Psychological Distress, Social Support, Coping Style, and Perceived Stress Among Medical Staff and Medical Students in the Early Stages of the COVID-19 Epidemic in China

Professional psychological qualities of Chinese medical students: theoretical models, questionnaire development, and relationship with mental health

Introduction

Professional psychological qualities are crucial for individuals' career development and overall well-being, especially in clinical medical professions. Medical students often face significant work, academic, and doctor-patient communication pressures, which can challenge their mental and emotional health. Measuring and understanding the relationship between medical students' professional psychological qualities and their mental health is of significant practical importance.

Methods

This study developed a comprehensive professional psychological qualities scale through a series of qualitative and quantitative studies, consisting of three main components and thirteen secondary dimensions. The scale's reliability was assessed using Cronbach's α coefficients. In Study 2, the scale was administered to 972 medical students to explore their anxiety and depression levels. A simple mediation analysis was conducted to investigate the relationship between professional psychological qualities, anxiety, and depression.

Results

The professional psychological qualities scale demonstrated satisfactory reliability, with a total scale α coefficient of 0.947 and subscale α coefficients ranging from 0.895 to 0.933. The mediation analysis revealed that medical students' professional psychological qualities directly negatively impact depression levels and indirectly positively influence them via their effects on anxiety levels, exhibiting an overall masking effect unrelated to depression levels.

Discussion

This study addresses the gap in research on the professional psychological qualities of medical students by providing a reliable measurement tool. The findings shed light on the complex mechanisms through which these qualities impact the mental health process. The scale can be used by other researchers to assess medical students' professional psychological qualities and further investigate their relationship with mental health outcomes.

The darkness of reacculturation: examining factors influencing depression among Chinese international student returnees in the post-COVID-19 era

Introduction

In the aftermath of the COVID-19 pandemic, the reintegration of Chinese international student returnees intersects with China's critical effort to combat a significant brain drain of highly skilled talents, highlighting an unprecedented psychological battleground. This convergence underscores the urgent need for nuanced research to navigate the uncharted territory of their mental health.

Methods

Employing Bayesian analysis supported by Markov Chain Monte Carlo (MCMC) algorithms, this study examined depression prevalence and associated factors among 1,014 Chinese returnees. The sample comprised 44.87% male participants (455), 51.58% female participants (523), and 3.55% identifying as "Others" (36), with an age distribution of 61.74% aged 18-30 (626), 28.80% aged 31-40 (292), and 9.47% aged 41-50 (96). The mean age of participants was 29.6 years, ranging from 18 to 50 years. PHQ-9 diagnoses revealed alarming levels of depression, with 47.9% exhibiting a moderately severe degree of depressive disorder.

Results

Our findings highlight the intricate interplay between identity clusters- "homestayers" (those leaning towards a Chinese cultural identity), "navigators" (those with a bicultural identity), and "wayfarers" (those leaning towards a foreign cultural identity)-and the likelihood of depression. Specifically, homestayers showed a clear and strong negative association, navigators demonstrated a positive association, and wayfarers had a positive yet unclear correlation with depression levels. Furthermore, acculturation, age, and gender showed no significant effects, whereas education mildly mitigated depression.

Discussion

Based on these findings, we suggest the implementation of better-tailored mental health support and policies to facilitate smoother reintegration.

Analysing the effect of resilience and perceived social environment on university students' intention to start sustainable ventures

The literature mostly has addressed the determinants of entrepreneurial intention in general and social entrepreneurship, without focusing specifically on sustainable entrepreneurial intention despite it has become highly relevant in addressing environmental degradation and social challenges. This study aims to contributes to the understanding of psychological and social factors that influence sustainable business, evaluating the effect of resilience, subjective norms, and perceived social support on sustainable entrepreneurial intention. We analysed the online survey responses of 433 students from Chile and Ecuador enrolled in business and engineering programs using Partial Least Squares Structural Equation Models (PLS-SEM), moreover, a multi-group analysis (MGA) has been conducted to assess gender differences. The findings have supported the positive effect of psychological resilience and subjective norms on perceived social support, besides, an important effect of social support on sustainable entrepreneurial intention was found. These results offer new evidence regarding the significance of the social environment, support networks, and resilience of university students in fostering the establishment of sustainable businesses with a focus on social well-being and environmental protection in Latin America. This is particularly pertinent as the countries in this region are grappling with social and environmental challenges that could be addressed through sustainable entrepreneurship.

The impact of perceived life stress and online social support on university students' mental health during the post-COVID era in Northwestern China: gender-specific analysis

BACKGROUND

Before the pandemic, research had already established the potential impact of perceived life stress and social support on the mental health status of Chinese students. However, in the Post-COVID Era, the specific mechanisms linking these variables and the distinct role of online social support remain relatively unexplored.

METHODS

After the cessation of China's dynamic zeroing policy, a total of 1180 university students from Northwestern China participated in this study by completing a demographic questionnaire, as well as self-report measures assessing mental health, perceived life stress, and online social support.

RESULTS

Approximately 25% of students exhibited psychological symptoms. When examining different categories of perceived life stress, males reported experiencing a significantly greater impact in terms of punishment and interpersonal relationships compared to females. Females experienced significantly higher levels of learning pressure compared to males. Specific types of perceived life stress were found to be significant predictors of students' mental health status. Moreover, online social support was identified as a significant moderator in the relationship between all types of perceived life stress and mental health, irrespective of gender.

CONCLUSION

Our study findings unveiled two significant aspects: Firstly, the impact of perceived life stress on the mental health of students was identified as a risk factor. Secondly, the role of online social support emerged as a protective factor, particularly in the post-pandemic context. Additionally, gender-specific patterns were observed in these relationships.

The effect of nurses' perceived stress on their work engagement and perceived professional benefit during the routine management of the COVID-19 pandemic

BACKGROUND

In a previous study, more attention has been given to the psychological state of doctors than to that of nurses although the workload, working hours, and patient contact time are generally higher for nurses than doctors. The current status of nurses' perceived stress, work engagement, and perceived professional benefit during the routine management of the Coronavirus disease 2019 (COVID-19) pandemic and how their perceived stress affects the other two variables are topics that merit research attention.

OBJECTIVE

In this study, the status of nurses' perceived stress, work engagement, and perceived professional benefit during the routine management of the COVID-19 pandemic was investigated to explore whether their perceived stress level has any effect on the other two variables.

METHODS

The convenience sampling method was adopted, and 669 nurses from the First People's Hospital of Jingzhou were selected to participate in this study. Questionnaires on perceived stress, work engagement, and perceived professional benefit were used in the survey, and the data were processed using the SPSS 20.0 program for the descriptive statistics, independent sample t-test, analysis of variance.

RESULTS

The total score of the nurses' perceived stress was 18.58±4.37 points. The total scores of their work engagement (43.32±14.01) and perceived professional benefit (140.23±17.75).

CONCLUSION

The nurses' total perceived stress score was at an upper-middle level, and their total work engagement and perceived professional benefit scores were relatively high. Overall, perceived stress has a negative effect on nurses' work engagement and perceived professional benefit. That is, the higher the pressure perception of nurses, the lower the degree of work engagement and perceived professional benefit.

Medical students on the COVID-19 frontline: a qualitative investigation of experiences of relief, stress, and mental health

Objective

During the early stages of the COVID-19 pandemic, medical students were abruptly removed from clinical rotations and transitioned to virtual learning. This study investigates the impact of this shift on students' wellbeing and preparedness for advanced training.

Methods

Through qualitative research methods, including semi-structured interviews, the experiences of medical students working on the COVID-19 frontline were explored.

Results

The comprehensive findings of the study shed light on the profound emotional journey that medical students embarked upon during the relentless public health crisis. Within the chaos and overwhelming demands of the pandemic, medical students discovered a profound sense of purpose and fulfillment in their contributions to the welfare of the community. Despite the personal sacrifices they had to make, such as long hours, limited social interactions, and potentially risking their own health, students reported feelings of relief and gratitude.

Conclusion

Tailored support systems for medical students' wellbeing are crucial for improving healthcare delivery during crises. Medical schools should adopt a holistic curriculum approach, integrating interdisciplinary learning and prioritizing student wellbeing. Recognizing the pandemic's impact on students and implementing targeted support measures ensures resilience and contributes to an improved healthcare system.

The effects of COVID-19 event strength on job burnout among primary medical staff

BACKGROUND

As a global pandemic, The Corona Virus Disease 2019 (COVID-19) has brought significant challenges to the primary health care (PHC) system. Health professionals are constantly affected by the pandemic's harmful impact on their mental health and are at significant risk of job burnout. Therefore, it is essential to gain a comprehensive understanding of how their burnout was affected. The study aimed to examine the relationship between COVID-19 event strength and job burnout among PHC providers and to explore the single mediating effect of job stress and work engagement and the chain mediating effect of these two variables on this relationship.

METHODS

Multilevel stratified convenience sampling method was used to recruit 1148 primary medical staff from 48 PHC institutions in Jilin Province, China. All participants completed questionnaires regarding sociodemographic characteristics, COVID-19 event strength, job stress, work engagement, and job burnout. The chain mediation model was analyzed using SPSS PROCESS 3.5 Macro Model 6.

RESULTS

COVID-19 event strength not only positively predicted job burnout, but also indirectly influenced job burnout through the mediation of job stress and work engagement, thereby influencing job burnout through the "job stress → work engagement" chain.

CONCLUSIONS

This study extends the application of event systems theory and enriches the literature about how the COVID-19 pandemic impacted PHC medical staff job burnout. The findings derived from our study have critical implications for current and future emergency response and public policy in the long-term COVID-19 disease management period.

What is the relationship between health-related quality of life among scoliosis patients and their caregiver burden? A cross-sectional study in China

BACKGROUND

Caregivers play a vital role in the recovery of scoliosis patients, but limited studies evaluate the caregivers' HRQoL and burden in health care. This study aimed to explore the health-related quality of life (HRQoL) of scoliosis patients and their caregivers, and identify the factors influencing caregiver burden in Eastern China.

METHODS

This cross-sectional study was conducted from August 2018 to January 2019 at the Shandong Provincial Hospital, Jinan, China. The HRQoL of scoliosis patients was measured by the Scoliosis Research Society-22r (SRS-22r), five-level EQ-5D (EQ-5D-5L) and Child Health Utility 9D (CHU9D). The caregivers' questionnaires consist of the EQ-5D-5L, WHO-five wellbeing index (WHO-5), 22-item Zarit Caregiver Burden Interview (ZBI-22) and Social Support Rating Scale (SSRS). Spearman correlation coefficients were used to estimate the relationship among caregivers' burden, social support, HRQoL, and SWB. Cohen's effect size (Cohen's d) was used to assess the ZBI-22 total score between different groups. Multiple stepwise hierarchical linear regression models were conducted to assess the associated factors of caregiver burden.

RESULTS

There were 59 scoliosis patients and their caregivers (n = 59) included in the analysis. The mean health state utility of adolescent scoliosis patients (n = 39) was 0.718 (95%CI: 0.654, 0.782) based on CHU9D and adult scoliosis patients (n = 20) was 0.663 (95%CI: 0.471, 0.855) based on EQ-5D-5L. The mean health state utility of male scoliosis patients (0.792/0.667) was higher than females (0.681/0.662) based on CHU9D and EQ-5D-5L (p > 0.05), respectively. The ZBI-22 total score of scoliosis patients' caregivers was 27.86 (SD: 20.59). Scoliosis patients' HRQoL was significantly inversely correlated with caregiver burden, and the HRQoL and subjective wellbeing (SWB) of caregivers were moderately and inversely correlated with caregiver burden. The regression results showed that the patients' age and caregivers' SWB were key characteristics associated with caregiver burden.

CONCLUSIONS

The caregiver burden of adolescent patients was higher than that of adult patients, and the satisfaction rate of adolescent scoliosis patients was higher than that of adult scoliosis patients. Improving the functional state of scoliosis patients and providing appropriate nursing practice education from health professionals would be necessary to effectively improve caregivers SWB and alleviate caregiver burden.

The status of e-learning, personality traits, and coping styles among medical students during the COVID-19 pandemic: a cross-sectional study

Objective

The objective of this study was to explore the learning preferences and habits of medical students during the pandemic home e-learning, and to investigate the incidence of adverse emotions, optimistic character level and coping style. To explore the influencing factors of adverse emotions.

Methods

A cross-sectional survey was conducted in China from March to June 2022. Medical students were recruited from three universities in China, and a questionnaire survey was conducted. The questionnaires consisted of a "e-learning preferences and habits questionnaire", life orientation test questionnaire (LOT-R), and simple coping style questionnaire (SCSQ). Finally, a total of 492 medical students who met the inclusion and exclusion criteria became the research subjects and completed the survey.

Results

A total of 57.7% believed they experienced no adverse emotions during home e-learning. ① During the COVID-19 pandemic, the score of optimistic personality of medical students was (7.25 ± 1.933), and the score of pessimistic personality was (5.82 ± 2.240). The score of positive coping was (21.75 ± 5.379), and the score of negative coping was (11.75 ± 3.611). ② The occurrence of medical students' adverse emotions during e-learning was influenced by "Whether there is a private, quiet space to study", "Degree of knowledge mastery", "Physical discomfort or not", "Keep a regular schedule or not", "Optimistic personality tendency".

Conclusion

This study demonstrates the during home e-learning, most medical students have their own learning equipment and can meet their learning needs. Their favorite mobile device to use is a mobile phone, and their favorite method of teaching is to provide course playback. More than half of medical students believe that they have some inconvenience in conducting research during home e-learning. With regard to teacher's real-time screen, the largest number of medical students support teachers turning on live screens so that they feel like they are interacting with the teacher. The preference for blended teaching is highest among medical students. In general, medical students were highly adaptive of the newest e-learning approach. Based on the statistic analysis, the factors that "Whether there is a private, quiet space to study", "Degree of knowledge mastery", "Physical discomfort or not", "Keep a regular schedule or not", and "Optimistic personality tendency" may be the influencing factors for the occurrence of adverse emotions.

Psychological distress among healthcare students in Poland from COVID-19 to war on Ukraine: a cross-sectional exploratory study

Objectives

Healthcare students went through a rough time in March 2022 due to extreme changes in the educational system (moving from online to stationary learning) and Ukrainian-Russian war circumstances. Our study aims to update knowledge about psychological distress and its impact on healthcare students in Poland after two years of the COVID-19 pandemic, followed by intense and political instability in Europe.

Methods

We conducted a cross-sectional study on healthcare students from Poznan University of Medical Sciences, Poland, from March to April 2022. The questionnaire included subjective retrospective 5-point Likert-scales ratings of anxiety, stress, and depression and self-reported information on various psychological distress predictors.

Results

The anxiety levels at the beginning of the COVID-19 pandemic were higher than in April 2022. There was no significant reduction in stress and depression. Females had higher initial anxiety levels than post-pandemic levels. Higher reported levels of anxiety, stress, and depression were significantly correlated with political instability in Eastern Europe (Spearman r_anxiety = 0.178, r_stress = 0.169, r_depression = 0.154, p ≤ 0.001, respectively). The concern about moving towards online education showed a significant association only with stress level (r_stress = 0.099, p = 0.034). We also observed a positive correlation between anxiety, stress, and depression and deteriorating sleep quality (Spearman r_anxiety,=0.325, r_stress = 0.410, r_depression = 0.440, p < 0.001), the feeling of worsening relationships with family and peers (r_anxiety = 0.325, r_stress = 0.343, r_depression = 0.379, p < 0.001), and the sense of loss of efficient time management (r_anxiety = 0.321, r_stress = 0.345, r_depression = 0.410, p < 0.001).

Conclusion

Throughout the progression of the Ukrainian war and the COVID-19 pandemic, females reported improved (lower levels) levels of anxiety. Nevertheless, the current levels of self-reported anxiety post-pandemic remain alarming, while stress and depression levels remained unchanged. Mental, psychological, and social support activities are required for healthcare students, especially those away from their families. Time management, academic performance, and coping skills in relation to the additional stressors of war and the global pandemic require further research in this group of students.

Associations between the use of psychedelics and other recreational drugs with mental health and resilience during the COVID-19 pandemic

The large-scale disruption to peoples' daily lives during the COVID-19 pandemic provides a context for examining whether use of substances such as psychedelics in a naturalistic (outside of a controlled environment) setting, is associated with better mental wellbeing and resilience relative to those who use other drugs, or who do not use drugs at all. We interrogate data from the Great British Intelligence Test and identify that 7.8% out of N = 30,598 unique respondents used recreational drugs inclusive of psychedelics, cannabis, cocaine, and MDMA during the COVID-19 pandemic. Recruitment materials did not mention drug use would be surveyed, thereby enabling us to model the relationship with mood and resilience in people who had not specifically self-selected themselves for a 'drug' study. We report that people form clusters, characterized by different real-world patterns of drug use, and the majority of psychedelics users also use cannabis. However, a subset of cannabis users do not use psychedelics, enabling a subtractive comparison. Those who primarily used psychedelics and cannabis during the COVID-19 pandemic had worse mood self-assessment and resilience scores compared to those who never used drugs or primarily used cannabis. This pattern was also evident for other recreational drug use clusters, except for those who primarily used MDMA and cannabis, who had better mood but were of too low incidence to have confidence in this estimate. These findings cast light on the significant differences in mental wellbeing between users of different drugs and the non-user population during a global-crisis and call for future research to explore the pharmacological, contextual and cultural variables associated with these differences, their generalisability and causal links with greater precision.

Predictive factors for enhanced community mental health vulnerability in this COVID-19 pandemic era

OBJECTIVE

Explore the mental health status and its influencing factors of local community residents under the post-epidemic era of coronavirus disease 2019 (COVID-19) in China.

METHODS

The basic information scale, self-rating depression scale and self-rating anxiety scale were used to carry out an online questionnaire survey among community residents in Jiangsu Province, China, and the influencing factors of depression and anxiety were analyzed by multivariate logistic regression.

RESULTS

A total of 993 residents completed the mental health survey. It was found that the incidence of depressive and anxiety symptoms was 37.06% and 22.86%. Multivariate logistic regression analysis showed that women [odds ratio (OR) 95% confidence interval (95% CI) = 26.239 (14.743-46.698)], college degree and above [OR (95% CI) = 1.843 (1.085-3.130)] and ordinary residents [OR (95% CI) = 2.222 (1.441-3.425)] were risk factors for depressive symptoms, urban residents had lower risk [OR (95% CI) = 0.655 (0.394-0.829)]. Women [OR (95% CI) = 33.595 (15.812-71.381)] and ordinary residents [OR (95% CI) = 3.017 (1.602-5.680)] were risk factors for anxiety symptoms while the incidence was reduced in professional and technical personnel [OR (95% CI) = 0.271 (0.123-0.597)], workers [OR (95% CI) = 0.383 (0.168-0.876)], soldiers or policemen [OR (95% CI) = 0.200 (0.042-0.961)], married residents [OR (95% CI) = 0.463 (0.230-0.931)] and urban residents [OR (95% CI) = 0.531 (0.251-0.824)].

CONCLUSION

The incidence of symptoms of depression and anxiety among residents was relatively high under the post-epidemic era of COVID-19, which could be affected by various factors.

Social Support Mediates the Relationship Between Coping Styles and the Mental Health of Medical Students

Purpose

This study aimed to explore the impact that coping styles and social support have on the mental health of medical students by constructing a corresponding structural situation model that reveals the complex relationship between these three factors. In doing so, it seeks to help medication students better manage mental health problems.

Patients and Methods

The online study was conducted between March 6, 2021 and May 6, 2021. A total of 318 participants from multiple medical schools were involved. The general information questionnaire, simple coping style questionnaire (SCSQ), perceived social support scale (PSSS) and symptom checklist 90 (SCL-90) were used to collect relevant information from the subjects by snowball sampling. An independent t-test, ANOVA, Pearson correlation coefficient analysis, and intermediary effect analysis were all used to analyze the relevant data and construct the structural equation model.

Results

There was a significant difference in SCL-90 between medical students and national college students (1.78±0.70, P < 0.001), and the positive rate of mental health status was as high as 40.3%. Sleep quality, regular diet, and positive coping style were positively correlated with mental health (P < 0.01), while negative coping styles and total scores of coping style as well as family, friends, and other sources of social support and total scores of social support were negatively correlated with mental health problems (P < 0.01). Positive and negative coping styles have an impact on mental health through the mediating effect of between social support and coping styles, as well as in the direct pathway.

Conclusion

The mental health status of medical students was significantly poor. Medical schools should thus pay close attention to the mental health status of students and encourage them to develop healthy living habits, optimize coping styles, and establish stable sources of social support to improve their psychological wellbeing.

Perceived stress and stress responses during COVID-19: The multiple mediating roles of coping style and resilience

Although many studies have examined the effects of perceived stress on some specific stress responses during the COVID-19, a comprehensive study is still lacking. And the co-mediating role of coping style and resilience as important mediators of stress processes is also unclear. This study aimed to explore the effects of perceived stress on emotional, physical, and behavioral stress responses and the mediating roles of coping style and resilience in Chinese population during the recurrent outbreak of COVID-19 from a comprehensive perspective. 1087 participants were recruited to complete the anonymous online survey including the Perceived Stress Scale, the Stress Response Questionnaire, the Simplified Coping Style Questionnaire and the Emotional Resilience Questionnaire. Pearson's correlation and Hayes PROCESS macro 3.5 model 6 were used in the mediating effect analysis. Results showed that positive coping style and resilience both buffered the negative effects of perceived stress on emotional, physical, and behavioral responses through direct or indirect pathways, and resilience had the strongest mediating effects. The findings urged relevant authorities and individuals to take measures to promote positive coping style and resilience to combat the ongoing pandemic stress and protect public physical and mental health.

An observatory on changes in dreaming during a pandemic: a living systematic review (part 1)

A 'new' way of dreaming has emerged during the pandemic, enhancing the interest of psychological literature. Indeed, during the years of the spread of coronavirus disease 2019 (COVID-19), many studies have investigated dream-related phenomena and dreaming functions. Considering the constant and rapid emergence of new results on this topic, the main aim of this study was to create an 'observatory' on the short- and long-term consequences of the COVID-19 pandemic on dreaming, by means of a living systematic review. The baseline results are presented, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines, to identify and discuss existing studies about dreams and dreaming during the COVID-19 pandemic published until February 2022. Web of Science, Embase, EBSCO, and PubMed were used for the search strategy, yielding 71 eligible papers included in the review. Our results show: (a) a more intense oneiric activity during lockdown; (b) changes in dreaming components (especially dream-recall and nightmare frequency); (c) a particular dreaming scenario ('pandemic dreams'); (d) an alteration of the dreaming-waking-life continuum and a specific function of dreaming as emotional regulator. Findings suggest that monitoring changes in dreaming provides important information about psychological health and could also contribute to the debate on the difficulties of dreaming, as well as sleeping, in particular during and after a period of 'collective trauma'.

Medical students' perceived stress and perceptions regarding clinical clerkship during the COVID-19 pandemic

BACKGROUND

It is important to ensure that both the qualitative and quantitative aspects of clinical education are maintained during the pandemic. Understanding students' views on clinical rotations and the extent of their perceived pandemic-related stress would thus be useful for designing and implementing effective clerkship programs. Therefore, this study aimed to investigate perceived stress and perceptions regarding clinical clerkship among incoming clinical students (third year) and senior clinical students (fourth year) during the COVID-19 pandemic.

METHODS

After completing orientation programs at the beginning of the academic year, we surveyed students on their perceived stress, their general perspectives regarding the appropriate scope of clinical clerkship, and their preferences regarding level of participation in clerkship. We examined the differences in stress and clerkship-related perceptions based on the students' study year and sex using independent t-test, chi-squared test, and Fisher's exact test. In addition, the influences of stress, sex, and study year on clerkship-related perceptions were examined using multinomial logistic regression.

RESULTS

The independent t-test indicated that third-year students experienced lower stress than did fourth-year students. Clerkship-related perceptions also differed significantly between third- and fourth-year students. Multinomial logistic regression analyses on the scope of and participation levels in clinical clerkship revealed that third-year students had significantly lower odds of preferring a limited range of clinical rotations and lower engagement in clerkships compared to fourth-year students.

CONCLUSION

The COVID-19 pandemic has affected clinical education and, consequently, medical students' inclination toward active participation in clinical rotations. It is thus essential to understand students' views and provide them with relevant intra-pandemic educational supports.

Prevalence and Correlates of Likely Major Depressive Disorder among Medical Students in Alberta, Canada

BACKGROUND

Medical students are exposed to multiple factors during their academic and clinical studies that contribute to depression.

AIMS

This study aims to examine the prevalence and correlates of likely major depressive disorder (MDD) among medical students.

METHODS

This study utilized a descriptive cross-sectional design. Data were collected through a self-administered online survey, which included questions on sociodemographic characteristics and likely MDD using the PHQ-9. Data were analyzed using a descriptive, Chi-square test and logistic regression model.

RESULTS

There were 246 medical students who participated in the survey. The majority were females, 155 (65.1%); Caucasian, 158 (66.4%); and in a relationship, 168 (70.5%). The prevalence of likely MDD was 29.1%. Respondents who did not feel supported and respondents who were neutral about their social support, friends, and family, were 11 and 4 times more likely to experience MDD than those who felt well supported (OR = 11.14; 95% CI: 1.14-108.80) and (OR = 4.65; 95% CI: 1.10-19.56), respectively.

CONCLUSIONS

This study suggests a high prevalence of likely MDD among medical students who do not feel they have sufficient social support from friends and family. Social adjustments, including talking to friends and family and participating in leisure activities, could reduce the level of depression among medical students.

Managing the Mental Health of Healthcare Professionals in Times of Crisis: The Aruban COVID-19 Experience

Hospital workers in Aruba have been facing an increased demand for healthcare in the unique setting of a Small Island Developing State (SIDS). This study assessed the impact of the first wave of the SARS-CoV-2 pandemic on the mental health of staff at the major hospital in Aruba, examining the differences between employee groups, with the goal of providing recommendations for targeted support and coping strategies in future crises in a small island setting. Patients and methods: In a mixed-method cohort design, Dr. Horacio E. Oduber Hospital staff were asked to complete a 25-item questionnaire about their concerns and worries, organization of work, and general wellbeing; 24% of the hospital staff filled in the questionnaire (mean age 41 ± 11 years, 79% female). Alongside the needs assessment questionnaire, six focus groups were established to explore staff feelings on specific measures taken by hospital management during the COVID-19 crisis. Results: Questionnaire analysis (n = 231) revealed employees’ concerns about infecting their relatives and their financial stability. In particular, nurses were significantly more concerned than other staff groups. In the wellbeing section of the questionnaire, items regarding future security scored poorest, alongside increased levels of tiredness and nervousness. Focus groups discussions revealed frustrations of the hospital staff with the foreign staff brought in to help during the crisis and a need for better leadership and communication practices from hospital management. Conclusions: Comprehensive and holistic approaches should be implemented by the hospital management to prevent occupational burnout and demoralized work ethics and further emotional exhaustion.

Coping strategies adopted by medical residents in dealing with work-related stress: a mixed-methods study

BACKGROUND

This study was carried out to identify and explore the difference in coping strategies for dealing with stress; adopted by medical residents in surgical and nonsurgical specialties.

METHODS

A mixed methods approach, was chosen for this study. In phase one (quantitative); data were collected by a web-based survey, using a structured questionnaire. This survey was carried out in five major teaching hospitals of Rawalpindi & Muzaffarabad in 2020. Purposive sampling was done and data were analysed using SPSS, recording frequencies and major trends. In phase two (qualitative); six focus group discussions were carried out with 24 participants, using semi-structured questions and prompts. Convenient sampling was done from the cohort of phase 1. These focus group discussions, explored the various coping strategies adopted by medical residents. Later, the data were analysed manually for development of codes, sub-themes and themes.

RESULTS

Out of 250 (100%) participants, 146 (58%) participants responded to the online survey. Surgical residents had a higher response rate (60%, n = 87) than nonsurgical residents. Moreover, female participation (54%, n = 79) was greater than male participation (46%, n = 67). The Mann-Whitney U test was statistically significant only for seeking medical advice to cope with stress (P = .029). There was no statistically significant difference found between the coping strategies, employed by medical residents. In focus group discussions, female involvement was more (58% n = 14) than their counterparts. Four main themes were developed after data analysis: self-regulation, tailor-made strategies, educational focus and support system. Finally, minor differences were obtained qualitatively; like, socializing is preferred by surgical residents whereas, spiritualism is chosen by nonsurgical residents.

CONCLUSION

Quantitatively, no significant differences were found between the coping strategies of medical residents, against work-related stress. However, minor differences were obtained qualitatively due to difference in job demands and level of burnout between these two specialities.

The impact of psychological capital on turnover intention among Chinese nurses: A moderated mediation model

AIMS

This study examined how the mediating effect of psychological distress and the moderating role of social support influence the connection between psychological capital and turnover intention among Chinese nurses.

BACKGROUND

Nurses play a crucial role in medical and health services, but turnover intentions are common among them.

METHODS

A cross-sectional survey was conducted involving 4,865 nurses in China. The Chinese Psychological Capital Questionnaire, Depression, Anxiety and Stress Scale, Social Support Rating Scale, and Turnover Intention Scale were used to gather data. Bootstrap and simple slope methods were used to test the mediating effect of psychological distress and the moderating effect of social support.

RESULTS

Psychological capital had a significant direct impact on turnover intention among nurses (B = -0.040, t = -10.032, P < 0.001). Psychological distress had a mediation effect of 46.89% between psychological capital and turnover intention. Moreover, social support had a moderating role in the relationship between psychological distress and psychological capital and between psychological distress and turnover intention.

CONCLUSIONS

Psychological capital correlated negatively with psychological distress and turnover intention and indirectly influenced turnover intention through psychological distress. Social support moderated the first and second half of the path in the mediating model of psychological distress. These findings have implications for early intervention for and the prevention of turnover intention in nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

This study's findings can inform the design of effective nurse support programs to reduce the impact of psychological distress on turnover intention among nurses.

Association Between Social Support and Perceived Stress: A Cross-Sectional Study on Staffs of the Epidemic Prevention During the Covid-19 Epidemic in China

Background

The Coronavirus Disease 2019 (COVID-19) lockdown considerably affects people's life in China, both physically and mentally. Staffs of the epidemic prevention and control in the community have played an irreplaceable role during community lockdown period in Wuhan. However, few studies have focused on their health status during epidemic prevention. This study aimed to appraise the available evidence of health conditions of them and explore the influencing factors.

Method

Used a multistage sampling method, we conducted a survey in staffs of the epidemic prevention and control in the community (N = 503). Descriptive analysis was used to characterize the respondents. T-test and analysis of variance were for group differences analysis. Confirmatory factor analysis (CFA) was used to verify the scale validity, correlation analysis and pathway analysis and Structural equation model (SEM) was used to study the relationship between stress perception, social support, mental resilience and sleep quality. Statistical analysis was performed with SPSS 26.0, R version 4.1.3 and Mplus 8.3.

Results

The mean Perceived Stress Scale (PSS) score of the respondents was 13.28 ± 7.31 and 51.1% had higher PSS score than the normal. In the absence of social support, people's sleeping quality and psychological resilience may decrease, their perceived stress may elevate and compromise mental health correspondingly. Social support could affect perceived stress directly, while Sleep quality and psychology resilience played significant partial mediating roles in social support affecting perceived stress. The mediating effects accounted for 50.8% of the total.

Conclusion

Staffs of the epidemic prevention and control in the community suffered from poor sleep quality and high level of stress perception. Establishment of good social support may effectively reduce their stress and this effect is mediated by sleep quality and psychological resilience. Physical health status would affect the staffs' mental health and they more attention should be paid to those with poor physical health.

Mental health status of medical staff in Xinjiang Province of China based on the normalisation of COVID-19 epidemic prevention and control

INTRODUCTION

The 2019 coronavirus disease (COVID-19) pandemic has burdened and threatened the psychological health of people around the world, especially those of front-line medical staff. This study aimed to explore the mental-health status and its associated factors amongst the medical workforce of Xinjiang province under the normalisation of the COVID-19 epidemic prevention and control.

METHODS

A total of 408 medical staff were recruited from February 20 to March 10, 2021. Symptom Checklist 90 (SCL-90) scale, Social support Scale, and Simplified Coping-Style Questionnaire were applied to assess their mental-health status and stress-coping tendency. Descriptive analyses, welch's T-test, chi-square test, and binary logistic regression were used to analyse the data.

RESULTS

The prevalence of mental-health problems was 20.25% (80/395) amongst the surveyed medical staff, and their total symptom mean score (1.31 ± 0.40) was lower than that of the general population (1.44 ± 0.43). Logistic regression analysis revealed that nurse, individual with poor health condition, those who lived with their elderly parents at home, those receiving less social support, and those with a negative stress-coping style were more likely to show psychological problems.

CONCLUSION

More attention should be paid to the mental state of the medical workforce during the COVID-19 pandemic. The government and professional institutes should facilitate social supportive activities and essential counselling services to help strengthen the psychological resilience of medical staff. Additionally, it is necessary for health administration committee and hospitals to make COVID-19 prevention practice guides and risk communication principles for improving the mental health of the front-line medical staff.

Depressive Symptoms Among Children and Adolescents in China During the Coronavirus Disease-19 Epidemic: A Systematic Review and Meta-Analysis

Background

The Coronavirus Disease-19 (COVID-19) pandemic negatively impacts mental health. Some published studies have investigated the prevalence of depression among children and adolescents in China during the pandemic. However, the results vary widely. We aimed to systematically analyze and estimate the prevalence of depressive symptoms and attempted to reveal the reasons for prevalence variety in previous studies.

Methods

Published studies were searched in PubMed, Embase, Cochrane Central, the Chinese Scientific Journal Database (VIP Database), China National Knowledge database (CNKI), and the WanFang database from December 2019 to May 2021. The quality of all included studies was assessed by the Joanna Briggs Institute (JBI) checklist and the American Agency for Health Care Quality and Research's (AHRQ) cross-sectional study quality evaluation items. Meta-analysis was performed using random-effects modeling.

Results

Of the 1,708 references screened, 13 related reports that involve 41,729 participants were included. The results suggested that the pooled prevalence of depressive symptoms among Chinese children and adolescents during the COVID-19 epidemic was 28.6%. Subgroup analyses showed that the pooled prevalence was highest among the studies using the Patient Health Questionnaire (PHQ)-9 (46.8%) and lowest among these using Depression Self-Rating Scale for Children (DSRSC) (11.4%). All studies using PHQ-9 set the cutoff at 5 points instead of 10. The pooled prevalence of studies that include primary school students was lower (16.5%) than that of studies excluding primary school students (39.1%).

Conclusion

The meta-analysis suggests that depressive symptoms were relatively prevalent among Chinese children and adolescents during COVID-19, especially among the secondary school students. The suitable screening tools and cutoff should be carefully chosen in the survey.

Physician challenges and supports during the first wave of the COVID-19 pandemic: A mixed methods study

INTRODUCTION

During the COVID-19 pandemic, physicians encountered significant COVID-19-related negative experiences and psychological distress in both their personal and professional lives. To understand the factors that negatively impact physician well-being, a number of studies have pointed to multiple work system factors such as excessive workload and workflow interruptions. In addition, studies have shown that positive interpersonal relationships that provide social support may also serve as a buffering role against psychological distress. The aim of our study explores the challenges and sources of support for physicians relative to mental health symptoms.

METHODS

In this study, We used a cross-sectional study design with a convergent parallel mixed method approach combining both qualitative and quantitative data collected in parallel from a self-report questionnaire immediately following the first wave of COVID-19. The aim of our study explores the challenges and sources of support for physicians relative to mental health symptoms.

RESULTS

Of the 457 physicians in the study, the most frequently potential negative occupational experiences were, "Being at risk of contracting COVID-19 from patients/co-workers" (90.5%) and "Contact with distressed family members who cannot be with a loved one" (69.5%). We identified five common themes for main sources of social support (e.g. emotional support from family/friends) and six themes for challenges (e.g., work-related demands exacerbated by the pandemic).

DISCUSSION

Our study highlights COVID-19 and other pandemic-related challenges that negatively impacted the mental health of physicians. Interventions that provide targeted organizational supports (e.g. sufficient PPE and child support), as well as specific sources of support (e.g. family and emotional), can attenuate those challenges and stressors experienced during a pandemic.

Anxiety, depression, psychological stress and coping style in medical postgraduates in southeastern China when restricted to commuting between the campus and hospital during the COVID-19 pandemic

BACKGROUND

As the COVID-19 epidemic was gradually brought under control, a new autumn semester began in 2020. How was the mental health of postgraduates as they experienced quarantine at home, only commuting between the school and hospital?

METHODS

The research was conducted in a cross-sectional online survey in October 2020. The data were collected from 1,645 medical postgraduates (master's and doctoral students) by using the demographic information questionnaire, the Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS), the Questionnaire on Psychological Stressors of Postgraduates (QPSP), the Simplified Coping Style Questionnaire (SCSQ) and the Social Support Rate Scale (SSRS). One-way ANOVA and Pearson correlation were used to explore the relationships among anxiety, depression, psychological stressors, social support and coping style. Structural equation modeling (SEM) was conducted to assess the mediation model.

RESULTS

Among the total of 1,645 medical postgraduates, 21.6% (n = 356) had self-rated depression symptoms, and 9.4% (n = 155) had self-rated anxiety symptoms. The main disturbances they experienced were employment, academic and interpersonal pressure. The master of third grade students had the highest employment pressure, and the master of second grade students had the highest academic and interpersonal pressure. Negative coping played a negative mediating role and social support played a positive mediating role in the relationships between perceived stress and anxiety (β = 0.027, P < 0.01; β = 0.124, P < 0.01) and depression (β = 0.016, P < 0.01; β = 0.193, P < 0.01).

CONCLUSION

Medical postgraduates in China restricted to studies on campus and in the hospital experienced psychological distress. Our results suggest that providing employment and learning guidance, while strengthening social support and guiding positive coping may be effective at improving the mental health of the medical graduate students, mediating their perceived stress and negative emotions.

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

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

Changing resuscitation strategies during a pandemic: lessons from the consecutive surges in New York and global challenges

PURPOSE OF REVIEW

To provide a framework for resuscitation of COVID-19 critical illness for emergency and intensive care clinicians with the most up to date evidence and recommendations in the care of COVID-19 patients in cardiac arrest or in extremis.

RECENT FINDINGS

Performing cardiopulmonary resuscitation (CPR) on COVID-19 patients requires the clinicians to adopt infection mitigation strategies such as full personal protective equipment, mechanical chest compression devices, and restricting the number of people present during the resuscitation. The time of intubation is a subject of ongoing research and clinicians should use their best judgment for each patient. Clinicians should prepare for CPR in prone position. Particular attention should be given to the psychological well-being of the staff. Point of care ultrasound has proved to be an invaluable diagnostic tool in assessing ventricular dysfunction and parenchymal lung disease. Although novel therapies to supplant the function of diseased lungs have shown promise in select patients the evidence is still being collected. The end-of-life discussions have been negatively impacted by prognostic uncertainty as well as barriers to in person meetings with families.

SUMMARY

The resuscitation of critically ill COVID-19 patients poses new challenges, but the principles remain largely unchanged.

Does Perceived Stress of University Students Affected by Preferences for Movie Genres? an Exploratory Cross-Sectional Study in China

This study aims to explore whether different preferences for movie genres were related to different perceived stress of college students. An online questionnaire was designed and it was filled out by 1,549 students voluntarily. The 10-item perceived stress scale (PSS-10) and multinomial logistic regression were used to access the perceived stress and the association between the movie preference genres. Over 90% of participants had mild to serious levels of stress. Differences were found between participants with different stress perception states in terms of smoking history, active exercise, and sleep duration (p < 0.05). The participants who showed a preference for suspense movies more probably had lower stress [relative risk ratio (RRR)1 = 0.34, RRR2 = 0.26, p < 0.05], while students who showed preferences for crime film and disaster film more probably had higher stress (RRR = 2.03, p < 0.05, RRR = 3.15, p < 0.05). And the significant gender gap in different film genre preferences was observed in this study (p < 0.05). The males who showed preference for horror movies were more probably to have moderate stress (OR = 3.68, p < 0.05), and females who showed a preference for disaster movies were more probably to have high stress (OR = 3.27, p < 0.05). The perceived stress of Chinese university students is high after 1.5 years of coronavirus disease (COVID-19) pandemic. The personal preferences for certain film genres were significantly associated with perceived stress. As different film genre preferences, such as the preference for disaster, crime, and horror, are associated with high perceived stress, it may turn out to be useful to pay more attention to an individual's film viewing. The teachers need to be concerned with the media usage history and preferences of their students and may advise students with high-level stress to avoid potentially harmful media content.

Impact of COVID-19 on the Mental Health of Medical Students in Portugal

(1) Background: The purpose of this article is to assess the impact of the COVID-19 pandemic on the mental health of medical students in Portugal in the period after returning to face-to-face classes during the COVID-19 pandemic, in the 2020/2021 academic year. (2) Methods: We conducted an observational, descriptive, and cross-sectional study, between December 2020 and February 2021 with a representative sample of Portuguese medical students (n = 649), applying an anonymous questionnaire which was composed by a sociodemographic characterization, The Brief Symptoms Inventory-18, The Fear of COVID-19 Scale and the Negative Impact Assessment Scale. For statistical processing, Statistical Package for Social Sciences (SPSS ©) was used. (3) Results: 65.3% of participants said that self-perceived relevant anxiety symptoms, and around 10% said that they had a physical or a mental illness diagnosis. Significant differences (p < 0.05) were found for Fear of COVID-19, Somatization, Anxiety and Overall Mental Health, indicating that women, students from the 1st and last years of training had higher scores. Age, year of training, Fear of COVID-19 and Negative Impact of COVID-19 were significant predictors of overall mental health. (4) Conclusion: In our sample of Portuguese medical students, age, year of training, but mostly fear of COVID-19 and the negative impact of COVID-19 contributed to mental health symptoms.

Impact of Stress on Menstrual Cyclicity During the Covid-19 Pandemic: A Survey Study

Background: The Covid-19 pandemic has introduced acute and persistent psychosocial stressors for many individuals, with emerging gender differences that suggest women may be at greater risk for poorer mental health outcomes. This may have unintended consequences for women's overall health and well-being, including disruptions to reproductive function as elevated stress is often associated with menstrual cycle irregularities. The objective of this study was to determine if and how the Covid-19 pandemic and its related stressors have impacted women's menstrual cyclicity. Materials and Methods: An online survey instrument designed to capture self-reported information on menstrual cycle changes and perceived stress levels was distributed between July and August 2020. A total of 210 women between the ages of 18-45 years met stringent inclusion and exclusion criteria and completed the survey. Results: Of the 210 respondents, more than half (54%) reported changes in their menstrual cycles. These included changes in menstrual cycle length (50%), the duration of menses (34%), and changes in premenstrual symptoms (50%). Respondents with high perceived stress scale (PSS) scores during Covid were more likely to experience a longer duration of menses (p < 0.001) and heavier bleeding during menses (p = 0.028) compared with those with moderate Covid PSS scores. Conclusions: By uncovering a trend in increased menstrual cycle irregularities during the early months of the Covid-19 pandemic, this study contributes to our understanding of the implications that the pandemic may have on women's reproductive health.