Depression and anxiety among online learning students during the COVID-19 pandemic: a cross-sectional survey in Rio de Janeiro, Brazil

Perception and Social Impact of Blackboard-Based Online Learning in a Psychology Course: Al-Qunfudhah Medical Students' Opinion

BACKGROUND

Online learning was considered a novel method of teaching that affects university lifestyle and health. This study focused on online perception of Al-Qunfudhah medical students during psychology course learning and the effect of online teaching on social life.

METHODS

Fifth-year students participated in an online psychology course. The online questionnaire consisted of 15 questions: three for demographic distribution, seven to assess online perception, and five to measure the effect of online teaching on students' social health. Questionnaire validity was checked by a preliminary pilot study, and Cronbach's alpha was used to assess internal consistency. A p-value less than 0.05 was considered significant.

RESULTS

Seventy-five (83.3%) students participated in the study: 48 (64%) female and 27 (36%) male. Fifty-eight (77.3%) medical students documented a good perception of online learning of a psychology undergraduate course, whereas 17 (22.7%) had a poor perception. Additionally, 29 (78.4%) female students reported online teaching had a significant effect on their social and psychological health (p < 0.010), whereas eight (21.6%) male students showed that online teaching does not affect their social life.

CONCLUSION

Al-Qunfudhah medical students, both men and women, highly participated in the psychology course online learning; however, female students were socially and psychologically affected by online learning more than male students.

Exploring the influence of learning modality preferences and COVID-19 infection experiences on depressive mood in Chinese students

The COVID-19 pandemic has significantly impacted the mental health of children and adolescents worldwide. While various factors contributing to this phenomenon have been explored, the role of learning style preferences remains underexamined. This cross-sectional study, conducted between October and November 2020, involved over 20,000 participants, including students from junior high school, senior high school, and undergraduate levels. Significant differences in depressive mood levels were observed among individuals with different learning modality preferences upon the return to traditional, in-person learning. Students with in-person learning preferences exhibited lower depression levels, while students with no preference for either learning style outperformed devotees of remote learning. The highest depression occurred among those endorsing neither learning mode. Importantly, the impact of these preferences on depressive moods was found to be moderated by COVID-19 infection experiences. The findings highlight the nuanced relationship between learning style preferences, COVID-19 infection experiences, and mental health outcomes among students. Acknowledging the moderating effect of infection experiences is crucial for developing targeted interventions and adapting pedagogical approaches post-pandemic. This study contributes valuable insights into the complex relationships shaping the mental well-being of students amidst educational disruptions caused by the pandemic.

Effects of the COVID-19 Pandemic on College Students in Brazil

The implementation of restrictive measures during the pandemic drastically changed the routine and habits of the population. In the academic sphere, the sudden closure of universities difficulted any advance planning. The objective of this study was to verify the effects of the pandemic on the routine, physical and mental health of students at a public university in southern Brazil. This is a cross-sectional study that applied a questionnaire from May to August 2020. The target population comprised 528 undergraduates. The questionnaire addressed questions about sociodemographic characteristics, physical and mental health. A response was obtained from 406 participants. During the quarantine period evaluated, the main results were: 66.2% reported worsening of anxiety symptoms; 57.6% declared that their physical health was "reasonable" to "bad". As for the quality of sleep there was an increase in 98.8% in the responses "bad sleep quality" and "very bad sleep quality"; increase in 26.6% for presence bruxism; 12.5% for orofacial pain, 3.8% for headache. It is concluded that there were several negative effects, among these effects, it was observed higher levels of anxiety, worsening physical health and quality of sleep, increase in the prevalence of bruxism, as well as the presence of orofacial pain and headache.

A public health view and comparison between online and on-campus learning to evaluate sleep and mental health among undergraduate students

Background

The COVID-19 pandemic changed people's lives. The majority had to adapt to working online including students. The shift to online learning caused serious sleep and mental health issues among students. This study aimed to examine the variations between the prevalence of sleep and mental health problems among undergraduate students during the periods of online learning and on-campus learning.

Method

An online survey was distributed to medical students in Saudi Arabia.

Results

A total of 110 participated in the study (age = 21 ± 1.4 years). The on-campus anxiety (8.2 ± 6.3) was significantly higher than online anxiety (5.5 ± 5.1). On-campus daytime sleepiness (8.5 ± 4) was significantly higher when compared to online daytime sleepiness (6.7 ± 4.6). Although not significant, the on-campus stress (7.7 ± 5.7) and insomnia (12 ± 7.3) were higher than online stress (6.9 ± 5.5) and insomnia (11.5 ± 6). The online depression (6.6 ± 5.7) was higher than the mean on-campus depression (5.8 ± 5.4). A significant strong positive correlation was found between on-campus anxiety and on-campus stress. A significant moderate positive correlation was detected between on-campus anxiety and on-campus daytime sleepiness. A weak but significant correlation was found between on-campus anxiety and on-campus insomnia. On-campus anxiety was significantly predicted by the following model, which included on-campus stress, insomnia, and daytime sleepiness (P < .001).

Conclusion

Medical students reported lower anxiety, daytime sleepiness, stress, and insomnia during their online learning compared to on-campus learning. Only depression was higher during online learning compared to on-campus learning.

The challenges of mental health in Chilean university students

Mental health is a crucial issue in Chile and worldwide, gaining even more relevance following social events in Chile in 2019, including the sociopolitical crisis and the COVID-19 pandemic. In Chile, over 20% of adolescents experience mental health problems such as anxiety, depression, and stress, with many going untreated due to limited access or the stigma associated with these issues. The COVID-19 pandemic has exacerbated this situation, with a 25% increase in the prevalence of anxiety and depression. The university population is particularly vulnerable to mental health challenges due to the unique pressures of the academic environment, including increased academic demands and the acquisition of university-related behaviors that can negatively impact physical and mental health, with notable gender differences. Effectively addressing these issues is essential for ensuring the emotional and psychological well-being of university students. Specific policies and programs are needed to address the mental health needs of university adolescents and ensure that they have access to mental health services required to navigate the challenges of daily life. A methodology reflective of the essayistic approach guides this exploration, which is characterized by critical reflection and structured argumentation.

Factors influencing Chinese EFL students' online learning anxiety in the post-COVID-19 era

Online learning has evolved as an attractive and viable option for education, yet there is a need for further research to investigate the factors contributing to students' online learning anxiety regarding the college English course. Based on Keegan's distance education framework, this study examines the factors impacting online learning anxiety among English as foreign language (EFL) students in the Chinese context during the post-COVID-19 era. Data were collected from 899 EFL students across different regions of China through an online survey. Follow-up interviews with ten students provided additional insights into the association between online English learning and anxiety. The collected data underwent descriptive analysis, exploratory factor analysis, reliability analysis, and multiple linear regression analysis to examine the relationship between online learning anxiety and the identified factors. The results of our study indicate that many Chinese EFL students experienced different degrees of anxiety, ranging from mild to moderate or severe. Moreover, online learning anxiety among Chinese EFL students was positively predicted by a lack of learning motivation, separation from instructors, separation from peers, and technological challenges, while a lack of two-way communication negatively predicted it. The findings underscore the importance of taking effective measures and offering psychological guidance for Chinese EFL students to alleviate anxiety and facilitate their successful adaptation to the new normal of online learning.

Mental health and resilience quotient of patients in primary care units during the widespread COVID-19 pandemic in Thailand: a cross-sectional study

BACKGROUND

The coronavirus disease 2019 pandemic impacted both the physical and mental health of individuals. The resilience quotient (RQ) is an important factor that decreases mental health problems. This study aimed to explore mental health problems and RQ in patients who visit Primary Care Units (PCU).

METHODS

A cross-sectional study was conducted on participants aged 18 to 60 years who visited the PCU of Songklanagarind Hospital from May 1, 2022, to June 31, 2022. Participants completed a self-administered questionnaire on baseline characteristics and the Primary Care Assessment, Personal Resource Questionnaire, satisfaction with life scale, Thai RQ, PHQ-9, and GAD-7, and the results were analyzed by descriptive, logistic regression, and Spearman's rank correlation.

RESULTS

Among the 216 participants, 72.2% were female, and the median age was 39 (24,51) years old. Most of them had normal RQ levels (61.1%). Of these, 4.2% and 12.1% exhibited moderate to high levels of depression and anxiety, respectively. This study found that sex (OOR 1.93; 95% CI 1.01-3.74), age (OOR 1.03; 95% CI 1.01-1.06), moderate and high social support levels (OOR 9.51; 95% CI 3.36-28.85), and a high life satisfaction level (OOR 4.67; 95%CI 1.75-13.25) were associated with RQ. Moreover, the results showed that ≥ 3 times visiting PCU (β 1.73; 95% CI 0.39-3.08), BMI (β 0.13; 95% CI 0.04-0.23) and experiencing stressful events (β 2.34; 95% CI 1.32-3.36) were positively associated with depression. Finally, experiencing stressful events (OR 4.1; 95% CI 1.09-15.47) significantly affected anxiety, however, moderate and high life satisfaction levels acted as a protective factor against anxiety (OR 0.19; 95% CI 0.07-0.54 and OR 0.03; 95% CI 0.01-0.16, respectively).

CONCLUSION

Although there were a few patients with moderate to severe levels of depression and anxiety, most of them had normal RQ levels. However, there were some patients with low RQ levels which correlated to a high risk of psychiatric diseases such as depression and anxiety. Healthcare providers should focus on interventions that enhance resilience in both proactive and defensive strategies to reduce negative mental problems during these formidable times.

Mediating effect of self-esteem on the relationship between academic self-efficacy and depression symptoms among nursing students participating in blended learning

Background

Blended learning, which comprises a combination of online and classroom-based activities, in nursing education can cause significant academic stress and depression symptoms among students. However, self-esteem may mediate the relationship between academic self-efficacy and depression symptoms. Studies of the relationship between academic self-efficacy, self-esteem, and depression symptoms among nursing students participating in blended learning are limited.

Objectives

To examine the determinants of depression symptoms and the mediating effect of self-esteem on the relationship between academic self-efficacy and depression symptoms among nursing students who participate in blended learning.

Design

Cross-sectional study using convenience sampling.

Settings

Ten universities across five provinces and two major Indonesian islands.

Participants

A total of 534 undergraduate nursing students with a mean age of 20.30 years (standard deviation, ±1.36 years).

Methods

An online survey was conducted between April and August 2022 to collect data from 10 universities applying blended learning. The study instruments included the General Self-Efficacy Scale, Rosenberg Self-Esteem Scale, and a 9-item Patient Health Questionnaire. Data were analysed by hierarchical linear regression using PROCESS macro version 4.1.

Results

Of the 534 participants, 213 (39.14 %) experienced moderate-to-severe depression symptoms. Two variables, online learning difficulties (β = 0.10; p = .012) and self-esteem (β = -0.40; p < .001), were significant determinants of depression symptoms. Self-esteem mediated the relationship between academic self-efficacy and depression symptoms.

Conclusions

It is necessary to understand the online learning difficulties experienced by blended learning students and improve their self-esteem by maximising academic self-efficacy to prevent depression symptoms.

Biophilic classroom environments on stress and cognitive performance: A randomized crossover study in virtual reality (VR)

The emerging Metaverse will likely increase time expenditure in indoor virtual environments, which could impact human health and well-being. The biophilia hypothesis suggests that humans have an innate tendency to seek connections with the natural world and there is increasing evidence that biophilic design such as the incorporation of green plants can yield health benefits. Recently, virtual reality (VR) has been used to regulate stress and improve overall wellness, particularly by incorporating natural settings. In this randomized crossover study, we designed five virtual classroom scenes with different biophilic elements and turbidity in VR and investigated whether the visual stimulations can affect the stress levels and cognitive functions of 30 young adults from a university in China. We measured their physiological indicators of stress reaction by wearable biomonitoring sensors (blood pressure (BP), heart rate (HR), heart rate variability (HRV), and skin conductance level (SCL)), conducted verbal cognitive tests on attention and creativity, and evaluated subjective/perceived (self-reported) stress levels and connection with nature. Albeit our results suggested no significant change in physiological stress reactions or cognitive functions induced by the biophilic and turbid interventions in VR, the addition of biophilic elements in the Metaverse could benefit students' health due to significantly decreased perceived stress levels and increased connections with nature.

The impact of innovative behaviors on academic misconduct among graduate students: a mediated moderation model

Introduction

Academic misconduct among graduate students poses a significant challenge in graduate education. This study aims to explore the impact of innovative behavior on graduate student academic misconduct and its underlying mechanisms.

Methods

A survey was conducted on 677 graduate students currently enrolled in Beijing universities to assess their innovative behavior, academic misconduct, academic anxiety, employment confidence, educational levels, among other factors. The study analyzed the mediating roles of academic anxiety, employment confidence, and educational levels in the relationship between innovative behavior and graduate student academic misconduct.

Results

Graduate student innovative behavior exerts a negative predictive effect on academic misconduct, with a stronger emphasis on innovative behavior associated with a reduced likelihood of academic misconduct. Academic anxiety plays a mediating role in the relationship between graduate student innovative behavior and academic misconduct. Educational levels and employment confidence each play moderating roles in the latter stages of the mediation effects concerning graduate student innovative behavior, academic anxiety, and academic misconduct.

Conclusion

This study reveals the mediating role of academic anxiety in the relationship between innovative behavior and graduate student academic misconduct. It also identifies the moderating roles of employment confidence and educational levels. These findings deepen our understanding of the relationship between innovative behavior and graduate student academic misconduct and are conducive to preventing such misconduct among graduate students.

Factors Influencing Satisfaction With Online Learning During COVID-19 Crisis by Undergraduate Medical Students From King Saud bin Abdulaziz University for Health Sciences (KSAUHS), Riyadh

Background During the coronavirus 2019 (COVID-19) pandemic, Saudi Arabia implemented strict measures to prevent the entry and spread of the virus and to minimize its burden on society, including the use of online education as an alternative to traditional classroom learning. This study surveyed medical students from King Abdulaziz bin Saud University for Health Sciences-Riyadh to evaluate the factors affecting their satisfaction and experience with online learning. Methods This cross-sectional study was conducted from March to May 2021, using consecutive sampling and a population of approximately 700 medical students from King Saud bin Abdulaziz University of Health Sciences. This study was carried out through an online questionnaire. Results The survey received 277 responses with a response rate of 40%. About 15.3% of respondents believed that online learning productivity was poor, and 18.9% found it below average; however, 21.7% rated it as excellent. The level of anxiety while studying at home was rated as fine by 32.7%, while 21% felt very anxious, and the level of distraction was reported to be high, by 23.1%. Additionally, 64.4% of respondents preferred more online courses even after the COVID-19 crisis. Overall, 29.2% of respondents rated online learning as excellent, while 12.5% rated it as poor. We found a significant positive correlation between feeling isolated while studying at home and feeling anxious (r=0.618; p<0.001) and a significant positive correlation between productivity during online learning and the impact on grades (r=0.495; p<0.001). Conclusion This study found that online learning had benefits but also negatively impacted academic performance and mental health, highlighting the need for tailored support services. Further research is recommended, and medical students should have more theoretical online classes while keeping practical sessions on-site.

Internet use time and mental health among rural adolescents in China: A longitudinal study

BACKGROUND

The digital divide between urban and rural adolescents is widening. Many existing studies have found an association between internet use and adolescent mental health, but few use longitudinal data to focus on rural adolescents. We aimed to identify the causal relationships between internet use time and mental health in Chinese rural adolescents.

METHODS

Using a sample of 3694 participants (aged 10-19) from the 2018-2020 China Family Panel Survey (CFPS). Fixed effects model, mediating effect model and instrumental variables method was used to evaluate the causal relationships between internet use time and mental health.

RESULTS

We find that more time spent on the internet has a significant negative effect on participants' mental health. This negative impact is stronger in female and senior students groups. Mediating effects analysis suggests that more time spent on the internet increase risk of mental health problems by reducing sleep duration and parent-adolescent communication. Further analysis find that online learning and online shopping is associated with higher depression scores, while online entertainment with lower depression scores.

LIMITATIONS

The data do not investigate the specific time spent on internet activities (e.g., learning, shopping, and entertainment), and the long-term impacts of internet use time and mental health have not been tested.

CONCLUSIONS

Internet use time has a significant negative impact on mental health by crowding out sleep duration and parent-adolescent communication. The results provide an empirical reference for the prevention and intervention of mental disorders in adolescents.

Is Satisfaction with Online Learning Related to Depression, Anxiety, and Insomnia Symptoms? A Cross-Sectional Study on Medical Undergraduates in Romania

The objective of this study was to investigate online learning satisfaction in a sample of university students and its relationship with depression, anxiety, insomnia, and the average number of hours spent online. A total of 463 medical students were recruited for an online survey conducted from February to March 2022 with the main objective of estimating online learning satisfaction, while secondary outcomes involved assessing the relationship between online learning and depression, anxiety, insomnia, and the average number of hours spent online. A total of 285 participants were female (71.4%) and the mean age was 20.2 years. The results revealed that depression, anxiety, and insomnia are negatively correlated with overall satisfaction with e-learning. The more time students spent online, the greater the overall satisfaction. There are significant differences regarding student perceptions of interactivity in online learning satisfaction outcomes (p < 0.05, η2 partial Eta Squared-0.284). The opportunity to learn via chat-box presented differences in overall satisfaction while pleasant aspects of online learning, such as “no travel” and “economy”, were related to satisfaction. The students revealed that the higher the psychopathology scores, the less satisfied they were with online learning, while a higher number of hours spent online contributed positively to satisfaction.

Satisfaction with online education among students, faculty, and parents before and after the COVID-19 outbreak: Evidence from a meta-analysis

The COVID-19 pandemic has presented a unique opportunity for the advancement of online education, as billions of students from 190 countries have been compelled to take classes remotely. The degree of satisfaction is considered one of the major factors in determining the quality of online educational programs. As a result, many empirical studies have been conducted on the level of satisfaction with online education over the last two decades. However, few studies have synthesized previous findings from similar research questions. Therefore, to reinforce statistical power, the study aimed to conduct a meta-analysis to examine satisfaction with online education among students, faculty, and parents before and after the COVID-19 outbreak. A total of 52 studies in English were screened from six academic electronic databases, yielding 57 effect sizes using Comprehensive Meta-Analysis (CMA) software. The results showed that the prevalence of satisfaction with online education among students, faculty, and parents before and after the COVID-19 outbreak was 59.5, 75.3, and 70.7%, respectively, with a significant difference between the satisfaction rates of students and those of their faculty and parents. Besides, we conducted a moderator analysis that found that (1) a significantly higher number of students in the pre-pandemic era in countries with developed digital infrastructure and emergency online learning environments were less satisfied with online education than their counterparts in the post-pandemic era, in countries with developing digital infrastructure, and in non-emergency online learning environments. Additionally, a significantly higher proportion of adult education learners reported being satisfied with online education compared to K-12 and university students. (2) The faculty in the non-emergency situation reported almost double the satisfaction rate of their counterparts in the emergency circumstance. With fewer satisfied remote learning students, efforts could be made by providing well-designed online lessons via faculty and strengthening digital infrastructure via governments to improve student satisfaction.

Nanoencapsulation of Vaccinium ashei Leaf Extract in Eudragit® RS100-Based Nanoparticles Increases Its In Vitro Antioxidant and In Vivo Antidepressant-like Actions

Depression is a major psychiatric disorder in Brazil and worldwide. Vaccinium ashei (V. ashei) leaves are cultivation by-products with high bioactive compound levels. Here, a hydroalcoholic extract of V. ashei leaves (HEV) was associated with Eudragit^® RS100-based nanoparticles (NPHEV) to evaluate the in vitro antioxidant and in vivo antidepressant-like effects. Interfacial deposition of the preformed polymer method was used for NPHEV production. The formulations were evaluated regarding physicochemical characteristics, antioxidant activity (DPPH radical scavenging and oxygen radical absorbance capacity), and antidepressant-like action (1-25 mg/kg, single intragastric administration) assessed in forced swimming and tail suspension tests in male Balb-C mice. The NPHEV presented sizes in the nanometric range (144-206 nm), positive zeta potential values (8-15 mV), polydispersity index below 0.2, and pH in the acid range. The phenolic compound content was near the theoretical values, although the rutin presented higher encapsulation efficiency (~95%) than the chlorogenic acid (~60%). The nanoencapsulation improved the HEV antioxidant effect and antidepressant-like action by reducing the immobility time in both behavioral tests. Hence, Eudragit^® RS100 nanoparticles containing HEV were successfully obtained and are a promising alternative to manage depression.

Assessing Anxiety and Depression Among Students Post-COVID-19: Exploring Associating Factors

Background

The COVID-19 pandemic has had a large impact on global mental health including anxiety and depression rates, many factors affected the vulnerability to these psychological conditions amongst university students.

Aim

To explore the level of anxiety and depression of university students living in Jordan.

Methods

A cross-sectional study design was conducted in which an electronic survey was created and distributed, university students residing in Jordan participated in the study.

Results

A total of 1241 students were enrolled in the study. The mean anxiety score among males and females was (9.68 (SD = 4.10)) and (10.46 (SD = 4.14)), respectively. 42.1% of males had "abnormal" anxiety score compared to 48.4% females. The mean depression score among males (7.77 (SD = 4.31)) was similar to that for the females (7.64 (SD = 4.14)), and 26.0% of the males had "abnormal" depression score compared to 22.6% of the females. Factors affecting anxiety scores included younger age, being a female, taking medication/s, or drinking two cups of coffee or more a day.

Conclusion

With 46% and 24% of students suffering from abnormal anxiety and depression respectively, it is important for education policy makers to take immediate measures to allocate students in need of psychological assessment and help to deliver suitable interventions.

Effect of Mindfulness Breathing Meditation on Depression, Anxiety, and Stress: A Randomized Controlled Trial among University Students

BACKGROUND

The COVID-19 outbreak has caused various changes in all aspects of human life, including the educational system. These changes have forced students to undertake an adaptive process that has inevitably affected aspects of their life and psychological well-being. Adaptation of learning into online forms in universities, including nursing, triggers depression, stress, and anxiety. The high number of incidences of stress, anxiety, and depression in undergraduate students throughout the pandemic has made it important to prevent and deal with health approaches, such as mindfulness therapy.

OBJECTIVE

This research intended to examine whether an intervention based on mindfulness was effective and had the potential to become an interference to reduce anxiety, stress, and depression in Indonesian university students.

METHODS

This research applied a randomized controlled trial. One hundred and twenty-two students from Universitas Padjadjaran and other provinces in Indonesia participated in this study, with sixty-one students in each group. A pretest and a post-test were administered before and after the intervention using the Depression Anxiety Stress Scales (DASS-42). The intervention was carried out for 4 weeks with 15 min practice in each session.

RESULTS

In this study, there was an effect of mindfulness breathing meditation on decreasing the mean scores for depression, anxiety, and stress in the intervention group. However, only stress (p = 0.007) and anxiety (p = 0.042) showed a significant difference in the post-test results of the intervention and control groups. In addition, there was no difference in the scores of stress, anxiety, and depression for the pre-post-tests in each group based on religion.

CONCLUSION

Mindfulness breathing meditation has an impact on reducing stress and anxiety in students, so it could be applied to all university students in order to develop psychosocial status and mindful attentiveness to one's needs.

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.