Mental health and behaviour of students of public health and their correlation with social support: a cross-sectional study

Occupational balance of Spanish occupational therapist – a challenge

BACKGROUND

Occupational balance is a central aspect in occupational therapy. Awareness of occupational balance/imbalance among occupational therapists could influence the orientation of their professional interventions.

OBJECTIVE

To describe and compare the occupational balance status of occupational therapists working in Spain.

MATERIAL AND METHODS

Cross-sectional descriptive study using an online questionnaire. Participants were occupational therapists working in Spain who answered a questionnaire including 22 questions on the sociodemographic and employment data and the Spanish version of the Occupational Balance Questionnaire (OBQ-E) ranging 0-65 where higher ratings equal better occupational balance.

RESULTS

A total of 648 currently working occupational therapists participated. Mostly women, with median age of 32 years, without partner, children, or dependents. The median OBQ-E was 37 (IQR = 27; 45). Statistically significant differences were found between the medians of participants varying in the categories 'hired as an occupational therapist', weekly work hours, and population working with children and adults.

CONCLUSIONS AND SIGNIFICANCE

Spanish occupational therapists presented a moderate occupational balance that varied between subgroups. Professional recognition, working hours, and the population they attend are aspects that influence their occupational balance. Knowledge of occupational therapists' occupational balance could contribute to the development of policies aimed at promoting it.

Socio-demographic characteristics, lifestyles, social support quality and mental health in college students: a cross-sectional study

Background

Mental health problems are important public health issues among college students and are associated with various social factors. However, these influencing factors were scarcely summarized in Chinese college students comprehensively. This study aims to assess the associations between socio-demographic characteristics, lifestyles, social support quality (SSQ) and mental health among Chinese college students .

Methods

A cross-sectional study was conducted in Wuhan, China, from October 2017 to February 2018. College students from 18 colleges or universities were randomly recruited using multi-stage cluster sampling method. The Multidimensional Scale of Perceived Social Support scale and 12-items General Health Questionnaire were used to estimate students’ SSQ and mental health statuses, respectively. Logistic regression analysis was used to evaluate the associations between socio-demographic characteristics, lifestyles, SSQ and mental health problems.

Results

A total of 10,676 college students were included. Among them, 21.4% were identified as having possible mental health problems. Students being a female, aged 18–22 years old, whose mother held college degrees and above, and drinking alcohol were more likely to have mental health problems (P < 0.05). Contrarily, having general or higher household economic levels, work-rest regularly, and sleeping ≥ 7 h were preventive factors (P < 0.05). Especially, a decreasing trend in the risk of having mental health problems with the improvement of SSQ was identified.

Conclusion

Besides socio-demographic and lifestyle factors, social support is a critical factor for mental health among college students. Improving SSQ, especially which from the family, could be an effective method to prevent mental health problems among college students.

Barriers to Seeking Mental Help and Interventions to Remove Them in Medical School during the COVID-19 Pandemic: Perspectives of Students

Medical students are at increased risk for psychological morbidity but the majority of those with mental health problems do not seek professional care. We aimed to uncover the viewpoints of medical students regarding barriers and facilitators to using university mental health services and their attitudes and preferences towards online counselling. Four semi-structured focus groups were conducted (n = 26, mean age = 21.8, ±1.88, 73% males). After reaching data saturation, interviews were audio-recorded, transcribed and content-analysed by two independent coders. Intrapersonal barriers emerged to be perceived low risk, excessive self-reliance, lack of belief in the effectiveness of service, lack of openness. Interpersonal factors were the following: assumed long waiting list, insufficient provision of service information, fear of exposure, and not being familiar with the counsellor and the process. Extrapersonal barriers such as insurance problems, the number of available sessions, adverse sociocultural attitudes, fear of stigmatisation were identified. Students suggested that the university should provide psychoeducation and routine screening, apply social marketing and stigma reduction campaigns, improve information flow, and offer not only personal but also online video counselling to target removing these barriers. The results provide a reference for the redesign of mental health services to facilitate their access by students. Implications and limitations are discussed.

Exploring Trends and Differences in Health Behaviours of Health Sciences University Students from Germany and England: Findings from the "SuSy" Project

Objectives: This research aimed to explore the health behaviours of health sciences students over time and across different settings. Methods: A health behaviour surveillance system has been implemented in Hamburg and Manchester among under- and postgraduate health sciences students. Trends among the Hamburg sample were described. In a cross-sectional assessment, health behaviours across both universities were examined using multivariate regression analysis. Results: Between 2014 and 2018, increasing trends in physical activity and cannabis and alcohol consumption were observed in Hamburg (n = 1,366). While fruit and vegetable intake was constantly low, tobacco smoking decreased. No clear trend was observed for stress perception. The comparison (n = 474) revealed that Manchester students had higher odds of smoking, excessive alcohol consumption, and fruit and vegetable consumption; and lower odds of being physically active, and consuming cannabis. No difference in stress perception was observed. Conclusions: Varying trends and potential areas of intervention were identified for health behaviours in Hamburg. The comparison with Manchester students revealed differences in behaviours, which could be further explored to help inform health promotion strategies in both settings.

Demographics, Socioeconomic Status, Social Distancing, Psychosocial Factors and Psychological Well-Being among Undergraduate Students during the COVID-19 Pandemic

The COVID-19 pandemic impacted on academic routine because of the social distancing measures. This study examined the relationships of sociodemographic characteristics, social distancing aspects and psychosocial factors on psychosocial well-being among undergraduate students during the social distancing period due to COVID-19. A web-based survey was conducted of undergraduate students at a public university in Brazil (n = 620). Demographics, socioeconomic status (SES), social distancing factors, negative affectivity (DASS-21), sense of coherence (SOC-13), social support and psychosocial well-being (GHQ-12) were measured. The direct and indirect links between was variables was tested using structural equation modelling. The estimated model showed that greater social support, higher sense of coherence and lower negative affectivity were directly associated with better psychological well-being. Female gender, higher SES, not working during the social distancing period and availability of online modules were indirectly associated with psychological well-being through psychosocial factors. Working during the social distancing period and availability of online modules mediated the link of age, gender, SES with psychological well-being. Our findings suggest the need to provide psychological support, online teaching and financial aid to undergraduate students during the social distancing period due to COVID-19 pandemic to improve their psychological well-being.

Awareness of COVID-19 influences on the wellness of Thai health professional students: An ambulatory assessment during the early "new normal" informing policy

The COVID-19 global pandemic has had a socioeconomic effect, including many people suffering from stress and mental disorders. Health professional students are at risk of health issues as well when compared to their age-matched counterpart in the population. The present study aimed to find out the impact of COVID-19 awareness on the wellness of Thai health professional students. The awareness of COVID-19 and wellness among Thai health professional students, such as medical, physical therapy, nursing, pharmacy, and medical technology students were surveyed during the early “new normal” informing policy. The participants included 1,001 students, aged 17 to 25 years old, who responded to a Google form questionnaire set by request. The results showed that the prominent health risks among the Thai health professional students included sedentary behavior, obesity, and mental symptoms. A positive rating in attitude towards the COVID-19 epidemic was mostly observed. There was a negative influence on anxiety symptoms (standardized coefficient beta = -0.079, p-value = 0.012), but a positive impact on social well-being (standardized coefficient beta = 0.158, p-value < 0.001) and quality of life (standardized coefficient beta = 0.136, p-value < 0.001) among the students even when the situation was improving. To relieve the domino effect of the COVID-19 pandemic on students’ wellness, an updated policy for enhancing awareness and providing updated information is continuously required. Improvements on self and situational awareness may help prevent health risk behaviors and promote health among Thai health professional students.

The challenges and mental health issues of academic trainees

In the last decade, mental health issues have come to the foreground in academia. Literature surrounding student mental health continues to grow as universities try to implement wellness services and study the mental health of their students. Studies vary greatly in terms of measurement tools, timeframe, sample demographics, as well as the chosen threshold of symptom severity for diagnosis. This review attempts to summarize, contextualize and synthesize papers that pertain to the challenges faced by academic trainees at the undergraduate, graduate and post-graduate level. The evidence for, and against, the common claim of increasing prevalence of mental health issues among students in recent years is discussed. While some studies support this claim, it is difficult to reach a definitive conclusion due to numerous confounding factors such as increased help-seeking behaviour, greater awareness of mental health issues and weak methodology. The prevalence of depression, anxiety, suicidal and self-injurious behaviour, distress and general mental illness diagnoses are discussed. Other issues known to influence mental health, such as sexual assault and bullying, are briefly addressed. Finally, select studies on a few wellness strategies that may improve mental health of trainees, such as mindfulness, are summarised, along with diverse recommendations for individual students, universities, and academia as a whole.

A Simple Method for Assessing the Mental Health Status of Students in Higher Education

Mental health problems are common among students in higher education all over the world, so identifying those who are at higher risk would allow the targeted provision of help. Our goal was to develop an assessment tool to identify students at risk for vulnerable mental health status. This tool was created from the 12-item General Health Questionnaire and Antonovsky’s abbreviated sense of coherence scale and was tested to distinguish between those with high or low mental resilience. Predictive ability was characterized by likelihood ratios taking the Beck Depression Inventory and perceived health as references. One-quarter (95% CI 21.1% to 29.7%) of the students had been in vulnerable mental health characterized by low sense of coherence and high distress, whereas 28.4% (95% CI 24.2% to 33.1%) seemed resilient, having high sense of coherence and low distress. The high negative predictive value of the assessment tool reliably identified resilient students in comparison with both the Beck Depression Inventory (98.6%) and perceived health status (83.9%). Use of the assessment tool is recommended for students to distinguish between those at decreased and increased risk in terms of mental health. Mental health services should be offered to students at higher risk.

[Integrative review: psychological distress among university students and correlated factors]

This review sought to identify risk factors and protection from psychic distress among university students. Empirical studies were analyzed in the Web of Science, Medline and Scopus databases. A total of 1,375 articles were located, and after the exclusion criteria were applied, 37 articles made up the final sample, most of which were cross-sectional studies published in the last five years, in developed countries and with students in the health area. The most frequently used instruments for psychic distress screening were the General Health Questionnaire and the Self Reporting Questionnaire, which identified a prevalence of between 18.5% and 49.1% and, as risk factors, conditions related to academic life (24) and to health (22). Twelve studies identified as protective factors: given coping strategies, sense of coherence, self-efficacy, vigor, self-esteem, resilience, among other psychological conditions. This review singles out directions for possible interventions that could contribute to the well-being of students and to stimulate more positive experiences in the educational environment.

Short-Term Effects of a Multidimensional Stress Prevention Program on Quality of Life, Well-Being and Psychological Resources. A Randomized Controlled Trial

It is well-documented that university students have an increased risk in developing psychological problems because they face multiple stressors. Cognitive, behavioral, and mindfulness-based stress prevention programs were shown to reduce symptoms of anxiety, depression, and perceived stress in university students. However, little is known of their effect on resource activation. Additionally, most validated interventions are unidimensional, i.e., including one stress-coping approach. In this study, we investigated the short-term effects of a multidimensional stress prevention program on students' quality of life, psychological symptoms and resources, and resilience factors against stress. Using an experimental design, 64 healthy undergraduate students (56 women), between 18 and 34 years old (M = 21.34, SD = 2.53), from the University of Fribourg, Switzerland, were randomly allocated either to the intervention or the wait-list control group. The intervention group participated in a multidimensional stress prevention program, integrating mindfulness-based activities, cognitive and behavioral strategies, social skills, and emotional regulation exercises. The program consisted of eight 2-h weekly sessions. Before and after the intervention, participants completed self-reported questionnaires evaluating quality of life; psychological symptoms such as depression, anxiety, social anxiety, and interpersonal problems; as well as psychological resources like self-efficacy, sense of coherence, self-compassion, and social support, presented online. A standardized clinical interview was performed at pre- and post-measurement times. To analyze the sort-term effects of the program, we used mixed, two-factorial ANOVAs (per-protocol analyses). In accordance with our hypotheses, our results showed significant reduction of psychological symptoms, including anxiety, interpersonal problems, and symptoms of pain; a significant increase in quality of life, sense of coherence, and self-compassion in students who participated in the intervention program compared to the control group, (all p < 0.05). No significant results were found for symptoms of depression, social anxiety, self-efficacy, and social support. These preliminary findings indicate specific short-term effects of our multidimensional stress prevention program on psychological symptoms and on quality of life as well as promising effects on psychological resources and factors associated with resilience against stress. Future studies should investigate the long-term effects of the intervention as well as the effects in clinical samples.

Lifestyle behaviors and mental health in medical students

Purpose

Recently, there has been a renewed interest in medical students’ mental health. The purpose of this paper is to determine factors associated with psychological distress in medical students and to assess the correlation between major lifestyle behaviours and mental health.

Design/methodology/approach

The authors conducted a cross-sectional questionnaire survey among 530 medical students randomized from a faculty of medicine in 2017. The authors used the 12-item General Health Questionnaire (GHQ-12) and the Simple Lifestyle Indicator Questionnaire (SLIQ) to assess mental health and lifestyle, respectively.

Findings

The mean value of GHQ-12 and SLIQ were 4.1±2.8 and 6.2±1.4, respectively. Bivariate correlation analysis showed that SLIQ was significantly correlated to GHQ-12 (r=−0.26; p<0.001). The prevalence of psychological distress (GHQ-12=4) was 50.1%. The authors found that low/middle financial situation of the family (OR=1.5; CI 95%=[1.1–2.3]), internship level, (OR=1.8; CI 95%=[1.1–3.3]), medium/poor perceived academic performance (OR=2.2; CI 95%=[1.5–3.2]) and medium/poor perceived health status (OR=2.3; CI 95%=[1.5–3.6]) were significantly associated with psychological distress. Multivariate analysis performing logistic regression showed that average and unhealthy lifestyle were independently associated with psychological distress, with an adjusted OR of 3.7 (CI 95%=[1.7–7.7]) and 5.8 (CI 95%=[2.4–14.8]), respectively.

Originality/value

The study highlighted the magnitude and the risk factors of psychological distress in medical students. Unhealthy lifestyle was a potential predictive of mental disorders. These findings provide fundamental information for future researches.

Psychological distress and coping amongst higher education students: a mixed method enquiry

Background

Psychological distress among higher education students is of global concern. Students on programmes with practicum components such as nursing and teacher education are exposed to additional stressors which may further increase their risk for psychological distress. The ways in which these students cope with distress has potential consequences for their health and academic performance. An in-depth understanding of how nursing/midwifery and teacher education students experience psychological distress and coping is necessary to enable higher education providers to adequately support these students.

Methods

This mixed method study was employed to establish self-reported psychological distress (General Health Questionnaire), coping processes (Ways of Coping Questionnaire) and lifestyle behaviour (Lifestyle Behaviour Questionnaire) of a total sample (n = 1557) of undergraduate nursing/midwifery and teacher education students in one university in Ireland. Individual interviews (n = 59) provided an in-depth understanding of students experiences of psychological distress and coping.

Results

A significant percentage (41.9%) of respondents was psychologically distressed. The factors which contributed to their distress, included study, financial, living and social pressures. Students used varied coping strategies including seeking social support, problem solving and escape avoidance. The positive relationship between elevated psychological distress and escape avoidance behaviours including substance use (alcohol, tobacco and cannabis) and unhealthy diet is of particular concern. Statistically significant relationships were identified between “escape-avoidance” and gender, age, marital status, place of residence, programme/year of study and lifestyle behaviours such as diet, substance use and physical inactivity.

Conclusion

The paper adds to existing research by illuminating the psychological distress experienced by undergraduate nursing/midwifery and teacher education students. It also identifies their distress, maladaptive coping and the relationship to their lifestyle behaviours. The findings can inform strategies to minimise student distress and maladaptive coping during college and in future professional years.

[Correlations of stress, coping and psychological well-being among preclinical medical students]

INTRODUCTION

Because the level of stress is rather high among medical students, it would be important to prepare them for preventing it.

AIM

The aim of the authors was to investigate the perceived stress level of medical students, their psychosomatic symptoms, coping strategies and satisfaction with life.

METHOD

Preclinical medical students from the University of Szeged, Hungary (N = 155) participated in the study. Data collection was performed by groups, in self-administered, anonymous and voluntary form.

RESULTS

Levels of stress load and satisfaction with life among medical students were similar to previous international and national data. There were no gender differences in the levels of life satisfaction, however, levels of perceived stress and psychosomatic symptoms were higher among girls. Satisfaction with life was primarily related to perceived stress level and the coping methods.

CONCLUSIONS

The results suggest that there are significant interrelationships among in the levels of perceived stress, psychosomatic symptoms and coping styles among in preclinical students. During medical education there is also a need for improving skills, such as coping and stress management.

Physical and mental health perspectives of first year undergraduate rural university students

BACKGROUND

University students are often perceived to have a privileged position in society and considered immune to ill-health and disability. There is growing evidence that a sizeable proportion experience poor physical health, and that the prevalence of psychological disorders is higher in university students than their community peers. This study examined the physical and mental health issues for first year Australian rural university students and their perception of access to available health and support services.

METHODS

Cross-sectional study design using an online survey form based on the Adolescent Screening Questionnaire modeled on the internationally recognised HEADSS survey tool. The target audience was all first-year undergraduate students enrolled in an on-campus degree program. The response rate was 41% comprising 355 students (244 females, 111 males). Data was analysed using standard statistical techniques including descriptive and inferential statistics; and thematic analysis of the open-ended responses.

RESULTS

The mean age of the respondents was 20.2 years (SD 4.8). The majority of the students lived in on-campus residential college style accommodation, and a third combined part-time paid work with full-time study. Most students reported being in good physical health. However, on average two health conditions were reported over the past six months, with the most common being fatigue (56%), frequent headaches (26%) and allergies (24%). Mental health problems included anxiety (25%), coping difficulties (19.7%) and diagnosed depression (8%). Most respondents reported adequate access to medical doctors and support services for themselves (82%) and friends (78%). However the qualitative comments highlighted concerns about stigma, privacy and anonymity in seeking counselling.

CONCLUSIONS

The present study adds to the limited literature of physical and mental health issues as well as barriers to service utilization by rural university students. It provides useful baseline data for the development of customised support programs at rural campuses. Future research using a longitudinal research design and multi-site studies are recommended to facilitate a deeper understanding of health issues affecting rural university students.