Rising stress in the developing world is a result of unresolved physical as well as mental pressures exacerbated by a rapidly transforming economic, demographic, and sociocultural environment. Chronic stress significantly affects well-being and health in terms of mental health, diabetes, cardiovascular disease, obesity, and so on. ^{1, 2, 3, 4, 5} Stress is a vibrant term that is impacted due to the interaction between the individual and environment, and its impact on the people varied according to his / her coping skills. ⁶ Sociocultural environments influenced by medical, physical, psychological, and psychosocial factors compose perceived stress, that measures the level to which circumstances in one's life are evaluated as stressful. ⁷ The evaluation of this felt stress is thought to surpass evaluation of actual stressful life experiences. 8

Sociodemographic characteristics (such as neighborhood profile, educational level, socioeconomic position, and gender) as well as behavioral risk factors (such as alcohol and smoking intake) have also related to perceived stress, according to previous research. 9, 10, 11, 12, 13, 14 However, most of the Indian research on perceived stress was undertaken within specialized demographic subgroups, and data on perceived stress and related variables in overall population are lacking. ¹⁵ Understanding the elements related to stress among Indian people can aid in the creation of community-based treatments for stress reduction. In addition, early identification of individuals as well as subgroups with stress-related risk factors accumulation can give chances for early strategic intervention in the avoidance of negative health and behavioral outcomes. ¹¹ The PSS (“Perceived Stress Scale”), established by Sheldon Cohen, is a self‑appraisal measure used by people to evaluate the perceived stressfulness of their varied life circumstances. ¹⁶ The data regarding the levels of perceived stress and its related factors in general Indian population is sparse, hence this study was undertaken to have an insight into the perceived stress levels among the Urban population of Gandhinagar, Kolar.

To assess the perceived stress levels and their associated factors among the urban population of Gandhinagar.

Data collection was from the residents of Urban field practice area of Gandhinagar, Kolar. For the data collection, a pretested semi-structured questionnaire was utilized. Systematic random sampling was used to select the houses. Study design was a community-based Cross-sectional analysis. All above 18 years and maximum 2 people of opposite sex from each house had been included. PSS-10 was utilized to measure perceived stress. PSS is the utmost utilized psychological tool for evaluating stress perception. It evaluates the extent to which circumstances in one's life are evaluated as stressful. The PSS includes questions that inquire about emotions and ideas from the previous month. Individual PSS scores can vary between 0 - 40, with the greatest levels indicating more perceived stress. Scores ranged between - 0 to 13 will be considered low stress; 14 to 26 will be considered moderate stress; 27 to 40 will be considered as high perceived stress. ¹⁶ The scale was linguistically verified in Kannada, the native language. The translating procedure included: (1) A native Kannada speaker translated the original PSS forward into Kannada, (2) the back‑translation into English has been performed by another native speaker. Among 10 individuals who were not involved in the study the translated version was pretested. The PSS was verbally managed to participants who lacked functional literacy, illiterate or to those requested it. The study was conducted between October 2022 to February 2023. Based on the prevalence of any mental health disorders in India as per National Mental Health Survey (2015-2016)17 as 10% with alpha error of 5% and at 95% confidence interval the minimum sample size calculated was 144 [calculated by Open Epi version 3.01].

For this study, households served as the sample unit. The houses were chosen using a systematic random sampling method. Every ninth house was chosen. Those houses which were locked were visited 3 times more at different timings. In the case that the same house could not be visited or no available qualified person was living there, the next residence was chosen. Two people, each of the opposing sexes, from each family household were allowed to participate in the study. The research participants were chosen at random by a draw of lots if more than one eligible person was present in the same household. Each day, a maximum of 20 people might be enrolled.

Total 283 participants were interviewed for the research.

Most of the participants belong to groups 34-50 years (40.9%) of age. 56.3% of the participants were females. Almost all (98%) were Hindu by religion. 92.5% were married and majority (57.3%) belongs to joint families. Majority of the participants interviewed were semiprofessionals. Regarding educational status, most of them were educated up to high school (20.8%) and post-high school diploma (20.8%). According to the modified BG Prasad’s classification, most of the participants belong to class II. (Table 1)

4% of the participants were smokers and have the habit of taking alcohol (Table 2)

3% of the participants were having hypertension and 4 4% were diabetic (Table 3)

Majority of the participants 69.6% were having moderate stress while 3.4% have severe stress. The mean PSS score was 16.19 among the participants (Table 4)

Those who are having the habit of smoking and alcoholism they are having increased mean PSS scores compared to those who do not smoke or consume alcoholism and this relationship was obtained to be significant statistically. Among the sociodemographic factors, occupation, marital status, and socioeconomic status have shown significant relationship with perceived stress scores statistically. Participants who were married are having higher mean perceived stress scores compared to those who were unmarried. In occupation, those who are having skilled jobs are having statistically significant differences in mean PSS scores compared to the professionals. (Table 5)

Regression analysis showed negative association between gender, religion, SES, marital status, and type of family, and perceived stress scores but this association was statistically significant only for SES. All the above factors were able to predict 7% of the changes in the perceived stress scores. (Table 6)

The study shows that the mean PSS score was 16.19 with very severe stress present in the 3.4% of the participants. Moderate to severe stress was found in 73% of the participants which is way more than the figures obtained through National Mental Health Survey (2015-2016). ¹⁷

When asked about the reasons for being stressed the participants pointed out low income, presence of co-morbidities among family members, and family problems as the main reasons.

The univariate analysis showed that habit of smoking, alcoholism, occupation, and socioeconomic status were the factors which can predict the perceived stress levels. When multiple linear regression was done only the SES was predicting the perceived stress levels. Higher the SES lesser the perceived stress levels.

In the current study, a low level of education was revealed to be a very significant predictor of greater stress. Although having a high degree of knowledge may also be stressful, it has been hypothesized that education helps people to become better at managing stress. ¹¹ We also discovered greater PSS scores among participants from the lower socioeconomic strata, which is consistent with the previous findings. 9, 10, 11

It has been noted that unemployment or lack of employment means among individuals who aspire to work relates to greater perceived stress owing to the possibility of lack of financial independence. ¹⁰ However, in present analysis, those who are semiprofessionals noted greater perceived stress. This may be attributable to the high proportion of semiprofessionals in sample.

In current research, married individuals noted higher levels of prevalent stress than unmarried participants, despite the perception that marriage reduces perceived stress levels. ¹⁸ However, it may also be recognized that economic deprivation may contribute to the spread of stress inside relationships. ¹⁹

Nevertheless, there are shortcomings in present study. First as it is cross-sectional research, it is unable to evaluate the temporal link between prevalent stress and the numerous stressor factors. Secondly, the analysis did not account for several characteristics, such as social isolation and neighborhood profile, which might impact the reported stress levels of community members. ^{11, 14, 20} Finally, analysis was done in a single Urban field practice area in Kolar, Karnataka which limits its external validity.

In conclusion, perceived stress among low socioeconomic status was high with habit of smoking, alcoholism, marital status, and occupation being its covariates. Future research should evaluate the significance of social networks in the Indian setting for dealing with perceived stress and should design interventional studies at the community level to reduce the perceived stress levels among the general population.