The relationship between COVID-19 knowledge levels and anxiety states of midwifery students during the outbreak: A cross-sectional web-based survey

Mental health in midwifery students: A French nationwide survey

BACKGROUND

Poor mental health in health students is a major public health issue, impacting personal quality of life and functioning, curriculum and care quality to patients.

PROBLEM

Few studies to date have examined mental health in midwifery students.

AIM

To evaluate the midwifery students'mental health.

METHODS

An online cross-sectional survey was performed between 02/11/2023 and 11/12/2023. Anonymous questionnaires were sent to midwife students via academic emails by all midwife faculties in France. We assessed the prevalence of current depressive symptoms, current generalised anxiety symptoms, burnout for students in internship, 12-month major depressive disorder and 12-month suicidal ideation, humiliation, sexual harassment, and sexual aggression during their curriculum with specific questions. Multivariate logistic regression was performed to identify the main factors associated with major depressive disorder and suicidal ideation.

FINDINGS

Among midwifery students, 1920 (response rate: 51.9 %) were included. The prevalences of current depressive symptoms, anxiety symptoms, burnout, 12-month major depressive disorder, and 12-month suicidal ideation were 62 %, 47 %, 44 %, 13 % and 14 %, respectively. Humiliation, sexual harassment and sexual aggression were reported by 19 %, 1.8 % and 0.7 %, respectively. In multivariable analyses, having important financial difficulties and sexual violence were associated with higher rates of major depressive episodes and suicidal ideation.

DISCUSSION

>1 in 10 students suffered from 12-month depression and/or suicidal ideation, and almost half of them expressed various distressing symptoms.

CONCLUSION

These alarming results highlighted the need for interventions to improve mental health in midwifery students, including safer conditions of education and living.

Indonesian COVID-19 lesson: A mixed-methods study on adolescent health status and health services during pandemic

TOPIC

The COVID-19 pandemic affected adolescents' physical and psychological health. There must be specific services to cater to the needs of adolescents during COVID-19 in Indonesia. Lessons learned from previous pandemics will be beneficial for nurses and other health professionals to prepare services for future pandemics.

PURPOSE

This mixed-method study aimed to examine 459 Indonesian adolescents' health, literacy, preventive measures, and preferred health services during the COVID-19 pandemic. This study also examines sociodemographics, respondent characteristics, health information sources, and media choices.

RESULTS

A total of 47.5% of adolescents knew about COVID-19, 26.8% experienced physical health changes, and 61.7% considered wearing masks. Adolescent health information came from teachers (26.6%) and the Internet (32.9%). Psychological changes showed 67.8% irritation. Indonesians preferred online counseling (53.8%) and WhatsApp (45.8%) for pandemic health services. COVID-19 literacy did not affect physical or mental health (p > 0.05).

CONCLUSIONS

Most adolescents reported mental and physical health changes during COVID-19. Our data suggest that adolescents' strong COVID-19 knowledge did not prevent anxiety and other psychological difficulties. The longitudinal studies could be utilized if pandemic demands social and physical distance. The government, as well as nurses, might utilize WhatsApp-based remote online treatment for health services.

Midwifery students' experiences of their clinical internship placement during the COVID-19 pandemic in Ireland: A qualitative descriptive study

OBJECTIVE

To explore the impact of the COVID-19 global pandemic on midwifery students' experiences of clinical internship placement in the final year of their midwifery programme.

DESIGN

A qualitative descriptive study was conducted following ethical approval. Four online focus groups were facilitated.

SETTING AND PARTICIPANTS

To prepare for autonomous practice, BSc Midwifery students in the Republic of Ireland (RoI) undertake a 36-week internship in the final year of their programme. Midwifery students (n = 15), from one Higher Education Institute (HEI), who were undertaking internship across two clinical practice sites volunteered to participate in the study.

FINDINGS

Four overarching themes were identified: Fear and uncertainty of internship in the context of a pandemic, Consequences of COVID-19 within the clinical environment, Student supports, Opportunities and challenges during internship. Working within a health care environment dominated by the presence of COVID-19 had significant consequences for the students and their provision of care for women and families. Students were challenged with managing increased responsibility within the context of COVID-19 practice requirements and restrictions. Students balanced their need to progress to autonomous practice, whilst acknowledging their needs as learners. COVID-19 also brought unexpected benefits, which included enhancing students' ability to develop relationships with women in their care, and students described a sense of belonging within the midwifery team.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Midwifery students identified internship, during the COVID-19 pandemic as challenging and stressful. However, students also portrayed a sense of pride in their achievements. Support structures assisted students to cope during this period which included peer support, protective reflective time (PRT) in the HEI and support from clinical placement coordinators in midwifery (CPC-Midwifery) within clinical placements sites. It is essential that these support structures continue within midwifery educational programmes. Promoting peer support in a more formal support structure may need consideration. These support structures need to be protected and enhanced during unprecedented times, such as the COVID-19 pandemic.

The effectiveness of a health education intervention to reduce anxiety in quarantined COVID-19 patients: a randomized controlled trial

INTRODUCTION

The COVID-19 pandemic is regarded as a serious public health concern that boosts levels of stress and anxiety which could be explained by several reasons, including social isolation. In this regard, we aimed to assess the impact of health education on the anxiety level of COVID-19 patients during the isolation period.

METHODS

This is a randomized controlled trial conducted between February 2021 and June 2021. Patients tested positive for Covid-19 with mild to moderate forms were randomized to Education (n = 267) or control (n = 269). The education group received a phone health education session on day 1 (D1) following the diagnosis. The three components of the health education intervention were an explanation of the coronavirus disease, what to do in the event of complications, and the recommended preventive measures. The two groups received a telephone evaluation of their Hospital Anxiety and Depression scores on D1 and day seven D7 following the positive diagnosis. The primary outcome was the rate of anxiety reduction in each group on D7 based on a HAD-A score ≥ 8. Secondary outcomes were the rate of anxiety reduction on D7 based on a HAD-A score ≥ 11, the percentage of people complying with isolation and the scores of adherences to preventive measures during the isolation in each group.

RESULTS

Hundred and ninety-six patients in the intervention group and 206 patients in the control group completed the study. The sociodemographic, clinical, and initial anxiety level features of the intervention and control groups were comparable at baseline (p ≥ 0.05). On D7, the education group's anxiety level (HAD-A ≥ 8) decreased from 26 to 16.3% (p = 0.013) while in the control group it increased from 19.4 to 22.8% (p = 0.37). Thus, the percentage change in anxiety between D1 and D7 (delta D7 - D1) was - 9.7% in the Education group and + 3.4% in the Control group. Using the HAD-A ≥ 11 thresholds, the percentage of anxiety decreased from 15.3 to 11.2% (p = 0.26) between D1 and D7, while it increased in the control group from 9.7 to 15.7% (p = 0.045). Thus, the education group's change in anxiety (delta D7 - D1) was - 4.1%, while the control group's change was + 6%.

CONCLUSION

During an outbreak, providing health education to quarantined patients may be beneficial to reduce the psychological impact of the disease.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov Identifier: NCT05715593, retrospectively registered on 8/02/2023 https://clinicaltrials.gov/ct2/results?term=NCT05715593&Search=Search .

Gender differences in sense of coherence among university students during the COVID-19 pandemic in Turkey

Non-pharmaceutical interventions (NPIs) implemented to mitigate the COVID-19 pandemic halted everyday life in higher education along with social and psychological impacts. The objective of our study was to explore the factors related to sense of coherence (SoC) from a gender perspective among university students in Turkey. This is a cross-sectional survey conducted online with a convenience sampling method as part of the international COVID-Health Literacy (COVID-HL) Consortium. SoC was measured by a nine-item questionnaire that was adapted to the Turkish language, including socio-demographic information and health status, including psychological well-being, psychosomatic complaints, and future anxiety (FA). 1595 students from four universities, of whom 72% were female, participated in the study. Cronbach's alpha for the SoC scale was 0.75. Based on the median split of the individual scores, levels of SoC showed no statistically significant difference according to gender. Logistic regression analysis indicated that higher SoC was associated with medium and high subjective social status, studying in private universities, high psychological well-being, low FA, and none/one psychosomatic complaint. While results were similar among female students, type of university and psychological well-being showed no statistically significant association with SoC among males. Our results indicate that structural (subjective social status) and contextual (type of university) factors, along with gender-based variations, are associated with SoC among university students in Turkey.

Association between COVID-19-related Stress and Self-Directed Learning Ability among Korean Nursing Students

Purpose

Traditional face-to-face classes for nursing students due to the COVID (Coronavirus Disease)-19 pandemic around the world made it inevitable to operate education delivery method using remote/hybrid fashion. This study was aimed to validate the Korean version of the Student Stress Inventory-Stress Manifestations (SSI-SM) and assess the association between COVID-19 pandemic related stress level and self-directed learning ability competence in nursing students.

Design

This research was a cross-sectional study design.

Methods

The study was conducted from December 2020 to January 2021, with a convenience sample of 172 nursing students in the 3rd and 4th grades in South Korea. The Korean version of SSI-SM(K-SSI-SM) was translated and adapted according to standard guideline, and tested construct validity and reliability. In addition, a multiple linear regression analysis was used to examine the associations between the COVID-19 related stress level and the self-directed learning ability.

Results

An exploratory analysis showed that K-SSI-SM composed of 13-item in three factors (uncertainty, non-sociability, and somatization) accounted for 68.73% of the total variance after it was modified. The internal consistency was good with 0.91. Multiple linear regression analysis revealed that higher self-directed learning ability was associated with lower stress levels (β=-0.19, p=0.008), positive toward online learning (β=0.41, p=0.003) and scored higher in theory (β=0.30, p<0.001) in nursing students.

Conclusion

The K-SSI-SM is an acceptable instrument for assessing stress levels in Korean-nursing students. And nursing faculties need to pay attention to related factors of self-directed learning ability, in order to achieve the course's self-directed learning goal in students attending online classes.

Emotional wellbeing of student midwives during COVID-19

BACKGROUND

Mental health of students in higher education was affected during the COVID-19 pandemic.

AIM

To examine the emotional wellbeing of midwifery students in the Netherlands and Flanders (Belgium) during COVID-19.

METHODS

A cross-sectional online-based survey with 619 Dutch and Flemish midwifery students. Sociodemographic details were obtained. Anxiety and depression were measured twice (T1, T2) during the COVID-19 pandemic.

FINDINGS

Flemish students had significantly higher mean depression and anxiety scores than Dutch students during the total period of study (p < .001; p < .001). Total group mean depression and anxiety scores were significantly higher at T2 compared to T1 (p < .001; p < .001). In the Dutch student group, there was a significant increase of depression from T1 to T2 (p < .001). In the Flemish student group, both depression and anxiety scores significantly increased from T1 to T2 (p < .001; p < .001). A history of psychological problems predicted both depression and anxiety, irrespective of COVID-19 period or country (p < .001; p < .001). Being single (p.015) and having a job (p.046) predicted depression, irrespective of period or country. A history of psychological problems predicted depression (p.004; p < .001) and anxiety (p.003; p.001) during the total period of study. Being single also predicted depression during T2 (p.024).

CONCLUSION

These findings inform how emotional wellbeing of midwifery students was affected during the COVID-19 pandemic and identify those students that might need extra attention after the pandemic, during another pandemic or similar situations with social restrictions.

The role of the Coronavirus pandemic on childbearing intentions in Iranian women based on path analysis: A cross-sectional study

Background

The Coronavirus disease (COVID-19) may lead to couples not being physically and mentally ready to assume a parenting role.

Objective

Given the changes in reproductive behaviors and the lack of accurate information about childbearing factors during the Coronavirus pandemic, this study was conducted to investigate the role of the COVID-19 pandemic in Iranian couples' childbearing intentions based on the theory of planned behavior model.

Materials and Methods

This cross-sectional study was conducted on 400 married Iranian women from July to October 2020 using official online popular social networks. Data were collected using a demographic checklist and the researcher-made questionnaire, which was designed based on the main constructs of the planned behavior model.

Results

Testing the indirect relationships of the mediation model effect showed a positive relationship between knowledge (β = 0.226, p < 0.001) and subjective norms (β = 0.155, p = 0.001) about COVID-19. Anxiety about COVID-19 mediated the relationship of knowledge (β = 0.105, p = 0.009), attitude (β = -0.125, p = 0.002), subjective norms (β = 0.238, p < 0.001), and perceived behavioral control (β = 0.513, p < 0.001) about COVID-19 with childbearing intentions.

Conclusion

The results showed that COVID-19-induced anxiety can affect the relationship between the components of the theory of planned behavior model and childbearing intentions. Therefore, it is suggested that by designing appropriate interventions through anxiety-reducing and relaxation techniques, a fundamental step can be taken in increasing childbearing desires.

The Effects of Individualized Information and Emotional Support Education on Midwifery Students' Anxiety during the COVID-19 Pandemic

Background and Objectives: Midwifery students were not able to participate in internship programs and related practices during the COVID-19 pandemic. This kept them from meeting graduation requirements because they could not do the one-on-one observations for clinical case management. In this study, we aim to determine the effects of Individualized Information and Emotional Support Education (IESE) on the midwifery students' anxiety levels during the COVID-19 pandemic. Materials and Methods: This is an experimental study with two stages. In the first stage, the researchers determined the anxiety levels of 268 students. In the second stage, 76 students with high levels of anxiety were provided with IESE. The IESE was conducted in interviews on online platforms and took a minimum of 60 min. The students' anxiety levels were measured again one week after the IESE. Results: Statistically significant differences were found between the students' State Anxiety Scale scores before and after the IESE (t = 8.756, p = 0.000). Before the IESE, 65.8% of the students had high anxiety levels about COVID-19-related disease or death, and the possibility of losing loved ones. After the education, this rate fell by 17.1% to 48.7%, and this difference was significant (χ2 = 5.077, p = 0.024). Conclusions: The IESE positively affected the students' anxiety levels. Even just showing interest can make people feel cared for and valued, and people are sensitive to their needs. After this study, 30 students with high anxiety levels were sent for consultation with an expert and have been followed up by researchers.

Forward-Looking Strategies for the Advancement of Obstetrics and Gynecology to Operate in a COVID-19 Рandemic World and Beyond: A Scoping Review

BACKGROUND: The difficult epidemiological situation of COVID‒19 infection in the world and in the country requires drastic measures to strengthen the material, technical, and staffing of health-care provision in the obstetrics and gynecology practices. It has also created an environment conducive to innovation and the accelerated implementation of new ideas. This is an attempt to discuss the potential implications for obstetrics and gynecologic practice in the world. AIM: This study review gives a comprehensive overview on the effects of the COVID-19 pandemic of the potential implications for obstetrics and gynecologic practice. METHODS: The data-based used in the source search were MEDLINE and PubMed databases using terms such as: COVID-19/SARS-CoV-2, impact of corona virus on the health sector and COVID-19 in obstetrics and gynecology care. We searched several databases for English articles published between January 2020 and February 2022 that discussed or touched on the effects the pandemic had of the potential implications for obstetrics and gynecologic practice in OECD countries. RESULTS: In total, eight relevant articles discuss the relationship between reorganization of the practice of obstetrics and gynecology and other challenges that placed health-care providers under considerable psychological stress. Some studies showed that the discussed extensively the potential implications of COVID-19 for obstetrics and gynecologic practice. CONCLUSION: Successful coping strategies have been adapted to local conditions and the working conditions of staff and, most importantly, patients, so we recommend turning these temporary strategies into permanent solutions that can be quickly applied during future pandemics.

Depression among young adults - risks and protective factors in the COVID-19 pandemic

Purpose

The present study aimed to assess the depression symptoms and predictors of depression in Polish young adults during online learning in the COVID-19 pandemic.

Methods

The online questionnaire, including the Kutcher Adolescent Depression Scale, was distributed to young Poles through school principals. The final sample consisted of 1,500 students between the ages of 18 and 23 attending secondary schools. Multivariable logistic regression assessed the relationships between sociodemographic factors, pandemic stressors, coping behaviours and depressive symptoms.

Results

56% of young Polish adults are experiencing significant depressive symptoms (95% CI: 1.82-13.96). Social isolation was recognized as the main stressor. Many significant predictors of depression were captured. Being female, living in the countryside, talking to parents, and participating in sports and hobbies are found to be protective factors. The following sociodemographic factors are important predictors of depression in young adults: being male, attending a secondary school, living in a large city. Experiencing stress due to pandemic and online learning is one of the risk factors for depression.

Conclusions

The majority of young Poles met the criteria for depressive disorders. The initial findings of the presented study not only highlight the need to address mental health consequences for young people during online learning, but also provide the grounds for the development of post-pandemic interventions.

The Psychological Well-Being of University Students amidst COVID-19 Pandemic: Scoping review, systematic review and meta-analysis

This review aimed to summarise the current evidence relating to university students' psychological well-being amidst the COVID-19 pandemic. A scoping review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, was first conducted to determine if the evidence can be systematically reviewed and meta-analysed. The search was performed via Google Scholar, MEDLINE/PubMed, Science Direct, Scopus and Web of Science. A total of 90 original articles were selected for the scoping review. Meta-analysis of a total of 46,284 cases revealed an overall pooled prevalence rate of 29.1% (95% confidence interval [CI]: 20.9-39.0; K = 9, N = 22357) for anxiety symptoms and 23.2% (95% CI: 15.7-32.9; K = 12, N = 23927) for depression symptoms. This data revealed that COVID-19 had a significant impact on university students' psychological well-being.

Preventive practice, vaccine acceptance, and knowledge toward coronavirus disease-19: An online cross-sectional questionnaire-based report in Iranian dentists

BACKGROUND

The coronavirus disease (COVID) is predicted to cause serious mental health problems among healthcare providers (HCPs) especially dentists. Also understanding the influencing factors of the acceptance of COVID-19 vaccination among HCPs are important aspects in the design of effective strategies to improve the vaccine coverage rate. Therefore, this study aimed to assess the knowledge, vaccination acceptance, fear, and obsession, as well as the preventive practice behaviors of Iranian dentists and dental students in late 2020 toward COVID-19.

MATERIALS AND METHODS

A descriptive, web-based cross-sectional survey was conducted among Iranian dental students and dentists (general practitioners and specialists). All Iranian dentists and dental students living in the Islamic Republic of Iran regardless of their city and workplace were invited to participate in the study. The total number of dentists in Iran was estimated to be 54,927. The sample size was calculated 380. The questionnaires used in this study were adapted from previously published studies based on the authors' permission. The questionnaire consisted of four sections that sought to collect information on the respondents' vaccination acceptance, knowledge, preventive practice, fear, and obsession toward COVID-19. The relationship between the study variables was assessed using Pearson's correlation coefficient and also multiple linear regression tests.

RESULTS

Overall, 394 dentists were filled the questionnaire (65 dental students, 151 general dentists and 178 specialists). There were no differences in terms of vaccination acceptance, knowledge and also fear score in different designation groups. Dentists had significantly higher obsession and also preventive practice scores than other designation groups (P < 0.05). The majority of respondents had good knowledge (more than 9), acceptable preventive practice (more than 19), low fear-obsession (<2.7), and high acceptance of COVID-19 vaccination (more than 8.8).

CONCLUSIONS

Although obsession and fear scores were low in all designation groups, dentists had higher obsession and also preventive practice scores than other designation groups. More than half of respondents preferred imported COVID-19 vaccines. Finally, organizations such as the World Health Organization and the Ministry of Public Health in Iran should increase vaccine convenience and accessibility in terms of vaccine importing, distribution, supply, and immunization service.

Mental health of students of biomedical sciences during the COVID-19 pandemic: a scoping review

Introduction

The coronavirus pandemic led to the closure of schools and colleges in March 2020. Medical and other schools shifted to online teaching-learning and assessment. Several factors have led to mental health problems among biomedical students.

Objectives

This scoping review seeks to identify stressors, delineate subgroups of students who may be at greater risk of mental health problems, and examine possible recommendations by the respondents and the authors to reduce stress levels and support students.

Methods

Eligibility criteria: studies published in English about the impact of the coronavirus pandemic on the mental health of health science students till 15th January 2021 were included. Sources of evidence: research articles and other publications obtained using the databases PubMed, Scopus, and Google Scholar. Charting methods: the criteria studied were the type of paper and study, the country, the institution, the mental health parameters studied, types and numbers of students/respondents involved, the main message, strengths and weaknesses and the main recommendation of the study.

Results

Thirty articles were included. Stressors were divided into health, workplace, academic, general, and financial apprehensions. Respondents at greater risk were females, below 20 years of age, and those with family/friends infected. Among the authors' recommendations to reduce stress were implementing effective plans to safeguard students' health, especially of those who were parents or interns, engaging in physical activities, workshops for faculty members in online teaching-learning, financial support, online counselling, reducing misinformation, further studies at later stages of the pandemic, and including topics related to the pandemic and pandemic preparedness in the curriculum.

Conclusions

Different types of apprehensions were responsible for stress and mental distress. Females, younger students, students with family and friends who were infected were at greater risk of problems. Recommendations were provided by the authors. Studies from countries which were not represented, and longitudinal studies may be required.

COVID-19-Related Knowledge and Anxiety Response among Physical Education Teachers during Practical In-Person Lessons: Effects of Potential Moderators

The COVID-19 pandemic has resulted in heightened anxiety levels among teachers, especially regarding PE teachers who are required to engage students in practical in-person or contact teaching lessons. Previous research showed that these levels of anxiety among PE teachers appeared to be explained by the interplay between COVID-19 knowledge, workplace safety perception, and educational qualification. This study assessed the relationship between COVID-19-related knowledge and anxiety response among PE teachers during such practical lessons while moderating the effects of workplace safety perception and educational qualification within the relationship. The study conveniently recruited 160 PE teachers to solicit responses through both online and printed questionnaires. Using correlation and linear regression analyses, the study revealed a significant negative relationship between COVID-19-related knowledge and anxiety response among PE teachers. The educational qualification of PE teachers did not significantly moderate the association between COVID-19-related knowledge and anxiety response. Workplace safety perception significantly moderated the association between COVID-19-related knowledge and anxiety response among PE teachers. The findings remind educational authorities about the essence of creating a positive and safe working environment conducive to academic work. Achieving this goal requires the provision of adequate COVID-19 management logistics (e.g., personal protective equipment, hand sanitizers) by educational authorities for PE teachers to maintain safety practices and optimal learning conditions.

Nursing and Midwifery Students’ Mental Health Status and Intention to Leave During Covid-19 Pandemic

Introduction

COVID-19 has not only affected the physical health of people but it has also had a major impact on their mental health.

Objective

To investigate the nursing, midwifery, and operating room students’ mental health and intention to leave during COVID-19 pandemic.

Methods

This cross-sectional study was conducted at the nursing and midwifery school of Tabriz, Iran. Over a period of three months (February–May 2021) and through random sampling, 284 students were selected. The research tool consisted of three parts including demographic information, Depression Anxiety Stress scales, and a questionnaire on intention to leave.

Results

More than 20% of the students experienced some degrees of depression, anxiety, and stress. Nearly one-third of participants mentioned a high level of intention to leave. Nursing students had a higher level of a turnover tendency than other students (p = .004). Male students and who experienced moderate to high level of depression displayed greater intention to leave (p = .005).

Conclusion

Students suffered from some degrees of stress, anxiety, and depression during the COVID-19, and it strengthened the participants’ intention to leave. Relevant authorities are recommended to improve mental health of the students by providing psychological counseling sessions, reducing their direct contact with patients, and providing personal protective equipment.

The effect of anxiety on nicotine dependence among university students during the COVID-19 pandemic

PURPOSE

This study investigated the effect of anxiety on nicotine dependence among university students during the COVID-19 pandemic.

DESIGN AND METHODS

This was a descriptive and correlational study. The sample consisted of 503 university students in Turkey. Data were collected online using a demographic characteristics form, the State-Trait Anxiety Inventory (STAI), and the Fagerström Test for Nicotine Dependence (FTND).

FINDINGS

FTND scores differed by gender, family type, and grade level, while STAI scores differed by gender, income, and region of residence (p < 0.05). Fifty-one percent of the participants had moderate anxiety, while 65.2% had low nicotine dependence. FTND and STAI mean scores were strongly correlated (p < 0.05).

PRACTICAL IMPLICATIONS

The higher the anxiety, the higher the nicotine dependence among university students during the COVID-19 pandemic.

Comparison of anxiety levels of hospitalized COVID-19 patients, individuals under quarantine, and individuals in society

PURPOSE

This study aims to compare the anxiety levels of COVID-19 patients, individuals under quarantine, and healthy individuals in society.

DESIGN AND METHODS

This cross-sectional study was conducted from May 25, 2020 to June 25, 2020 in a city located in the northwest of Turkey. The data were collected using a personal information form, the Beck Anxiety Scale, administered in face-to-face interviews, and online questionnaires. The data were analyzed using descriptive statistics, Kruskal-Wallis, Mann-Whitney U, and logistic regression analyses.

FINDINGS

The anxiety level of individuals under quarantine (Median: min-max = 1: 0-55) was significantly lower statistically compared to that of the rest of the society (Median: min-max = 6: 0-63) and hospitalized COVID-19 patients (Median: min-max = 5: 0-42) (p = 0.0001). Female gender, being 61 years of age and older, having psychiatric and chronic illnesses, and experiencing disrupted sleep patterns were determined to be the factors associated with high levels of anxiety.

PRACTICE IMPLICATIONS

This study found that society in general and hospitalized COVID-19 patients had high anxiety levels. The study results can be useful for creating training and population-based screening programs to control the anxiety of individuals under quarantine, hospitalized COVID-19 patients, and the rest of the society during the pandemic. Additionally, the finding from this study on groups at risk for anxiety will provide important data for future research on this subject and for the planning of health services offered to these groups.

Effects of the Covid-19 pandemic on maternity staff in 2020 - a scoping review

In the spring of 2020, the SARS-CoV-2 virus caused the Covid-19 pandemic, bringing with it drastic changes and challenges for health systems and medical staff. Among the affected were obstetricians and midwives, whose close physical contact with pregnant women, women who recently gave birth, and their children was indispensable. In the obstetric setting, births cannot be postponed, and maternity staff had to adapt to assure obstetric safety while balancing evidence-based standards with the new challenges posed by the pandemic. This scoping review gives a comprehensive overview of the effecs the Covid-19 pandemic had on maternity staff. We followed the evidence-based approach described by Arksey & O'Malley: we searched several databases for English and German articles published between January 2020 and January 2021 that discussed or touched upon the effects the pandemic had on maternity staff in OECD countries and China. We found that structural challenges caused by the crisis and its subjective effects on maternity staff fell into two main topic areas. Structural challenges (the first main topic) were divided into five subtopics: staff shortages and restructuring; personal protective equipment and tests; switching to virtual communication; handling women with a positive SARS-CoV-2 infection; and excluding accompanying persons. The pandemic also strongly affected the staff's mental health (the second main topic.) Attempting to meet challenges posed by the pandemic while afraid of contamination, suffering overwork and exhaustion, and struggling to resolve ethical-moral dilemmas had severe negative subjective effects. Several studies indicated increased depression, anxiety, stress levels, and risk of post-traumatic stress symptoms, although the crisis also generated strong occupational solidarity. Care for pregnant, birthing, and breast-feeding women cannot be interrupted, even during a pandemic crisis that requires social distancing. Maternity staff sometimes had to abandon normal standards of obstetric care and were confronted with enormous challenges and structural adjustments that did not leave them unscathed: their mental health suffered considerably. Researchers should study maternity staff's experiences during the pandemic to prepare recommendations that will protect staff during future epidemics.

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.

Psychological well-being and death anxiety among breast cancer survivors during the Covid-19 pandemic: the mediating role of self-compassion

Background

Despite the abundance of clinical data available for Coronavirus Disease 2019 (COVID-19), little research on the psychological well-being of breast cancer survivors has been published. We investigate the extent to which self-compassion accounted for the association between psychological well-being (depression, anxiety) and death anxiety in breast cancer survivors.

Methods

A cross-sectional study design was applied. Participants were recruited from three departments of oncology in Zanjan, Iran. Data were collected from 210 breast cancer patients. Participants completed self-report measures. Pearson correlation coefficient was used to assess the relationship among the study variables. Bootstrapping analyses were used to test the significance of indirect effects.

Results

Correlational analyses revealed that depression and anxiety were significantly and positively related to death anxiety (r = 0.77, p < 0.01; r = 0.85, p < 0.01, respectively) and negatively to self-compassion (r = − 0.48, p < 0.01; r = − 0.53, p < 0.01, respectively). Bootstrapping analyses revealed significant indirect effects of depression (β = 0.065, SE = 0.35, p < 0.03, 95% CI [LL = − 0.0083, UL: − 0.1654]) and anxiety (β = 0.089, SE = 0.09, p < 0.04, 95% CI [LL = − 0.0247, UL: − 0.1987]) on death anxiety through self-compassion.

Conclusions

Findings from this study indicate that self-compassion may be considered as one treatment strategy to improve psychological well-being of cancer patients in the new context of the COVID-19 pandemic.

Knowledge about the COVID-19 pandemic among undergraduate medical and dental students in Lalitpur, Nepal

Background

Coronavirus disease-19 (COVID-19) has become a major global problem. There is an urgent need to measure the knowledge of the disease among health science students who can play an active role in pandemic control. The research was conducted to examine COVID-19 knowledge among medical and dental students in a Nepalese medical college, compare the knowledge to other studies in the literature and identify educational needs of students who may be involved in treating COVID-19 patients.

Methods

The cross-sectional study was performed during the third week of June among first to final year medical and dental students. As the country was in lockdown, a structured online questionnaire was used. The responses obtained were entered into IBM SPSS Statistics for Windows and the normality of the data checked using one-sample Kolmogorov Smirnov test. The demographic parameters were tabulated, and total score compared among different subgroups of participants. The frequency of different measures mentioned by respondents were also noted.

Results

More than half of the participants were females (59.6%). Nearly half 282 (49.8%) belonged to age group 21-23 years. The majority 415 (73.5%) were undergraduate medical and 150 (26.5%) were undergraduate dental students. The largest number of respondents, 140 (24.9%), were from the second year of study and 344 (60.9%) were from urban areas. The median total score was 20 and the interquartile range 4. The maximum possible score was 29. The scores among students belonging to different years of study were significantly different (p=0.006). Total scores were not significantly different among other subgroups.

Conclusions

The knowledge of the participants was good. Deficiencies in knowledge were noted in certain areas and these should be addressed through an educational intervention. One of the challenges is the rapid evolution of our knowledge about this condition, which may require regular refresher sessions. Similar studies can be undertaken in other medical colleges in the country and in nursing and pharmacy colleges.

Knowledge, attitude, practice and clinical recommendations of health care workers towards COVID-19: a systematic review

OBJECTIVES

This study aimed to evaluate the knowledge, attitude, practice, and clinical recommendations of health care workers (HCWs) towards COVID-19.

METHODS

In this systematic review study, international databases (Web of Science, PubMed, and Scopus) were searched for the relevant studies published in English from the inception of databases until July 30, 2020. Hoy et al.'s tool was used to evaluate the quality of studies. All search steps, screening, selection of studies, quality assessment, and data extraction were performed separately by two researchers.

RESULTS

Out of 3460 articles searched, 28 articles conducted on 16,427 HCWs were included in the study. Most of the HCWs had good knowledge (72.2%), a positive attitude (70.9%), and good practice (78.8%) towards COVID-19. The most important clinical recommendation to improve knowledge, attitude, and practice (KAP) was to provide HCWs with a periodic training program regarding COVID-19. The most important source of information for HCWs on COVID-19 was social networks.

CONCLUSIONS

Despite HCWs' good knowledge, attitude, and practice (KAP), it is recommended to periodically review KAP and carry out further studies in different countries as well. It is also recommended to use social media to improve KAP.

Perception and awareness of COVID-19 among health science students and staff of Kuwait University: An online cross-sectional study

Background: Coronavirus disease 2019 (COVID-19) pandemic is unprecedented. Health science students are the future frontliners to fight pandemics. Awareness and perception toward COVID-19 among health science students and staff at Kuwait University was assessed. Methods: Between June and July 2020, an online questionnaire was distributed to all students and staff at HCS. The questionnaire was divided into six sections: socio-demography, risk and awareness, preparedness and prevention, source of information, policies, and social stigma. Results: A total of 592 students and 162 staff completed the questionnaire. The prevalence of self-reported chronic condition among students and staff was 14.0% and 19.1%, respectively. Moreover, self-reported COVID-19 prevalence among students and staff was 2.7% and 1.2%, respectively. Interestingly, 54% of students and 38.3% of staff reported that they knew someone within their immediate social environment who have been/are infected with SARS-CoV-2. Among students, 92.4% wore face mask in indoor places (outside of their home) 'often/all the time' compared to wearing it outdoors (69.3%); whereas, for staff, it was more common to wear it outdoor than in indoor places (75.9% vs. 81.5%). Willingness to take COVID-19 vaccine was indicated by 50% of students 'strongly agreed' and an additional 25.8% agreed to taking it. Interest vaccine uptake was lower among staff (28.4% and 34.6% strongly agreed or agreed, respectively). Participants strongly agreed or agreed (72.5% and 19.6% of students as well as 68.5% and 22.2% of staff ) that wearing face mask in public should be obligatory. More than 18% of students and staff indicated that they would avoid contact with COVID-19 infected people. Conclusions: Responses of students and staff were mostly similar and showed that they follow precautionary measures to control spread of COVID-19, understand the viral transmission risk, and willing to raise awareness to reduce social stigma.

Medical Students' Voluntary Service During the COVID-19 Pandemic in Poland

From the very first moment coronavirus struck, medical students volunteered to support healthcare professionals' fight against the COVID-19 pandemic. To learn more about future healthcare professionals' volunteering during such an outbreak, we conducted a survey among 417 students of Poznan University of Medical Sciences. Our findings suggest that although numerous studies demonstrate that traditional, value-based volunteering is decreasing, and especially higher education students are more oriented toward their own career, in the times of the current health crisis, young peoples' involvement in volunteering has been mainly driven by altruism and the ethical imperative to serve their community, their fellow healthcare professionals and their patients. Thus, while the prime role of the volunteering was to relieve the healthcare system, it also reinforced such important medical values as altruism, public service and professional solidarity. Moreover, it proved that whilst risk is inherent to medicine, the students' volunteering is truly a moral enterprise.

Medical Students' Voluntary Service During the COVID-19 Pandemic in Poland

From the very first moment coronavirus struck, medical students volunteered to support healthcare professionals' fight against the COVID-19 pandemic. To learn more about future healthcare professionals' volunteering during such an outbreak, we conducted a survey among 417 students of Poznan University of Medical Sciences. Our findings suggest that although numerous studies demonstrate that traditional, value-based volunteering is decreasing, and especially higher education students are more oriented toward their own career, in the times of the current health crisis, young peoples' involvement in volunteering has been mainly driven by altruism and the ethical imperative to serve their community, their fellow healthcare professionals and their patients. Thus, while the prime role of the volunteering was to relieve the healthcare system, it also reinforced such important medical values as altruism, public service and professional solidarity. Moreover, it proved that whilst risk is inherent to medicine, the students' volunteering is truly a moral enterprise.

Experiences of receiving and providing maternity care during the COVID-19 pandemic in Australia: A five-cohort cross-sectional comparison

Introduction

The global COVID-19 pandemic has radically changed the way health care is delivered in many countries around the world. Evidence on the experience of those receiving or providing maternity care is important to guide practice through this challenging time.

Methods

A cross-sectional study was conducted in Australia. Five key stakeholder cohorts were included to explore and compare the experiences of those receiving or providing care during the COVID-19 pandemic. Women, their partners, midwives, medical practitioners and midwifery students who had received or provided maternity care from March 2020 onwards in Australia were recruited via social media and invited to participate in an online survey released between 13^th May and 24^th June 2020; a total of 3701 completed responses were received.

Findings

While anxiety related to COVID-19 was high among all five cohorts, there were statistically significant differences between the responses from each cohort for most survey items. Women were more likely to indicate concern about their own and family’s health and safety in relation to COVID-19 whereas midwives, doctors and midwifery students were more likely to be concerned about occupational exposure to COVID-19 through working in a health setting than those receiving care through attending these environments. Midwifery students and women’s partners were more likely to respond that they felt isolated because of the changes to the way care was provided. Despite concerns about care received or provided not meeting expectations, most respondents were satisfied with the quality of care provided, although midwives and midwifery students were less likely to agree.

Conclusion

This paper provides a unique exploration and comparison of experiences of receiving and providing maternity care during the COVID-19 pandemic in Australia. Findings are useful to support further service changes and future service redesign. New evidence provided offers unique insight into key stakeholders’ experiences of the rapid changes to health services.

Assessing the Psychological Impact of COVID-19 among College Students: An Evidence of 15 Countries

Mental health issues among college students is a leading public health concern, which seems to have been exacerbating during the COVID-19 pandemic. While previous estimates related to psychological burden among college students are available, quantitative synthesis of available data still needs to be performed. Therefore, this meta-analysis endeavors to present collective evidence discussing the psychological impact of COVID-19 among college students. Bibliographical library databases, including Embase, Medline, CINAHL, Scopus, and PsycINFO, were systematically searched for relevant studies. Titles, abstracts, and full articles were screened, and two reviewers extracted data. Heterogeneity was assessed by I² statistic. The random-effects model was utilized to obtain the pooled estimates of psychological indicators among college students. Location, gender, level of severity, and quality scores were used as moderator variables for subgroup analyses. Funnel plot and Egger linear regression test was used to assess publication bias. Twenty-seven studies constituting 90,879 college students met the inclusion criteria. The results indicated 39.4% anxiety (95% CI: 28.6, 51.3; I² = 99.8%; p-value < 0.0001) and 31.2% depression (95% CI: 19.7, 45.6; I²= 99.8%, p < 0.0001) among college students. The pooled prevalence of stress (26.0%), post-traumatic stress disorder (29.8%), and impaired sleep quality (50.5%) were also reported. College students bear a disproportionate burden of mental health problems worldwide, with females having higher anxiety and depression levels than males. This study‘’s findings underscore the need to develop appropriate public health interventions to address college students’ emotional and psychosocial needs. The policies should be reflective of demographic and socioeconomic differentials.

Nursing students, mental health status during COVID-19 quarantine: evidence from three European countries

BACKGROUND

The SARS-CoV2 pandemic obligated most of the European countries to implement strict measures and lockdowns to minimize the spread of the virus. Universities closed and on-line classes started. However, COVID-19 epidemic has significant impact on mental health of population.

AIM

To assess depression level of nursing students (undergraduate and master) in Greece, Spain and Albania during COVID-19 pandemic as well as to identify possible determinants of depression level.

METHODS

A multicenter cross-sectional study was conducted between April and May 2020. An on-line questionnaire was used to collect the data. The Patient Health Questionnaire-9 was used to evaluate the depression levels of nursing students.

RESULTS

Seven hundred and eighty-seven nursing students participated in the study out of which 83.9% were of female gender, 92.9% single and 94.7% lived with others. One third of the nursing student population experienced mild depression, with higher depression levels noted for Spanish students (59.1%) followed by Albanian (34.5%) and Greek (21.8%) students. Multivariate linear regression analysis identified that Spanish students experienced more depression than Greek and Albanian (p < 0.001). Also, decreased age was associated with increased depression.

CONCLUSION

The impact of lockdown and quarantine on nursing students mental health is clear. Provision of university based mental health interventions should be a priority.

Exploring Perceived Stress among Students in Turkey during the COVID-19 Pandemic

Students have been highly vulnerable to mental health issues during the COVID-19 pandemic, and researchers have shown that perceived stress and mental health problems have increased during the pandemic. The aim of this study was to reveal the prevalence of perceived stress and mental health among students during the pandemic and to explore predictors of stress levels. A cross-sectional study was conducted on a sample of 358 undergraduates from 14 universities in Turkey, including 200 female students (56%). The measurements used in the study were the Generalized Anxiety Disorder 7-item (GAD-7) scale, Patient Health Questionnaire (PHQ-8), Satisfaction with Life Scale (SWLS), Perception of COVID Impact on Student Well-Being (CI), Perceived Stress Scale (PSS-10), Physical Activity Scale (PA), and a sociodemographic survey. Students reported high perceived stress, mild generalized anxiety, and low satisfaction with life. More than half of the students met the diagnostic criteria of GAD (52%) and depression (63%). Female and physically inactive students had higher PSS-10 levels. A hierarchical linear regression model showed that after controlling for gender and negative CI, anxiety and physical inactivity significantly predicted high perceived stress. The study shows that students’ mental health during the pandemic is at high risk.

COVID-19-Related Mental Health Effects in the Workplace: A Narrative Review

The Coronavirus Disease 2019 (COVID-19) pandemic has deeply altered social and working environments in several ways. Social distancing policies, mandatory lockdowns, isolation periods, and anxiety of getting sick, along with the suspension of productive activity, loss of income, and fear of the future, jointly influence the mental health of citizens and workers. Workplace aspects can play a crucial role on moderating or worsening mental health of people facing this pandemic scenario. The purpose of this literature review is to deepen the psychological aspects linked to workplace factors, following the epidemic rise of COVID-19, in order to address upcoming psychological critical issues in the workplaces. We performed a literature search using Google Scholar, PubMed, and Scopus, selecting papers focusing on workers' psychological problems that can be related to the workplace during the pandemic. Thirty-five articles were included. Mental issues related to the health emergency, such as anxiety, depression, post-traumatic stress disorder (PTSD), and sleep disorders are more likely to affect healthcare workers, especially those on the frontline, migrant workers, and workers in contact with the public. Job insecurity, long periods of isolation, and uncertainty of the future worsen the psychological condition, especially in younger people and in those with a higher educational background. Multiple organizational and work-related interventions can mitigate this scenario, such as the improvement of workplace infrastructures, the adoption of correct and shared anti-contagion measures, including regular personal protective equipment (PPE) supply, and the implementation of resilience training programs. This review sets the basis for a better understanding of the psychological conditions of workers during the pandemic, integrating individual and social perspectives, and providing insight into possible individual, social, and occupational approaches to this "psychological pandemic".

Prevalence of Anxiety in Medical Students during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis

The novel coronavirus disease (COVID-19) pandemic has brought a great deal of pressure for medical students, who typically show elevated anxiety rates. Our aim is to investigate the prevalence of anxiety in medical students during this pandemic. This systematic review and mini meta-analysis has been conducted following the PRISMA guidelines. Two researchers independently searched PubMed on 26 August 2020 for cross-sectional studies on medical students during the COVID-19 outbreak, with no language restrictions applied. We then performed a manual search to detect other potentially eligible investigations. To the 1361 records retrieved in the initial search, 4 more were added by manual search on medRxiv. Finally, eight studies were finally included for qualitative and quantitative analysis, which yielded an estimated prevalence of anxiety of 28% (95% CI: 22-34%), with significant heterogeneity between studies. The prevalence of anxiety in medical students is similar to that prior to the pandemic but correlates with several specific COVID-related stressors. While some preventive and risk factors have been previously identified in a non-pandemic context, knowledge and cognitions on COVID-19 transmission, treatment, prognosis and prevention negatively correlate with anxiety, emerging as a key preventive factor that may provide a rationale for why the levels of anxiety have remained stable in medical students during the pandemic while increasing in their non-medical peers and the general population. Other reasons for the invariability of anxiety rates in this population are discussed. A major limitation of our review is that Chinese students comprised 89% the total sample, which could compromise the external validity of our work.