financial support for optimal outcomes.
DOI: 10.7860/JCDR/2024/64984.19032
Date of Submission: May 06, 2023
Date of Peer Review: Jul 31, 2023
Date of Acceptance: Nov 16, 2023
Date of Publishing: Feb 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? No
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: May 11, 2023
• Manual Googling: Aug 22, 2023
• iThenticate Software: Nov 14, 2023 (11%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com