E-learning: Depression, anxiety, and stress symptomatology among Lebanese university students during COVID-19 quarantine

Do academic advising and levels of support affect nursing students' mental health? A cross-sectional study

AIM

The current study aimed to identify the association between social support, academic advising and mental health disorders among nursing students.

BACKGROUND

Stress and workload can trigger multiple mental health disorders, especially for nursing students. Thus, academic advising and counselling help support students with academic and mental health problems.

DESIGN

This cross-sectional study utilized online questionnaires in Egypt and Saudi Arabia.

METHODS

Multidimensional Scale of Perceived Social Support (MSPSS), Patient Health Questionnaire (PHQ-4) and the Student Academic Advising and Counseling Survey (SAACS) were utilized to measure social support, depression and anxiety and evaluation of academic advising and counselling services, respectively.

RESULTS

The study included 1134 nursing students (mean age of 20.3 years). Students with higher academic advising satisfaction were 37% less likely to experience depression (OR 0.63, 95% CI 0.46-0.85) and mental disorders (OR 0.68, 95% CI 0.50-0.94). Moderate family social support was associated with lower depression (OR 0.58, 95% CI 0.37-0.93) and mental disorders (OR 0.55, 95% CI 0.33-0.92).

CONCLUSION

Academic advising and social support can mitigate mental health disorders among nursing students. These findings will help nurses and post-secondary providers develop strategies to support nursing students during difficult times.

Depression, Anxiety and Poor Sleep Quality are Associated with Chronotype and Financial Wellness in University Students

Background: Evidence suggests the importance of a person's chronotype in predicting various aspects of an individual's physical and mental health. While the effect of depression on sleep is well established, the impact of a person's specific sleep timing and chronotype on the prevalence of both depression and anxiety has yet to be fully understood, especially among university students, vulnerable to mental health problems. In addition, other factors also seem to influence the occurrence of depression and anxiety among students as well as their quality of sleep, one of which being the students' financial wellness. The objective was to evaluate the association between chronotype and the severity and prevalence of depression among Lebanese university students, while also taking into account the possible connection between chronotype and financial wellness and both anxiety and sleep quality. Methods: This cross-sectional study was conducted between December 2021 and February 2022; 330 Lebanese university students was included (mean age 21.75 ± 2.43; 67.3% females). Results: The majority of the Lebanese university students in our sample were found to have an intermediate typology (63.0%), followed by the evening typology, which appeared to constitute 28.2% of the sample, while only 8.8% possessed a morning typology. In this study, having an intermediate or evening typology compared to a morning one was significantly associated with higher depression and worse sleep quality. In addition, having an evening chronotype compared to a morningness propensity was significantly associated with more anxiety. Conclusion: This study found a positive association between an evening typology (chronotype) and higher depression and anxiety and poorer quality of sleep. Although preliminary and based on cross-sectional data, this research could help provide a better understanding of the different chronotypes among university students, and of the possible increased susceptibility of some of these typologies (i.e., evening-type) to mental health problems.

Assessing the Relationship between Physical Health, Mental Health and Students' Success among Universities in Lebanon: A Cross-Sectional Study

BACKGROUND

Achieving high academic success is known to be influenced by many factors including, but not limiting to, physical and mental health. The present study aimed to assess the relationship between physical health, mental health, and university students' success, and to explore the associations between these factors and their academic achievement.

METHODS

A cross-sectional, self-administered online survey was used to collect data from college students in three different universities in Lebanon during the Fall 2023 semester. Mental health was evaluated using validated screening tools for depression, anxiety, and stress, specifically the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder (GAD-7), and Cohen's Perceived Stress Scale (PSS), respectively. Additionally, general questions regarding physical health and lifestyle factors were incorporated into the questionnaire. Academic achievement was measured using students' grade point average (GPA).

RESULTS

A total of 261 students completed the self-administered online survey. The results revealed that approximately 42% and 36% of students were experiencing moderate to severe symptoms of depression and anxiety, respectively, and 75.1% of students exhibited symptoms of moderate stress. The majority of participants (99.2%) did not report any physical disability. Chi-square analysis revealed a significant association between mental health status (depression, anxiety, and stress) and GPA level (p = 0.03, p = 0.044, p = 0.015, respectively). Multiple logistic regression models identified eight correlates of GPA and highlighted the relationship between physical health and student success. For instance, students who considered themselves moderately active had lower odds of achieving a higher GPA than those who considered themselves active (OR = 0.41, p = 0.045).

CONCLUSIONS

This is the first investigation into Lebanese university students' academic success in relation to lifestyle and mental health profiles. The findings indicate that implementing public health programs and interventions targeting mental health and lifestyle behaviors is essential for enhancing student success.

Immigrant Origin and Disability Increase Risk for Anxiety Among Youth During COVID-19: The Role of Unmet Needs for Support in Distance Learning and Family Conflicts

PURPOSE

Shifting to distance learning due to COVID-19 may decrease teacher support and increase family conflicts, potentially increasing anxiety. Nevertheless, there is scarce information on this topic among disability and/or immigrant-origin groups. Thus, we investigated whether these minority groups reported more anxiety than the reference group-Finnish-origin youth without disabilities-and whether unmet needs for support in distance learning and family conflicts mediated differences in anxiety during the pandemic. Differences in these mediators were also investigated.

METHODS

Population-based data of 165,033 youth aged 12 to 29 from the cross-sectional Finnish School Health Promotion study were obtained in 2021 using total population sampling. Logistic regressions with Stata were used to investigate the differences between the target (youth with disabilities, immigrant backgrounds, or both of these characteristics) and reference groups. The Karlson-Holm-Breen method was used to test for mediation.

RESULTS

The groups with disabilities (odds ratio [OR] = 4.14 [95% confidence interval (CI): 4.02-4.27]), immigrant backgrounds (OR = 1.15 [95% CI: 1.06-1.25]), or both of these characteristics (OR = 5.03 [95% CI: 4.59-5.52]) reported anxiety more often than the reference group. The difference between the minority and reference groups in unmet needs in distance learning and family conflicts were significant. Immigrant-origin youth with disabilities were most vulnerable to family conflicts, and the groups with disabilities were more prone to unmet needs. Unmet needs and family conflicts accounted for 28% of the association between immigrant-origin youth without disabilities and anxiety, whereas the mediating percentage was smaller for immigrant-origin youth with disabilities (13%) and Finnish-origin youth with disabilities (11%).

DISCUSSION

Immigrant-origin youth with disabilities need targeted support to prevent anxiety. Alleviating family conflicts and unmet needs in distance learning during crises could help decrease anxiety. Support for distance learning should be provided to youth with disabilities, regardless of their immigrant backgrounds.

Serial mediation effect of physical activity and sleep quality between dietary behaviour and depression symptoms: A nationwide cross-sectional survey

Background

Substantial studies have revealed the potential mechanisms underlying the link between dietary behaviour and depression symptoms. This study investigated the relationship between depression symptoms and dietary behaviour, physical activity, and sleep quality in a nationwide sample of Chinese residents.

Methods

A total of 18 819 Chinese Residents completed the dietary behaviour, patient health questionnaire, international physical activity questionnaire, and Pittsburgh sleep quality index. We used the Hayes' serial mediation model to investigate the correlation between the variables.

Results

Among the participants, 85.5% were aged between 18 and 59, 41.2% were male, and 73.8% were urban residents. There is a negative correlation between dietary behaviour and physical activity (r = -0.038, P < 0.001), while there is a positive correlation with depression symptoms (r = 0.238, P < 0.001) and sleep quality (r = 0.115, P < 0.001). Additionally, depression shows a positive correlation with physical activity (r = 0.024, P < 0.001) and sleep quality (r = 0.298, P < 0.001), while there is a negative correlation between physical activity and sleep quality (r = -0.035, P < 0.001). Dietary behaviour was found to be connected with depression symptoms via three mediation pathways: (1) physical activity (B = -0.003, 95% confidence interval (CI) = -0.016, -0.007), (2) sleep quality (B = 0.034, 95% CI = 0.126, 0.164), and (3) physical activity and sleep quality (B = 0.001, 95% CI = 0.001, 0.003).

Conclusions

These findings highlight the significance of psychological and physical factors in exploring the mechanisms through which dietary behaviour is related to depression symptoms. Overall, this study showed the important role of lifestyle factors in depression symptoms, suggesting that appropriate dietary behaviours, appropriate physical activity, and good sleep quality are necessary for the avoidance or improvement of depression symptoms.

Does mindfulness moderate the association between impulsivity and well-being in Lebanese university students?

Limited evidence showed that impulsivity is negatively related to life satisfaction and wellbeing; however, the mechanisms underlying this relationship remain unclear. We aimed through this work to investigate the relationship between impulsivity dimensions and well-being and to explore the moderator role of mindfulness on this relationship in a sample of Lebanese university students. This cross-sectional study was carried out among 363 university students recruited through convenience sampling through several universities in Lebanon's governorates. Higher mindfulness was significantly associated with better wellbeing in the models that considered urgency and sensation seeking as independent variables. A lack of premeditation and a lack of perseverance were both inversely associated with well-being. The interaction lack of perseverance by mindfulness was significantly associated with wellbeing; for students who were low in mindfulness, more lack of perseverance was significantly associated with a lower wellbeing. Our study suggested that mindfulness practice may offer a promising avenue for implementing strategies aiming at improving the well-being of students with high levels of impulsivity.

Screen Time and Child Behavioral Disorders During COVID-19 Pandemic: A Systematic Review

Background

The extensive use of various electronic games and communication devices, particularly among children and adolescents, has raised concerns, particularly during the COVID-19 pandemic. This study investigated the link between screen time and internalizing disorders, such as anxiety and depression, among individuals aged ≤18 during the global COVID-19 pandemic.

Methods

This systematic review aims to summarize scientific publications from 2019 to early 2022 by searching databases, including the Cochrane Library, PubMed, Web of Science, Scopus, and PsycINFO, to identify suitable studies. In each paper, we searched the following keywords and their synonyms: screen, child, high school, middle school, and psychiatric disorders. The quality of the selected papers was evaluated using a checklist recommended by the National Institutes of Health (NIH) for observational cohort studies.

Results

Out of 986 reports identified, we included 12 papers with 14,483 participants. The study revealed a negative correlation between screen time (TV, computer, video games, and mobile phones) and behavioral outcomes. Smartphones were the most frequently used devices, with video games being more prevalent among older participants for education, communication, and entertainment purposes. The prevalence of depression ranged between 10% and 25%. Furthermore, anxiety and depression were identified as predictors of increased screen usage. Some results displayed variation based on the type of screen exposure, the questionnaires used, and the age of the participants.

Conclusions

The findings imply an indirect association between increased screen time and depression and anxiety. It is crucial to consider limitations on screen time exposure and parental supervision as measures to prevent certain mental disorders.

Prevalence and correlates of depressive symptoms among matriculated university students in Singapore during Covid-19 pandemic: findings from a repeated cross-sectional analysis

BACKGROUND

Depression is a common issue among university students and has been particularly exacerbated during the COVID-19 pandemic. However, limited research has specifically focused on depression among university entrants.

OBJECTIVES

This study aimed to determine the prevalence of depression severity and identify associated factors during different phases of the COVID-19 pandemic using health screening questionnaires completed by matriculated university students in Singapore.

METHODS

A repeated cross-sectional study was conducted at a public university in Singapore. Data from health screening questionnaires administered in 2020 and 2021, involving 15,630 newly enrolled university students, were analyzed. The questionnaires covered students' sociodemographic information, physical health status, own and family medical history, lifestyle behaviours, and the Patient Health Questionnaire (PHQ-9). The PHQ-9 was used to measure the severity of depressive symptoms, categorizing into moderate to severe depressive symptoms (MSDS), mild depressive symptoms (MDS), or no depressive symptom (NDS). Multinomial logistic regression was used to assess the sociodemographic, physical and behavioural correlates of depression.

RESULTS

The prevalence of MSDS was 1% in both 2020 and 2021, while the rates for MDS were 1.93% in 2020 and 1.64% in 2021. In the 2020 cohort, male freshmen who reported better health had a lower likelihood of experiencing depression. Conversely, students of Malay ethnicity, those majoring in Engineering, those with multiple chronic diseases, monthly alcohol consumers, current smokers, and those with a family history of mental disorder had a higher likelihood of experiencing depression. Moreover, students who lived on-campus in the 2021 cohort were less likely to experience depression than those living off-campus. However, the associations between academic majors, alcohol consumption, and smoking with depression were not significant in the 2021 cohort.

CONCLUSIONS

This study reported a low prevalence of both MSDS and MDS among university entrants in Singapore. The study further identified three categories of factors associated with depression: sociodemographic, physical, and behavioural. This study suggests policy interventions to enhance targeted social support that address each student group's specific requirements and susceptibilities. A more extensive and comprehensive study is warranted to assess the changes in student mental health status post-COVID-19 pandemic.

Effects of the COVID-19 Pandemic on University Students' Mental Health: A Literature Review

This review aims to focus on the effects of COVID-19 on university students' mental health and deepen our understanding of it. The conclusions are based on the review of 32 studies conducted during the pandemic. This review confirms that university students were at high risk for mental health disorders, heightened stress, and increased sleep comorbidities both pre-pandemic and during the pandemic. This literature review confirmed a few universal trends, i.e., increased stress, anxiety, and depression, during the pandemic. The rates of insomnia, obsessive-compulsive disorder, and suicidal ideation also went up. Overall, female students are at a disadvantage in the development of mental health issues. Male students coped better but may be at higher risk for lethality in suicidal ideation. Students with a history of mental health issues and other comorbidities prior to the pandemic had worse outcomes compared to healthy individuals. The study points to a strong positive correlation between fear and increased rates of stress, anxiety, and insomnia. There is also a positive correlation between declining mental health and online learning. A strong negative correlation was present between physical activity and depressive symptoms. These findings are universal across many countries and regions where the studies occurred.

Relationship between depression, anxiety, stress and smartphone addiction in COVID-19 nursing students

OBJECTIVE

to verify the relationship between symptoms of depression, anxiety, stress and smartphone addiction in COVID-19 nursing students.

METHOD

this was a descriptive-analytical study of 206 nursing students. A sociodemographic characterization and smartphone use instrument adapted from the literature and the following scales Depression, Anxiety and Stress Scale and Smartphone Addiction Inventory were used for data collection. Sociodemographic data and smartphone use were analyzed using descriptive statistics and the relationship between symptoms of depression, anxiety, stress and smartphone addiction was analyzed using multiple logistic regression.

RESULTS

the prevalence of smartphone addiction among nursing students was 129 (62.6%) and there was a relationship between symptoms of moderate depression (p=0.049), severe/very severe depression (p=0.005) and mild anxiety (p=0.028) and severe/very severe anxiety (p=0.019) and smartphone addiction.

CONCLUSION

the data show that the construction and implementation of smartphone use policies in the academic and hospital context to prevent smartphone addiction and control associated risk factors is necessary.

BACKGROUND

(1) High prevalence of smartphone addiction among nursing students. (2) There was a relationship between symptoms of depression, anxiety and smartphone addiction. (3) Nursing has a leading role in identifying and managing addictions. (4) A multidisciplinary approach to the prevention and management of smartphone addiction. (5) Smartphone addiction in nursing students is a new issue in Brazil.

Perception and attitude towards online clinical modules: a cross-sectional study among medical students from two countries

COVID-19 has deeply affected the world in various aspects including the education system worldwide. In this study, we intended to explore the merits and demerits of online clinical learning and its effect on medical education from a student's perspective. The study also assessed the perception and attitude of final-year medical students towards online clinical modules. This observational study was carried out in the Department of Community Medicine, Kasturba Medical College, Manipal (KMC) in collaboration with King's College London, UK (KCL). In our study, a total of 42 students were enrolled, with 37 students from KMC and 5 students from KCL. 81% of students reported that they were not willing to continue the online mode of learning. The abrupt switch to e-learning without prior preparedness has exposed some pitfalls that must be attended to. Contrary to other fields, the medical field places high importance on offline clinical teaching which has recently been impacted by online teaching. The survey responses were analyzed for improvisation of online clinical modules as well as to come up with better ideas and outcomes since this mode of learning may have to continue till the spread of the disease is under control.

Side Effects Reported by Moroccan Medical Students Who Received COVID-19 Vaccines

BACKGROUND

Low confidence in the safety of COVID-19 vaccines was found to be a key promoter of vaccine reluctance especially among youth. Furthermore, young adults are an important demographic for building herd immunity through vaccination. As a result, their reactions to getting COVID-19 vaccines are crucial in our fight against SARS-CoV-2.

OBJECTIVE

The overall goal of this study was to look into the shortterm side effects experienced by Moroccan medical and pharmacy students after receiving COVID-19 vaccines.

METHODS

A cross-sectional survey-based study to assess the COVID-19 vaccines' short-term AEFIs among Moroccan medical and pharmacy students. The validated questionnaire was delivered in a digital form to explore the side effects (SE) they encountered after the first or the second dose of one of three vaccines namely: AstraZeneca Vaxzevria, PfizerBioNTeck, and SinoPharm vaccines.

RESULTS

There were 510 students in total who took part. After the first and second doses, approximately 72 percent and 78 percent of subjects, respectively, reported no SE. The remainder had localized injection site side effects (26%). Fatigue (21%), fever (19%), headache (17%), and myalgia (16%) were the most common systemic adverse effects after the first dose. There were no serious SEs reported.

CONCLUSION

The majority of the reported AEFIs in our data were mild to moderate in intensity and lasted only one or two days. COVID-19 vaccinations are highly likely safe for young adults, according to the findings of this study.

Predictive Machine Learning Models for Assessing Lebanese University Students' Depression, Anxiety, and Stress During COVID-19

University students are experiencing a mental health crisis. COVID-19 has exacerbated this situation. We have surveyed students in 2 universities in Lebanon to gauge their mental health challenges. We have constructed a machine learning (ML) approach to predict symptoms of depression, anxiety, and stress based on demographics and self-rated health measures. Our approach involved developing 8 ML predictive models, including Logistic Regression (LR), multi-layer perceptron (MLP) neural network, support vector machine (SVM), random forest (RF) and XGBoost, AdaBoost, Naïve Bayes (NB), and K-Nearest neighbors (KNN). Following their construction, we compared their respective performances. Our evaluation shows that RF (AUC = 78.27%), NB (AUC = 76.37%), and AdaBoost (AUC = 72.96%) have provided the highest-performing AUC scores for depression, anxiety, and stress, respectively. Self-rated health is found to be the top feature in predicting depression, while age was the top feature in predicting anxiety and stress, followed by self-rated health. Future work will focus on using data augmentation approaches and extending to multi-class anxiety predictions.

Math anxiety and math motivation in online learning during stress: The role of fearful and avoidance temperament and implications for STEM education

Students' math motivation can predict engagement, achievement, and career interest in science, technology, engineering, and mathematics (STEM). However, it is not well understood how personality traits and math anxiety may be linked to different types or qualities of math motivation, particularly during high-stress times such as the COVID-19 pandemic. In this study, we examined how fearful or avoidant temperaments contribute to math anxiety and math motivations for college students during the COVID-19 pandemic. Ninety-six undergraduate students from a large public university were assessed on temperamental fear, math anxiety, and math motivation in an online math course. Results showed that higher levels of temperamental fear are directly linked to higher levels of math anxiety. In addition, temperamental fear is indirectly linked to higher levels of autonomous motivation (i.e., intrinsic motivation and identified regulation) and lower levels of controlled motivation (i.e., external regulation) through math anxiety. Results have implications for helping students at high risk for both high math anxiety and for low motivation to engage in math learning.

A comparison of anxiety levels before and during the COVID-19 pandemic

The COVID-19 Pandemic upended the lives of nearly everyone worldwide, and recent studies have reported higher rates of anxiety, depression, and other mental health problems. Using a repeated crosssectional design, the current study compares anxiety levels from a representative sample of college students prior-to and during the COVID-19 Pandemic. Additionally, differences in anxiety prior to and following U.S. approval for use of the Pfizer-BioNTtech COVID-19 vaccine were also compared. Findings indicate that state-anxiety levels did not differ significantly prior to and during the Pandemic as well as before the vaccine and during and after the vaccine (M = 43.01, 44.10, 44.77, respectively). Surprisingly, trait anxiety levels were significantly higher during the Pandemic than before (p = .003), and anxiety levels trend down after the approval of the vaccine, but not significantly (M = 45.10, 48.85, 47.58, respectively). Future research should continue to investigate and compare anxiety levels during the COVID-19 Pandemic.

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

Background

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

Objectives

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

Design

Cross-sectional study using convenience sampling.

Settings

Ten universities across five provinces and two major Indonesian islands.

Participants

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

Methods

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

Results

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

Conclusions

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

Socio-demographic and mental health correlates of internet addiction amongst Hong Kong university students under COVID-19

Introduction

Regarding the problem of Internet addiction (IA) amongst university students under the pandemic, there are several research gaps. Firstly, few studies have examined IA of university students in Hong Kong, which is a Chinese society heavily influenced by Western values. In addition, findings on the socio-demographic correlates and psychological well-being predictors of IA in university students are unclear. Finally, researchers have not systematically examined the interaction effects of socio-demographic factors (particularly gender and personal infection of COVID-19) and psychological morbidity on IA. This pioneer study aimed to investigate the predictive role of socio-demographic factors and psychological morbidity in IA, and the moderating effects of gender and personal infection of COVID-19 on the relationship between psychological morbidity and IA.

Methods

We conducted an online survey (N = 1,020 university students) during the ending phase of Wave 5 of the pandemic in Hong Kong (late 2022 to early 2023). Socio-demographic correlates included age, gender, living status, personal and family financial situation, student status, personal and family infection of COVID-19. Participants responded to validated measures of psychological morbidity, including depression, suicidal behavior, and hopelessness. Hierarchical regression and simple slope analyses were used to examine the predictive role of socio-demographic variables and psychological morbidity in IA and the interactive effect of gender and personal infection of COVID-19 with psychological morbidity on IA.

Results

Personal financial difficulty was a significant socio-demographic predictor of IA. Depression, suicidal behavior, and hopelessness positively predicted IA. We also found a significant interaction effect of gender and psychological morbidity on IA. While the predictive relationship between depression and IA was stronger in males than in females, hopelessness was more strongly related to IA in females than in males. Finally, there was a significant interaction effect of personal infection of COVID-19 and suicidal behavior on IA.

Conclusion

Personal financial difficulty was a socio-economic correlate of IA. Psychological morbidity also predicted IA. Gender and personal infection of COVID-19 moderated the linkage between psychological morbidity and IA. The findings of the study enhance our understanding of individual differences in IA in university students during the pandemic, particularly concerning different ecological risk factors.

University students' and educators' perceptions on the use of digital and social media platforms: A sentiment analysis and a multi-country review

Due to Covid-19, an inevitable restructuring of higher education teaching and learning pedagogies ensuring the continuous and effective learning of students is deemed important. Despite such vitality, a prevalent disparity worldwide on the usages and gains of digital and social media integration is still noticeable. Following a Scoping Literature Review and using the Atlas.ti software for a Grounded Theory qualitative analysis, this study aims to ascertain the significance of digital and social media tools during and after the Covid-19 pandemic. The study explains the common challenges and opportunities both students and educators faced in thirty countries. Drawing on the sentiment analysis of these stakeholders, results indicate that despite the acceleration of digital education into a flexible, and student-centered didactic approach, various barriers in effectively fulfilling online learning still exist. Findings also revealed the lack of, and therefore need for, proper teaching and learning material and strategies suitable for digital education.

Determinants of the mental health status of university students in Japan: comparison between pandemic and recession periods during the 7th wave of COVID-19

Introduction

Although the number of identified coronavirus disease 2019 (COVID-19) cases and deaths has decreased, the repetitive crest-trough pattern of the spread of COVID-19 has yet to cease. The current situation may affect the mental health status of university students who are distracted in their academic and daily lives by the pandemic. This cross-sectional study aimed to identify the determinant factors of the mental health status of Japanese university students before and in the middle of the 7th wave of the pandemic, one of the largest waves to be experienced in Japan.

Method

A survey was administered to two groups of students during the recession period between the 6th and 7th waves (n = 156) and during the 7th wave of the pandemic (n = 97).

Results

T-tests showed no statistically significant differences between the two groups in Perceived Stress Scale (PSS) scores, while the COVID-19 anxiety scores (p < 0.001) and General Health Questionnaire (GHQ) scores were significantly higher in the Pandemic period group (p = 0.011). The multiple regression model indicated that PSS scores were the only determinant of GHQ scores in the Pandemic period group.

Discussion

The results indicate that stressful life events, such as the COVID-19 pandemic and daily hassles, which are measured by the PSS, affect students' mental health differently. Therefore, the author submits that school counselors should provide counseling to students to reduce anxiety caused by daily hassles, during recession and pandemic periods. Students also require assistance with the reduction of stress and anxiety caused by daily hassles, regardless of the pandemic situation.

COVID-19 era-related e-learning: a cross-sectional web-scale study of cyberchondria, internet addiction and anxiety-related symptomatology among university nursing students

OBJECTIVE

The study assessed COVID-19 era-related e-learning cyberchondria, internet addiction and anxiety-related symptomatology among nursing students. The relationships, predictors and differences between the studied concepts were measured.

DESIGN

In 2021, a quantitative cross-sectional research design using a web survey with a sample size of 333 nursing students yielded a response rate of 70%.

RESULTS

Nursing students had a moderate level of cyberchondria, low to moderate internet addiction, a moderate to severe level of anxiety and depression, and a normal stress level. Demographic characteristics, cyberchondria, internet addiction and anxiety-related symptomatology were significantly correlated. Grade point average, age, type of organisation where the students were trained and level of education were significant predictors of the studied variables. Significant differences in the studied concepts were found based on the sample's characteristics such as gender, type of organisations or universities where the students were trained or studied, and age.

CONCLUSION

Cyberchondria, internet addiction, depression, anxiety and stress symptomatology are troublesome. Higher education organisations might benefit from examining the variables of interest and investigating the relations between internet addiction and depression and anxiety symptomatology among nursing students. Such research will aid in tailoring treatments to assist vulnerable students by targeting counselling and educational efforts toward building a future generation of nurses with reduced cyberchondria, internet addiction and anxiety-related symptomatology.

Influence of Stress and Emotions in the Learning Process: The Example of COVID-19 on University Students: A Narrative Review

Emotional instability and stress are the main disturbances that condition the learning process, affecting both teachers and students. The main objective of this review is to analyze the influence of stress and emotions (as part of stress) on the learning environment. Stress is a physiological mechanism that the organism develops to adapt and survive external and internal challenges. In this context, stress tends to be seen as a negative condition in the learning process when it is chronic. Extreme stress situations, such as the COVID-19 pandemic, can generate anxiety and frustration in students. However, other studies indicate that controlled stress can positively enhance the learning process. On the other hand, the quality and intensity of emotions resulting from stress can influence as well the learning process. Positive emotions are healthy and can promote optimal learning. Emotions lead to sentimental, cognitive, behavioral, and physiological changes, which will have a strong influence on intellectual performance. The activation of coping strategies constitutes a key mechanism for dealing positively with problems and challenges, generating positive emotions essential for the self-regulation of learning. In conclusion, correct management of emotions in stressful situations could promote effective learning through enhanced attention and capacity to solve problems.

Anxiety during the COVID-19 pandemic in hospital staff: systematic review plus meta-analysis

BACKGROUND

This study was conducted to systematically review the existing literature examining the prevalence of anxiety among hospital staff and identifying the contributing factors to address the complications of this disorder and develop effective programmes for reducing the complications of this mental health problem.

METHODS

We searched the electronic databases including PubMed, EMBASE, Scopus, Web of Science and Google Scholar from January 2020 to February 2021. To perform meta-analysis, the random effects model was used. To assess the statistical heterogeneity of the included studies, the I2 index was used, and 95% CI was estimated. Data analysis was performed by R software.

RESULTS

In the final analysis, 46 articles with the total sample size of 61 551 hospital staff members were included. Accordingly, anxiety prevalence among healthcare workers (HCWs) was 26.1% (95% CI 19% to 34.6%). The prevalence rates of anxiety in health technicians and medical students were 39% (95% CI 13% to 73%) and 36% (95% CI 15% to 65%), respectively, indicating a much higher prevalence than other hospital staff members. Furthermore, a positive significant relationship between prevalence of anxiety among HCWs and their age was approved (p<0.001). The prevalence rate of anxiety was higher among women 37.7% (95% CI 25.4% to 51.8%) than men 27.2% (95% CI 18.2% to 38.6%).

CONCLUSION

The findings show a moderately high prevalence rate of anxiety in hospital staff. Due to the high prevalence of this mental health problem in health technicians, medical students and frontline health workers, it is highly suggested that healthcare institutions offer mental health programmes for these working groups in order to appropriately manage anxiety during the COVID-19 pandemic.

Risk factors and strategies for prevention of depression, anxiety and eating disorders among adolescents during the coronavirus disease 2019 (COVID-19) pandemic: a review

The purpose of this review is to identify prevalent trends and risk factors in depression, anxiety, and eating disorders in the adolescent population in the post coronavirus disease 2019 (COVID-19) scenario. We examined the literature published on adolescent mental health since the COVID-19 pandemic. We chose to summarize studies published from 2019 to 2022, using bibliographic search tools. We developed criteria for selecting articles for our review using diagnostic indicators and keywords. Mental health conditions such as depression, anxiety and eating disorders are commonly prevalent in this population and have shown increasing rates in the past three years. Some risk factors associated with these diagnoses include reduction in social interaction, increased workloads, routine shifts, sleep quality, social media usage and parental involvement. Routines, sleep cycles, physical activity, and social media should all be considered as a part of prevention in this population. Approaches that seem to be successful include maintaining social ties and avoiding negative social media usage with harmful content. Increased global public awareness, as well as parental awareness, through media campaigns, is critical to slowing the spread of mental health challenges in adolescents and teenagers in the post-COVID-19 era.

Depression and associated factors in medical students in Acapulco during the COVID-19 pandemic: A cross-sectional study

BACKGROUND

Depression is common in medical students and the Mexican state of Guerrero has the highest rates of depression in the country. Acapulco, the seat of the state medical school, is a tourist destination that experienced early high rates of COVID-19. The COVID-19 pandemic closed all schools in Mexico, obliging a shift from face-to-face to virtual education. In this new context, medical students faced challenges of online teaching including inadequate connectivity and access technologies. Prolonged isolation during the pandemic may have had additional mental health implications.

AIM

Assess depression prevalence and its associated factors affecting medical students in Acapulco, Mexico during the COVID-19 pandemic.

METHODS

A cross-sectional survey of students of the Faculty of Medicine of the Universidad Autónoma de Guerrero, in November 2020. After informed consent, students completed a self-administered questionnaire collating socio-demographic, academic and clinical variables, major life events and changes in mood. The Beck inventory provided an assessment of depression. Bivariate and multivariate analyses relied on the Mantel-Haenszel procedure to identify factors associated with depression. We estimated the odds ratio (OR) and 95% confidence intervals.

RESULTS

33.8% (435/1288) of student questionnaires showed evidence of depression in the two weeks prior to the study, with 39.9% (326/817) of young women affected. Factors associated with depression included female sex (OR 1.95; 95%CI 1.48-2.60), age 18-20 years (OR 1.36; 95%CI 1.05-1.77), perceived academic performance (OR 2.97; 95%CI 2.16-4.08), perceived economic hardship (OR 2.18; 95%CI 1.57-3.02), and a family history of depression (OR 1.85; 95%CI 10.35-2.54). Covid-19 specific factors included a life event during the pandemic (OR 1.99; 95%CI 1.54-2.59), connectivity problems during virtual classes and difficulties accessing teaching materials (OR 1.75; 95%CI 1.33-2.30).

CONCLUSIONS

The high risk of depression in medical students during the COVID-19 pandemic was associated with perceived academic performance and technical barriers to distance learning, in addition to known individual and family factors. This evidence may be useful for the improvement of programs on prevention and control of depression in university students.

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

BACKGROUND

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

METHODS

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

RESULTS

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

LIMITATIONS

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

CONCLUSIONS

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

A comparison of the effects of remote coaching HIIT training and combined exercise training on the physical and mental health of university students

Aim

To compare the differences in the effects of based on remote coached high intensity interval training and combined exercise training on the physical and mental health of university students.

Method

Sixty university students were recruited from Shandong Normal University and randomly divided into HIIT group (n = 30) and AR group (n = 30), with the HIIT group using high-intensity interval training intervention and the AR group using combined exercise (aerobic combined with resistance) training intervention for 8 weeks. Mental health indicators, fitness indicators and body composition indicators were measured at the beginning and end of the intervention.

Results

After 8 weeks, among the mental health indicators, the results of the Symptom Self-Rating Scale (SCL-90) test showed a significant improvement in the HIIT group in terms of total score, somatization, obsessive-compulsive, interpersonal sensitivity, depression, hostility, and psychoticism (p < 0.05); the AR group showed significant improvements in psychoticism (P < 0.05). There were no significant differences between the two groups. The results of the Pittsburgh Sleep Quality Index scale (PSQI) showed a significant difference in sleep efficiency in the HIIT group with an inverse improvement in scores; the AR group showed no significant improvement in each test item. The results of the between-group covariance showed significant differences in sleep efficiency and hypnotic drugs in the HIIT group (p < 0.05). Among the fitness indicators, the HIIT group showed significant improvements in maximum oxygen uptake, grip strength and flexibility (P < 0.05); the AR group showed significant improvements in back muscle strength and flexibility (P < 0.05). The results of the between-group covariance showed significant improvements in maximum oxygen uptake in the HIIT group (P < 0.01). Regarding body composition indicators, there was a significant improvement in Body weight, BMI, Body fat percentage and Waist-to-hip ratio in both the HIIT and AR groups (P < 0.01). There were no significant differences between the two groups.

Conclusion

HIIT and combined exercise training based on remote coaching had some improvement on fitness level and body composition of university students, HIIT was more advantageous in improving aerobic endurance, and HIIT based on remote coaching may have better effect than combined exercise in mental health.

Trial registration

Chinese Clinical Trial Register, ChiECRCT20220149. Registered on 16 May 2022.

How nursing students' risk perception affected their professional commitment during the COVID-19 pandemic: the mediating effects of negative emotions and moderating effects of psychological capital

Nurses play a pivotal role in the delivery of medical services. Professional commitment is crucial for nursing professionals' long-term, healthy, and sustainable development. However, nursing students' professional commitment levels are currently unsatisfactory in China, especially given that the COVID-19 pandemic has posed unprecedented challenges to the profession. Therefore, studies investigating the professional commitment levels of nursing students and the underlying influencing factors are urgently required. This study explored how nursing students' risk perceptions, negative emotions, and psychological capital affected their professional commitment during the COVID-19 pandemic. A cross-sectional study was conducted among nursing students using risk perception, professional commitment, negative emotions, and psychological capital scales. An analysis of 1142 Chinese nursing students suggested that nursing students' risk perception positively impacted professional commitment and that negative emotions mediated this association. Importantly, psychological capital moderates the mediating effect of negative emotions and can buffer the negative emotions caused by risk perception. This study demonstrated that effective intervention strategies should be implemented in multiple dimensions such as education, individual, public and society to improve the professional commitment of nursing students.

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.

Mindfulness among lebanese university students and its indirect effect between mental health and wellbeing

BACKGROUND

University students are a high-risk population for developing mental health issues. Mindfulness, the non-judgmental awareness of the present moment, has an effective role in numerous psychological contexts among students. However, no previous studies have investigated the association between mindfulness, mental health and wellbeing among Lebanese university students. Therefore, this study aimed to assess the mediating effect of mindfulness in the association between mental health and wellbeing in this population.

METHODS

This cross-sectional study enrolled 363 Lebanese university students recruited through convenience sampling (July-September 2021). The Wellbeing Index Scale, Lebanese Anxiety Scale, Patient Health Questionnaire and Freiburg Mindfulness Inventory were used to assess subjective well-being, anxiety, depression and mindfulness respectively.

RESULTS

Our findings showed that higher mindfulness (Beta = 0.18; p < 0.001) was significantly correlated with a higher wellbeing, whereas more depression (Beta=-0.36; p < 0.001) was significantly associated with a lower wellbeing. The results of the indirect effect analysis showed that mindfulness mediated the association between anxiety and wellbeing and between depression and wellbeing. Higher anxiety/depression were significantly associated with lower mindfulness and a lower wellbeing (direct effect). Moreover, higher mindfulness was significantly associated with a higher wellbeing.

CONCLUSION

Mindfulness is associated with improved wellbeing and plays an indirect role between mental health issues and wellbeing. Our results suggest that mindfulness presents an adaptive approach and coping method associated with improved students' wellbeing.

Exploring educational impacts among pre, during and post COVID-19 lockdowns from students with different personality traits

The influence of personality traits on educational outcomes has been widely recognized and studied. Research has explored its effects on factors such as student satisfaction, academic anxiety, and dishonesty, particularly during the COVID-19 pandemic. However, there has been a lack of studies comparing the learning behaviors and performance of students with different personality traits during the pre, during, and post-COVID-19 lockdown periods. This study fills this gap by analyzing the differences in academic metrics, such as class grades and assignment submissions, among students with varying personality traits during different lockdown periods. Our research, based on a dataset of 282 graduate students in the USA, identified correlations and patterns between lockdown periods, personality traits, and academic metrics. For example, the class grades and the rate of late submissions were affected by different lockdown periods. Students with lower degree in extraversion and agreeableness made less attempts in assignment submissions. These findings can assist educators in identifying impacted students and developing effective teaching strategies at early stage in future incidents.

Characterizing fluid intake and physical activity in university students within the United States during the COVID-19 pandemic

PURPOSE

This study determined fluid intake and physical activity behaviors among college students during the COVID-19 pandemic.

METHODS

College students (n = 1014; females, 75.6%) completed an online survey during the Spring 2020 academic semester following the initial global response to the COVID-19 pandemic. Academic standing, habitation situation, and University/College responses to COVID-19 were collected. Participants completed the Godin Leisure-Time Exercise Questionnaire and a 15-item Beverage Questionnaire (BEVQ-15) to determine physical activity level and fluid intake behaviors, respectively.

RESULTS

Females (1920 ± 960 mL) consumed significantly less fluid than males (2400 ± 1270 mL, p < 0.001). Living off-campus (p < 0.01) and living with a spouse/partner (p < 0.01) was associated with increased consumption of alcoholic beverages. 88.7% of participants reported being at least moderately active; however, Black/African American and Asian participants were more likely to be less active than their Caucasian/White counterparts (p < 0.05). Participants reporting no change in habitation in response to COVID-19 had a higher fluid intake (p = 0.002); however, the plain water consumption remained consistent (p = 0.116). While there was no effect of habitation or suspension of classes on physical activity levels (p > 0.05), greater self-reported physical activity was associated with greater fluid intake (std. β = 0.091, p = 0.003).

CONCLUSIONS

Fluid intake among college students during the initial response to the COVID-19 pandemic approximated current daily fluid intake recommendations. Associations between COVID-19-related disruptions (i.e., suspension of classes and changes in habitation) and increased alcohol intake are concerning and may suggest the need for the development of targeted strategies and programming to attenuate the execution of negative health-related behaviors in college students.

Association between COVID-19-related Stress and Self-Directed Learning Ability among Korean Nursing Students

Purpose

Traditional face-to-face classes for nursing students due to the COVID (Coronavirus Disease)-19 pandemic around the world made it inevitable to operate education delivery method using remote/hybrid fashion. This study was aimed to validate the Korean version of the Student Stress Inventory-Stress Manifestations (SSI-SM) and assess the association between COVID-19 pandemic related stress level and self-directed learning ability competence in nursing students.

Design

This research was a cross-sectional study design.

Methods

The study was conducted from December 2020 to January 2021, with a convenience sample of 172 nursing students in the 3rd and 4th grades in South Korea. The Korean version of SSI-SM(K-SSI-SM) was translated and adapted according to standard guideline, and tested construct validity and reliability. In addition, a multiple linear regression analysis was used to examine the associations between the COVID-19 related stress level and the self-directed learning ability.

Results

An exploratory analysis showed that K-SSI-SM composed of 13-item in three factors (uncertainty, non-sociability, and somatization) accounted for 68.73% of the total variance after it was modified. The internal consistency was good with 0.91. Multiple linear regression analysis revealed that higher self-directed learning ability was associated with lower stress levels (β=-0.19, p=0.008), positive toward online learning (β=0.41, p=0.003) and scored higher in theory (β=0.30, p<0.001) in nursing students.

Conclusion

The K-SSI-SM is an acceptable instrument for assessing stress levels in Korean-nursing students. And nursing faculties need to pay attention to related factors of self-directed learning ability, in order to achieve the course's self-directed learning goal in students attending online classes.

Psychological impacts of transition to distance learning due to COVID-19 on nursing students

The purpose of this study was to assess the psychological impacts of the abrupt transition to distance learning due to COVID-19 and associated factors among Jordanian nursing students. A cross-sectional online survey with a sample of 224 nursing students in three universities was carried out. The survey measured students' depression, anxiety, stress, post-traumatic stress disorder (PTSD), academic self-efficacy, and demographic and distance learning-related data. Students have moderate levels of depression, anxiety, and stress. Depression, anxiety, stress, and PTSD were significantly associated with various demographic, disease-related, and distance learning-related variables. Further work is required to prepare professional psychological help for nursing students and develop future teaching plans that take into consideration factors underlying students' negative symptoms.

Students' adoption towards behavioral intention of digital learning platform

The purpose of this research was to investigate students' behavioral intentions toward a digital learning platform. In the framework of Thai education, an empirical study evaluated and applied the adoption model. The recommended research model was tested using structural equation modeling with a sample of 1406 students from every part of Thailand. According to the findings, the best facilitator for students' recognition of using digital learning platforms is attitude (ATT), followed by internal factors such as perceived usefulness (PU) and perceived ease of use (PEU). Furthermore, technology self-efficacy (TSE), subjective norms (SN), and facilitating conditions (FC) are peripheral factors that enhance comprehension of a digital learning platform's approval. These results are consistent with past research, with the exception that PU is the only factor that has a negative influence on behavioral intention. Consequently, this study will be useful to academics and researchers by bridging a research gap in the literature review whilst also demonstrating the practical application of an impactful digital learning platform relating to academic accomplishment.

Internet and depression in adolescents: Evidence from China

Despite growing attention to Internet activity as a social determinant of depression in adolescents, few studies have focused on its diverse effects on depressive symptoms. Using data from the 2020 China Family Panel Study, this study employed logistic regression analysis to examine how Internet activity affects depressive symptoms in adolescents in China. The results indicated that adolescents with longer online duration using mobile phones tended to have higher levels of depression. Adolescents who engaged in online activities related to games, shopping, and entertainment had more severe depressive symptoms, but their time spent on online learning was not significantly associated with their level of depression. These findings suggest a dynamic link between Internet activity and adolescent depression and offer policy implications for addressing depressive symptoms in adolescents. Specifically, Internet and youth development policies and public health programs during the COVID-19 pandemic should be designed based on a comprehensive account of all aspects of Internet activity.

Well-being variations on students of health sciences related to their learning opportunities, resources, and daily activities in an online and on-crisis context: a survey-based study

BACKGROUND

Universities' training process intensely relies on face-to-face education. The COVID-19 pandemic interrupted it and forced them to reinvent their process online. But this crisis seems not to be the last we will face, and we take it as a lesson to prepare for future crises. These critical contexts are especially challenging because they imply changing teaching strategies, and students may not have the technology access or the living conditions to connect as they need. They also lived through a pandemic where the virus and the life changes added stress to their learning process and threatened their well-being. So, this study aims to analyze how well-being variations reported by Health sciences students relate to their learning opportunities, access conditions, and daily activities.

METHOD

We surveyed 910 Health sciences students from six different Chilean universities at the end of the first semester of 2020, the first in pandemic conditions. Respondents answered online questionnaires about 1) Remote teaching activities, 2) Learning resources availability, 3) Daily life activities, and 4) Well-being changes. We performed descriptive analysis and Structural Equation Modelling.

RESULTS

Live videoconference classes were the most frequent teaching activity; only a third of the students had quiet spaces to study online, and most had to housekeep daily. More than two third reported some well-being deterioration. The structural equation model showed a good fit.

CONCLUSION

Results show an online learning scenario that tries to emulate traditional learning focusing on expositive strategies. Most students reported that their well-being deteriorated during the semester, but tutorials, workplace availability, and social support were protective factors.

A framework for designing AI systems that support community wellbeing

Introduction

Designing artificial intelligence (AI) to support health and wellbeing is an important and broad challenge for technologists, designers, and policymakers. Drawing upon theories of AI and cybernetics, this article offers a design framework for designing intelligent systems to optimize human wellbeing. We focus on the production of wellbeing information feedback loops in complex community settings, and discuss the case study of My Wellness Check, an intelligent system designed to support the mental health and wellbeing needs of university students and staff during the COVID-19 pandemic.

Methods

The basis for our discussion is the community-led design of My Wellness Check, an intelligent system that supported the mental health and wellbeing needs of university students and staff during the COVID-19 pandemic. Our system was designed to create an intelligent feedback loop to assess community wellbeing needs and to inform community action. This article provides an overview of our longitudinal assessment of students and staff wellbeing (n = 20,311) across two years of the COVID-19 pandemic.

Results

We further share the results of a controlled experiment (n = 1,719) demonstrating the enhanced sensitivity and user experience of our context-sensitive wellbeing assessment.

Discussion

Our approach to designing "AI for community wellbeing," may generalize to the systematic improvement of human wellbeing in other human-computer systems for large-scale governance (e.g., schools, businesses, NGOs, platforms). The two main contributions are: 1) showcasing a simple way to draw from AI theory to produce more intelligent human systems, and 2) introducing a human-centered, community-led approach that may be beneficial to the field of AI.

Readiness and Challenges of E-Learning during the COVID-19 Pandemic Era: A Space Analysis in Peninsular Malaysia

During the COVID-19 era, most countries, including Malaysia, have shifted from face-to-face teaching systems to online teaching programs. The aim of this study is to identify the main challenges that higher education students face during e-learning based on their residential location throughout Peninsular Malaysia. This study further examines the readiness of higher education students to apply e-learning. Therefore, a cross-sectional survey approach is used to fulfil the outlined objectives. Accordingly, 761 public (95.3%) and private (4.7%) higher education students residing in Peninsular Malaysia are sampled in this study. The survey was administered online for 37 days, from 21 October 21 to 6 December 2021, using either WhatsApp or Facebook. The raw data is inferentially (Principal Component Analysis, K-Means Clustering, Kruskal Wallis, and spatial analysis) and descriptively (mean, standard deviation & percentage) analyzed. It has been revealed that six clusters of students in Peninsular Malaysia face various challenges while following the e-learning program. Most states in Peninsular Malaysia are dominated by students in Cluster D (Terengganu, Perlis, Penang, Selangor, WP Kuala Lumpur, and WP Putrajaya) and Cluster B categories (Melaka, Johor, Kelantan, and Kedah). Students in the Cluster D category tend to suffer from physical health disorders and social isolation, while students in the Cluster B category face problems with decreased focus in learning, mental health disorders, and social isolation. The outcomes further indicate that the more challenges students face during e-learning programs, the lower their willingness to continue with the program. The results of this study are significant in addressing the challenges of e-learning, which will help stakeholders address and strengthen student abilities.

Depression, anxiety, and stress among university students in Selangor, Malaysia during COVID-19 pandemics and their associated factors

INTRODUCTION

This study aims to assess the impacts of COVID-19 pandemics among university students in Malaysia, by identifying the prevalence of depression, anxiety and stress among them and their respective predictors.

METHODOLOGY

An online cross-sectional study was conducted via non-probabilistic convenience sampling. Data were collected on sociodemographic characteristics, lifestyle, COVID-19 related influences. Mental health status was assessed with depression, anxiety, and stress scale (DASS-21).

RESULTS

388 students participated this study (72.4% female; 81.7% Bachelor's student). The prevalence of moderate to severe depression, anxiety and stress among university students are 53.9%, 66.2% and 44.6%, respectively. Multivariable logistic regression analysis found that the odds of depression were lower among students who exercise at least 3 times per week (OR: 0.380, 95% CI: 0.203-0.711). The odd ratio of student who had no personal history of depression to had depression, anxiety and stress during this pandemic was also lower in comparison (OR: 0.489, 95% CI: 0.249-0.962; OR: 0.482, 95% CI: 0.241-0.963; OR: 0.252, 95% CI: 0.111-0.576). Surprisingly, students whose are currently pursuing Master study was associated with lower stress levels (OR: 0.188, 95% CI: 0.053-0.663). However, student who had poorer satisfaction of current learning experience were more likely to experience stress (OR: 1.644, 95% CI: 1.010-2.675).

LIMITATIONS

It is impossible to establish causal relationships between variables on mental health outcomes, and there is a risk of information bias.

CONCLUSION

The prevalence of mental health issues among university students is high. These findings present essential pieces of predictive information when promoting related awareness among them.

Individuals' Coping Styles and Levels of Depression, Anxiety, and Stress During the COVID-19 Pandemic in Turkey: A Web-Based Cross-Sectional Study

This cross-sectional study aimed to determine the correlation between the coping styles and depression, anxiety, and stress levels of individuals living in Turkey during the COVID-19 pandemic. The study was conducted using an online questionnaire (Socio-demographic Form; Depression, Anxiety, and Stress Scale-21; Coping Styles Scale) and it included 483 individuals. Descriptive statistics, ANOVA, Independent Samples t-test, Kolmogorov-Smirnov, Hosmer-Lemeshow and Scheffe tests, Pearson Correlation, and Binary Logistic Regression analyzes were used to analyze the data. There was a negative correlation between the participants' self-confident and optimistic coping styles mean scores and their depression, anxiety, and stress mean scores. There was a positive correlation between the participants' helpless, submissive, and seeking social support coping styles mean scores and their depression, anxiety, and stress mean scores. The regression analysis revealed that using the helpless coping style increased the depression, anxiety, and stress levels of the participants while using the optimistic coping style and visiting a physician during the pandemic decreased them. In addition, seeking social support coping style increased the level of depression while the testing during the pandemic increased stress levels. As a result, it is recommended to strengthen society's psychological resilience and expand mental health support services for such mental illnesses.

The effectiveness of the using scenario and video in distance nursing education during COVID-19 pandemic

To determine the effects of using case scenarios and skill videos in distance education as a practical teaching-learning strategy on student satisfaction, professional perception, and professional values among nursing students during the COVID-19 pandemic. This is a quasi-experimental study with a one-group, pretest-post-test design. The study was conducted with 166 baccalaureate nursing students who attended online classes for 13 weeks, which included 80-minute theoretical and 120-minute practical training each week. A Student Information Form, the Student Satisfaction Scale-Short Form, the Nursing Profession Perception of Scale (NPPS), and the Nurses' Professional Values Scale-Revised (NPVS-R). We found significant differences between the students' pre- and post-test scores for the scales NPPS and the NPVS-R (p < .05), who attended online classes during the pandemic. However, our findings demonstrated that distance education had no effect on the level of student satisfaction (p > .05). The using case scenarios and skill videos in distance education as a strategy to deliver nursing course during the pandemic showed positive effects on the adoption of professional values and the perception about nursing profession among nursing students.

Deterioration of Mental Health in Children and Adolescents During the COVID-19 Pandemic

This paper reviews the global effect of the coronavirus disease 2019 (COVID-19) pandemic on the mental health of children and adolescents in South Korea, the U.S., Japan, and China. We reviewed research on deteriorated mental health, including increased suicide, suicidal thoughts, and self-harm. Various studies have shown that students' mental health issues, such as depression and anxiety, have worsened during the COVID-19 pandemic. Furthermore, the number of students who committed suicide has significantly increased in the U.S. and Japan. Factors such as prior mental health status, change in daily routine, reduced physical activity, excessive screen time, overuse of electronic devices, and reduced social support have been reported to have a significant effect. The chain of deteriorating mental health among the youth began at the onset of COVID-19, social distancing, and school closure. As youths began to stay at home instead of going to school, they lost opportunities to connect with their friends or teachers, who could provide support outside of their homes. Young people spent less time on physical activity and more time online, which damaged their sleeping schedule and daily routine. In preparing for the post-pandemic phase, we should thoroughly analyze the long-term effects of the pandemic on youth mental health, while simultaneously tackling current imminent issues.

Psychological Impact of the 2022 Round COVID-19 Pandemic on China's College Students

In response to the new round of COVID-19 outbreaks since March 2022, universities with high outbreak rates around the country have taken quarantine measures to contain the epidemic. Evidence from previous coronavirus outbreaks has shown that people under quarantine are at risk for mental health disorders. To better understand the impacts of this round of COVID-19 quarantine on domestic college students and their responses, we conducted a systematic survey to assess the stress and anxiety, and to evaluate effective measurements in this population. We searched relevant documents and literature, and designed a questionnaire from six aspects, including psychological status, epidemic situation, study, daily life, sports, and interpersonal communication, with 51 items in total. We sent the questionnaire on the Wenjuanxing Web platform, from April 2 to 8, 2022. We evaluated the mental status according to parts of the Generalized Anxiety Disorder-7 (GAD-7) and Depression Anxiety Stress Scales-21 (DASS-21), and investigated the influencing risk factors and countermeasures. Statistical analysis was performed by using the Chi-square test and multi-variable logistic regression. In total, 508 college respondents were recruited in our survey, and the pooled prevalence of mild anxiety (GAD score ≽ 5, or DASS-21 anxiety score ≽ 8) or stress (DASS-21 pressure score ≽ 14) caused by the new round of COVID-19 pandemic quarantine was 19.69% (100/508). The prevalence of the anxiety or stress in college students with COVID-19 quarantine between different genders, regions, and majors was not significantly different. Independent risk factors for the mild anxiety or stress of undergraduates by COVID-19 quarantine included learning efficiency or duration [OR = 1.36, 95%CI (1.14-1.62), P = 0.001], based on the combined analysis of Chi-square test analysis with multi-variable logistic regression analysis. Interestingly, the mental well-beings before COVID-19 epidemic quarantine [OR = 0.22, 95%CI (0.13-0.36), P < 0.0001], more low-intensity exercise [OR = 0.36, 95%CI (0.15-0.87), P = 0.02, high-intensity exercise as reference], and good sleep quality [OR = 0.14, 95%CI (0.07-0.30), P < 0.0001: OR = 0.42, 95%CI (0.30-0.59), P < 0.0001] are protective factors for alleviating the quarantine-caused anxiety or stress in Chinese college students for this round of COVID-19 epidemic quarantine. During the round of COVID-19 epidemic quarantine in 2022, a small number of college students have mild anxiety, affected by decreased learning efficiency or duration, which could be mitigated with low-intensity exercise and good sleep quality.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Determining attitudes toward e-learning: what are the attitudes of health professional students?

Aim

The research was carried out to determine the attitudes of nursing undergraduate students toward e-learning implemented during the COVID-19 pandemic.

Subject and methods

The study sample consisted of 320 undergraduate students studying at the Faculty of Health Sciences, Nursing Department of a state university. Personal Information Form and the Test of e-Learning Related Attitudes were administered to the research participants.

Results

Of the students, 68.8% were female and 51.6% were between the ages of 21-24. The attitude of 55.3% (177) toward e-learning is negative. Attitude scores of students aged 25-29 were significantly higher compared to those aged 17-20 and 21-24 years old (p = 0.002). The attitude scores of the students who have a computer are significantly higher than those who do not (p = 0.001). Most students did not agree with the statement "E-learning will provide me with better learning opportunities than conventional learning methods." (disagree n = 121; 37.8%, strongly disagree n = 110; 34.4%).

Conclusion

It is noticed that e-learning is not sufficient in subjects such as conducting clinical and laboratory practices in health sciences fields with practical training like nursing, and students' attitudes are generally negative. For undergraduate health sciences education, face-to-face and online education for support purposes can be used together in theoretical courses. In addition, it is recommended to use effective online communication techniques in online courses.

Online Learning Stress and Chinese College Students' Academic Coping during COVID-19: The Role of Academic Hope and Academic Self-Efficacy

Colleges around the world have adopted emergency online learning to continue with teaching and learning activities during COVID-19. Existing research has indicated that this teaching mode is perceived negatively by many college students. The difficulty students encounter in emergency online learning can adversely affect their mental health and academic performance. To shed further light on how emergency online learning may have impeded college students' academic functioning and adjustment, this study examined the association between online learning stress and academic coping and the mediating roles of academic self-efficacy and academic hope. It was conducted in early 2021, a year after the outbreak of the pandemic. Ninety-nine Chinese college students in Hong Kong were recruited and they completed an online questionnaire for this study. Results showed that online learning stress was negatively associated with approach academic coping and social support seeking, and the associations were mediated by academic hope. On the other hand, online learning stress was positively associated with avoidance academic coping, which was not mediated by academic hope. The mediation effects of academic self-efficacy were all non-significant. In sum, college students used more passive and maladaptive coping to handle academic problems when they experienced more online learning stress, and this was partly explained by lower levels of academic hope.

Psychological Status of College Students During COVID-19 Pandemic: A Cross-Sectional Study in Saudi Arabia

PURPOSE

This study aimed to assess the prevalence and associated factors of depression, anxiety, and stress among college students in Saudi Arabia during the COVID-19 outbreak.

METHODS

This cross-sectional study was conducted between February 10th to April 10th, 2021. An online self-administered questionnaire was emailed to college students at a large institution in Saudi Arabia. The questionnaire consisted of sociodemographic, educational backgrounds, and the Depression Anxiety Stress Scale-21 (DASS-21).

RESULTS

The study included 311 university students (62.7% female and 39.3% male). The prevalence of higher than moderate level in each of the depression, anxiety, and stress were (n= 164, 52.7%), (n= 222, 71.4%), and (n= 112, 36%), respectively. Further analysis revealed that females, younger age, history of depression, history of being quarantined by a health authority, and having contact with a confirmed case of COVID-19 were associated with a greater level of depression, anxiety, and stress.

CONCLUSION

Depression, anxiety, and stress were highly prevalent among college students during the outbreak. There was a significant association between demographic characteristics and the DASS 21 score. Researchers are recommended to concentrate their future studies on establishing strategies to enhance students' flexibility and adaptability in the face of future catastrophes.

Anxiety, Depression, and Stress among Radiography Undergraduates During the COVID-19 Pandemic

Introduction

The COVID-19 pandemic has severely impacted education and other aspects of life, causing psychological distress. The current study aims to identify anxiety, depression, and stress among radiography undergraduates during the COVID-19 pandemic.

Method

A descriptive, cross-sectional study was conducted between November and December 2021 on a sample of 140 radiography undergraduates at the Department of Radiography/Radiotherapy, Faculty of Allied Health Sciences, University of xxx, xx. An online survey with two sections: demographic characteristics and a psychometric scale (DASS-42) was used for data collection.

Results

A total of 107 undergraduates responded to the questionnaire giving a response rate of 76.2%. The results revealed that the majority of radiography undergraduate students suffered from mild to extremely severe depression (87.85%), anxiety (92.52%), and stress (73.83%) levels. In addition, more than two-thirds of the students (>73 % of participants) reported at least one symptom of depression, anxiety, or stress to varying degrees. Scores for depression, anxiety, and stress did not differ significantly across gender and academic year. However, a significant difference was observed between the two age groups, 23-26 years and > 27 years, regarding depression. The older students reported severe depression, whereas younger students reported moderate depression.

Conclusion

A high prevalence of negative psychological impact was observed among radiography undergraduates during the COVID-19 pandemic. This necessitates taking proactive steps to address, safeguard, and nurture undergraduates’ mental health and well-being during the current and future pandemic crises to mitigate the negative impacts.