Impact of the first wave of the COVID-19 pandemic on French Health students

Stress, physical activity, and mindfulness practices among youth amidst COVID-19

Introduction

The COVID-19 pandemic has exacerbated stress and anxiety among young people, particularly university students, impacting their mental well-being and daily life. Given the rise in social isolation and economic uncertainty, the adoption of mindfulness practices such as sophrology, meditation, and yoga becomes essential for improving their mental health. This study aims to evaluate the impact of these practices on stress levels and their effect on engagement in physical activities among youths.

Method

This study employed a mixed methods design to assess the impact of different wellness and mindfulness practices on stress levels and physical activity (PA) engagement among university students. Quantitative data were gathered electronically from 218 students at the University of Rouen and the university of Paris-Cité through validated questionnaires, including custom tools on sports and mindfulness practices and the Perceived Stress Scale (PSS). The sample consisted mainly of young adults aged 18 to 35, with a majority of 170 female and 48 male participants. Qualitative insights were gathered through semi-structured interviews with three directors of the university's sports and physical activities department (SUAPS), as well as four wellness program instructors. Data analysis involved statistical techniques using Statistical Analysis System (SAS) software for quantitative data, while qualitative data were analyzed thematically using Sphinx software, a tool for textual analysis. Ethical approval for the study was obtained, and confidentiality of all participants was maintained throughout the research.

Results and conclusion

The COVID-19 pandemic had significant effects on French university students' PA, mental health, and stress levels. Lockdowns led to a decline in sports practices for many, while others adapted by increasing their engagement in fitness and wellness practices. The majority of participants (64.68%) reported moderate levels of stress. A significant correlation was found between motivations for mental health support and stress management, and higher levels of stress (p = 0.0000 and p = 0.0024, respectively). Regular participation in wellness activities was associated with lower stress (p = 0.0193). The findings reinforce the idea that incorporating wellness practices into educational environments can strengthen students' mental resilience and overall well-being, equipping them with essential tools to effectively cope with future stressors.

Health Behaviours and the Quality of Life of Students of Medical Fields during the COVID-19 Pandemic

(1) Background: Social distancing and closing down public spaces associated with learning, leisure and physical activity limited the spread of COVID-19. These measures had an impact not only on the economy and education but also on health behaviours and the quality of life of individuals affected by the restrictions. The aim of this study was to identify the role of health behaviours in the perception of the quality of life of students during the COVID-19 pandemic. (2) Methods: This study was conducted among 796 students of the University of Warmia and Mazury in Olsztyn in the first quarter of 2022. Subgroup 1 consisted of students at the Public Health School (n = 428; 53.8%) and subgroup 2 consisted of students belonging to the Faculty of Veterinary Medicine (n = 368; 46.2%). The diagnostic survey method was applied, and an original survey questionnaire, the Health Behaviour Inventory and the Quality of Life Questionnaire (WHOQoL-Bref version) were used. (3) Results: The largest contribution to the prediction of quality of life of students in subgroup 1 was made by a positive mental attitude related to avoiding too strong emotions, which explained 19% of the result variability in the somatic domain (ßeta = 0.24; R2 = 0.21), 20% of the result variability in the psychological domain (ßeta = 0.36; R2 = 0.20), 16% of the result variability in the social domain (ßeta = 0.52; R2 = 0.17) and 17% of the result variability in the environmental domain (ßeta = 0.19; R2 = 0.19). Moreover, in subgroup 2, a predominantly positive mental attitude significantly predicted quality of life in the somatic domain, explaining 23% of the result variability (ßeta = 0.24; R2 = 0.26), while it explained 25% of the result variability in the psychological domain (ßeta = 0.47; R2 = 0.25), 16% of the result variability in the social domain (ßeta = 0.46; R2 = 0.17) and 21% of the result variability in the environmental domain (ßeta = 0.38; R2 = 0.23). (4) Conclusions: Positive correlations between health behaviours and the quality of life among the study participants were determined. Health-promoting behaviours had a beneficial impact on the respondents' quality of life during the COVID-19 pandemic. The category of health behaviours described as a positive mental attitude was an important predictor for the participants' quality of life.

Occupational, academic, and personal determinants of wellbeing and psychological distress in residents: results of a survey in Lyon, France

Introduction

The mental health of residents is a growing significant concern, particularly with respect to hospital and university training conditions. Our goal was to assess the professional, academic, and psychological determinants of the mental health status of all residents of the academy of Lyon, France.

Materials and methods

The Health Barometer of Lyon Subdivision Residents (BASIL) is an initiative which consists in proposing a recurrent online survey to all residents in medicine, pharmacy, and dentistry, belonging to the Lyon subdivision. The first of these surveys was conducted from May to July 2022. Participants should complete a series of validated questionnaires, including the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and the Kessler Psychological Distress Scale (K6), respectively, and ad-hoc questions assessing their global health and hospital and academic working conditions. A Directed Acyclic Graph (DAG) analysis was conducted prior to multivariable analyses, to explore the determinants associated with low wellbeing (WEMWBS <43) and high psychological distress (K6 ≥ 13).

Results

A total of 904 residents (response rate: 46.7%) participated in the survey. A low level of wellbeing was observed in 23% of participants, and was significantly associated to job strain (OR = 2.18; 95%CI = [1.32-3.60]), low social support (OR = 3.13; 95%CI = [2.05-4.78]) and the experience of very poor university teaching (OR = 2.51; 95%CI = [1.29-4.91]). A high level of psychological distress was identified for 13% of participants, and associated with low social support (OR = 2.41; 95%CI = [1.48-3.93]) and the experience of very poor university teaching (OR = 2.89, 95%CI = [1.16-7.21]).

Conclusion

Hospital working conditions, social support, and the perception of teaching quality, were three major determinants of wellbeing and psychological distress among health profession residents. Demographic determinants, personal life and lifestyle habits were also associated. This supports a multilevel action in prevention programs aiming to enhance wellbeing and reduce mental distress in this specific population and local organizational specificities.

Factors related to increased alcohol misuse by students compared to non-students during the first Covid-19 lockdown in France: the Confins study

BACKGROUND

The closure of bars and lockdowns related to the Covid-19 pandemic changed alcohol use levels in France during the spring of 2020. We wondered whether this sudden cessation of social interactions impacted students more than non-students and what factors specific to students would explain the increase in alcohol misuse. The aims of this study were to compare self-reported changes in alcohol misuse (alcohol intake and binge-drinking frequency) during the first Covid-19 lockdown from March 17 to May 10, 2020, between French students and non-students and describe factors associated with this alcohol misuse in each subgroup.

METHODS

Data collected in the Confins study from April 8 to May 10, 2020, were used in cross-sectional analyses stratified by student status. Multiple logistic regression was performed to estimate the association between self-reported increase in alcohol intake or binge-drinking frequency (at least six drinks of alcohol on one occasion) and demographic, socioeconomic, and clinical factors, as well as conditions associated with the Covid-19 pandemic. The population-attributable fraction was then used to estimate the contribution of identified risk factors to increased alcohol misuse in students and non-students.

RESULTS

Among both students and non-students, a self-reported decrease or no change in alcohol intake or binge-drinking was more common than an increase. However, the risk factors explaining an increase in alcohol intake differed among students (≥ 25 years old, not working or studying in the health field, and having suicidal ideation during the last 7 days) and non-students (having a medical diagnosis of mental disorders). The risk factors explaining an increase in binge-drinking frequency were similar in the two subgroups (being a tobacco smoker before lockdown and not practicing any physical activity during the last 7 days), except suicidal thoughts, which was a risk factor for alcohol misuse specific to students.

CONCLUSIONS

These results highlight the vulnerability of certain French students to alcohol misuse and the necessity of combining both mental health and substance use-related screening in the student population.

National cross-sectional survey on psychological impact on French nursing homes of the first lockdown during the COVID-19 pandemic as observed by psychologists, psychomotor, and occupational therapists

Objectives

The main objective was to explore the psychological impact of the French lockdown during the first wave of the COVID-19 pandemic on nursing home residents, their relatives, and healthcare teams, as observed by mental health professionals.

Design

A national online cross-sectional survey was conducted from May 11 to June 9, 2020.

Setting and participants

Respondents were psychologists, psychomotor therapists, and occupational therapists (mental health professionals).

Results

A total of 1,062 participants responded to the survey, encompassing 59.8% psychologists, 29.2% occupational therapists, and 11% psychomotor therapists. All mental health professionals felt fear (76.1%), fatigue and exhaustion (84.5%), and inability to manage the emotional burden (78.4%). In nursing homes with COVID-19 cases, residents felt significantly sadder (83.2%), more anxious (65.0%), experienced more anorexia (53.6%), resurgence of traumatic war memories (40.2%), and were more often disoriented (75.7%). The suffering of relatives did not vary between nursing homes with and without COVID-19 cases. The nursing staff was heavily impacted emotionally and was in need of psychological support particularly when working in nursing homes in a low COVID-19 spread zone with COVID-19 cases (41.8 vs. 34.6%).

Conclusion and implications

Primary prevention must be implemented to limit the psychological consequences in the event of a new crisis and to prevent the risk of psychological decompensation of residents and teams in nursing homes.

Oral manifestations in patients with coronavirus disease 2019 (COVID-19) identified using text mining: an observational study

Text mining enables search, extraction, categorisation and information visualisation. This study aimed to identify oral manifestations in patients with COVID-19 using text mining to facilitate extracting relevant clinical information from a large set of publications. A list of publications from the open-access COVID-19 Open Research Dataset was downloaded using keywords related to oral health and dentistry. A total of 694,366 documents were retrieved. Filtering the articles using text mining yielded 1,554 oral health/dentistry papers. The list of articles was classified into five topics after applying a Latent Dirichlet Allocation (LDA) model. This classification was compared to the author's classification which yielded 17 categories. After a full-text review of articles in the category "Oral manifestations in patients with COVID-19", eight papers were selected to extract data. The most frequent oral manifestations were xerostomia (n = 405, 17.8%) and mouth pain or swelling (n = 289, 12.7%). These oral manifestations in patients with COVID-19 must be considered with other symptoms to diminish the risk of dentist-patient infection.

The prevalence and risk factors of mental problems in medical students during COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

This meta-analysis and systematic review aimed to evaluate the global prevalence and risk factors of mental problems (i.e., depression, anxiety, stress, sleep disorder, posttraumatic stress disorder (PTSD), burnout, psychological distress, and suicidal ideation) among medical students during the COVID-19 pandemic.

METHOD

We searched PubMed, Embase, Web of Science, psycARTICLES, PsycINFO, CNKI, and Wan Fang for studies on the prevalence of mental problems among medical students from January 1, 2020, to April 1, 2022. The pooled prevalence was calculated by random-effect models. We performed a narrative review to identify the risk factors.

RESULTS

The meta-analysis included 201 studies (N = 198,000). The prevalence of depression (41 %, 95 % CI, 37-45 %,), anxiety (38 %,95 % CI, 34 %-42 %), stress (34 %, 95 % CI, 27 %-42 %), sleep disorder (52 %, 95 % CI, 44 %-60 %), psychological distress (58 %, 95 % CI, 51 %-65 %), PTSD (34 %, 95 % CI, 22 %-46 %), suicidal ideation (15 %, 95 % CI, 11 %-18 %) and burnout (38 %, 95 % CI, 25 %-50 %) was high. The major risk factors were being female, being junior or preclinical students, exposure to COVID-19, academic stress, psychiatric or physical disorders history, economic trouble, fear of education impairment, online learning trouble, fear of infection, loneliness, low physical activity, low social support, problematic internet or smartphone use, and young age.

LIMITATIONS

Most studies were cross-sectional. Few studies provided a reasonable response rate, suggesting potential selection bias.

CONCLUSIONS

The study demonstrated a high prevalence and risk factors for mental problems during COVID-19, calling for mental health services. Our findings are valuable for college and health authorities to identify high-risk students and provide targeted intervention.

A scoping review of the literature on the impact of the COVID-19 quarantine on the psychological wellbeing of medical students

BACKGROUND

The goal of this study was to identify the nature and extent of the available published research on the impact of social isolation, on the psychological wellbeing of medical students, who had to quarantine due to the COVID-19 pandemic.

METHODS

Design. Scoping review.

SEARCH STRATEGY

The PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews), guideline, was used to structure this study. A search strategy was carried out across six bibliographic databases. PubMed, Embase, ERIC, Scopus, Cochrane Database of Systematic Reviews and Web of Science. The following search terms were used, "medical student*" AND "impact" AND "quarantine" AND "COVID-19". Searches were initially confined to articles published (excluding conference abstracts) between 1 January 2019- 21 August 2021 but updated in September 2022 with the original search terms expanded to include "isolation" or "lockdown" as well as "quarantine" and the period of search extended to 21 August 2022. A search of secondary references was conducted. Data from the selected studies were extracted, and the following variables recorded; first author and year of publication, country of study, study design, sample size, participants, mode of analysing impact of quarantine from COVID-19 on mental health and results of the studies.

RESULTS

A total of 223 articles were identified in the original search in 2021 and 387 articles, in the updated search in 2022. Following the exclusion of duplicates and application of the agreed inclusion and exclusion criteria, 31 full-text articles were identified for the final review, most of which were cross sectional studies. Sample sizes ranged from 13 to 4193 students and most studies used a variety of self-administered questionnaires to measure psychological wellbeing. Overall, 26 of the 31 articles showed that quarantine had a negative impact on the psychological well-being of medical students. However, two studies showed no impact, and three studies showed an improvement.

CONCLUSION

The evidence is growing. Quarantine because of the COVID-19 pandemic may have had a negative impact on the psychological wellbeing of medical students, but this is not certain. There is therefore a need for more studies to further evaluate this research question.

COVID-19 pandemic's impact on French Health Students: A cross-sectional study during the third wave

BACKGROUND

COVID19 pandemic had a huge impact on global mental health. Health students, because of their age and status, are a more at-risk population. National survey during the first wave already found high levels of psychological distress.

OBJECTIVE

This nationwide study aimed to assess health's student mental health during the third wave in France.

METHODS

We did an online national cross-sectional study, which addressed all health students from April 4th to May 11th 2021. The questionnaire included sociodemographic and work conditions questions, Kessler 6 scale, and numeric scales.

RESULTS

16,937 students answered, including 54% nurse and 16% medical students. Regarding K6 scale, 14% have moderate (8-12) and 83% high (≥13) level of psychological distress. In multivariate analysis, being a man (OR = 0.54, 95% CI [0.48; 0.60], p < 0.001) and not living alone (OR = 0.71, 95% CI [0.62; 0.82], p < 0.001), are associated with a reduced risk of psychological distress. Not having the ability to isolate themselves (OR = 1.58, 95% CI [1.39; 1.81], p < 0.001), and having low (OR = 2.31, 95% CI [2.08; 2.56], p < 0.001) or important (OR = 4.58, 95% CI [3.98; 5.29], p < 0.001) financial difficulties are associated with an increased risk of psychological distress.

LIMITATIONS

The response rate was low regarding the target population (300,000 health students).

CONCLUSION

Compared to the first national survey, we noticed mental health deterioration. Psychological distress (83% high level versus 21%), substance use (21% versus 13%), and psychotropic treatment use (18% versus 7.3%) hugely increased. These results highlighted the need to increase support actions for health students.

Purpose in Life and Character Strengths as Predictors of Health Sciences Students' Psychopathology During the COVID-19 Pandemic

BACKGROUND

Health sciences students experience high levels of psychopathology conditioned by psychosocial, financial, and academic factors. However, COVID-19 pandemic might even have worsened their mental health. Thus, this article aims to evaluate how the exposure to COVID-19 pandemic has affected these students' mental health and to determine the effect of purpose in life and character strengths on this psychopathology.

METHODS

A cross-sectional study of unpaired samples was carried out in Spain during the first and third waves of the pandemic in 70 medical and 52 nursing students.

RESULTS

The risk factor that most determined the appearance of anxiety was the exposure of family and friends to COVID-19 (OR = 4.01; p < 0.001), while the most protective factors were honesty (OR = -1.14; p = 0.025) and purpose in life (OR = -0.18; p < 0.001). Purpose in life also protected against the onset of depression and total psychopathology. In addition, we observed studying medicine was a protective factor against total psychopathology while being a nursing student was associated with high levels of acute stress.

CONCLUSION

Exposure of the students' family and friends to SARS-CoV-2 favored the appearance of symptoms of anxiety. Honesty had a preventing role in the onset of anxiety and a high purpose in life was protective against the appearance of anxiety, depression, and total psychopathology.

Détresse et résilience des étudiants en médecine de Paris Saclay lors de la première vague de la pandémie de COVID-19

Les étudiants en médecine sont exposés à des risques psychosociaux responsables d’un plus haut niveau d’anxiété, de dépression, de syndrome d’épuisement professionnel que la population française de même âge. Lors de la première vague de la pandémie COVID-19 en France, un certain nombre d’entre eux se sont mobilisés pour venir en aide aux hôpitaux débordés. Au travers de cette expérience, ils ont rapporté une détresse psychologique modérée, laquelle était nuancée par différentes capacités de résilience. Cette étude explore les ressources et les difficultés d’étudiants en médecine de l’université Paris-Saclay (France) engagés lors de la première vague dans les services hospitaliers. Si l’exposition à la mort et les conditions de soins dégradés ont pu impacter leurs motivations à étudier, l’expérience a également permis à certains d’entre eux d’acquérir des compétences complémentaires, de participer à l’effort collectif, d’éviter le confinement généralisé et d’aider les autres soignants. La prise en compte de ces facteurs de résilience au regard des difficultés rencontrées (exacerbées par la crise sanitaire, mais qui existaient déjà avant cette dernière) permet de nourrir la réflexion sur l’amélioration de la qualité de vie des étudiants en médecine dans le système universitaire médical français.