Increased Levels of Anxiety Among Medical and Non-Medical University Students During the COVID-19 Pandemic in the United Arab Emirates

The era of E-learning from the perspectives of Jordanian medical students: A cross-sectional study

Introduction

Online learning is becoming a crucial part of the educational process worldwide, especially after the recent COVID-19 pandemic. This study was designed to assess medical students’ perception toward online learning and their perceived preparedness and barriers during the COVID-19 pandemic.

Methods

An electronic-based, cross-sectional survey was used to recruit eligible students in Pharmacy, Doctor of Pharmacy, Medicine, Nursing, Dentistry, and Veterinary Medicine programs at various Jordanian universities (public and private). Descriptive and linear regression analysis were conducted using S.P.S.S. software. The perception score was calculated based on a 5-point Likert scale.

Results

A total of 939 students agreed to participate in this study. The prominent category was females (n = 691, 73.6%), the median age of students was 22.0 years (IQR = 2.0), and around 56% of the students study in private universities (n = 520, 55.6%). More than half of the students reported that their experiences were unsatisfactory or very unsatisfactory (n = 510, 54.3%). The majority of students preferred face-to-face communication with their professors and colleagues and considered it more effective (n = 682, 72.6%). The median of the mean perception score was 2.4 (IQR = 1.1). Regarding challenges and barriers, more than 70% reported weak internet connection, E-learning boredom, and lack of motivation (n = 723, 77.0%).

Conclusion

This study reported inadequate satisfaction and perception towards the current experience in E-learning during the COVID-19 pandemic. It also discussed the barriers and challenges hindering this transition, such as weak internet connection and the lack of motivation, indicating a need for implementing new pedagogies to enhance students’ experiences regarding online education.

Psychological Impact of COVID-19 on Doctors and Medical Students of Punjab, Pakistan: A Logistic Regression Analysis

Background

This study was carried out to find the awareness level, prevalence of anxiety and depression, and their associated factors among doctors and medical students during the COVID-19 pandemic in Punjab province, Pakistan.

Materials and Methods

An online questionnaire-based cross-sectional study was conducted; data were collected regarding the demographic profile, awareness of COVID-19, anxiety symptoms using a self-rating anxiety scale (SAS), and depression symptoms using a self-rating depression scale (SDS). A total of 504 responses were obtained. The Chi-square test was used to compare groups and the logistic regression model for the association of factors with anxiety and depression.

Results

A total of 504 medical students and doctors responded to the questionnaire. The mean age of participants was 25.66 ± 6.71 years. The awareness rate of COVID-19 was 97.6%. The prevalence rate of anxiety and depression was 3.4% and 15.1%, respectively. According to the logistic regression model, those with low awareness levels (≤6 points) and spending more time on the news (>3 hours) had higher levels of anxiety, while higher levels of depression symptoms were reported in females, young people, and medical students.

Conclusion

Doctors and medical students had a high level of awareness of COVID-19 and a low level of anxiety and depression. However, female gender and younger age group were the most vulnerable groups significantly associated with depression.

Comparing the Effectiveness of Virtual and In-Person Delivery of Mindfulness-Based Skills Within Healthcare Curriculums

Purpose

To promote well-being, healthcare education programs have incorporated mindfulness-based skills and principles into existing curriculums. Pandemic-related restrictions have compelled programs to deliver content virtually. Study objectives were to determine (1) whether teaching mindfulness-based skills within physician assistant (PA) programs can promote well-being and (2) whether delivery type (virtual vs. in-person) can impact the effectiveness.

Methods

During this 2-year study, a brief mindfulness-based curriculum was delivered to incoming first-year students at six PA programs, while students at two programs served as controls. The curriculum was delivered in-person in year one and virtually in year two. Validated pre- and post-test survey items assessed mindfulness (decentering ability, present moment attention and awareness, and psychological flexibility) and well-being (perceived stress and life satisfaction).

Results

As expected, coping abilities and well-being were adversely impacted by educational demands. The mindfulness-based curriculum intervention was effective in increasing mindfulness and life satisfaction, while decreasing perceived stress when delivered in-person. Virtual curricular delivery was effective in decreasing perceived stress but not improving life satisfaction. Over half of the participants receiving the curriculum reported positive changes on mindfulness measures with approximately 14-38% reporting a change of greater than one standard deviation. Changes on mindfulness measures explained 30-38% of the reported changes in perceived stress and 22-26% of the changes in life satisfaction. Therefore, the mindfulness curriculum demonstrated statistically significant improvements in measures of mindfulness and mitigated declines in life satisfaction and perceived stress.

Conclusion

Mindfulness-based skills effectively taught in-person or virtually within PA programs successfully promote well-being.

The Relationship between Duration of Smartphone Uses and Anxiety in University Students during the COVID-19 Outbreak

Background: During the COVID-19 pandemic, China adopted a home isolation policy, which caused lifestyle changes for university students, including increased smartphone use. Several studies indicate that problematic smartphone use is associated with anxiety. However, this association has not been examined in the context of epidemics. The aim of this study was to investigate whether the duration of smartphone use was associated with anxiety in Chinese university students during the COVID-19 pandemic. Methods: Participants included 9716 university students (5458 men and 4258 women) from Liaoning, China. We assessed the duration of smartphone use with a self-reported questionnaire. Anxiety was assessed using the generalized anxiety disorder seven-item scale. A multivariate logistic regression analysis was performed to determine the adjusted association between smartphone use and anxiety. Results: After adjusting for confounding factors, we observed a positive association between smartphone use duration and the prevalence of anxiety in all participating students. Compared with short periods of smartphone usage, the odds ratios (95% confidence interval) for moderate and long smartphone usage duration were 1.17 (1.00, 1.36) and 1.58 (1.36, 1.83), respectively. This significant positive association did not change in the sex-stratified analysis (for both men and women). Conclusions: Our examination of the association between duration of smartphone uses and university students’ anxiety levels revealed that long smartphone use was associated with a high prevalence of anxiety during the COVID-19 pandemic.

The dental office: A safe place against COVID19 and other future pandemics

Background

The pandemic caused by the spread of COVID19 generated throughout the world great changes in all areas of life. Social distancing was carried out very drastically in some countries, and even in the field of dental care, some countries prohibited the practice of dentistry.

Objective

To demonstrate that the dental office is safe regarding the possibility of contagion of Sars-Cov-2 as long as good biosecurity protocols are used.

Methods

A structured survey of 19 questions was applied to 103 patients who subsequently attended a periodontics and oral and maxillofacial surgery office in Mexico, to receive care from these specialties between April 2020 and July 2021. The questions posed in this survey were aimed at knowing the opinion of the patients regarding the measures that this establishment has for the prevention of the transmission of COVID19, as well as questions regarding the possible effects of attending this office in contagion of the disease from patients and their families.

Results

A total of 18 (17.5%) patients reported having suffered COVID19, and none reported that they fell ill after the consultation. None of the clinic's specialists and assistants have fallen ill with COVID-19 during the pandemic.

Conclusions

It is not necessary to suspend or condition dental care during times of pandemics such as what happened with COVID19, as long as strict safety protocols are observed within clinical facilities.

Depression, Anxiety, and Stress among Sudanese Medical Students during the COVID-19 Lockdown Period

Background: The novel coronavirus disease-2019 (COVID-19) pandemic has imposed a compulsory lockdown that has led to the emergence of various type of psychological distress among medical students. This study aimed to identify the determinants and the levels of depression, anxiety and stress among Sudanese medical students during the COVID-19 lockdown period. Methods: A web-based cross-sectional study was conducted from April to July 2020. The data were collected using a questionnaire that contained two sections – sociodemographic items and the Depression, Anxiety, Stress Scale (DASS-21). Results: A total of 1,058 students responded and completed the questionnaire. The study sample consisted of 604 (57.1%) females, and the rest were males. The students attending a public university comprised the majority (n = 632 or 59.7%). Many of the respondents were at the pre-clinical phase of their studies (n = 572 or 54.1%). Approximately 81.6% of all participants reported symptoms of psychological distress. The prevalence rates of depression, anxiety and stress were 75%, 55.3% and 51.8%, respectively. Binary logistic regression analysis revealed that depression was significantly associated with the female gender (adjusted odds ratio [AOR] = 1.63, 95% confidence interval [CI] = 1.22‒2.16) and students at the pre-clinical phase (AOR = 1.65, 95% CI = 1.24‒2.20). Anxiety was significantly associated with the female gender (AOR = 1.73, 95% CI = 1.35‒2.22) and studying at a private university (AOR = 1.36, 95% CI = 1.05‒1.76). Stress was significantly associated with the female gender (AOR = 1.36, 95% CI = 1.07‒1.74) and students at the pre-clinical phase (AOR = 1.43, 95% CI = 1.12‒1.83). Conclusions: Logistic regression analysis showed that female students at the pre-clinical phase had an increased risk of depression and stress. Female students attending a private university had an increased risk of anxiety. Depression, anxiety and stress were highly prevalent among Sudanese medical students.

The Effect of Perceived Threat Avoidability of COVID-19 on Coping Strategies and Psychic Anxiety Among Chinese College Students in the Early Stage of COVID-19 Pandemic

Background

The novel coronavirus disease 2019 (COVID-19) outbreak has seriously threatened the mental health of college students. This study intended to invest whether perceived threat avoidability of COVID-19 relates to psychic anxiety among college students during the early stage of the COVID-19 pandemic, as well as the mediating roles of COVID-19-specific wishful thinking and COVID-19-specific protective behaviors in this relationship.

Methods

A cross-sectional study was conducted in China, using a random sampling method (February 6-25, 2020). Self-reported questionnaires were conducted online included the Perceived Threat Avoidability of COVID-19 Scale, COVID-19-specific Wishful Thinking Scale, COVID-19-specific Protective Behaviors Scale, and the Hamilton Psychogenic Anxiety Scale. The data were analyzed using Structural equation modeling and Bootstrapping procedure.

Results

A total of 2922 samples were collected in this study. Perceived threat avoidability of COVID-19 is negatively related to psychic anxiety (β = -0.158, p< 0.001), and both COVID-19-specific wishful thinking (β = -0.006, p = 0.029, 95% CI: [-0.012, -0.001]) and protective behaviors (β = -0.029, p< 0.001, 95% CI: [-0.043, -0.018]) mediate this relationship. Also, COVID-19-specific wishful thinking is found to correlate with COVID-19-specific protective behaviors negatively (β = -0.112, p < 0.001).

Conclusion

Perceived threat avoidability of COVID-19 contributes to psychic anxiety among college students. COVID-19-specific wishful thinking strategy plays a negative mediating role and increases the level of anxiety; COVID-19-specific protective behaviors strategy plays a positive mediating role and reduces the level of anxiety; meanwhile, wishful thinking also suppresses college students from adopting protective behaviors.

Impact of COVID-19 on School Populations and Associated Factors: A Systematic Review

Apart from the severe impact on public health and well-being, the chain effect resulting from the COVID-19 health crisis is a profound disruption for various other sectors, notably in education. COVID-19 has driven massive transformation in many aspects of the educational landscape, particularly as teaching and learning shifted online due to school closure. Despite the many impacts of the health crises on school populations, a systematic review regarding this particular issue has yet to be conducted. This study, therefore, attempts to comprehensively review the impact of health crises on school populations (student, teacher, parent, and school administration). An extensive literature search guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting checklist was performed in two selected databases, namely Web of Science (WoS) and Scopus to identify how this particular topic was previously studied. Exclusion and inclusion criteria were set to ensure that only research papers written in English from the year 2000 to the present (April 2021) were included. From a total of 457 studies screened, only 41 of them were deemed eligible to be included for qualitative synthesis. The findings revealed that the COVID-19 pandemic was the only health crisis discussed when it comes to investigating the impact of health crises on school populations. This study found four notable consequences of health crises on school populations, which are impacts on mental health, teaching and learning, quality of life, and physical health. Among factors associated with the impact of the health crises are; demographic factors, concerns about the pandemic, education-related factors, health-related factors, geographic factors, economic concerns, teaching challenges, and parenting in the pandemic. This study is expected to be a reference for future works in formulating crises mitigation strategies to reduce the impact of health crises on schools by exploring the contexts of the crises.

Fear of COVID-19 Among College Students: A Systematic Review and Meta-Analysis

Background

Mental health issue among college students is routinely a major public health concern, and coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the students' mental health issues which include psychological distress, panic disorder, insomnia, and posttraumatic stress symptoms. However, few studies reached a consensus on the impact of COVID-19 fear on mental health among college students. Therefore, we aimed to conduct a systematic review and meta-analysis that quantitatively synthesized the fear among college students during the COVID-19 pandemic.

Methods

PubMed, EMBASE, CINAHL, and PsycINFO electronic databases were systematically searched to identify cross-sectional study reporting the state of COVID-19 fear examined by the Fear of COVID-19 Scale (FCV-19S) published up until November 20, 2021. Methodological quality was complied with the evaluation criteria of the Agency for Healthcare Research and Quality. The random effects model was employed to estimate the pooled mean of FCV-19S score. Subgroup analysis and meta-regression analysis were also conducted. Publication bias was assessed by Begg's test and funnel plot.

Results

A total of 16 studies with a sample size of 11,872 were included. A pooled mean of FCV-19S score was 17.60 [95% confidence interval (CI): 16.41–18.78]. The mean of COVID-19 fear in women (17.11, 95% CI: 16.59–17.64) was higher than that in men (15.21, 95% CI: 14.33–16.08). The highest and lowest pooled means of FCV-19S score were observed in the studies conducted in multiple countries that include Israel, Russian, and Belarus (21.55, 95% CI: 20.77–22.33) and in Europe (16.52, 95% CI: 15.26–17.77), respectively. No significant publication bias was detected by Begg's test.

Conclusions

College students experienced a moderate level of fear caused by COVID-19 pandemic. It is necessary to design and implement prevention programs that target the mental health of college students.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287017, identifier: CRD42021287017.

Development and psychometric properties of COVID-19 related Healthcare Student stress scale (CHSSS)

Background

There is no valid and reliable tool to measure COVID-19 healthcare stress felt by healthcare students. A scale was developed to assess COVID-19 stress in healthcare students and its psychometrics was examined.

Methods

This is a two phases mixed-method study including a qualitative stage consisting of student interview and literature review to develop content of the tool. In the quantitative stage, the psychometrics of the scale was examined in 2020–2021.

Results

The COVID-19 related healthcare student stress scale (CHSSS) featured five factors including fear of catching coronavirus, social constraints, changes in education, non-compliance of health protocols and worrying news and overload information, which totally explained 51.75% of the total variance.

Conclusion

Validity and reliability of CHSSS with 17 items were supported to measure COVID-19 stress in healthcare students as a self-assessment tool. Researchers can utilize this tool to assess COVID-19 stress in healthcare students and introduce policies and intervention especially designed for healthcare students.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-022-00778-9.

Challenges Facing Undergraduate Medical Education in Ambulatory Care Clinics at Tertiary Care Hospitals

Background: Medical education has been rapidly growing and transforming due to the enormous evolution of medicine. There have been many proficient ways to learn in medicine, but academic lectures, attending wards, and ambulatory care clinics (ACC) remain the three main ways of gaining clinical knowledge and experience for medical students. Over the past decade, there has been a dramatic shift in care by focusing on ambulatory care rather than inpatient settings, which provides a golden opportunity to reinforce medical education. Purpose: Most of the published studies that have focused on the teaching barriers in ACC were descriptive rather than analytic studies. Herein, we aim to detect and determine the barriers to teaching in ACC settings using qualitative analysis. Methods: This is a cross-sectional, observational study, involving medical students in their clerkship years (i.e., fourth and fifth) from two different medical colleges in Riyadh, Saudi Arabia. Faculty who are involved in undergraduate medical education in both colleges were also included. Main Results: A total of 387 medical students studying at the two universities were enrolled in the study. Most of the participants preferred attending outpatient clinics with consultants (44.2%) and the majority preferred attending internal medicine (IM) and IM subspecialties clinics (40.4%). Regarding the challenges, students believe the top three barriers are related to: faculty (39%), environment (34.8%), and patients (14.8%). Faculty on the other hand see that the top three barriers are related to environment (55.6%), patients (24.4%), and faculty (20%). Conclusion: Undergraduate medical education in outpatient settings has many challenges. In our study, the most significant challenges were COVID-19-related restrictions, patient refusal, and insufficient time for teaching. Future studies are needed to investigate these barriers and explore potential solutions that can decrease their burden on undergraduate medical education.

Factors influencing medical and nursing students' willingness to care for COVID-19 patients in South Korea: a cross-sectional study

BACKGROUND

The COVID-19 pandemic has threatened the stability and adequacy of the global healthcare system. In this situation, authorities have considered engaging medical and nursing students to address the shortage of frontline healthcare workers. This study investigated the effect of COVID-19-related knowledge, attitudes, and preventive behaviors on medical and nursing students' willingness to care for COVID-19 patients.

METHODS

Medical and nursing students from universities in two regions of South Korea participated in this cross-sectional study. A total of 330 questionnaires were distributed; of them, 99.3% were collected, and 315 questionnaires were analyzed. Data were collected on participants' general characteristics, COVID-19-related knowledge, attitudes, and preventive behaviors, and willingness to care for COVID-19 patients.

RESULTS

In total, 66.3% of the participants were willing to care for patients during the COVID-19 pandemic. Students in higher grades and those with more clinical practice experience showed higher levels of willingness to care. Specifically, willingness to care was correlated with the senior year (OR = 3.58, 95% CI = 1.24 - 10.37, p = .019), a high level of COVID-19-related knowledge (OR = 1.03, 95% CI = 1.00 - 1.05, p = .041), an optimistic attitude that COVID-19 can be overcome (OR = 1.63, 95% CI = 1.24 - 2.14, p < .001), and increased engagement in infection prevention behaviors (OR = 1.41, 95% CI = 1.16 - 1.71, p < .001).

CONCLUSIONS

The findings indicated that a high level of knowledge regarding the COVID-19 pandemic, having an optimistic attitude, and engaging in preventive behaviors affected students' willingness to care for COVID-19 patients. Integrating disaster preparedness courses in the early years of their curriculum could increase future healthcare providers' willingness to care for patients.

The impact of the COVID-19 pandemic on the lifestyle and behaviours, mental health and education of students studying healthcare-related courses at a British university

BACKGROUND

The COVID-19 pandemic has affected most industries, including health education. In this study, we surveyed students studying healthcare-related courses at our university on how their lifestyles and behaviours, mental health and education had been affected by the pandemic.

METHODS

Mixed methods cross-sectional study.

RESULTS

Two hundred thirty-three students responded to the questionnaire. Lifestyle and behaviours: 51.5% of the participants changed their diet (n=120); 45.5% (n=106) exercised less; 66.5% (n=155) experienced a change in sleep; 51.1% (n=119) reported a change in appetite. Mental health: 84.2% (n=196) reported worrying too much about different things; 61.9% (n=144) could not stop or control worrying; 71.2% experienced trouble relaxing on several days or more (n=166). At least sometimes, 72.1% (n=168) felt unable to cope with things they had to do; 8.5% (n=20) never, or almost never, felt confident about handling personal problems. Education: 65.7% (n=153) struggled to complete learning outcomes with online delivery; 82% (n=191) worried about practical skills being affected; 60.5% (n=141) worried about the impact of COVID-19 on their future career. Almost half (48.9%, n=114) believed that online teaching should be part of the standard curriculum.

CONCLUSION

In general, there was a negative impact on behaviours, lifestyle and mental health and virtual education was perceived as necessary in making up for the loss of face to face experiences. Students' mental health and educational needs have been affected by the current pandemic and healthcare educational facilities must respond to these needs to ensure students continue to receive the support they need.

Generalized anxiety disorder among Bangladeshi university students during COVID-19 pandemic: gender specific findings from a cross-sectional study

In the current COVID-19 pandemic there are reports of deteriorating psychological conditions among university students in lower-middle-income countries (LMICs), but very little is known about the gender differences in the mental health conditions on this population. This study aims to assess generalized anxiety disorder (GAD) among university students using a gender lens during the COVID-19 pandemic. A cross-sectional study was conducted using web-based Google forms between May 2020 and August 2020 among 605 current students of two universities in Bangladesh. Within the total 605 study participants, 59.5% (360) were female. The prevalence of mild to severe anxiety disorder was 61.8% among females and 38.2% among males. In the multivariable logistic regression analysis, females were 2.21 times more likely to have anxiety compared to males [AOR: 2.21; CI 95% (1.28-53.70); p-value: 0.004] and participants' age was negatively associated with increased levels of anxiety (AOR = 0.17; 95% CI = 0.05-0.57; p = 0.001). In addition, participants who were worried about academic delays were more anxious than those who were not worried about it (AOR: 2.82; 95% CI 1.50-5.31, p = 0.001). These findings of this study will add value to the existing limited evidence and strongly advocate in designing gender-specific, low-intensity interventions to ensure comprehensive mental health services for the young adult population of Bangladesh.

Impact of the first wave of the COVID-19 pandemic on French Health students

Context

In France, care workers and health students have been intensely mobilized during the first wave of the COVID-19 pandemic. But few studies have evaluated psychological distress on non-medical health students, in addition to the challenges posed by pedagogical continuity while universities are closed following health and safety regulations.

Objectives

This study aims to assess COVID-19's impact on health students in France on different levels: psychological, educational and social.

Methods

An online national cross-sectional study, from April 11 to May 30 2020, included sociodemographic, work conditions and numeric scales.

Results

A total of 4411 students answered. Regarding the K6 scale, 39% of students had moderate distress, and 21% had a high level of distress. Risk factors of psychological distress included being a woman (P < 0.001), being between 19 and 21 years old (P < 0.001), living alone (P = 0.008), and not having the ability to isolate (P < 0.001). Students on the frontline had less psychological distress (57 vs 62%, P = 0.003), better quality of sleep (34% vs 28% high quality, P < 0.001) but a higher consumption of medical (8.5% vs 6.5%, P = 0.044) and non-medical (18% vs 10%, P < 0.001) psychotropic drugs. Nurse and medical students had more distress and used more non-medical psychotropic substances than other health students (15% vs 9.2%).

Discussion

COVID-19’ crisis had an important impact on health students’ mental health, social life and training with discrepancies regarding the speciality whether they were on the frontline or not. There is an urgent need for psychological and pedagogical support for students, and even more so regarding the prolongation of the COVID-19 epidemic.

Mental health of medical students during the COVID19: Impact of studies years

Background

The COVID-19 pandemic had led to severe education disruption in many countries, including for medical students (MS). We aimed to evaluate MS mental health in France and search for a difference depending on studies’ years and clinical activities.

Methods

In a cross-sectional, survey-based study during the first confinement, 668 (8.35%) MS were compared to 7 336 non-medical students (non-MS) (91.65%). The PHQ-9 (≥ 10), the GAD-7 (≥ 8), and the IES-R (≥ 26) were collected to assess depressive, anxiety, and distress symptoms. Multivariable logistic regression analyses were performed.

Results

MS reported significant psychological distress (depressive symptoms: 38.17%, anxiety: 38.77% and distress: 36.83%). Compared to non-MS, they reported less significant depressive (OR, 0.80; 95% CI, 0.67–0.91; P = .007) and distress symptoms (OR, 0.73; 95% CI, 0.62–0.87; P < .001), after taking into account potential confounding variables including COVID-19 diagnosis. First year-MS reported higher rates of significant psychological distress than MS with clinical activities. Moreover, depressive symptoms’ rates were higher among MS with COVID-19 diagnosis (OR, 2.61; 95% CI, 1.21–6.13; P = .016).

Conclusions

Special attention should be offered to first year-MS and MS with COVID-19 diagnosis. Systematic companionship could be implemented for first year MS, and systematic psychiatric/psychological consultations for students with COVID-19 diagnosis.

Effect of COVID-19 outbreak on anxiety among students of higher education; A review of literature

BACKGROUND AND PURPOSE

The Covid-19 pandemic has impacted the mental health of students and exacerbated the prevalence of anxiety among them. The purpose of the literature review was to consolidate evidence for the prevalence of anxiety among students of higher education during the COVID-19 pandemic and to underscore the effect of various pandemic-related factors on this anxiety.

METHODS

A comprehensive literature search was conducted utilizing various databases such as MEDLINE, PsycInfo Google Scholar, ScienceDirect, Scopus, and Embase to identify relevant studies. To be incorporated in this review, studies had to include students of higher education, measure the prevalence of anxiety, and assess anxiety during Covid-19 pandemic.

RESULTS

37 studies met the inclusion criteria and assessed the prevalence of anxiety among students during confinement. Studies showed that more than one-third of the students suffered from anxiety during the early stages of the pandemic. Moreover, being a female, living in rural areas, facing financial hardship, working full-time, spending the quarantine in isolation, worrying about infection for themselves and others, having the uncertainty of the future, having reduced sleep quality, and transitioning to online learning, were factors associated with increased anxiety during the pandemic.

CONCLUSION

Anxiety was shown to be highly prevalent among the student population during the Covid-19 pandemic. Higher education institutions and governments should take action to ensure the safety and the physical, social, and mental wellbeing of the students.

Validation of the Peruvian Spanish Version of the Stress and Anxiety to Viral Epidemics-6 Scale to Measure Viral Anxiety of Medical Students During COVID-19

INTRODUCTION

The COVID-19 pandemic has created academic problems for Peruvian medical students leading to anxiety and depression. Hence, validated scales, such as the Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), are required to identify and propose interventions to improve mental health. We aimed to perform a psychometric validation of the Peruvian version of SAVE-6 on medical students during the COVID-19 pandemic in Lima, Peru, in 2022.

METHODS

A total of 260 medical students at National University of San Marcos (UNMSM) participated in an online survey in January 2022. We collected sociodemographic characteristics and classified psychiatric symptoms using SAVE-6, the Generalized Anxiety Disorder-7 items (GAD-7) scale, and the Patient Health Questionnaire-9 items (PHQ-9). We performed confirmatory and parallel factor analysis to examine the validity of the Peruvian Spanish version of SAVE-6.

RESULTS

We explored the reliability and validity of SAVE-6 and SAVE-6 after excluding item 5, since factor loading of item 5 is too low. Both scales showed good internal consistencies (Cronbach's α = 0.780 and.82 and McDonald's Ω = 0.792 and.829, respectively). Furthermore, SAVE-6 after excluding item 5 showed good convergent validity with GAD-7 (r = 0.224, p <.001) and PHQ-9 (r = 0.217, p <.001). Consequently, instead of the full SAVE-6, SAVE-6 excluding item 5 proved to be reliable and valid enough to assess the anxiety of Peruvian medical students during the pandemic.

CONCLUSION

The Peruvian Spanish SAVE-6 scale excluding item 5, rather than the full SAVE-6, can be applied to measure viral anxiety of medical students in Peru with good validity and reliability.

Distanciamento social por Covid 19: repercussão na rotina de universitários

Introdução: Necessitando de medidas de combate à pandemia por SARS-CoV-2, a Organização Mundial da Saúde orientou o distanciamento social como estratégia para mitigar seus impactos. Dentre as medidas adotadas para evitar aglomerações, universidades se adaptaram para modalidade de ensino online. O objetivo é refletir sobre a influência do distanciamento social por covid-19, na rotina de estudantes de ciências da saúde. Materiais e Métodos: É uma revisão integrativa, com buscas nas bases de dados Pubmed, MEDLINE, LILACS, WHO COVID, bioRxiv, e medRxiv, nos sites da Pubmed, BVS e Portal de buscas da Organização Mundial da Saúde para covid-19, com descritores nas seguintes combinações: “Infecções por coronavírus e estudantes de ciências de saúde” e “Covid-19 e estudantes de ciências de saúde”. Inicialmente encontrou-se 1069 artigos. Resultados: Após refinamento 23 artigos compuseram o estudo. Os resultados foram categorizados como 1-desordens nas competências emocionais, 2-ensino, 3-alimentação, sono e atividade física e 4-efeitos de natureza diversas. Manifestações frequentes: ansiedade, depressão, estresse, incerteza e angústia, mudanças no sono e atividade física. Vantagem ou desvantagem do ensino online, teve percentual de 50% cada. Conclusão: Conhecer como o distanciamento social influenciou na rotina dos estudantes é relevante para que as universidades desenvolvam programas de suporte para as necessidades apresentadas na realidade atual, e consigam projetar programas de enfrentamento para futuras crises epidêmicas, auxiliando na redução dos impactos resultantes.

Anxiety and coping strategies among nursing students returning to university during the COVID-19 pandemic

BACKGROUND

Despite the continued expand of the coronavirus disease 2019 (COVID-19) pandemic, nursing students are returning to on-campus learning and training in clinical settings. The COVID-19 pandemic might constitute a new source of anxiety that increases the already high anxiety levels of nursing students. This study aimed to assess the COVID-19 infection-related anxiety and coping strategies among nursing students returning to university campuses during the COVID-19 pandemic in Jordan.

METHODS

A cross-sectional study was conducted on a sample of 282 nursing students who returned to campus during the summer semester of the academic year 2019/2020. The returning students were invited to complete an online questionnaire consisting of three parts: 1) sociodemographic variables and infection-related information, 2) the Generalized Anxiety Disorder 7 (GAD-7) Scale, and 3) the Brief-Coping Behavior Questionnaire (Brief-COPE).

RESULTS

Of the participating students, 70.6% reported mild to severe anxiety levels. Female students and students who had fears of becoming infected with COVID-19 were found to be at higher risk of anxiety than were other students. A positive correlation was found between students' anxiety levels and their dysfunctional coping strategies, which included denial, behavioral disengagement, venting, and self-blame. Students who had chosen to study nursing willingly used coping planning. Further, other sociodemographic variables and infection-related information were associated with dysfunctional and emotion-focused coping strategies.

CONCLUSIONS

The participating nursing students showed significant COVID-19-related anxiety upon returning to on-campus learning. Unfortunately, the students were found to use some dysfunctional coping strategies which were associated with increased levels of anxiety. The results highlight the important role of universities and nursing faculty members in supporting students emotionally and ensuring their personal safety inside the classroom and in clinical settings.

Anxiety and fear of COVID-19 among nursing students during the COVID-19 pandemic: A descriptive correlation study

PURPOSE

The aim of this study was to assess current situations regarding anxiety and fear of coronavirus disease 2019 (COVID-19) level among nursing students.

DESIGN AND METHODS

A descriptive correlation design was adopted. The sample consisted of 234 nursing students. Data were collected using sociodemographic form, Beck Anxiety Inventory (BAI), and Fear of COVID-19 scale.

FINDINGS

The mean BAI score of the students was 26.56 ± 8.86 and Fear of COVID-19 total score was 18.95 ± 7.00. A positive correlation between total scores of the BAI and Fear of COVID-19. The results of this study reveal that anxiety and fear of COVID-19 levels were high among nursing students.

PRACTICE IMPLICATIONS

These findings have underlined there is an urgent need for interventions to reduce anxiety and fear of COVID-19 among nursing students.

The relationship between mental distress and perception of COVID-19 stress in healthcare students

Introduction/Aim: Healthcare students are among the groups affected by the COVID-19 pandemic in various ways. This study aimed to investigate the relationship between mental distress and perceptions of COVID-19 stress in healthcare students. Methods: The present analytical cross-sectional study included all students of Saveh University of Medical Sciences in 2021 as the statistical population. Through convenience sampling, 419 students were included in the study. A 12-item general health questionnaire (GHQ-12) and a 19-item the COVID-19 related healthcare students stress scale were used to collect data. Data analysis was performed using SPSS and descriptive and analytical statistical methods methods (Pearson correlation coefficient, paired t-test and analysis of variance). Results: The mean score of students' mental health status was 12.91, and 41.05% (N = 172) of them had some degree of mental distress. There was a significant relationship between mental distress score with the perception of COVID-19 stress, gender and field of study (P < 0.05). Conclusion: A significant number of students had some degree of mental distress, which had a direct and significant correlation with the perception of COVID-19 stress. Therefore, planning to identify and reduce the stressors associated with COVID-19 is one of the most beneficial actions for the students in restoring their mental health.

The Psychological Effects of the COVID-19 on Students Who Choose the Medical Profession With Different Motivational Factors: A Cross-Sectional Study

The COVID-19 pandemic has generated mental and psychological health problems worldwide. The aim of this study was to determine whether the psychological effects of COVID-19 were different in medical students who chose the medical profession with different motivational factors. In the study, there were 389 medical school students. The survey asks about sociodemographic features and the students’ reasons for choosing the medical profession. The study also included a self-assessed Hospital Anxiety-Depression Scale and Beck Hopelessness Scale. While 41% of students chose the medical profession for economic reasons, the ratio of whom have an extrinsic and intrinsic source of motivation was 37% and 22%, respectively. It was found that there was a statistically significant difference in the distribution of motivational factors by gender. Almost 50% of males were affected by economic motivation factors. The difference in motivational factors between genders was found to be statistically significant. Anxiety in females, depression in students with low-income families, and hopelessness in students older than 22 years and interns were higher than in the others (P < .05). Median scores for anxiety, depression, and hopelessness were higher for students with extrinsic motivational sources. However, only the difference in scores of anxiety and hopelessness was found statistically significant (P < .05). We found that the psychological effects of the COVID-19 pandemic varied according to both sociodemographic characteristics of the medical students and reasons for choosing medical profession. According to our results, the idealistic students interested in the medical profession, who want to support others and prioritize economic benefits, had fewer psychological issues than those who chose the medical profession due to family pressure or external factors.

Medical students' psychological and behavioral responses to the COVID-19 pandemic: A descriptive phenomenological study

On February 19, 2020, the Iranian government officially confirmed the first deaths due to COVID-19 and within a week, all universities were closed. The purpose of this study is to explore Iranian medical students' psychological and behavioral responses to the COVID-19 pandemic. This descriptive phenomenological study was conducted on 52 medical students. Data were collected using a purposive sampling method by means of synchronous virtual focus group discussions which were conducted using the WhatsApp messaging application. Data were analyzed using the MAXQDA software version 2020. Data analysis resulted in the emergence of three categories consisting of psychological responses to the pandemic and the behavioral and psychological responses to the quarantine. Most of the extracted themes are related to students' psychological reactions to the pandemic. During the quarantine period, students suffered from uncertainty, experienced boredom, worried about delay in their graduation, and were concerned about losing employment opportunities. Medical students must be prepared for crisis situations like the present pandemic. We recommend that online courses and training programs be developed with the aim of offsetting the negative effects of university closure on students' education and skill training.

Psychological Impact of the COVID-19 Pandemic on Students, Assistants, and Faculty of a Dental Institute of Saudi Arabia

This study aimed to assess the perceived stress levels in students, assistants, and faculty members of the College of Dentistry, Imam Abdulrahman Bin Faisal, University (IAU), Kingdom of Saudi Arabia (KSA) during the novel coronavirus disease 2019 (COVID-19) pandemic. Using the Cohen's perceived stress scale (PSS) questionnaire (consisting of 14 items, hence called PSS-14), an online observational survey was conducted. The PSS 14 was rated on a 5-point Likert scale ranging from 0 (never) to 4 (very often). The scores ranging from 0-18 represented low stress, 19-37 represented moderate stress, and 38-56 represented high stress. The second-and third-year students were designated as junior year students, while fourth-year onwards were considered senior year students. Out of total 265 participants, 65% (173) were female, and the majority of the participants were dental students 70% (185) with a mean age of 26.71 ± 9.26 years. In the present study, the average PSS score for the participants was computed as 29.89 (range score: 0-56) which shows moderate stress levels among the respondents. The PSS score for the students was 31.03; for the faculty, it was 28, while for the assistants, it was 27.05. Among the three participant groups, the students were found more on the severe stress side (19%) (p-value = 0.002), and among them, the senior year students (6th year) showed significantly higher stress levels compared to the junior year students (p-value = 0.005). Age-wise, the participants below 20 years were most stressed (21%), followed by those 20-30 years old (18%). Female participants were more severely stressed than males (17% vs. 10%, respectively). It was concluded that the students experienced more stress, followed by the faculty members and dental assistants. In addition, younger participants, females, and senior year students were more stressed than their counterparts. Future studies directed at evaluating stress levels of these groups from different dental institutes could provide an opportunity for policymakers to offer various resources to improve their mental health.

A longitudinal study of the impact of COVID-19 restrictions on students' health behavior, mental health and emotional well-being

BACKGROUND

COVID-related restrictions impacted the lives of students on and off campus during Academic Year 2020/2021.

METHODS

Our study collected data on student health behavior and habits as well as their mental and emotional health using anonymous surveys. We compared these data with data collected prior to COVID in the longitudinal part of our study (n = 721) and analyzed them for the cross-sectional part of the study (n = 506).

RESULTS

The longitudinal data show a significant difference for some student behaviors and habits, such as sleeping habits, physical activity, breakfast consumption, time spent online or playing video games, vaping, and marijuana use, during the COVID pandemic compared with pre-COVID data. Respondents also reported a significant increase in difficulty concentrating, remembering, or making decisions, as well as being impacted by feelings of sadness or hopelessness. Yet, there was no increase in the proportion of respondents considering, planning or attempting suicide during COVID. The cross-sectional data illuminate the negative effect of the overall situation and the restrictions on students' mental and emotional well-being. Three-quarters of respondents reported having craved human interaction during the past six months, more than half felt that their mental/emotional health had been impacted by the lack of social events or the switch to virtual (online) teaching. Two-thirds or more of respondents also expressed that they felt less connected to their peers and less motivated in their studies than in previous semesters. Fifty percent or more of respondents selected anxious, stressed, overwhelmed, disconnected, tired, and fatigued as words that best described their emotional state during the pandemic.

CONCLUSIONS

The impact of COVID-related restrictions on students' behaviors and habits as well as their mental and emotional health was less severe than one would have expected based on studies during the early stage of the pandemic. While some behaviors and habits changed during the COVID pandemic compared with the pre-COVID period, the changes were not substantial overall. Our study did not find an increase in the proportion of respondents considering, planning or attempting suicide during COVID, although the cross-sectional data from our survey make the negative effect of the overall situation and the restrictions on students' mental and emotional well-being evident. The impact of the pandemic will unquestionably be long-lasting and will necessitate further and future investigations.

Post-secondary Student Mental Health During COVID-19: A Meta-Analysis

The COVID-19 pandemic has posed notable challenges to post-secondary students, causing concern for their psychological well-being. In the face of school closures, academic disruptions, and constraints on social gatherings, it is crucial to understand the extent to which mental health among post-secondary students has been impacted in order to inform support implementation for this population. The present meta-analysis examines the global prevalence of clinically significant depression and anxiety among post-secondary students during the COVID-19 pandemic. Several moderator analyses were also performed to examine sources of variability in depression and anxiety prevalence rates. A systematic search was conducted across six databases on May 3, 2021, yielding a total of 176 studies (1,732,456 participants) which met inclusion criteria. Random-effects meta-analyses of 126 studies assessing depression symptoms and 144 studies assessing anxiety symptoms were conducted. The pooled prevalence estimates of clinically elevated depressive and anxiety symptoms for post-secondary students during the COVID-19 pandemic was 30.6% (95% CI: 0.274, 0.340) and 28.2% (CI: 0.246, 0.321), respectively. The month of data collection and geographical region were determined to be significant moderators. However, student age, sex, type (i.e., healthcare student vs. non-healthcare student), and level of training (i.e., undergraduate, university or college generally; graduate, medical, post-doctorate, fellow, trainee), were not sources of variability in pooled rates of depression and anxiety symptoms during the pandemic. The current study indicates a call for continued access to mental health services to ensure post-secondary students receive adequate support during and after the COVID-19 pandemic. Systematic Review Registration: PROSPERO website: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021253547.

Factors Associated with Psychological Distress in French Medical Students during the COVID-19 Health Crisis: A Cross-Sectional Study

BACKGROUND

The purpose of this study was to assess the prevalence of psychological distress in medical students during the COVID-19 health crisis and to identify factors associated with psychological distress.

METHODS

A cross-sectional observational study was presented to 1814 medical students (from first to sixth year) in a French university hospital center. Sociodemographic, occupational and medical information (psychological distress measured on the French GHQ12 scale) were collected via an online anonymous self-administered questionnaire. Variables associated with psychological distress were investigated using univariate analysis and multivariate analysis (modified Poisson regression).

RESULTS

In total, 832 medical students responded (46%) and 699 completed the questionnaire in full (39%); 625 (75%) showed signs of psychological distress and 109 (15%) reported suicidal ideation. Female gender, psychological trauma during the COVID-19 health crisis, change in alcohol consumption, and difficulties with online learning emerged as risk factors for psychological distress, whereas a paid activity, a feeling of mutual aid and cooperation within the studies framework, and recognition of work appeared to be protective factors.

CONCLUSIONS

Mental health care or suicide prevention should be provided to students at risk in the aftermath of the pandemic. Knowing the educational and medical factors associated with psychological distress enables areas for prevention to be identified.

Mental Health among Higher Education Students during the COVID-19 Pandemic: A Cross-Sectional Survey from Lithuania

Mental health issues—anxiety, depression, suicidal ideation and behavior—are prevalent among students of higher education. The COVID-19 pandemic further affected students’ daily life through academic and socioeconomic disturbances. We set out to investigate students’ mental health amidst the COVID-19 pandemic and conducted a cross-sectional online survey at higher education institutions in Lithuania in 2021. The questionnaire consisted of the Hospital Anxiety and Depression scale (HADS) and the Sense of Coherence scale (SOC-3) questionnaires, evaluation of suicidal risk, experiences during the COVID-19 pandemic and self-rated health status (SRHS). Among 1001 students who completed the survey, the prevalence of clinically relevant anxiety was high (46.6%) and contrasted with the lower prevalence of depression (11.1%). 37.5% of all students admitted that they had thought about suicide at least once during their lifetime and a similar number of students thought about suicide during the previous year. High levels of anxiety and depression were statistically significant predictors of suicidal ideation and planning during the past year in binary regression models. High SRHS (higher score refers to more positive health status) was the only significant independent variable associated with less frequent suicidal attempts in the past year (p < 0.01, OR = 0.29, 95% CI = 0.12 to 0.66). Our study highlights anxiety and suicidality to be burdensome mental health issues among higher education students in Lithuania during the COVID-19 pandemic.

After the Pandemic: The Future of Italian Medicine. The Psychological Impact of COVID-19 on Medical and Other Healthcare-Related Degrees Students

Objective: The study aimed to explore the psychological symptoms and the readiness to fight the pandemic of the new generation of healthcare professionals: medical and other healthcare degree students. Methods: We enrolled 509 medical and healthcare-related degree students during the second outbreak of COVID-19 in Italy. We have examined their psychological symptoms using the 12-item General Health Questionnaire (GHQ-12) and their readiness to fight the pandemic together with their academic career status, their relationship with the university, and their emotional reactions to the pandemic with Visual Analog Scales. Results: We retrieved a GHQ mean of 21.65 (SD = 40.63) and readiness to fight the pandemic mean of 53.58 (SD = 31.49). Perceived control affects variables: a negative effect on psychological symptoms and a positive effect on the willingness to fight the pandemic. The other variables with an impact were stress, loneliness, and anger that had a significant and positive impact on psychological symptoms. Age and concern for patients had a significant positive impact on readiness to fight for the pandemic, while years of attendance had a significant but negative impact. Conclusion: Universities and Institutions should consider the impact of the pandemic on students, in particular, for its effect on their mental health.

Anxiety and Stress Levels Associated With COVID-19 Pandemic of University Students in Turkey: A Year After the Pandemic

The outbreak of COVID-19 has been affecting the daily lives of almost everyone and puts huge psychological pressure on people worldwide, including Turkey. Anxiety and stress levels among university students were already a public health concern. Our study aims to demonstrate the anxiety and stress levels of university students in Turkey after the outbreak of COVID-19 according to the Coronavirus Anxiety Scale (CAS) and COVID Stress Scale (CSS). CAS is a brief mental health screener to identify probable cases of dysfunctional anxiety associated with the COVID-19 pandemic, and CSS was developed to understand and assess COVID-19-related distress. An online questionnaire was administered to active 1,265 university students in Turkey between February 27 and March 8, 2021, via Google forms. The questionnaire consists of three parts that assess participants' demographic information, anxiety, and stress levels related to the pandemic. According to CAS and CSS analysis, anxiety and stress levels were associated with each other and influenced university students during the COVID-19 pandemic. Both were associated with gender and family member loss. The academic year of students had a relationship with anxiety. It was observed that the danger factor was the highest stressor in university students in Turkey related to the novel coronavirus, followed by contamination fears. Both factors were shown as moderate stressors. As a result of the study, it was revealed that anxiety and stress associated with the COVID-19 pandemic are now included in the social, academic, and physical burdens of the university years, which are decisive and important in terms of mental development and psychological health of the person. It is essential to ascertain the long-term effects of COVID-19 and take effective precautions to support the physical and mental health of today's university students accordingly.

Nursing Students’ Challenges and Experiences of Undergoing Clinical Rotation Program during Coronavirus Disease 2019 Pandemic

BACKGROUND: The coronavirus disease 2019 (COVID-19) contagion which has resulted in millions of casualties worldwide has been bringing pressure and challenges to nursing students undergoing clinical rotation programs. In Indonesia, several schools of nursing have issued policies to keep facilitating clinical rotation education in the hospital. This policy identified several challenges that the students should face. AIM: This study aimed to explore nursing students’ challenges and experiences undergoing clinical rotation programs during the COVID-19 pandemic. METHODS: A qualitative descriptive approach to content analysis was employed. The study participants were 31 nursing students who undergo clinical rotation. These participants were purposefully chosen to use criteria. Participants’ age ranged from 23 to 25 years and has passed both the intensive care unit and intensive cardiovascular care unit stage. Data were collected through focus group discussion which was carried out 4 times and each FGD lasted for 90–120 min then analyzed using content analysis method that includes five major segments: Introduction, coding, theme creation, thematic classification, and reporting. RESULTS: The themes from the study included negative emotion in the initial stage, positive emotions, a competency that difficult to achieve, and strategies for coping and self-care. CONCLUSION: Constructive emotion coping strategy is believed to assist students in dealing with challenges amid the clinical rotation program. Implementation of clinical rotation learning for nursing students requires preparation from various aspects, such as student readiness, clinical supervisors, and support from academic institutions.

Psychological impact of COVID-19 and contributing factors of students' preventive behavior based on HBM in Gondar, Ethiopia

BACKGROUND

The Ethiopian Federal government has locked down schools as one measure to contain Covid-19 pandemic. Psychological effect of COVID-19 on students is increased due to the reopening of schools. The psychological effect of the pandemic is increasing along with physical aspect of health. Therefore, this study aimed to assess the psychological impact of Covid-19 and its contributing factors of students' behavior in Ethiopia.

METHODS

A cross sectional design was conducted from November to December 2020. Data were collected using pre tested self- administered questionnaire from secondary school students in Gondar city North West Ethiopia. Stratified simple random sampling technique was used to select 403 secondary school students. Data were entered and cleaned with Epidata version 4.62 and exported for analysis STATA version 14. Multivariable logistic regression and multiple linear regression were used to show the association of dependent and independent variables. Independent variables in relation to dependent variable measured using odd ratios and B coefficient with 95% confidence interval for Covid-19 anxiety and preventive behavior of Covid-19 respectively were used.

RESULTS

A total of 370 students were participated giving response rate of 92%. The prevalence of Covid-19 anxiety and obsession among secondary school students were 38.1% and 40.27% respectively. Being 11thgrade 54% (AOR = 0.46; 95%CI:0.22, 0.95) and increased knowledge16% (AOR = 0.84;95%CI: 0.77, 0.89) score associated with decreased COVID-19 anxiety while Covid-19 obsession, 14.51 times (AOR = 14.51;95%CI: 8.05, 26.17), and being female 1.6 times (AOR = 1.6; 95%CI: 1.01, 2.51) increased Covid-19 Anxiety. Furthermore, increased self-efficacy 0.5 times (B = 0.5; 95%CI: 0.28, 0.62), and increased cues to action 0.4 times (B = 0.4; 95% CI: 0.19, 0.69) increased preventive behavior of Covid-19 while perceived barrier 0.1 times (B = -0.1; 95%CI:-0.22, 0.01) decrease preventive behavior of Covid-19.

CONCLUSION

Almost two individuals of five participants developed COVID-19 anxiety and COVID-19 obsession. Being grade 11th and knowledge were negatively associated with anxiety while being female and being obsessed with COVID-19 were positively associated with anxiety. No variable was associated with obsession of Covid-19. Intervention is needed to reduce anxiety among females. Furthermore, perceived barrier, self-efficacy and cues to action were significant factors of preventive behaviour of Covid-19. Therefore, to increase preventive behaviour of Covid-19, information, education and communication and behavioural change communication should be targeted on reducing barriers and increasing motivations and confidences.

Prevalence of Anxiety in Dental Students during the COVID-19 Outbreak: A Meta-Analysis

Background: Since the onset of the COVID-19 pandemic, the psychological state of university students has been a cause for concern. In particular, odontology students have experienced symptoms of anxiety due to the closure of universities and the suspension of clinical training. Methods: Medline via PubMed was searched for studies on the prevalence of anxiety in dental undergraduates, published from 1 December 2019 to 1 August 2021. Results: A total of fifteen studies were included in this review. Our results show a prevalence of anxiety of 35% reported by dental students, which was independent of gender, response rate or methodological quality. The only significant finding was a lower prevalence of anxiety in studies located in Europe compared to those located in other continents. Conclusions: The results suggest dental students are experiencing significant levels of anxiety during this COVID-19 pandemic and that there seem to be differences between students from different regions of the world. Therefore, it is important to help dental students psychologically as the pandemic situation continues.

Risk perception, attitude, and practice related to COVID-19: A cross-sectional study among 1085 Iranian healthcare workers

BACKGROUNDS

Healthcare workers are at risk of mental illness during COVID-19 pandemic. We investigated the level of perceived risk and adherence to preventive behaviors regarding COVID-19 among medical students and physicians.

MATERIALS AND METHODS

We conducted an online nationwide cross-sectional survey among Iranian physicians and medical students. We collected data regarding perceived risk, perceived stress scale (P·S·S.), attitude, practice, and information sources. We assessed the association of four main outcomes (risk perception, P·S.S. score, attitude, and practice) with demographic variables.

RESULTS

A total of 1085 participants with an overall fear score of 6.48 ± 2.29 out of 10 filled the questionnaires. Older and more educated participants had a higher risk perception level and adherence to protective measures. In contrary, participants in lower-risk workplaces had lower risk perception scores. Main sources of information did not affect the scores of risk perception, P·S·S., and practice. Higher risk perception scores were observed in those with higher practice and P·S.S. scores.Contrary to risk perception, the P·S.S. score was not affected by many of the demographic variables, except gender. The most positive attitude was observed in individuals with a higher level of trust in governmental information sources. Participants with higher P·S.S. scores adhered more to protective measures.

CONCLUSION

Risk perception had the greatest impact on adherence to preventive behaviors. Therefore, policymakers should consider perceived risk as a predictor of the extension of the pandemic. Both risk perception and P·S.S. reflect the severity of fear from COVID-19; however, P·S.S. is less affected by sociodemographic and workplace characteristics.

Student Pharmacists during the Pandemic: Development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey

Background: The COVID-19 pandemic has caused innumerable changes to all aspects of human life and behavior, including academic life. This study describes the development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey among U.S. student pharmacists. The survey was administered at Doctor of Pharmacy programs in three states—Tennessee, Ohio, and Pennsylvania. Methods: The COVKAP survey—an online cross-sectional survey—was distributed to U.S. student pharmacists enrolled in three different colleges of pharmacy in three states during the fall semester of 2020. The survey was developed using literature review and Dillman’s recommendations for survey design. The COVKAP survey consisted of 23 closed and Likert-scale questions, and three open-ended questions. The research team conducted descriptive and inductive thematic analyses on the quantitative and qualitative data, respectively using SPSS (v27) and Dedoose^® software. Results: A total of 421 responses were received. Respondents were predominantly female (72%) and White (79%). The average age of respondents was 23.4 years. The qualitative analysis revealed three themes: (1) Wellbeing and mental health struggles; (2) Being part of the decision-making process; (3) Necessity of adequate protection measures. Conclusions: Preliminary study findings indicate that student pharmacists’ concerns and the challenges that they face in their academic pursuits are largely similar across the three states in this study and inform about the importance of recognizing and mitigating the impact of widespread disruption in education. This disruption provides an opportunity for pharmacy academia to examine practices and methods that can be improved upon to help students become successful practitioners.

COVID-19 health awareness among the United Arab Emirates population

In response to the global COVID-19 epidemic, the United Arab Emirates (UAE) government is taking precautionary action to mitigate the spread of the virus. The aim of this study was to evaluate the knowledge and practices toward COVID-19 among the general public in the UAE during the current outbreak. A cross-sectional online survey of 1356 respondents in the UAE was conducted during the epidemic outbreak between 9^th to 24^th June-2020. The questionnaire consisted of three sections: Socio-demographic, knowledge, practices. Independent-samples t-test, one-way analysis of variance (ANOVA), chi-square and binary logistic regression was used. A p-value of (p < 0.05) was considered statistically significant. The total correct score of knowledge and practice questions was high 85% and 90%, respectively. Male’s sex, other marital status, and illiterate/primary educational levels had a lower level of knowledge and practices than others. Participants aged 18–29 had little higher knowledge than other ages but had a lower level in practices, people who live in Abu Dhabi had better knowledge and practices than other emirates, employed people had a lower level of knowledge but higher in practices. Binary logistic regression analysis presented that females, 18–29 years, and married participants significantly associated with a higher score of knowledge, while female, over 30 years old, the martial status of singles, college-level and higher, unemployed, were significantly associated with high mean practices score. This study provided a full screening of the knowledge and practices among a sample of residents in The UAE toward COVID-19, continuing to implement the health education programs pursued by the UAE is highly important to maintain the appropriate level of awareness among the public.

The Psychological Impact of the COVID-19 Pandemic in Remote Learning in Higher Education

Stressful events can cause a significant impact on education; however, it is not yet clear how the interplay between anxiety, work, and social dysfunction relates to learning impairments. In this study, we investigated the impact of the COVID-19 pandemic on students’ learning and mental health. This study was conducted during four modules of a remote Psychopharmacology course between 5 October and 20 December 2020. We collected data from 28 Psychology undergraduate students at the University of São Paulo, Brazil. We used pre- and post-test multiple-choice questions to obtain a quantitative measure of learning. Students completed an online survey to report demographic information, functional impairment (Work and Social Adjustment scale; WSAS), generalized anxiety (Generalized Anxiety Disorder scale; GAD-7), coronavirus anxiety (Brazilian adapted version of the Coronavirus Anxiety Scale; CAS-BR), and self-perception with the remote lectures’ methodology. In our sample, 42.9% of respondents experienced symptoms of generalized anxiety disorders (GAD-7 ≥ 15), and 53.6% had moderate to severe functional impairment (WSAS > 20). We also observed an overlapping profile of highly anxious and dysfunctional students. A chi-square test of independence revealed a relation between pairs of multiple-choice questions answers and GAD-7 scores, indicating that less anxious students were more likely to perform better in pairs of pre- and post-tests. Intriguingly, the correlational analysis suggested that students with moderate to severe functional impairment (WSAS scores > 20) were less likely to change from an incorrect to a correct answer to pairs of pre- and post-tests. This data suggests that psychological distress and anxiety states might influence students’ ability to coordinate social and work activities and performance during remote learning. Although this study evaluated a small sample of students, our data highlights the importance of investigating anxiety and functional impairment measures as part of the remote-learning curriculum.

COVID-19 anxiety and hygiene status in vocational schools of health services students in Turkey: A multicenter study

BACKGROUND

While the coronavirus (COVID-19) pandemic creates fear and anxiety on the students' academic achievement, the risk of an infectious disease may negatively affect education by reducing the concentration ability of students. Thus, it is essential to evaluate the knowledge, behaviors, anxiety levels, and hygiene status of students.

OBJECTIVE

This study aimed to investigate the knowledge, behavior change, anxiety, and hygiene status of university students about COVID-19.

METHODS

The investigation was conducted with students of three vocational schools of health services located in different provinces of Turkey (n = 1055). Data collected by an online survey consisted of knowledge questions about COVID-19, items about behavior change, the hygiene behavior scale (HBS), and the Generalized Anxiety Disorder 7 (GAD-7) scale.

RESULTS

The knowledge scores of women were significantly higher than the scores of men. Of the students, 59.6%showed positive hygiene behaviors, and 31.5%had anxiety. Female students' total HDC scale score was significantly lower than that of men, and the total HDC scale score of those who received hand hygiene education was significantly lower than that of participants who did not receive training, which shows a positive hygiene behavior. The total GAD-7 scale score of women was significantly higher than that of men. More than half of the students showed positive hygiene behaviors, and about a third had anxiety.

CONCLUSIONS

Based on the study's results, psychological support and training should be provided to students.

The Effect of Mental Health Status on the Quality of Life of Faculty of Medicine Students during the Pandemic Coronavirus Disease 2019 Period

BACKGROUND: The spread of Coronavirus Disease 2019 (COVID-19) disease which has not been balanced with effective protocols can create mental health problems which could affect the quality of life; as of today, there is not any research that examines the influence of both factors. AIM: This study purpose was to analyze the mental health status on the quality of life amongst medicine students during COVID-19 period. METHODS: This is a cross-sectional survey on 361 students from Faculty of Medicine Tanjungpura University. This study was conducted from June 2019 to November 2020 by spreading Depression Anxiety Stress Scale questionnaire and a WHOQOL-BREF questionnaire through online. The data analysis was administered using Kruskal–Wallis statistics. RESULT: The students’ mental health status was dominantly on the normal category with depression domain by 323 students (89.5%), anxiety domain by 311 students (86.1%), and stress domain by 343 students (95%). The quality of life measurement was in category medium in all domains which are physical health (88.6%), psychological health (92.5%), social relationships (50.7%), and environment (78.7%). There was significant effect of mental health status of depression and anxiety toward the aspect of physical health, psychological health, and social relationships (p < 0.05). Stress significantly influenced all domains of quality of life, and there was no significant effect of mental health status domain depression (p = 0.051) and anxiety (p = 0.881) toward the environment aspect. CONCLUSION: Students’ mental health status in this research belongs to the category normal with moderate level in quality of life. To compare, there was a significant effect of mental health status toward the quality of life domains. The good application of self-coping mechanisms and the social encouragement from the environment is suitable intervention strategies during the pandemic COVID-19 period.

Anxiety, PTSD, and stressors in medical students during the initial peak of the COVID-19 pandemic

Purpose

To assess psychological effects of the initial peak phase of the COVID-19 pandemic on United States (US) medical students in clinical training to anticipate sequelae and prepare for future outbreaks.

Methods

Authors emailed a cross-sectional survey in April-May, 2020 to students in clinical training years at six US medical schools which included validated General Anxiety Disorder (GAD-7) and Primary Care-PTSD (PC-PTSD-5) screening tools, and asked students about pandemic-related stress and specific concerns. Authors used quantitative and thematic analysis to present results.

Results

Of 2511 eligible students, 741 responded (29.5%). Most students (84.1%) reported at least “somewhat” increased levels of stress and anxiety related to the pandemic. On the GAD-7, 34.3% showed mild, 16.1% moderate, and 9.5% severe anxiety symptoms, with 39.6% demonstrating no/minimal symptoms. One quarter (25.4%) screened positive for PTSD risk symptoms. Top concerns of students chosen from a pre-populated list included inadequate COVID-19 testing, undiagnosed or asymptomatic spread and racial or other disparities in the pandemic. In thematic analysis, students’ reactions to removal from clinical learning included: understanding the need to conserve PPE (32.2%), a desire to help (27.7%), worry over infectious risk to others (25.4%) and self (21.2%), and lost learning opportunities (22.5%). Female students were significantly more likely to report anxiety and PTSD risk symptoms. Asian students had a greater risk of moderate anxiety and those underrepresented in medicine (UIM) had greater risk of moderate and severe anxiety symptoms compared to white students.

Conclusions

During the initial peak phase of COVID-19, over 60% of US medical students screened positive for pandemic-related anxiety and one quarter were at risk for PTSD. Female and UIM students were significantly more affected. Medical schools should consider broad support of students, and targeted outreach to female and UIM students.

Medical Faculty's and Students' Perceptions toward Pediatric Electronic OSCE during the COVID-19 Pandemic in Saudi Arabia

BACKGROUND

The educational process in different medical schools has been negatively affected by the COVID-19 pandemic worldwide. As a part of the Saudi government's attempts to contain the spread of the virus, schools' and universities' educational activities and face-to-face lectures have been modified to virtual classrooms. The purpose of this study was to explore the perceptions of the faculty and the students of an electronic objective structured clinical examination (E-OSCE) activity that took place during the COVID-19 pandemic in the oldest medical school in Saudi Arabia.

METHODS

An e-OSCE style examination was designed for the final-year medical students by the pediatrics department, College of Medicine at King Saud University in Riyadh, Saudi Arabia. The examination was administered by Zoom™ video conferencing where both students and faculty participated through their laptop or desktop computers. In order to explore the students' and the faculty's perceptions about this experience, a newly designed 13-item online questionnaire was administered at the end of the e-OSCE.

RESULTS

Out of 136 participants (23 faculty and 112 students), 73 respondents (e.g., 54% response rate) filled out the questionnaire. Most of the respondents (69.8%) were very comfortable with this new virtual experience. Most participants (53.4%) preferred the e-OSCE compared to the classic face-to-face clinical OSCE during the pandemic. Regarding the e-OSCE assessment student tool, 46.6% reported that it is similar to the classic face-to-face OSCE; however, 38.4% felt it was worse.

CONCLUSIONS

The e-OSCE can be a very effective alternative to the classic face-to-face OSCE due to the current circumstances that still pose a significant risk of infection transmission. Future studies should examine different virtual strategies to ensure effective OSCE delivery from the perspective of both faculty and students.

Anxiety symptoms and alcohol abuse during the COVID-19 pandemic: A cross-sectional study with Brazilian dental undergraduate students

Aim

The aim of this study is to assess whether anxiety symptoms are associated with alcohol abuse in Brazilian undergraduate dental students during the COVID‐19 pandemic.

Method

A cross‐sectional study was conducted. A semi‐structured questionnaire addressing the variables of interest was hosted on Google Forms and shared with dental undergraduate students from all Brazilian regions between July 8 and 27, 2020. Alcohol abuse was measured using the Cut down, Annoyed, Guilty, Eye opener (CAGE) questionnaire score of ≥2. All participants responded to the seven‐item Generalized Anxiety Disorder Scale (GAD‐7). Hierarchical logistic regression was also conducted.

Results

Among the 1050 students evaluated, 18.7% (n = 196) had a positive screening for alcohol abuse during the pandemic. The prevalence of mild (GAD‐7 = 5–9), moderate (GAD‐7 = 10–14), and severe (GAD‐7 ≥15) anxiety among students were 31.3%, 29.6%, and 24.2%, respectively. The final hierarchical logistic regression model showed that during the COVID‐19 pandemic, anxiety levels predict the likelihood of alcohol abuse among students with moderate (OR 10.05 [95% IC: 4.12–24.52]) or severe (OR 15.82 [95% IC: 6.46–38.73]) anxiety, especially for male students (moderate anxiety: OR 17.06 [95% CI: 8.36–34.78]; severe anxiety: OR 28.38 [95% CI: 8.62–38.24]).

Conclusion

The prevalence of alcohol abuse and moderate or severe anxiety in Brazilian undergraduate dental students during the COVID‐19 pandemic was high. Male students may be more sensitive to the presence of anxiety symptoms in this period, thus contributing to higher levels of alcohol consumption, in comparison to female students. Intervention strategies that promote the adoption of healthier lifestyles can enable the effective management of anxiety symptoms during the pandemic and thus, hold the potential to reduce exacerbated alcohol intake in this population.

Psychosocial impact on health-related and non-health related university students during the COVID-19 pandemic. Results of an electronic survey

Introduction

The current SARS-CoV-2 pandemic has caused feelings of anxiety, confusion, and panic among the world population. Due to these psychological changes resulting from the stress produced by the disease, we sought to investigate the psychological impact of the pandemic on the university student community.

Material and methods

1,283 students were surveyed, of which 1,149 students were selected. The majority of the subjects were female, and the overall average age was of 20 years. They were provided with an 82-question online questionnaire divided into four sections; looking for the prevalence of significant symptomatology of major depression and generalised anxiety using the PHQ-9 and GAD-7 scales; and factors that potentially affect the mental health of our university population.

Results

We found a high prevalence of significant depression (47.08%) and anxiety (27.06%) symptomatology, considering a score of 10 or more as cut-off point. There was no significant difference in depression and anxiety symptomatology between the health-care students and non-health-care students.

Conclusions

Our results, together with what is observed in the literature, allow us to conclude that the college student population has a high risk of mental illness, and these should be taken into consideration for the search of effective strategies for detection and control of mental health illnesses. Undoubtedly, the COVID-19 pandemic is a red flag that shows the need to upgrade mental health programmes in universities and to validate virtual instruments.

The prevalence of depressive symptoms, anxiety symptoms and sleep disturbance in higher education students during the COVID-19 pandemic: A systematic review and meta-analysis

The COVID-19 pandemic and its accompanying infection control measures introduced significant disruptions to the routines of many higher education students around the world. It also deprived them of in-person counselling services and social support. These changes have put students at a greater risk of developing mental illness. The objective of this review is to assess the prevalence of depressive symptoms, anxiety symptoms and sleep disturbances in higher education students during the pandemic. A systematic search of English and Chinese databases was conducted current to January 1^st, 2021. The quality of included studies was evaluated using a modified Newcastle-Ottawa scale. Prevalence of depressive symptoms, anxiety symptoms and sleep disturbances were pooled using random-effects meta-analysis. Eighty-nine studies (n=1,441,828) were included. The pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances was 34%, 32% and 33%, respectively. The prevalence values differ based on geographical regions, diagnostic criteria, education level, undergraduate year of study, financial situation, living arrangements and gender. Overall, the prevalence of depressive symptoms and anxiety symptoms synthesized in this study was higher compared to pre-pandemic prevalence in similar populations. Evidently, mental health screening and intervention should be a top priority for universities and colleges during the pandemic.

Postgraduate Physiotherapy Training in a Quandary - Ramifications of Corona virus pandemic Lockdown: A Survey-based Study

INTRODUCTION

Coronavirus disease-2019 (COVID-19) has disrupted clinical services and postgraduate training across the world. Hence, this survey was conducted to understand the impact of pandemic on Physiotherapy post-graduate (PG) education.

METHODS

It was a cross-sectional, observational study. A total of 254 Physiotherapy PG trainees were recruited through snowball sampling from Physiotherapy colleges across the state of Maharashtra. A 34-item structured questionnaire was developed, based on available literature, to evaluate the impact of COVID-19 pandemic on four domains: academic training, clinical training, research activities, and concerns faced by a PG trainee. The face validity of this questionnaire was assessed by six academicians and their suggestions were examined. Subsequently, it was piloted on five PG trainees before administering it to the participants. The validated questionnaire was then circulated via various social media platforms and personal contacts using Google form. Descriptive statistics were summarized as frequencies/ percentages. McNemar's test was used to determine the differences on a dichotomous dependent variable between the two related groups using SPSS software.

RESULTS

Overall 131 trainees provided complete responses. Although 85% (n=111) of them claimed they attended PG teaching activities through online mode, almost 67% (n=101) disagreed to have achieved their learning objectives. A vast majority (91%, n=119) of them felt that their specialty related practical training was severely affected, and 98% (n=129) reported that reduced caseload had impacted their clinical learning. Also, 70% (n=54) of final year PGs had difficulty in recruiting new participants for their dissertation. Spread of infections to family (98%), commuting in public transport (98%), uncertainty about exam dates (91%), and competency development in specialty areas (96%) were some of their concerns.

CONCLUSION

COVID-19 pandemic had impacted various domains of Physiotherapy PG program such as academic, clinical and research areas. Regulatory authorities should take serious consideration and devise strategies to overcome it.

Impact of COVID-19 on medical students' mental wellbeing in Jordan

COVID-19 has spread throughout the world and has resulted in significant morbidity, mortality, and negative psychological impact. This prospective cross-sectional study is exploring the effect of the pandemic on mental health of medical students. The study was conducted at six Jordanian medical schools using an online survey to collect students’ socio-demographic and academic data. Assessment of mental wellbeing status was done using Kessler’s psychological stress scale (K10); the impact of COVID-19 on life activities and strategies followed to manage the situation were also examined. A total of 553 medical students were recruited for the study. Men constituted 40.1%, and women were 59.9%. Students reported that COVID-19 has affected the aspects of physical fitness (73.1%), study (68.4%), and social relationships (65.6%) the most. Sixty-six percent of the students were concerned about family members’ affection, and more than half (58.4%) explained their concerns about the inability to get clinical sessions and labs. Cooking, baking, and hobby practicing were the most popular methods to improve their mental wellbeing. About half of the participants had a severe mental disorder, and only 13.2% were likely to be well. The study indicates that half of our medical students suffer severe mental disorders, with physical fitness, exercise, and studying being among the most affected aspects during the COVID 19 pandemic. It is recommended that measures need be taken to alleviate students’ stress, which might have deleterious effects in many aspects.