Background The current pandemic of COVID-19 impacted the psychological wellbeing of populations globally. Objectives We aimed to examine the extent and identify factors associated with psychological distress, fear of COVID-19 and coping. Methods We conducted a cross-sectional study across 17 countries during Jun-2020 to Jan-2021. Levels of psychological distress (Kessler Psychological Distress Scale), fear of COVID-19 (Fear of COVID-19 Scale), and coping (Brief Resilient Coping Scale) were assessed. Results A total of 8,559 people participated; mean age (±SD) was 33(±13) years, 64% were females and 40% self-identified as frontline workers. More than two-thirds (69%) experienced moderate-to-very high levels of psychological distress, which was 46% in Thailand and 91% in Egypt. A quarter (24%) had high levels of fear of COVID-19, which was as low as 9% in Libya and as high as 38% in Bangladesh. More than half (57%) exhibited medium to high resilient coping; the lowest prevalence (3%) was reported in Australia and the highest (72%) in Syria. Being female (AOR 1.31 [95% CIs 1.09-1.57]), perceived distress due to change of employment status (1.56 [1.29-1.90]), comorbidity with mental health conditions (3.02 [1.20-7.60]) were associated with higher levels of psychological distress and fear. Doctors had higher psychological distress (1.43 [1.04-1.97]), but low levels of fear of COVID-19 (0.55 [0.41-0.76]); nurses had medium to high resilient coping (1.30 [1.03-1.65]). Conclusions The extent of psychological distress, fear of COVID-19 and coping varied by country; however, we identified few higher risk groups who were more vulnerable than others. There is an urgent need to prioritise health and well-being of those people through well-designed intervention that may need to be tailored to meet country specific requirements.

Background The Internet has become a major source of health-related information. In order to provide better health services and health-care education to society, nurses should have acceptable electronic health (eHealth) literacy. Objective The main aim was to measure eHealth-literacy skills among nursing students of Kathmandu Medical College Teaching Hospital, Nepal. Methods A cross-sectional study was conducted among 152 Bachelor of Science nursing students at the hospital. Data were collected using the self-administered eHealth Literacy Scale. This is an eight-item tool that is assessed on 5-point likert scale to measure consumers’ perceived skills at finding, evaluating, and applying eHealth information to health problems. Demographical and personal variables were collected to explore their relationship with eHealth literacy. Results A total of 152 nursing students with mean age of 19.84±1.62 years participated in the study. While 44.7% perceived that they had average Internet skills, 65.1% found the Internet useful in helping them make decisions about their health. Nursing students had a moderate self-perceived level of eHealth literacy (median 3.69, IQR 0.87). Related factors included students’ Internet skills, frequency of using the Internet for health related purposes, and self-perception of the usefulness and importance of the Internet. Conclusion This study represents a baseline reference for eHealth literacy among nursing students. Students have some basic necessary skills, while other skills still need to be improved. There is a need to pay attention to eHealth-literacy needs of nursing students.

There has been a rapid rise in the burden of noncommunicable diseases in low-income countries like Nepal. Political and economical instability leading to internal migration give rise to haphazard urbanization in Nepal. This, coupled with negative effects of globalization, is largely responsible for changing lifestyle and developing risky behaviour among the urban poor that put them at high risk of developing noncommunicable diseases. A descriptive cross-sectional quantitative study was conducted from September to December 2012 in an urban slum of Kathmandu to explore the prevalence of four major behaviour risk factors namely physical inactivity, low fruit and vegetable consumption, and tobacco and alcohol use and to measure the burden of obesity and hypertension in the population. We used WHO NCDs Risk Factor steps 1 and 2 questionnaires in all the 689 households of the slum. The major behavioral risk factors for noncommunicable diseases were very common with at least a quarter of the population having the major risk factors. The results may serve to form a framework to future planning, policy-making, implementation, and evaluation of any measures undertaken to reduce these risk factors, especially as the government is planning to unveil the National Urban Health Policy soon.

BackgroundNepal currently faces an increasing burden of cardiovascular disease (CVD). Earlier studies on health literacy and the behavior dimension of cardiovascular health reported a substantial gap between knowledge and practice.ObjectiveThis qualitative study aimed to deepen understanding of the community perspective on cardiovascular health from the patients’ viewpoint.DesignWe conducted in-depth interviews (IDIs) with 13 individuals with confirmed heart disease, hypertension, or diabetes mellitus. All participants provided verbal consent. We used an IDI guide to ask respondents about their perception and experiences with CVD, particularly regarding causation and preventability. We manually applied qualitative content analysis to evaluate the data and grouped similar content into categories and subcategories.ResultsRespondents perceived dietary factors, particularly consumption of salty, fatty, and oily food, as the main determinants of CVD. Similarly, our respondents unanimously linked smoking, alcohol intake, and high blood pressure with cardiac ailments but reported mixed opinion regarding the causal role of body weight and physical inactivity. Although depressed and stressed at the time of diagnosis, respondents learned to handle their situation better over time. Despite good family support for health care, the financial burden of disease was a major issue. All respondents understood the importance of lifestyle modification and relied upon health professionals for information and motivation. Respondents remarked that community awareness of CVD was inadequate and that medical doctors or trained local people should help increase awareness.ConclusionsThis study provided insight into the perceptions of patients regarding CVD. Respondents embraced the importance of lifestyle modification only after receiving their diagnosis. Although better health care is important in terms of aiding patients to better understand and cope with their disease, interventions should be tailored to improve the community's cardiovascular health literacy and preventive practices.

ObjectivesNon-communicable diseases account for 50% of all deaths in Nepal and 25% result from cardiovascular diseases. Previous studies in Nepal indicate a high burden of behavioural cardiovascular risk factors, suggesting a low level of knowledge, attitude and practice/behaviour regarding cardiovascular health. The behavioural foundation for a healthy lifestyle begins in early childhood, when mothers play a key role in their children's lives. This qualitative study, conducted in a Nepalese peri-urban community, aimed to explore mothers’ perception of their children's diet and physical activity.DesignWe notated, tape-recorded and transcribed all data collected from six focus group discussions, and used qualitative content analysis for evaluation and interpretation.SettingThe study was conducted in the Jhaukhel-Duwakot Health Demographic Surveillance Site in the Bhaktapur district of Nepal.ParticipantsLocal health workers helped recruit 61 women with children aged 5–10 years. We distributed participants among six different groups according to educational status.ResultsAlthough participants understood the importance of healthy food, they misunderstood its composition, perceiving it as unappetising and appropriate only for sick people. Furthermore, participants did not prioritise their children's physical activities. Moreover, mothers believed they had limited control over their children's dietary habits and physical activity. Finally, they opined that health educational programmes would help mothers and recommended various intervention strategies to increase knowledge regarding a healthy lifestyle.ConclusionsOur data reveal that mothers of young children in a peri-urban community of Nepal lack adequate and accurate understanding about the impact of a healthy diet and physical activity. Therefore, to prevent future cardiovascular disease and other non-communicable diseases among children, Nepal needs health education programmes to improve mothers’ cardiovascular health knowledge, attitude and behaviour.