Mental health in medical, dentistry and veterinary students: cross-sectional online survey

Well-being of undergraduate dental students: Questionnaire design, findings and future directions

INTRODUCTION

The recent pandemic has highlighted the importance of addressing well-being in the overall health of students. There is a need for support systems within dental schools to help students demonstrate resilience, adapt to learning environments and thrive in their professional careers.

OBJECTIVES

The main aim of the study was to evaluate Bachelor of Dental Surgery (BDS) students' understanding and experience of well-being. The objectives were to create a suitable survey to assess students' well-being, investigate the factors affecting dental students' well-being and develop a student well-being action plan based on the analysis of the survey.

METHODS

A literature review was conducted to identify and critically assess existing measures of well-being in dental students. Four domains of well-being (emotional, physical, social, intellectual) relevant to dental students were identified. Through a comprehensive iterative process, a two-part survey was developed and tested, which measured individual experiences of well-being across the four domains and collected feedback on proposed initiatives to support student well-being. The survey was disseminated to all 452 dental students from Years 1 through 6, of which 71% (321) responded.

RESULTS

The survey revealed low levels of overall well-being among the dental student population, which worsened with increasing years of clinical study. Fear of failing exams presented the biggest challenge with regard to emotional well-being, while sleep deprivation and occupational health hazards most affected the physical well-being domain. Intellectual well-being was compromised by insufficient free time to pursue extracurricular interests and concerns about achieving the required skills. Despite a majority experiencing positive relationships with their peers and tutors, less than a fifth agreed that the Faculty of Dentistry 'supported my well-being as a dental student'.

CONCLUSION

As the first investigation of the well-being of dental students in Hong Kong, the key stressors identified were examinations, long schedules and the physical burden of dental work, which are consistent with international literature. The findings reveal students' needs and preferences for well-being initiatives which will be optimized in the implementation of student-centred curricular activities.

Workplace stressor factors, profiles and the relationship to career stage in UK veterinarians, veterinary nurses and students

BACKGROUND

Veterinary professionals experience higher psychological distress and lower wellbeing compared with the general population. Identifying workplace stressors is key to understanding and alleviating these difficulties.

OBJECTIVE

Identify the severity of workplace stressors in veterinary professions across different levels of professional experience.

METHOD

A cross-sectional quantitative design was utilised via administration of a veterinary stressor questionnaire that measured the severity of 93 generic and veterinary-specific workplace stressors.

RESULTS

A total of 658 participants reported stressor severity score. Factor analysis revealed four main stressor categories: workload and job demands, client relations stress, performance and accountability, patient care challenges. An inverse relationship was found between experience level and stressor severity scores. Furthermore, the most severe stressors varied as a function of career stage.

FINDINGS AND IMPLICATIONS

Stressor severity tends to decrease with increasing experience levels. Stressors can be categorised by theme and unique stressor profiles can be derived for practitioners according to experience level. This knowledge can assist in the design and delivery of workplace support initiatives.

CONCLUSIONS

Identify key stressors across different levels of experience is important in focusing efforts to support people in the workplace.

The prevalence of depression, anxiety, and sleep disorder among dental students: A systematic review and meta-analysis

BACKGROUND

Despite the increasing concern, the literature lacks a comprehensive synthesis of the prevalence of depression, anxiety, and sleep disturbances among dental students.

METHODS

We conducted a systematic review following Cochrane Manual for Systematic Reviews of Interventions and PRISMA guidelines. Our search, spanning databases like Medline, Web of Science, and Scopus, covered data until June 5, 2023. A random effect model was utilized for the meta-analysis.

RESULTS

From 508 initially identified articles, 45 studies met eligibility criteria. The pooled prevalence of depression, anxiety, and sleep disorders among dental students was estimated as follows: depression [38%, 95% confidence interval (CI): 32%-44%; I2 = 98%], anxiety [48%, 95% CI: 41%-55%; I2 = 97.7%], and sleep disorders [31%, 95% CI: 24%-38%; I2 = 85.7%]. Subgroup analyses based on geographical regions and assessment scales revealed significant between-subgroup differences. Meta-regression identified associations between the prevalence of depression and the year of publication and between the prevalence of anxiety and total sample size, participant age, and year of publication. Publication bias assessments demonstrated a lack of significant bias, strengthening the validity of the findings.

CONCLUSIONS

The prevalence of depression, anxiety, and sleep disturbances in dental students is significant. This study highlighted the need for targeted interventions and support systems within dental education to alleviate the mental health challenges students face, ultimately ensuring their well-being and competence as future healthcare providers. Further research should explore the effectiveness of interventions in this population.

Awake bruxism behaviors frequency in a group of healthy young adults with different psychological scores

OBJECTIVE

To assess the frequency of awake bruxism (AB) behaviors in a group of undergraduate dentistry students and correlate it with the status of anxiety and depression.

MATERIALS AND METHODS

The frequency of five oral behaviors (i.e., relaxed jaw muscle, teeth contact, mandible bracing, teeth clenching, teeth grinding) was evaluated using a smartphone-based ecological momentary assessment (EMA) approach. The anxiety and depression status was investigated with the four-item patient health questionnaire for anxiety and depression (PHQ-4). ANOVA with Tukey post-hoc test was used to assess the difference in frequency of AB behaviors among the four PHQ-4 groups.

RESULTS

Among the four groups, there was a statistically significant difference in the frequency of relaxed jaw muscle, teeth contact, mandible bracing, and teeth clenching, but not for teeth grinding.

CONCLUSION

Based on this cross-sectional study's findings, psyche seems to have a determinant impact on AB behaviors, which is significantly higher in individuals with anxiety and depression traits.

Sociodemographic Correlates of Mental Health Treatment Seeking Among College Students: A Systematic Review and Meta-Analysis

OBJECTIVE

College students have high rates of mental health problems and low rates of treatment. Although sociodemographic disparities in student mental health treatment seeking have been reported, findings have not been synthesized and quantified. The extent to which differences in perceived need for treatment contribute to overall disparities remains unclear.

METHODS

A systematic search of PubMed, PsycInfo, and Embase was conducted. Studies published between 2007 and 2022 were included if they reported treatment rates among college students with mental health problems, stratified by sex, gender, race-ethnicity, sexual orientation, student type, student year, or student status. Random-effects models were used to calculate pooled prevalence ratios (PRs) of having a perceived need for treatment and of receiving treatment for each sociodemographic subgroup.

RESULTS

Twenty-one studies qualified for inclusion. Among students experiencing mental health problems, consistent and significant sociodemographic differences were identified in perceived need for treatment and treatment receipt. Students from racial-ethnic minority groups (in particular, Asian students [PR=0.49]) and international students (PR=0.63) reported lower rates of treatment receipt than White students and domestic students, respectively. Students identifying as female (sex) or as women (gender) (combined PR=1.33) reported higher rates of treatment receipt than students identifying as male or as men. Differences in perceived need appeared to contribute to some disparities; in particular, students identifying as male or as men reported considerably lower rates of perceived need than students identifying as female or as women.

CONCLUSIONS

Findings highlight the need for policy makers to address barriers throughout the treatment-seeking pathway and to tailor efforts to student subgroups to reduce treatment disparities.

Investigating changes in student mental health and help-seeking behaviour after the introduction of new well-being support services at a UK university

BACKGROUND

Growing numbers of students now seek mental health support from their higher education providers. In response, a number of universities have invested in non-clinical well-being services, but there have been few evaluations of these. This research addresses a critical gap in the existing literature.

AIMS

This study examined the impact of introducing non-clinical well-being advisers on student mental health and help-seeking behaviour at a large UK university.

METHOD

Survey data collected pre-post service introduction in 2018 (n = 5562) and 2019 (n = 2637) measured prevalence of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), and low mental well-being (Warwick-Edinburgh Mental Wellbeing Scale), alongside student support-seeking behaviour. Logistic regression models investigated changes in outcome measures. Administrative data (2014-2020) were used to investigate corresponding trends in antidepressant prescribing at the onsite health service, student counselling referrals and course withdrawal rates.

RESULTS

Adjusted models suggested reductions in students' levels of anxiety (odds ratio 0.86, 95% CI 0.77-0.96) and low well-being (odds ratio 0.84, 95% CI 0.75-0.94) in 2019, but not depression symptoms (odds ratio 1.05, 95% CI 0.93-1.17). Statistical evidence showed reduced student counselling referrals, with antidepressant prescribing and course withdrawal rates levelling off. Student perception of the availability and accessibility of university support improved.

CONCLUSIONS

Our findings suggest a non-clinical well-being service model may improve student perception of support, influence overall levels of anxiety and low well-being, and reduce clinical need. The current study was only able to examine changes over the short term, and a longer follow-up is needed.

Opening the black box of school-wide student wellbeing programmes: a critical narrative review informed by activity theory

PURPOSE

Medical schools have a duty of care to support student wellbeing but there is little guidance on how to translate this mandate into practice. Often schools focus on implementing and reporting individual-level interventions which typically only address one aspect of wellbeing. Conversely, less attention has been paid to holistic school-wide approaches towards student wellbeing that address multiple wellbeing dimensions. Thus, this review sought to improve our understanding of how support is mediated within such school-wide wellbeing programmes.

METHOD

This critical narrative review was conducted in two stages. First, the authors searched several key databases for papers published up to 25th May 2021, using a systematic search strategy and TREND checklist to guide our data extraction process. We later expanded our search to include literature published from the original date to 20th May 2023. Second, the identified articles were critically analysed using activity theory as a theoretical lens to aid explanation.

RESULTS

We found school-wide wellbeing programmes emphasize social connectivity and building a sense of community. Tutors take a key role in the activity of supporting students' wellbeing. We mapped out the activity system components to describe the complexity of this tutor role. This analysis illustrated: tensions and contradictions in the system which may open up opportunities for change; the importance of context for influencing how system components interact; and that students' trust underpins the whole activity system.

CONCLUSIONS

Our review shines a light into the black-box of holistic school-wide wellbeing programmes. We identified that tutors play a key role in wellbeing systems but confidentiality is a recurring tension which may jeopardise a wellbeing system. The time has come to investigate these systems in more detail, embracing and exploring the role of context at the same time as looking for common threads.

Examining the mental health of university students: A quantitative and qualitative approach to identifying prevalence, associations, stressors, and interventions

ObjectiveTo identify the prevalence of anxiety, depression, and suicidal ideation that would place university students at risk for mental health disorders. To explore the source of stressors and possible interventions that may benefit student mental health in a university setting.

PARTICIPANTS

University students (n = 483) who had been learning remotely due to the COVID-19 pandemic.

METHODS

A mixed-methods cross-sectional survey was administered in 2020.

RESULTS

Students were at an increased rate of depression, anxiety and suicidal ideation as compared to the general population. Female gender, lack of social support, living alone, being a first-generation college student and COVID-19 were significantly associated with mental health disorders. Stressors were identified and categorized into themes and interventions were recognized that may improve student well-being.

CONCLUSION

Students enrolled in university programs appear to experience significant amounts of anxiety, depression, and suicidal ideation. Additional mental health education, resources, and support is needed.

Stressed and Depressed: Prevalence of Anxiety and/or Depression in Physician Assistant Students

INTRODUCTION

This research highlights the prevalence of anxiety and/or depression among physician assistant (PA) students compared with the general population. It is believed that the results of this study will encourage graduate programs to place a stronger emphasis on the mental health of students and create a more positive learning environment.

METHODS

An original survey was created using questions from Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and several original questions. The survey was distributed using a SurveyMonkey link to directors of all accredited US PA programs. Program directors were asked to distribute the survey to their students. The survey remained open for 6 weeks, after which a cross-sectional statistical analysis was performed to compare the results with national anxiety and depression data in the United States.

RESULTS

There is a statistically significant increase in the rate of occurrence of anxiety and/or depression among PA students compared with the general population. According to survey results, 84.4% of respondents experienced feelings of anxiety and 80.9% experienced feelings of depression while enrolled in PA school. Physician assistant students found the greatest need for anxiety and depression treatment during the didactic portion of their program.

DISCUSSION

When compared with the national population, the level of anxiety in PA students was found to be 65.3% higher and the levels of depression in PA students to be 72.5% higher. These results should encourage PA programs and health care providers to take action regarding the mental health of future providers.

Assessing students' mental health in two American dental hygiene programs

OBJECTIVES

Dental hygiene students adapt to new environments while learning technical skills and providing clinical care during their education. Understanding how stress affects students in their professional healthcare program warrants exploration. This study assessed stress among dental hygiene students in two educational settings in the Southeastern United States.

METHODS

First and second-year dental hygiene students (N = 136) from a community college setting (n = 67) and a university setting (n = 69) were invited to complete an anonymous online survey on mental health in fall 2019. Validated surveys on depression, anxiety, social support, and burnout were included. Data analysis included chi-squared and Mantel-Haenszel statistics, depending on the scale of measurement, with the level of significance set at 0.05 for all analyses.

RESULTS

Participants included 54 dental hygiene students from a community college (Response rate = 80.6%) and 69 dental hygiene students from a university (RR = 100%). There was a statistically significant difference in the proportion of students reporting moderately severe or severe anxiety (p = 0.007), with 56% (n = 30) of the community college respondents and 36% (n = 24) of the university reporting these anxiety levels. Students attending a community college were also more likely to express feelings of worry (n = 34) compared to students in a university setting (p = 0.005). There was no statistically significant difference in depression (p = 0.07) or suicidal thoughts (p = 0.41).

CONCLUSION

Dental hygiene students enrolled in these two programs reported high levels of self-reported stress, mental and emotional concerns that may increase suicidal tendencies.

How do veterinary students perceive and prepare for compulsory slaughterhouse visits?

BACKGROUND

Veterinary students in the UK must visit a slaughterhouse as part of their studies. There is currently limited evidence exploring how students perceive these visits or which activities have been implemented to support learning during a visit that may be emotionally challenging.

METHODS

Veterinary students at the Royal Veterinary College and the University of Glasgow were invited to complete an online survey and participate in follow-up focus groups.

RESULTS

Participants appreciated the important role that veterinarians play in the slaughterhouse. Most (69%) agreed that in-person visits are important and would choose to visit, with around half (49%) thinking it should be optional. Previous slaughterhouse experience improved students' views towards compulsory in-person visits. Teaching events covering the slaughter process, videos and discussion sessions were perceived as useful preparatory activities. Anxiety was the most common emotion associated with visits.

LIMITATIONS

The response rate was low, at 15.6%, and a small number of students participated in focus groups. Data on diets and gender were not collected.

CONCLUSION

Slaughterhouse visits are valued by students, although they can cause negative emotions. Managing expectations and increasing awareness of visitation requirements during the application process and subsequent studies may improve the educational and emotional experience of visits.

Predictors of Suicide Risk and Mental Health Outcomes among Hong Kong Veterinarians: A Cross-Sectional Study

The professional quality of life (ProQOL) in the veterinary profession has gained increasing attention, yet little is known about its association with the mental health status of Hong Kong veterinarians. This study aimed to examine the impact of elements that make up ProQOL on the risk of suicide, depression, and anxiety among Hong Kong veterinarians. All veterinarians registered and practicing in Hong Kong at the time of recruitment were eligible to take part in the e-survey study between 1 January and 31 March 2022. Binary logistic regression was used to analyze the data from 56 participants. The results showed that 22.0% of the participants were at risk of suicide, 19.6% had current suicidal ideation, 29.4% had depression, and 29.4% had anxiety symptoms. The findings suggested poor mental health status among Hong Kong veterinarians and were comparable to or more prevalent than those reported in Anglophone and European countries. Results from the binary logistic regression suggested that burnout was a predictor of depressive symptoms, and that secondary traumatic stress showed potential in predicting suicide risk. Our study, however, did not find conclusive evidence supporting compassion satisfaction as a predictor of reduced symptoms of common mental issues. Further investigation into contextual factors affecting the mental health of veterinarians in Hong Kong is warranted. Improving the profession's mental health literacy and self-efficacy should be prioritized as a suicide prevention strategy to enhance mental health awareness.

Prevalence of anxiety, depression, mania, insomnia, stress, suicidal ideation, psychotic experiences, & loneliness in UK university students

Despite existing wellbeing services, university students remain particularly vulnerable to mental health difficulties. Therefore, this study was designed to provide a comprehensive assessment of the prevalence of psychiatric symptoms by using well validated scales with robust psychometric properties. More specifically, the current data provides crucial information concerning the prevalence of anxiety, depression, mania, insomnia, stress, suicidal ideation, psychotic experiences and loneliness amongst a sample of N = 1408 UK university students. A cross-sectional online questionnaire-based study was implemented. Online recruitment for this dataset began on September 17th, 2018, and ended on the 30th July 2019. Eight validated measures were used: Generalized Anxiety Disorder Scale; Patient Health Questionnaire; The Mood Disorder Questionnaire; The Sleep Condition Indicator; The Perceived Stress Scale; Suicidal Behaviours Questionnaire-Revised; The Prodromal Questionnaire 16 (PQ-16); and the University of California Loneliness Scale. The dataset is available to other researchers and is provided on figshare. Information concerning the data records, usage notes, code availability and technical validation are presented. Finally, we present demographic information concerning psychiatric symptom prevalence.

Prevalence and Risk Factors for Anxiety Symptoms among Student Nurses in Gauteng Province of South Africa

Background: Globally, mental disorders are common among nursing students; therefore, effective prevention and early detection are urgently needed. However, the prevalence rate of anxiety symptoms has not been investigated in South African nursing colleges. Aim: The study aimed to assess the prevalence of anxiety symptoms and their sociodemographic risk factors among nursing students in Gauteng province, South Africa. Methods: This cross-sectional descriptive study was conducted at Chris Hani Baragwanath and SG Lourens nursing colleges in the first week of June 2022. A purposeful sampling technique selected the third- and fourth-year nursing students aged ≥ 18 years registered at the two nursing colleges. The seven-item Generalised Anxiety Disorder scale was used to assess anxiety symptoms. Results: The prevalence of anxiety symptoms was 74.7% (95% confidence interval: 69.9-78.9). Being a student at nursing college B, being in the fourth academic year of study and use of substances were identified as predictors of anxiety symptoms in these nursing students. Conclusions: The prevalence of anxiety symptoms in this study is relatively high, with predictors of developing anxiety being a student at nursing college B, in the fourth academic year and current use of psychoactive substances were predictors of anxiety symptoms. These findings highlight the need to develop interventions and strategies to promote mental health assessments and management to prevent and reduce the problem of mental disorders among nursing students.

Veterinarian burnout demographics and organizational impacts: a narrative review

Burnout is a work-related syndrome of physical and emotional exhaustion secondary to prolonged, unresolvable occupational stress. Individuals of different demographic cohorts may have disparate experiences of workplace stressors and burnout impacts. Healthcare organizations are adversely affected by burnt out workers through decreased productivity, low morale, suboptimal teamwork, and potential impacts on the quality of patient care. In this second of two companion reviews, the demographics of veterinary burnout and the impacts of burnout on affected individuals and work environments are summarized, before discussing mitigation concepts and their extrapolation for targeted strategies within the veterinary workplace and profession.

Psychological symptoms and correlates of Chinese healthcare professionals in the intensive care unit before and after the COVID-19 outbreak: A comparison of two cross-sectional studies

BACKGROUND

The outbreak of COVID-19 disarranged lives across mainland China. No study has examined changes in psychological symptoms of healthcare professionals in the intensive care unit (ICU) before and after the outbreak of COVID-19. The aim of this study was to estimate changes in psychological symptoms of ICU healthcare professionals before and after the COVID-19 outbreak, and to analyze factors related to psychological symptoms.

METHODS

Two waves' administrations were implemented between December 13 and December 14, 2018, and between April 5 and April 7, 2020, respectively. The symptom checklist-90 (SCL-90) were used to evaluate psychological symptoms. Multiple logistical regression was used to reveal the risk of psychological symptoms.

RESULTS

A total of 3902 and 3908 ICU healthcare professionals took part in the first and second surveys. The mean total score of the SCL-90 was 179.27 (70.02) at wave 1 and 147.75 (58.40) at wave 2, respectively. The proportion of psychological symptoms was 55.6 % (95%CI = 54.0-57.1) at wave 1. But rates of psychological symptoms decreased to 36.6 % (95%CI = 35.1-38.2) at wave 2. ICU healthcare professionals with western economic belt and 6-10 years of work were more likely to develop psychological symptoms, while ICU healthcare professionals with the later survey and doctoral degree were less likely to develop psychological symptoms.

CONCLUSION

Although COVID-19 period benefited psychological symptoms of ICU healthcare professionals, psychological symptoms still had a related high prevalence. Regular screening and appropriate interventions should still be implemented to decrease the risk for psychological symptoms among Chinese ICU healthcare professionals.

Depression and opinion of dental students regarding the hybrid learning model during the COVID-19 pandemic

BACKGROUND

The global spread of COVID-19 forced schools at all educational levels to close, which was repeated in more than 60 countries. In addition, the COVID-19 pandemic has affected the mental health of dental students world wide. This study hypothesizes that the prevalence of depression in dental students from El Salvador is higher than that reported in studies from Europe, Asia, and North America.

METHODS

This study was an online cross-sectional survey performed at the Faculty of Dentistry of the University of Salvador. The PHQ-9 questionnaire was applied to know the level of depression of the students, and a questionnaire focused on learning the opinion of the students on the hybrid teaching model adopted. Approximately 450 students participated in both questionnaires.

RESULTS

Regarding the levels of depression present in the students, 14% had minimal depression, 29% had medium depression, 23% had moderate depression and, 34% had severe depression. The students had an excellent opinion regarding the hybrid learning model.

CONCLUSIONS

The prevalence of depression in dental students in El Salvador seems to be higher than that reported in studies in non-Latin American countries. Therefore, universities must generate care plans for mental health to avoid these harmful effects on students during future contingencies.

A systematic review and meta-analysis of studies exploring prevalence of non-specific anxiety in undergraduate university students

BACKGROUND

Anxiety is a common mental health problem in the general population, and is associated with functional impairment and negative impacts upon quality of life. There has been increased concern about university students' mental health in recent years, with a wide range of non-specific anxiety rates reported worldwide in undergraduate university students. We aimed to explore prevalence of non-specific anxiety in undergraduate university student populations.

METHODS

Four databases were searched to identify studies published between 1980 and 2020 which investigated prevalence of non-specific anxiety in undergraduate university students. Each study's quality was appraised using a checklist. Sub-analyses were undertaken reflecting outcome measure utilized, course of study, location of study, and whether study was before or during the COVID-19 pandemic.

RESULTS

A total of 89 studies - representing approx. 130,090 students-met inclusion criteria. Eighty-three were included in meta-analysis, calculating a weighted mean prevalence of 39.65% (95% CI: 35.72%-43.58%) for non-specific anxiety. Prevalence from diagnostic interview studies ranged from 0.3%-20.8% 12-month prevalence. Prevalence varied by outcome measure used to assess non-specific anxiety, the type of course studied by sample, and by study location. In half the studies, being female was associated with being more likely to have higher non-specific anxiety scores and/or screening above thresholds. Few of the included studies met all quality appraisal criteria.

CONCLUSION

The results suggest that approximately a third of undergraduate students are experiencing elevated levels of non-specific anxiety. Results from sub-analyses have identified some methodological issues that need consideration in appraising prevalence in this population.

Correlates of self-harm in university students: A cross-sectional study

Objective: To determine the prevalence of university students who have ever engaged in self-harm and to examine its correlates. Frequency of thinking about self-harm was explored as a secondary outcome. Participants: Students at Western University in London, Ontario, Canada. Methods: This cross-sectional study was completed via an online questionnaire. Logistic regressions assessed the influence of sociodemographic and behavioral factors associated with lifetime self-harm and thoughts about self-harm. Results: The sample consisted of 2626 university students. Almost 25% engaged in self-harm in their lifetime and close to 33% have thought about harming themselves. A non-straight sexual orientation, marijuana use, prescription drugs not prescribed, and mental health problems increased the risk of both outcomes. Females were over two times more likely to engage in self-harm than males. Conclusion: This study provides evidence that is needed for developing effective interventions to reduce the risk of self-harm by targeting university students who are most at-risk.

Assessing the Mental Wellbeing and Help-Seeking Behaviors of Pre-Veterinary Undergraduates at a Land-Grant Institution

Recent research conducted within the veterinary profession has reported higher rates of depression and stress than the general US population. While this decline in mental wellbeing has been documented in Doctor of Veterinary Medicine (DVM) students and veterinary professionals, there is a lack of research on the mental wellbeing of the pre-veterinary population. This gap led the authors to conduct a survey in the fall of 2021 utilizing the DASS-21 and ATSPPH-sf inventories to assess the levels of depression, anxiety, stress, and help-seeking stigma in pre-veterinary students to better understand when the decline in veterinary mental wellbeing begins. A pre-test survey was completed by 233 pre-veterinary students in September, and an identical post-test survey was completed by 184 pre-veterinary students in November. From the pre- and post-test data, depression, anxiety, and stress scores increased as students advanced in academic status during their undergraduate degree. Juniors reported the highest averages of depression, anxiety, and stress compared to their peers. In the post-test, sophomores and juniors exhibited higher rates of depression than freshmen, and juniors and seniors exhibited higher rates of stress than freshmen. Current VMCAS applicants exhibited higher levels of stress than non-VMCAS applicants in the pre-test, and lower levels of stress in the post-test. In both the pre-test and post-test data, respondents averaged a neutral attitude toward help-seeking. Based on these results, a decline in pre-veterinary mental wellbeing occurs as students' progress in their undergraduate career and should be further studied to assess its impact on Doctor of Veterinary Medicine and veterinary professional wellbeing.

Before and during the COVID-19 Pandemic, Physical Fitness Association with Mental Health among Higher Education Students: A Multi-Group Analysis Model

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), created a significant problem people's health around the world. The mental and physical health of entire populations has been negatively impacted due to the introduction of several restriction methods. Maintaining a specific physical activity and fitness level is crucial given the pandemic situation. The connection between physical fitness and mental health has recently received growing attention. In contrast to the message from physiological research, which lauds the general benefits of fitness for physical health, the corresponding psychological literature reveals a more complex relationship. This paper outlines the research evidence, focusing on the relationship between physical fitness and depression, anxiety, and stress before and during the COVID-19 pandemic. Data were obtained from 390 higher education students (measuring their perception before and during the pandemic). They were analyzed by a structural equation modeling multi-group analysis to detect the variance in the test relationship before and during the COVID-19 pandemic. Theoretical and empirical implications are also discussed.

­Barriers faced by medical students in seeking mental healthcare: A scoping review

Background: Medical students commonly exhibit mental health issues. Despite the availability of professionals on medical campuses, seeking help continues to be a challenge for some students. Our review aimed to identify the barriers medical students face when seeking professional mental healthcare. Methods: A Medical Subject Headings (MeSH) search was created for articles using PubMed, Embase, and PsychINFO databases to identify articles specifically about medical students and their barriers to professional mental healthcare. Inclusion criteria included articles in which barriers to mental healthcare were either the primary variable or one of multiple study results. No date limits were imposed. Reviews, pilot projects, or articles that did not address barriers to mental healthcare faced by medical students or focused on veterinary or dental students were excluded. A total of 454 articles were identified and screened by title/abstract and then full text. Data were extracted from 33 articles using an independent framework. Barriers identified were compiled and reported.  Results: From a total of 33 articles, the most identified barriers were fear of negative effect on residency/career opportunities, fear of confidentiality breach, stigma and fear of shaming from peers, lack of perceived seriousness/normalization of symptoms, lack of time, and fear of documentation on academic record. Students also preferred to seek care outside of their institution from fear of their provider being an academic preceptor.  Conclusions: Many of the barriers to mental healthcare faced by medical students relate to a fear of academic and career reprisal, and fear of confidentiality breach. It appears that despite recent efforts to decrease stigma surrounding mental illness, many medical students struggle to seek appropriate support. Access to mental healthcare can be improved by increasing transparency regarding what information will be displayed on academic records, dispelling common myths about mental healthcare, and increasing awareness about resources available for medical students.

"This program should come with a warning sign!": Mental wellness in occupational therapy and physical therapy students

Objectives: To measure and compare distress in entry-level masters occupational therapy (OT) and physical therapy (PT) students; to evaluate distress levels relative to existing data; and to explore factors that cause stress, effects of stress, and coping strategies. Participants: Ninety-eight OT and PT students (75 females, 23 males) from two cohorts at a Canadian university. Methods: Sequential mixed-methods including questionnaires and inductive analysis of focus group discussions. Results: OT and PT students from one cohort reported higher levels of stress, anxiety and/or depression compared to the following academic year and compared to undergraduate and general population samples. The overall theme was the unrelenting tug of war between school and other aspects of students' lives. Factors related to academic workload negatively affected mental health. Coping strategies included physical activity, strategic selection of peers, and modifying expectations. Conclusions: Wellness in OT and PT students is an important concern that deserves attention.

Web-based support services to help prevent suicide in young people and students: A mixed-methods, user-informed review of characteristics and effective elements

The online world may provide an alternative means to engage young people and students with suicidal feelings, who are typically reluctant to seek help. We aimed to map, characterise and obtain user evaluation of current online suicide support for this group in order to assess the usefulness of current provision and how it may be improved. We conducted a mixed-methods study, comprised of an internet search, content analysis of site features and qualitative interviews with site users: 9 young people and 4 general practitioners. Data collection took place in 2019 and 2020 in the UK. Young people participants were recruited through the well-being networks of a large University in South-West England and via a national young person's mental health app. General practitioners were recruited locally through professional networks. We identified a wide range of easily accessible online support, including examples of interactive services, such as live chat and text messaging, but a lack of support that is both suicide-specific and young adult-specific, and an absence of online suicide or mental health crisis support services tailored specifically for students. Qualitative data showed that clarity, brevity and immediacy are the most important facets of engaging crisis help for young people, and that young people may prefer to use text-based rather than verbal forms of communication when seeking help. Few services provided access to active peer support, outside of lived-experience stories, which were evaluated as both valuable and potentially harmful. There is a need to further develop tailored suicide specific online crisis support for young people and students, which is able to 'speak to' their age-specific needs and preferences. While lived experience may provide a valuable means of supporting young audiences, caution is required since this may have unintended negative consequences and further research is needed to understand the safe framing of such material.

Mental well-being and diversity, equity, and inclusiveness in the veterinary profession: Pathways to a more resilient profession

Mental well-being (MWB) and diversity, equity, and inclusiveness (DEI) continue to be critical within the veterinary profession but there is less information regarding how professional associations around the world tackle these issues. A mixed-method study including an international online survey in English (n = 137 responses via snowball sampling), fourteen interviews, and two webinars was used to identify the availability and impact of MWB and DEI support programs for veterinarians. Survey results showed that more veterinary organizations designated MWB and DEI challenges (54%, n = 43/79 and 58%, n = 45/78, respectively) as a key priority area than veterinary clinics (26%, n = 15/57 and 33%, n = 19/57, respectively). Whereas, MWB support programs were available in a moderate number of mainly English-speaking countries, DEI support programs were available in only a few countries and focused primarily on specific groups, with an unknown impact due to their recent implementation. Universally, survey respondents believed activities for specific groups, such as MWB webinars, training, and awareness campaigns, as well as MWB/DEI helplines and DEI peer-to-peer support programs had a high impact (median 3.5–4/5) yet were underemployed by both veterinary organization and veterinary clinics. Further feedback from respondents during focused interviews indicated that requiring initial and continuing training as well as tailored group activities would be most beneficial to improve MWB/DEI throughout the veterinary professional career. There are many areas of the intersection between MWB and DEI that remain to be elucidated in the future studies. Having a sufficient sample size, improving accessibility, and addressing varying cultural perceptions are the main challenges, as seen in our study. To truly address MWB and DEI disparities, change is also needed in veterinary workplace culture and environment. In conclusion, raising awareness for an inclusive profession, including increasing openness and acceptance to enhance DEI and destigmatizing MWB challenges, is needed to ensure a thriving, modern veterinary profession.

Mental health and working constraints of first-year PhD students in health and science in a French university: a cross-sectional study in the context of occupational health monitoring

OBJECTIVES

To assess the mental health and working constraints perception of first-year PhD in France.

DESIGN

It is a cross-sectional study.

SETTING

The study was conducted by the team of the Lyon 1 University's Occupational Health and Medical Service for Staff, from October 2019 to February 2020. First-year PhD students employed by the university were seen during the routine occupational health medical check-up.

PARTICIPANTS

A total of 161 PhD students in science from the 2019 intake were included in the study (participation rate 98%).

OUTCOME MEASURES

Data were collected using a self-questionnaire on psychosocial constraints at work (Job Content Questionnaire), the quality of the professional relationship with the supervisor (Advisory Working Alliance Inventory, Student perspective (AWAI-S)), medical conditions, anxiety (Generalized Anxiety Disorder-7) and depressive symptoms (Patient Health Questionnaire-9).

RESULTS

A total of 161 PhD students from the 2019 intake were included in the study (participation rate 98%). Most of the PhD students reported high psychological demands (58%), high decision latitude (53%), high social support (55%) and good professional relationships with their supervisor (mean of global score of AWAI-S=114.5). However, 34% showed signs of at least mild depression, 19% showed signs of anxiety and 20% were referred to a mental health professional after the survey. Bivariate analyses showed that history of psychiatric disorders, their relationship with their supervisor, having complementary teaching activities and stressful working conditions contributed to anxiety and depression.

CONCLUSIONS

Even in the first year of their PhD, some students had mental health issues. It seems relevant to generalise the medical follow-up of all PhD students as soon as they enter the doctoral programme in order to detect and treat their health problems and psychological disorders at an early stage.

Exploring the psychological impact of working during COVID-19 on medical and nursing students: a qualitative study

OBJECTIVES

To identify the psychological impact of working during the COVID-19 pandemic on medical and nursing students' psychological well-being. To inform recommendations for the provision of future student well-being support.

DESIGN

An interpretative qualitative, semistructured interview study employing maximum variation sampling, snowball sampling and a thematic analysis.

SETTING

A large West Midlands (UK) university with medical and nursing undergraduate and postgraduate programmes. Study undertaken between January and May 2020.

PARTICIPANTS

A purposive sample of eight medical (six women and two men) and seven nursing (all women) students who worked >2 weeks in a healthcare setting during the COVID-19 pandemic (from 1 March 2020 onwards).

RESULTS

Four core themes with corresponding subthemes were identified: (1) COVID-19 sources of distress-working conditions, exposure to suffering, death and dying, relationships and teams, individual inexperience and student identity, (2) negative impact on mental health and well-being-psychological and emotional distress, delayed distress, exhaustion, mental ill health, (3) protective factors from distress-access to support, environment, preparation and induction, recognition and reward, time for breaks and rest and (4) positive experiences and meaningful outcomes.

CONCLUSIONS

Student pandemic deployment has had a significant negative impact on students' psychological well-being, as a result of demanding working conditions, unprecedented exposure to death and suffering and lack of preparation for new job roles. Universities and healthcare organisations must formally acknowledge this impact and provide well-being support for distressed students working in such challenging contexts. They must also establish more supportive and inclusive healthcare environments for medical and nursing students in future pandemic and postpandemic circumstances, through the implementation of support systems and adequate preparation.

Oral health-related quality of life and psychological states of dental students with temporomandibular disorders

PURPOSE/OBJECTIVES

This study investigates the frequency of temporomandibular disorders (TMD) in dental students, and evaluates the association between TMDs, psychological states, and oral health-related quality of life (OHRQoL). The presence of bruxism was also determined.

METHODS

Two hundred ninety-three dental students completed the Symptom Checklist 90-Revised (SCL-90-R) and Oral Health Impact Profile 14 (OHIP-14) questionnaires and underwent a clinical examination according to Diagnostic Criteria for TMDs.

RESULTS

TMDs were detected in 46.4% of the dental students. OHIP-14 scores of students with TMDs were significantly higher than scores for students without TMDs (p < 0.05). Significant differences were observed in all SCL-90-R scores among students with and without TMDs, except for phobic anxiety and additional SCL-90-R subscale scores (p < 0.05). The prevalence of myalgia was significantly higher in clinical students (26.6%) than in preclinical students (15.6%). OHIP-14 scores of clinical students were significantly higher than preclinical students (p < 0.05).

CONCLUSIONS

In dental students, there was a high frequency of TMDs and bruxism. OHRQoL was poorer in clinical students. Levels of anxiety, depression, and somatization were not different in clinical and preclinical students. SCL-90-R scores are higher in students with TMDs except for phobic anxiety and additional SCL-90-R subscale scores.

The relationship of educational environment and preparedness to practice - perceptions of Malaysian dental graduates

Gauging dental graduates' perceptions of their university training and of how it prepares them for professional practice is useful in measuring the quality and adequacy of the curriculum to which they were exposed.

OBJECTIVES

This study aimed to evaluate the perceptions of dental graduates' educational environment as well as preparedness to practice, and how these two components are correlated.

METHODS

A self-administered, validated questionnaire, developed from previous studies, was distributed to dental graduates of a public Malaysian university (n = 178, response rate = 60%) via online and postal surveys. Bivariate analyses were carried out using Spearman's rank-order correlation (Spearman's Rho, significance level p < .01) to determine the correlation between (1) Global Preparedness Score and Global DREEM Score, (2) domains of DREEM Inventory and perceived preparedness, and (3) domains of perceived preparedness and DREEM Score.

RESULTS

The Global Preparedness Score was 191.52, with more than 90% of respondents feeling well prepared in the "General Patient Management," "Drug and Emergency Management" and "Practice Management" domains. The Global DREEM Score was 148.99/200, interpreted as "more positive than negative." The DREEM Inventory domains with the highest and lowest scores were "Students' Academic Self-Perception" (78.03%) and "Students' Social Self-Perception" (71.86%), respectively. A moderate positive correlation was found between Global Preparedness Score and Global DREEM Score (p < .01). In addition, moderate to large positive correlations were noted between perceived preparedness and "Student Perception of Learning," "Student Perception of Atmosphere" and "Student Academic Self-Perception" (p < .01). Moderate positive correlations were also found between the DREEM Score and most domains of perceived preparedness (p < .01).

CONCLUSIONS

The majority of graduates were well prepared to perform in most areas of clinical practice and perceived their overall educational environment as positive. In particular, those who viewed the educational environment in a positive light were also found to possess a good level of preparedness.

Stress level of dentists during COVID-19 pandemic in hot spots of Tamil Nadu: A cross-sectional study

BACKGROUND

The novel 2019 COVID-19 spreads by respiratory and aerosols, and this elevates the risk of dentistry during this pandemic. Widespread disease, in a short time, creates stress and has a psychological impact. The aim of this study was planned to assess the stress level of the dentists living or practicing or studying in hot spots which could help to understand mental status among the general dentists during COVID-19 lockdown.

MATERIALS AND METHODS

This cross-sectional study was conducted during the period of August 10 to August 25, 2020, on an Internet platform after getting consent from the dentists and practitioners using the Perceived Stress Scale (PSS). Chi-square association was used. Parametric tests such as independent t-tests and one-way ANOVA were also used. In all instances, P < 0.05 was considered statistically significant.

RESULTS

This study had a total response from 1044 dental students and dentists residing in hot spot zones in Tamil Nadu. Out of them, 68.4% were female and 31.6% were male. 37.9% of the participants were dental practitioners and 32.5% were undergraduate students. There is a significant association between age groups and PSS, work style, and PSS. There is no significant association between gender and PSS and degree and PSS.

CONCLUSION

This study shows that levels of distress were higher than expected during the COVID-19 pandemic among the dentists and majority of the respondents have moderate-to-high-stress levels. As the unlock has been started throughout the country, it is the right time to work with the authorities and focus on formulating protocols for disinfection and sterilization and work on treating the patients with exact safety measures for the welfare of the patients.

The association of sleep patterns and depressive symptoms in medical students: a cross-sectional study

Objective

Mental health is a fundamental aspect in ensuring the stable and successful professional life of future physicians. Depressive symptoms can negatively affect the work-life-balance and efficiency at work of medical students.

To date, there have been very few studies involving medical students that examine the association between single sleep characteristics and the outcome of the Beck Depression Inventory-II score. Therefore, the aim of the present study is to investigate this possible association. A classroom survey using socio-demographic characteristics, the Beck Depression Inventory-II, and the Pittsburgh Sleep Quality Index was conducted amongst students at a German medical school from December 2017 to September 2018. Data analysis was performed with descriptive statistics and binary logistic regression.

Results

Of the students surveyed, 19% showed depressive symptoms with a Beck Depression Inventory-II score over 13 and 42% of these cases were moderate or severe. The occurrence of relevant depressive symptoms was associated with lower sleep quality, higher sleep latency, and the consumption of sleeping pills. In general, female students and students from abroad had a higher risk of depressive symptoms. Addressing these relevant findings in medical school can increase awareness of mental health.

Experiences and impact of moral injury in U.K. veterinary professional wellbeing

BACKGROUND

Veterinary professionals (VPs) are often exposed to distressing and ethically challenging events in their line of work, yet little is known about whether they may experience moral injury and the impact potentially morally injurious events (PMIEs) may have on their wellbeing. This cross-sectional study aimed to examine the association between PMIEs and the mental health outcomes of U.K. VPs.

METHOD

Assessments of PMIE exposure and self-report measures of common mental disorders were administered using an anonymous online questionnaire to 90 U.K. VPs between December 2020 and May 2021.

RESULTS

Exposure to PMIEs was reported by almost all VPs (89.0%), with acts of omission most frequently reported. Experiences of PMIEs were significantly associated with symptoms of PTSD (p < 0.01) and experiencing a betrayal event was significantly associated with PTSD symptoms (p<0.05). However, there was no significant association found between PMIE exposure and alcohol misuse or CMD (p > 0.05).

CONCLUSIONS

This study provides some of the first evidence that experiences of moral injury are significantly associated with adverse mental health outcomes in U.K. VPs. Future work is needed to design effective pathways for prevention and intervention for VPs exposed to highly challenging events.

HIGHLIGHTS

U.K. veterinary professionals were found to experience moral injury.Experiences of moral injury were significantly associated with symptoms of PTSD.

Mental burden and perception of the study situation among undergraduate students during the COVID-19 pandemic: a cross-sectional study and comparison of dental and medical students

OBJECTIVES

To investigate levels of distress, depression, anxiety, stress and perception of their current study situation during the COVID-19 pandemic among undergraduate dental and medical students.

DESIGN

Observational, cross-sectional study including two consecutive surveys (May and July 2020).

SETTING

A large medical school in Germany.

PARTICIPANTS

All first year dental and medical students were invited. 132 participating first year students (44 dental, 88 medical) from the first survey and 150 students (50 dental, 100 medical) from the second were included in our analyses.

PRIMARY AND SECONDARY OUTCOME MEASURES

Mental burden (distress thermometer, Patient Health Questionnaire-4, Perceived Stress Scale-4) and self-reported changes in mental health and perception of study situation during the COVID-19 pandemic (self-developed items) were compared. Open-ended questions were analysed by conventional content analyses.

RESULTS

A considerable proportion of students (t1: May 2020: 84.1%; t2: July 2020: 77.3%) reported distress levels above cut-off. In July 2020, dental students reported significantly higher distress scores than medical students (dental: M=7.0, SD=2.3; medical: M=5.7; SD=2.1; p<0.001). More dental than medical students reported mild, moderate and severe levels of anxiety and depression symptoms. The majority stated that their mental health and study motivation had not changed during the pandemic. Logistic regression showed that being a dental student was significantly associated with a higher likelihood for serious worries regarding the study situation during COVID-19 at t1 (OR 4.0; 95% CI 1.1 to 14.2). At t2 higher distress was significantly associated with a higher likelihood for experiencing serious worries (OR 1.8; 95% CI 1.3 to 2.5). Regarding current concerns related to the pandemic, students most frequently reported difficulties with self-regulated learning (15.2%), study-related worries and uncertainty (14.4%), missing feedback of students and lecturers (11.4%) and lack of practical training (9.8%).

CONCLUSION

The results suggest that high mental burden and the lack of practical training among medical and dental students is an increasing problem, with a possibly even higher urgency in dental students. Tailored psychological and educational support offers during and after the COVID-19 pandemic might help them as they progress through (medical and) dental school.

Impact of a pilot elective course to address student pharmacist well-being

INTRODUCTION

Survey results from 2016 and 2018 at the University of Michigan College of Pharmacy highlighted mental health concerns for the student population, including struggles with depression, anxiety, and academic distress. This led to creation of a pilot well-being elective course for first year doctor of pharmacy students. This article describes how this course was assessed and adapted for the future.

METHODS

The well-being elective course used a course-specific survey and the Brief Inventory of Thriving to assess student outcomes. The course-specific survey was based upon the course objectives and the University of Michigan Common Agenda for Well-Being. Both surveys were given pre- and post-course to identify change.

RESULTS

Course survey results illustrated an improvement in student well-being over a single semester. Compared with pre-course responses, students who completed the course were significantly more likely to agree with statements indicating they had strong time management skills, resilience to manage the fluctuations of life, were able to make thoughtful choices to reduce harm and promote well-being, and overall rated their well-being as excellent. Additionally, nearly all students felt a sense of strengthened community with peers and faculty within the course, better able to recognize or refer a peer for help, and felt the course contributed to their overall well-being.

CONCLUSIONS

Implementation of this well-being elective pilot course provided students the tools and resources to improve upon their overall well-being in an effort to address anxiety, depression, and academic distress.

Work-life balance amongst dental professionals during the COVID-19 pandemic-A structural equation modelling approach

BACKGROUND

The Coronavirus disease (COVID-19) outbreak in 2019, has shocked the entire world. As an effort to control the disease spread, the Indian government declared a nationwide lockdown on March 25th, 2020. As dental treatment was considered high risk in the spread of COVID-19, dentistry became one of the most vulnerable professions during this time. Dental professionals had to face job layoffs, salary cuts in professional colleges, closure of private clinics resulting in huge psychological, moral, and financial crises. Studies during the previous and present pandemics have shown mental issues among health care workers necessitating institutional reforms, along with early care and support. A balance in the work-life amongst professionals is the key to better efficiency and, was majorly affected during the COVID-19 pandemic lockdown due to sudden unexpected changes. Hence this study was conducted to understand the changes they underwent both at home and professional front with a hypothesis that physical and mental health, activities, relationship status, and workplace influence the work-life balance.

METHODS

A pre-validated questionnaire survey was done on dentists across India. Structural Equation Modelling and path analysis were applied to the data collected.

RESULTS

The results of the study supported the hypothesis that factors like physical and mental health, activities, relationship status, and workplace influenced the work-life balance directly. A significant imbalance was seen amongst the female dentists.

CONCLUSION

The present study proved the unpreparedness among dental professionals. Hence an evolutionary phase in every field with better working protocols, robust mental health support, and a focus on strategies to face future such emergencies is required.

Mental health and wellness in Canadian dental schools: Findings from a national study

OBJECTIVES

To survey the mental health and wellbeing content in the curricula, services, and activities of the 10 Canadian dental schools, and to explore the specifics of this area in the Faculty of Dentistry (FoD) at The University of British Columbia (UBC).

METHODS

An electronic survey consisted of four major categories: curricular activities and services, structural approaches, infrastructural approaches, and evaluation methods, was distributed to all Canadian dental schools. A situational analysis was conducted at UBC's FoD via document appraisal and key informants' exploratory interviews.

RESULTS

Eight dental schools responded to the survey showing that didactic sessions being the pedagogical method to deliver resilience content. None of the responding schools reported formally evaluating their mental health content. Through situational analysis, a relational map that identified four major areas contributing to students' mental health at UBC's FoD was generated which includes four major aspects: (1) curricular content on mental health, (2) informal wellbeing and mental health networks, (3) protective, and (4) risk factors influencing students' mental health.

CONCLUSIONS

As this study described the mental health and wellbeing activities, services, and curricular content across multiple Canadian dental schools, the diverse approaches each school adopted and how personal and professional aspects of students' lives being attempted to be addressed are a critical starting point to engage educators in dentistry. The situational analysis outcome, where a detailed description of the mental health situation at UBC's FoD, can be used to guide in-depth studies of the area of wellbeing at other dental schools.

Grief in Response to Uncertainty Distress Among Veterinary Students During the Early Stages of the COVID-19 Pandemic

The abrupt and life-altering shifts brought on by the COVID-19 pandemic have stimulated research in fields ranging from social sciences to virology. This study explored perceptions and experiences of COVID-19's impact on students at Lincoln Memorial University–College of Veterinary Medicine (LMU-CVM) and considered how to respond to these. Semistructured interviews were conducted with 20 students from LMU-CVM. Thematic analysis elucidated five subthemes that were combined into two main themes based on Bertuccio's framework of grief in response to uncertainty distress. Uncertainty and disruption of routine were subthemes of ambiguous loss, while lost opportunities, milestones missed, and risk concern came under anticipatory grief. There was overlap and fluidity within these themes, with frustration, stress, and unexpected benefits pervading all categories. Differences were noted between classes, with clinical students expressing concern over graduation and lack of preparedness, and preclinical students with online assessment, lost opportunities for clinical experiences, and the loss of social connections. These results point to mitigation strategies for the adverse effects of COVID-19-related stressors specific to this population that encompass academic, physical, and mental well-being concerns. Clear communication, assurance of quality education, flexibility for meeting family needs, financial assistance, and mental health support are the areas evident from the interviews where successful responses might be targeted. This study also highlights areas for future research, including follow-up interviews, given the prolonged timeline of COVID-19, surveys of beliefs and practices across a larger university population, and exploration of the long-term impact on academic and practice success of the affected cohorts.

Dental Students in Germany throughout the COVID-19 Pandemic: A Psychological Assessment and Cross-Sectional Survey

Multiple investigations have reported high psychological distress among students since the coronavirus (COVID-19) outbreak started. This survey examined the associations between psychological features, and several demographic and social factors among dental students in German universities. Dental students registered in German universities nationwide were asked to join this survey via a self-directed online questionnaire, from July 2020 to January 2021. This study assembled data on demographic statistics, the depression anxiety stress scales (DASS-21), and the impact of events scale-revised (IES-R) instrument. The relationships between demographic-related variables and mental consequences of depression, anxiety, stress, intrusion, avoidance, and hyperarousal were inspected. Two hundred and eleven students contributed to the questionnaire and conveyed overall normal or mild outcomes of depression, anxiety, stress, intrusion, avoidance, and hyperarousal. In addition, female gender, cardiovascular diseases, smoking habits, and seeing the COVID-19 outbreak as a financial risk were stated as significant related factors (p < 0.05), with increased IES-R and DASS-21 scores. These results highlight the features that should be considered to better protect dental students' mental health in German universities during the crisis.

Mental Health and Physical Activity in Health-Related University Students during the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic led to increased negative emotional states among students. Physical activity is known to have positive impacts on mental health and well-being. However, due to the closure of gyms and other recreational facilities as a restrictive measure, students' physical activity levels may decrease. This cross-sectional study aimed to determine the prevalence of depression, anxiety, and stress symptoms and physical activity among health-related students during the second partial COVID-19 lockdown. The study included 823 students from the Faculty of Dental Medicine and Health of the University of Osijek in Croatia. The Depression Anxiety Stress Scale-21 (DASS-21) and the Godin-Shephard Leisure Time Questionnaire for Physical Activity (GSLTPAQ) questionnaires were used to assess the prevalence of depression, anxiety, and stress symptoms as well as physical activity. Two-thirds (59.2%) of students in health-related fields were insufficiently active, while the prevalence of depression (50.8%), anxiety (50.9%), and stress (49.9%) symptoms were high. Also, female respondents had significantly higher levels of depression, anxiety, and stress than their male counterparts. Graduate students had higher levels of all three negative emotional states, but only anxiety levels were significant. This study shows that students in health-related fields had reduced physical activity and a high prevalence of negative emotional conditions (depression, anxiety, and stress) during the second partial lockdown. The resulting symptoms were mostly of mild intensity; however, we consider this a significant mental health issue during the COVID-19 pandemic. Hence, it is crucial to control and support students' mental health, especially in more affected female individuals, in order to reduce the pandemic's negative impact.

Depression, stress and self-stigma towards seeking psychological help in veterinary students

Previous research indicates that the prevalence of depression among veterinarians and veterinary students is high. Although self-stigma in seeking psychological help is reportedly elevated in veterinary students, its impact on mental health has been largely unexplored. The aim of this study was to compare the levels of study-related stress, depression symptoms and self-stigma in veterinary students with those of non-veterinary students, and examine whether stress and self-stigma positively predicted depression symptoms in veterinary students. A total of 287 veterinary students and 317 non-veterinary students from Australian universities completed an online questionnaire measuring study-related stress, self-stigma and depression symptoms. Results showed that veterinary students reported significantly higher levels of stress and self-stigma than non-veterinary students, but there was no significant difference between veterinary and non-veterinary students in depression symptoms. Multiple regression analysis indicated that stress and self-stigma both predicted depression symptoms in veterinary students. These findings suggest that reducing stress and help-seeking self-stigma in veterinary students may be important in improving their wellbeing levels. These findings are important in developing a whole-of-career life course approach to understanding the professional and psychological experiences of veterinarians.

Rethinking Strategies and Programs to Improve Physical and Emotional Well-being Among Healthcare Professionals: Facing the New Normalcy

Background

With the advent of coronavirus disease 2019 (COVID-19), a different perspective on the future of humanity has emerged that emphasizes the importance of building the capacities of healthcare providers in order to assist them with the heavy burden that these changes have placed on them both now and in the future. A reduction in the quality of life and the presence of prolonged fatigue are some of the most imminent problems that emerge among these professionals.

Objective

The aim of this study was to determine the effectiveness of a holistic intervention (workshop) for health science students aimed at developing skills that will enable them to obtain a better self-assessment of their quality of life, and prolonged fatigue.

Methods

Pre- and post-measures of quality of life, and prolonged fatigue were obtained from 130 health science students, including a group of 96 attendees (cases) of a 4-h wellness workshop and 34 students who did not attend (controls).

Results

Paired t tests indicated a significant improvement in nearly all dimensions related to quality of life, and prolonged fatigue in the case group who attended the workshop.

Conclusions

A comprehensive wellness strategy that utilizes a holistic approach can play an important role in improving and promoting essential skills to improve healthcare provider's self-assessment about the quality of life and reduce their prolonged fatigue. The critical importance of these needs has long been recognized, and this will also be crucial for addressing new challenges and emerging realities.

Self-reported depressive symptoms in dental students: Systematic review with meta-analysis

OBJECTIVE

This study aimed to systematically review the literature about the prevalence of self-reported depressive symptoms in dental students.

METHODS

PUBMED, SCOPUS, and EMBASE databases were search up to January 2020 with the following focused questions: "What is the prevalence of self-reported depression symptom in dental students?" and "Are sex and years of educational training associated with self-reported depressive symptom in dental students?". Observational studies that applied a questionnaire assessing depression were eligible. Standard mean differences (SMD) and pooled odds ratios (OR) were calculated for the questionnaires' scores and self-reported depressive symptom, respectively.

RESULTS

Fifty-eight studies were included, and 15 different questionnaires were used. The prevalence of self-reported depressive symptoms/at least mild depression ranged from 2.75% to 89.84%, and the pooled overall prevalence was 29% (95% confidence interval [CI]: 26-34). Meta-analysis showed significantly lower scores in the questionnaires for self-reported depressive symptoms of male students (SMD: -0.22; 95% CI: -0.42 - -0.03). Conversely, no significant difference was detected for the OR of self-reported depressive symptom in the comparison between sex (OR: 1.11 - 95% CI: 0.77-1.62). Similarly, no significant difference was observed for the different school years regardless of the analytical strategy used.

CONCLUSION

It was concluded that female dental students presented more self-reported depressive symptoms, but no difference is demonstrated during the years of dental education.

Self-reported psychological problems amongst undergraduate dental students: A pilot study in seven European countries

AIM

To map psychological problems amongst undergraduate dental students with a focus on different time points in clinical work in seven Eastern European and Scandinavian countries.

MATERIALS AND METHODS

A total of 1063 3rd- and 5th-year dental students (response rate 70%) participated in this pilot study and completed a pre-tested, structured questionnaire, which collected information on sociodemographic characteristics and self-reported psychological problems. Data were analysed by bivariate and multivariate methods.

RESULTS

The majority of participants were female and were younger than male participants. Most participants, though more females than males, agreed that the clinical work of dentistry was psychologically difficult. Almost half of participants felt nervous before working with patients (N = 506, 48%) and experienced a lot of stress whilst working with patients (N = 488, 46%); almost one-third (N = 287, 27%) felt anxious/worried after working with patients. Being a 3rd- and 4th-year student (vs 5th-year) reduced the odds for anxiety after working with patients; being a 3rd-year student (vs 5th-year) increased the odds for stress whilst working with patients. Studying in countries other than Norway reduced the odds for stress whilst working with patients. Less than good self-perceived health, presence of psychological health complaints before starting dental education, female gender and lack of physical activity increased the odds for psychological problems.

CONCLUSION

A high number of undergraduate dental students reported psychological problems in connection with clinical work. It is unlikely that "one size fits all"; therefore, further qualitative investigations on stressors in clinical learning environments should be done in order to design tailor-made supportive strategies.

Current insights in veterinarians' psychological wellbeing

This article outlines some of the key prevalence studies regarding the psychological health of veterinarians, and highlights the reasons for distress, with factors such as workload, financial issues, long working hours, challenging interactions, unexpected outcomes, euthanasia and fear of complaints or making mistakes being commonly cited. During the last decade, many ways to improve veterinarians' wellbeing have been suggested, including both individual and organisational strategies. However, what appears to be lacking is a body of intervention research to test the effectiveness of these strategies.This article outlines some of the types of psychological distress which have been reported in veterinarians, and emphasises key issues such as the impact of practitioners' help-seeking behaviour and moral and ethical dilemmas. Some wellbeing interventions from overseas studies are highlighted, with a focus on strategies that can be adopted by organisations as well as individuals. The review includes several recommendations to improve the psychological wellbeing of veterinarians such as using multi-disciplinary clinician wellbeing models to structure interventions, the possibilities of mindful self-compassion practices, and the regular use of peer support and reflective groups. It concludes that implementation and robust evaluation of wellbeing initiatives in the New Zealand veterinary population are urgently needed.

The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis

Anxiety, although as common and arguably as debilitating as depression, has garnered less attention, and is often undetected and undertreated in the general population. Similarly, anxiety among medical students warrants greater attention due to its significant implications. We aimed to study the global prevalence of anxiety among medical students and the associated factors predisposing medical students to anxiety. In February 2019, we carried out a systematic search for cross-sectional studies that examined the prevalence of anxiety among medical students. We computed the aggregate prevalence and pooled odds ratio (OR) using the random-effects model and used meta-regression analyses to explore the sources of heterogeneity. We pooled and analyzed data from sixty-nine studies comprising 40,348 medical students. The global prevalence rate of anxiety among medical students was 33.8% (95% Confidence Interval: 29.2–38.7%). Anxiety was most prevalent among medical students from the Middle East and Asia. Subgroup analyses by gender and year of study found no statistically significant differences in the prevalence of anxiety. About one in three medical students globally have anxiety—a prevalence rate which is substantially higher than the general population. Administrators and leaders of medical schools should take the lead in destigmatizing mental illnesses and promoting help-seeking behaviors when students are stressed and anxious. Further research is needed to identify risk factors of anxiety unique to medical students.