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 Table of Contents  
Year : 2021  |  Volume : 6  |  Issue : 2  |  Page : 132-136

Evaluation of psychological stress, awareness, and attitude regarding COVID-19 infection pandemic within senior citizen homes in Kanpur, Uttar Pradesh: An online pioneer survey

1 Department of Public Health, UWA School of Population and Global Health, University of Western Australia, Perth, Australia
2 Department of Oral Medicine and Radiology, Rama Dental College, Kanpur, Uttar Pradesh, India
3 Department of Public Health, Indian Institute of Public Health, Gandhinagar, Gujarat, India

Date of Submission24-Sep-2020
Date of Decision19-Apr-2021
Date of Acceptance03-May-2021
Date of Web Publication08-Jan-2022

Correspondence Address:
Dr. Rohan Sachdev
117/K-68 Sarvodaya Nagar, Kanpur, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/bjhs.bjhs_99_20

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CONTEXT: Senior citizens with comorbidities are more vulnerable to severe illness and associated high mortality rate due to the prevailing pandemic.
AIMS: The aim of this online survey is to evaluate the psychological stress, awareness, and attitude regarding COVID-19 and the infection control measures taken by the senior citizens.
SETTINGS AND DESIGN: The present study involves an online descriptive cross-sectional questionnaire survey conducted at a senior citizen home.
SUBJECTS AND METHODS: The questionnaire of the study consists of 20 questions and was performed among 84 older adults of two senior citizen homes supervised by nongovernment organizations through video conferencing on WhatsApp.
STATISTICAL ANALYSIS USED: Participant's response was calculated and expressed as percentages and frequency, with the mean values.
RESULTS: Seventy-one percent of senior citizens responded to the study, and 91.6% accepted phobic anxiety due to COVID-19 lockdown, while 97.6% reported behavioral disorders. Majority of the senior citizens (96.4%) had awareness regarding COVID-19 infection, 97.6% were aware of water and hand sanitization, while 98.8% of the respondents had a positive response toward COVID-19 protection practice in the future.
CONCLUSIONS: The awareness regarding COVID-19 was found to be satisfactory among the senior citizens, although psychological counseling and more precautions are required to make them feel secure from the current pandemic scenario.

Keywords: COVID-19, infection, pandemic, psychological stress, senior citizens

How to cite this article:
Sachdev R, Garg K, Vishal M, Nigam K, Shwetam S. Evaluation of psychological stress, awareness, and attitude regarding COVID-19 infection pandemic within senior citizen homes in Kanpur, Uttar Pradesh: An online pioneer survey. BLDE Univ J Health Sci 2021;6:132-6

How to cite this URL:
Sachdev R, Garg K, Vishal M, Nigam K, Shwetam S. Evaluation of psychological stress, awareness, and attitude regarding COVID-19 infection pandemic within senior citizen homes in Kanpur, Uttar Pradesh: An online pioneer survey. BLDE Univ J Health Sci [serial online] 2021 [cited 2023 Mar 23];6:132-6. Available from: https://www.bldeujournalhs.in/text.asp?2021/6/2/132/335328

The 2019 coronavirus disease outbreak (COVID-19), which emerged in Wuhan, China, last December, has become a global public health problem for countries across the world.[1] The World Health Organization declared on January 30, 2020, that the infections of the novel coronavirus represented an emergency of international public health significance.[2],[3] A possible route of human-to-human transmission is by infectious droplets, encountering or handling an infected individual, or polluted surface.[4] The COVID-19 pandemic poses a high risk to older people as they may have higher mortality and may present atypically with postural instability or diarrhea.[5],[6]

Older adults and those with a weakened immune system, which are frequently associated with chronic underlying conditions, are at a higher risk of developing a serious infection and dying as a result of it.[6],[7],[8] However, COVID-19 still being a new and rapidly evolving global crisis, there is currently very little known about its broader impact on mental health-related to fatality risks, stress, and behaviors that may lead to infections along with consequences of social distancing.[9],[10] The neurological consequences of the accompanying stress and inflammation, which may increase older adults' vulnerability to psychological health difficulties.[11] The risk of getting severely ill from COVID-19 increases as we get older. As a response, it is essential to protect senior citizens who are at a higher risk of serious sickness from COVID-19. Therefore, this present online questionnaire survey was performed among the senior citizens living in a shelter home to assess the psychological stress, their awareness, and their attitude toward this prevailing pandemic COVID-19.

  Subjects and Methods Top

An online cross-sectional survey was performed in association with two senior citizens' home. 118 senior citizens from two senior citizens residences operated by nongovernmental organisations (NGOs) were approached to participate in the study. However, only 84 senior citizens showed interest and gave their consent to participate in the study. The inclusion criteria consisted of all the senior citizens willing to participate in the research and answered all the questions of the questionnaire. The exclusion criteria consisted of all those senior citizens not present on the predecided days of the research and the senior citizens who did not give consent to participate in the study. The senior citizens had to complete the online digital pretested, self-administered, close-ended questionnaire consisting of 20 questions in Hindi and English language. Initially, a pilot study was conducted among 10 (excluded from the total sample) older adults to determine the feasibility of the course. Cronbach's coefficient was 0.77, which signifies acceptable internal reliability of the questionnaire. For testing, the content validity ratio was calculated by using item-rated validity indices. It was achieved by recording the responses where the academician indicated whether an item is favorable (score of + 1) or unfavorable (score of 0). The content validity ratio was calculated as 0.89 by the panel of two academicians. Further, besides, there were no changes made in the questionnaire as a result of the pretest. The study protocol was approved by the institutional ethical review board, and verbal consent was obtained from all the senior citizens.

This present research consisted of a half an hour duration questionnaire which was performed via video conferencing on WhatsApp (WhatsApp Version 2.20.61 WhatsApp.Inc from Facebook) for each individual on the predecided date and time by a single investigator, and all the senior citizens were assured about the confidentiality of their responses. The video conferencing procedure was performed under the supervision of NGO workers along with the comfort of every senior citizen was taken care of. The language of the questionnaire was in Hindi as requested by the participants. The questionnaire comprised three parts as follows:

Sociodemographic details

Questions relating to psychological stress due to COVID-19.

Questions to assess the awareness and attitudes regarding COVID-19

The duration of the study spanned for a period of 1 month, i.e., March 2020. The data were collected, compiled, arranged in a systematically manner and analyzed in terms of percentage and frequencies using SPSS Version 17.0 (SPSS Inc., Chicago, IL, USA).

  Results Top

In the present survey, out of 118 senior citizens from two old citizens' home running under the supervision of NGOs, 84 of them gave consent to participate in the study. Thus, the response rate was 71%. The mean age among the senior citizens was found to be 69.6 with a standard deviation of 7.82. Demographic data showed that the majority of participants were females (65%) when compared to males (35%) [Table 1].
Table 1: Demographic distribution of senior citizens

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In the present course, 91.6% of older adults responded to phobic anxiety due to COVID-19 lockdown period. Older adults of the study (97.6%) were not taking proper sleep and 92.8% reported no functional impairment due to fear or anxiety because of infection, while 97.6% reported behavioral disorders. Majority of the older adults (96.4%) had awareness regarding COVID-19 condition and 97.6% about water and hand sanitization. About 91.6% of older adults were familiar with the fact that wearing a mouth mask is the practice for the personal protection. In the current review, 94% of older adults were aware of the symptoms, and 82.1% stated to avoid handshake. Most of the respondents (92.8%) believed that COVID-19 is not a serious public health issue. 94% of older adults were aware of their role in case of having sign and symptoms, and 65.4% agreed to their role in informing others about COVID-19. High response (96.4) was obtained for the question: “Are you following social distancing and wearing mouth mask?” Majority of the respondents had positive response toward COVID-19 protection practice in the future (98.8%). 97.6% older adults agreed to the question “Will you support a government initiative whereby older patients could obtain advice on treatment need from a central facility such as primary health care center connected via telephonic consultation?” On the contrary, mixed response 76.1%/23.8% of senior citizens suggested that the significant challenges in COVID-19 infection are illiterates, population below the poverty line, and lack of medical infrastructure [Table 2].
Table 2: Responses in psychological stress, awareness, and attitude-related questions

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  Discussion Top

The results of the present study reveal that the senior citizens were having adequate awareness about the incubation period of the disease. Nonetheless, senior citizens in this study could identify the main symptoms of COVID-19, which helps them to recognize the threat and take the necessary actions, which considered a ground stone in the management and control the spread of the disease in their day-to-day life.[12],[13],[14] Senior citizens response to prevention measures were better for the personal protective face mask and disinfection/sanitation procedures.[14]

One of the most extensive case series carried out by Wu and McGoogan stated that 72,314 cases were reported by the Chinese Centers for Disease Control and Prevention, with the case fatality 8.0% (312 of 3918) in patients aged 70–79 years and 14.8% in patients aged ≥80 years (208 of 1408).[15],[16] There has been no evidence-based specific treatment for COVID-19, and management of COVID-19 has been mostly supportive.[17],[18],[19] The current approach to COVID-19 is to control the source of infection; use infection prevention and control measures to lower the risk of transmission; and provide early diagnosis, isolation, and supportive care for affected patients.[1],[20] This fact was reflected by the response of participants to treatment; almost half of the senior citizens stated that the disease self-resolves over time with no need for special treatment. This perception about the disease self-resolution resulted in that most participants perceived COVID-19 is not a serious public health issue.[21],[22] However, the vast majority of senior citizens prefer to would avoid sitting with an infected person who was a suspect of COVID-19 because of the possibility of disease transmission during incubation periods, during which, no symptoms may appear.[23]

In the present study, majority of the senior citizens agreed that significant challenges in COVID-19 infection are illiterates, population below the poverty line, and lack of medical infrastructure in India. In the current study, significant differences were found for the questions such as “Are you aware of your role in informing others about COVID-19 infection. Majority of senior citizens were ready to adapt telemedicine and teledentistry for their health-related needs,” and “In the future, will you follow the rules and staying back inside taking all precautions.” There are no studies reported in the literature (PubMed Central November 2019–July 2020) estimating awareness of the home population of senior citizens concerning COVID-19 coronavirus infection, so it is not possible to compare the results of our study with any.


Despite the findings introduced here, it is essential to emphasize that this survey had loads, including the relatively low response rate, which resulted in a smaller than expected sample size, which may be due to the short period of data collection. The current study thus demands further extensive sample size studies to be conducted shortly to measure the psychological and physical stress the senior citizens are going through in the pandemic.

  Conclusions Top

The result obtained from the present study highlights that the senior citizens have adequate knowledge and increased psychological stress and insecurity among them regarding the outbreak of COVID-19 pandemic. The emergence of COVID-19 represents a dynamic specific and real threat to the health and well-being of older people as they are more prone to get exposed to various systemic disease and its associated complications. It is strongly advised that an emphasis should be given to educational campaigns and psychological counseling of the senior citizens, to overcome the mental stress and anxiety prevailing in them regarding the outburst of COVID-19.


Authors would like to thank administration of NGOs and all senior citizens for their kind cooperation throughout the study and the ethical committee of the college for support.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

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Freedman A, Nicolle J. Social isolation and loneliness: The new geriatric giants: Approach for primary care. Can Fam Physician 2020;66:176-82.  Back to cited text no. 10
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  [Table 1], [Table 2]


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