COVID-19 pandemic and its aftermath: Knowledge, attitude, behavior, and mental health-care needs of medical undergraduates

Motivation for solitude, COVID-19-related anxiety and resilience among Indian medical students

Background

Recent reports indicate that self-isolation because of coronavirus disease 2019 (COVID-19)-related lockdowns had significant influence on mental health of medical students.

Aim

To understand the relationship between two different motivations for solitude - self-determined versus non-self-determined with medical students' COVID-19-related anxiety and psychological resilience during their self-isolation because of COVID-19-related lockdowns.

Materials and Methods

After the approval of the Institutional Ethics Committee, this online survey was done on undergraduate Indian medical students during the COVID-19 pandemic. Expressing consent at the beginning of the online form, enabled the students to proceed to the next section comprising their sociodemographic details and clinical details. The last section of the form comprised the Motivation for Solitude Scale-Short Form, the COVID-19 Anxiety Scale, and the Connor-Davidson Resilience Scale-Abbreviated.

Results

282 out of 286 students of either sex gave their consent and completed the given form. Both self-determined and non-self-determined motivations for solitude were higher in female medical students. The self-determined motivation for solitude was directly related to all students' resilience. A past history of psychiatric illness was directly associated with the non-self-determined motivation for solitude of the students. The non-self-directed motivation for solitude of female students was indirectly related to their resilience. The COVID-19-related anxiety was not related to either type of motivation for solitude as well as the resilience of the medical students.

Conclusion

Indian female medical students are more motivated for solitude, be it self-determined or non-self-determined, than their male counterparts. The student's resilience has a direct relationship with students' self-determined motivation. The COVID-19-related anxiety among the medical students is not related to their motivations for solitude or resilience.

Perceptions of change in the environment caused by the COVID-19 pandemic: Implications for environmental policy

COVID-19 lockdown measures have impacted the environment with both positive and negative effects. However, how human populations have perceived such changes in the natural environment and how they may have changed their daily habits have not been yet thoroughly evaluated. The objectives of this work were to investigate (1) the social perception of the environmental changes produced by the COVID-19 pandemic lockdown and the derived change in habits in relation to i) waste management, energy saving, and sustainable consumption, ii) mobility, iii) social inequalities, iv) generation of noise, v) utilization of natural spaces, and, vi) human population perception towards the future, and (2) the associations of these potential new habits with various socio-demographic variables. First, a SWOT analysis identified strengths (S), weaknesses (W), opportunities (O), and threats (T) generated by the pandemic lockdown measures. Second, a survey based on the aspects of the SWOT was administered among 2370 adults from 37 countries during the period from February to September 2021. We found that the short-term positive impacts on the natural environment were generally well recognized. In contrast, longer-term negative effects arise, but they were often not reported by the survey participants, such as greater production of plastic waste derived from health safety measures, and the increase in e-commerce use, which can displace small storefront businesses. We were able to capture a mismatch between perceptions and the reported data related to visits to natural areas, and generation of waste. We found that age and country of residence were major contributors in shaping the survey participants ´answers, which highlights the importance of government management strategies to address current and future environmental problems. Enhanced positive perceptions of the environment and ecosystems, combined with the understanding that livelihood sustainability, needs to be prioritized and would reinforce environmental protection policies to create greener cities. Moreover, new sustainable jobs in combination with more sustainable human habits represent an opportunity to reinforce environmental policy.

COVID-19 and mental health: A systematic review of international medical student surveys

Background

The medical school curriculum has imposed psychological stressors on students worldwide, some of which may induce feelings of increased depression and anxiety. Meanwhile, the COVID-19 pandemic has exacerbated the feelings of stress, depression, and anxiety that a portion of medical students experience in their daily life. The aim of this systematic review is to gather concrete data from medical schools around the globe, and further evaluate how the COVID-19 pandemic has impacted medical students' mental health.

Materials and methods

Systematic search of data from PubMed, EMBASE, psycINFO, MEDLINE Complete, and Global Health for studies conducted between December 2019 and July 2021 was conducted. Data from 47 different surveys of medical students from various medical institutions throughout the world were included in this review. These surveys, administered in the form of questionnaires that utilized rating scales, measured anxiety, depression, and stress levels in medical students amidst the COVID-19 outbreak.

Results

The COVID-19 outbreak was found to have negative effects on medical students, most notably causing emotional and behavioral changes and detrimental mental health impacts. Higher levels of stress, depression, and anxiety have been found in medical students since the outbreak.

Conclusion

This systematic review highlights the sustained high prevalence of moderate depression, anxiety and stress among medical students during the COVID-19 pandemic. Appropriate support and research on which interventions could mitigate these risks is essential in order to ensure that future physicians are properly cared for, and ultimately have the adequate tools needed to provide high quality and empathetic care to future patients.

The impact of covid-19: Anxiety, depression, and wellbeing among medical students

BACKGROUND

Medical students have been considered as a vulnerable group at higher risk of mental health issues during the COVID-19 outbreak.

AIMS

We set out to detect symptoms of depression and anxiety in medical students in St. Petersburg (Russia) during the first wave of COVID-19 outbreak and explore the associations between psychosocial factors related to the pandemic and students' psychological well-being.

METHOD

An anonymous online survey of medical students was conducted in May-June 2020. The Hospital Anxiety and Depression Scale (HADS) was used for screening anxiety and depression symptoms. The final sample consisted of 144 students (78.5% females).

RESULTS

About 69.4% of respondents reported that COVID-19 pandemic and social restrictions were a new source of stress in their lives. More than one-third (38.9%) of respondents reported a need for psychological (emotional) support due to a change in their daily life during the COVID-19 pandemic, with the vast majority (83.9%) of these respondents indicated an increased need for support in this specific period. Symptoms of anxiety were reported by 55.8% of females (HADS score: 9.05 ± 4.69) and 48.4% of males (8.09 ± 5.0), and symptoms of depression were found in 38.9% of females (6.40 ± 3.57) and 41.9% of males (6.16 ± 3.21).

CONCLUSIONS

These findings indicate that it is necessary to develop additional measures for the prevention and early diagnosis of mental disorders along with right levels of support for wellbeing and mental health of medical students in this ongoing pandemic.

Factors Predicting the Quality of Life of University Students in Japan Amidst COVID-19: A Cross-Sectional Study

Owing to the COVID-19 pandemic, classes and club activities in Japanese universities have been canceled; this may increase students' perceived stress and adversely affect their quality of life. This study investigated the factors that influence Japanese university students' quality of life during the pandemic. An online questionnaire collating data related to demographic characteristics, the perceived stress scale (PSS), sense of coherence (SOC), number of social supports, and quality of life (Short Form Health Survey; SF-8) was distributed to university students. Participants were divided into two groups: those who entered university before (seniors) and after (juniors) the onset of the pandemic. Their scores on the two sub-domains (physical and mental) of the SF-8 were evaluated. Multiple regression analysis was performed to identify factors associated with the composite mental summary of the SF-8. Regression analysis indicated that the predictor model of the composite mental summary differed between juniors and seniors. Among seniors, the composite mental summary was significantly indicated by the composite physical summary (β = 0.549, p < 0.0001) and PSS (β = 0.422, p < 0.0001). Among juniors, it was significantly indicated by the composite physical summary (β = 0.531, p < 0.0001), PSS (β = 0.390, p < 0.0001), and number of social supports (β = -0.148, p = 0.006). The factors associated with quality of life differed between seniors and juniors. Universities must provide opportunities for students to find more friends, especially for juniors who have limited socialization opportunities owing to the pandemic.

Mental Health Risk Factors and Coping Strategies among Students in Asia Pacific during COVID-19 Pandemic—A Scoping Review

The impact of COVID-19 has forced higher education institutes to go into lockdown in order to curb the situation. This sudden change caused students within the institutions to forgo traditional face to face classroom settings and to attend immediate online classes. This review aims to summarize the evidence of the social demographic mental health impacts of the COVID-19 pandemic on students in higher education institutes within the Asia Pacific region and identify the coping mechanisms adopted during these times. A systematic literature search was conducted using three databases (PubMed, Google Scholar, and Scopus), out of which 64 studies met the inclusion/exclusion criteria. The findings revealed that the social demographic groups most at risk were female students, those who were in the final years of their studies (i.e., students who were almost graduating), and postgraduate students as well as students studying medical fields (nursing, dental, medicine, health sciences etc.). The majority of the studies identified that students were relying on mobile devices and extended screen time to cope with the pandemic. Having proper social support, be it through a network of friends or positive family cohesion, can be a good buffer against the mental impacts of COVID-19. Students in higher education institutes are at risk of mental consequences due to COVID-19. By reducing their screen time, finding a healthier coping system, increasing the availability of support within the family and community, as well as actively engaging in beneficial activities students may be able to alleviate general negative emotions, specifically during the pandemic.

The Mediating Effect of Reassurance-Seeking Behavior on the Influence of Viral Anxiety and Depression on COVID-19 Obsession Among Medical Students

OBJECTIVES

Healthcare workers experienced great psychological burden due to the continuation of the COVID-19 pandemic. During the pandemic, medical healthcare workers experienced greater instances of insomnia, anxiety, depression, somatization, and obsessive-compulsive symptoms than the general population. This study aimed to explore the association between viral anxiety and obsession with COVID-19 among medical students with reassurance-seeking behavior as a mediator.

METHODS

In October 2021, an online survey was conducted among medical students at the University of Ulsan College of Medicine. The clinical characteristics of 162 participants and their responses to rating scales, including stress and anxiety to viral Epidemics-6 items (SAVE-6), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Patient Health Questionnaire-9 items (PHQ-9), and Obsession with COVID-19 scale were collected.

RESULTS

Medical students' obsession with COVID-19 was based on the PHQ-9 (β = 0.15, p = 0.01), SAVE-6 (β = 0.43, p < 0.001), and CRBS (β = 0.38, p < 0.001) scores (adjusted R² = 0.49, F = 39.9, p < 0.001). Mediation analysis showed that medical students' viral anxiety and depression directly influenced their obsession with COVID-19, and their reassurance-seeking behavior partially mediated the effects of depression or viral anxiety on obsession with COVID-19.

CONCLUSIONS

Medical students' viral anxiety and depression may affect their obsession with COVID-19, and reassurance-seeking behaviors may mediate this. Therefore, medical students should adopt adaptive coping strategies to prevent high levels of viral anxiety and recurrent reassurance-seeking behavior.

Post-secondary Student Mental Health During COVID-19: A Meta-Analysis

The COVID-19 pandemic has posed notable challenges to post-secondary students, causing concern for their psychological well-being. In the face of school closures, academic disruptions, and constraints on social gatherings, it is crucial to understand the extent to which mental health among post-secondary students has been impacted in order to inform support implementation for this population. The present meta-analysis examines the global prevalence of clinically significant depression and anxiety among post-secondary students during the COVID-19 pandemic. Several moderator analyses were also performed to examine sources of variability in depression and anxiety prevalence rates. A systematic search was conducted across six databases on May 3, 2021, yielding a total of 176 studies (1,732,456 participants) which met inclusion criteria. Random-effects meta-analyses of 126 studies assessing depression symptoms and 144 studies assessing anxiety symptoms were conducted. The pooled prevalence estimates of clinically elevated depressive and anxiety symptoms for post-secondary students during the COVID-19 pandemic was 30.6% (95% CI: 0.274, 0.340) and 28.2% (CI: 0.246, 0.321), respectively. The month of data collection and geographical region were determined to be significant moderators. However, student age, sex, type (i.e., healthcare student vs. non-healthcare student), and level of training (i.e., undergraduate, university or college generally; graduate, medical, post-doctorate, fellow, trainee), were not sources of variability in pooled rates of depression and anxiety symptoms during the pandemic. The current study indicates a call for continued access to mental health services to ensure post-secondary students receive adequate support during and after the COVID-19 pandemic. Systematic Review Registration: PROSPERO website: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021253547.

Social Media Use, Psychological Distress and Knowledge, Attitude, and Practices Regarding the COVID-19 Among a Sample of the Population of Pakistan

This study was conducted to assess social media (SM) use, psychological distress, and knowledge, attitude, and practices (KAP) regarding the coronavirus disease 2019 (COVID-19) among a sample of the population of Pakistan. A cross-sectional study was conducted in Multan, Pakistan between April and May 2020. Demographics details, SM use, psychological distress, and KAP on the COVID-19 were investigated. A total of 800 respondents were analyzed out of which 33.5% (n = 268) were women. No gender-wise difference was found in the terms of SM use and duration of SM use. Women were prone to have psychological disorders such as anxiety, depression, and stress than men in the current COVID-19 pandemic. The mean knowledge score of men was significantly higher compared to women (18.69 ± 4.20 vs. 16.89 ± 3.04, p < 0.001), while the mean score of the attitude and practices on the COVID-19 prevention measures was significantly better in women (p = 0.012 and p < 0.001, respectively). The psychological problems such as anxiety (p < 0.001) and depression scores (p = 0.033) were higher among women than men. The stress score was also higher in women but not significantly higher (p = 0.079). The knowledge was significantly correlated with attitude, anxiety, depression, and stress. The regression analysis showed that the COVID-19-related KAPs are the predictors of psychological suffering of an individual. The female gender was positively associated with anxiety and depression. The SM use was the predictor of the stress. Male respondents had significantly more knowledge of the COVID-19 than female respondents, but women had significantly better attitudes and practiced the COVID-19 prevention measures. Gender is a significant determinant of psychological distress and KAP about the COVID-19. The government has already taken significant steps to limit the spread of the disease; however, much more effort is required to tackle this COVID-19 pandemic.

Analysis of change in knowledge, attitude, and practices about COVID-19 following and awareness session in rural population of Western India

BACKGROUND

Beginning of the pandemic showed our limitations in our understanding of the spread of the dreaded coronavirus-19 that had sprung from China and spread through thick and thin across the world. The measures to contain the spread of virus in the absence of specific treatment protocol had everyone grope for the solutions in a very short time frame. One such is the knowledge, attitude, and practice in the rural setup.

AIM

The aim of the study is to measure the change in knowledge, attitude, and practices (KAP) regarding COVID-19 following an awareness session in rural population.

MATERIALS AND METHODS

A cross-section interventional study was carried out in January 2021. An interactive awareness session was conducted with the help of audiovisual aids following MOHFW guidelines for COVID-19, and the change in KAP about COVID-19 was measured by pre- and posttest standardized questionnaire.

RESULTS

Of all the participants, statistically significant change in knowledge was seen from 43% to 52%. The villagers were educated about preventive steps and a positive change was measured in the practice of changing masks regularly (84%-100%), maintaining social distancing (44%-64%), frequent handwashing (52%-64%). No change was seen in wearing of masks (92%) and negative change was seen in avoiding handshakes (32%-28%). The preventive practices regarding COVID-19 pandemic changed significantly from 50% to 58%. Our study measured positive attitude change toward getting vaccinated from 64% to 72%.

CONCLUSION

A single, short awareness session led to significant change in KAP about COVID-19 in rural population.

COVID-19 lockdown: Online survey of psychosocial factors of adolescents

BACKGROUND

The coronavirus pandemic has affected more than 14 million people in the world. Adults are somehow able to manage their stress created by the most fearful disease. However, it is the children and adolescents who are most affected by COVID-19 lockdown.

AIM

This study aimed to assess the effect of COVID-19 lockdown on adolescent's psychosocial factors.

MATERIALS AND METHODS

Using the Google Form link, a questionnaire was developed and an online survey was conducted. This online questionnaire consisted of 40 items assessing personal, social, academic, and family domains related to adolescents.

RESULTS

A total of 223 responses were obtained. The results indicate that 6.5% of adolescents experience extreme level of anxiousness, 29.8% become little irritable and angry, affecting their personal/emotional domain. About 12.6% of the adolescents are uncomfortable with social distancing and 48.4% of them greatly miss their friends; 38.1% miss their school and 28.8% are unable to clear their doubts through online teaching. Mathematics was the most uncomfortable subject for them to deal with 49.8%. About 79% of adolescents suffer mildly from family distress, 43.3% (extremely) are eagerly waiting for the lockdown to end.

CONCLUSION

Among all four domains, the family domain was the most affected due to COVID-19 lockdown, followed by social, academic, and personal domains.

Exploring cyberchondria and its associations in dental students amid COVID-19 infodemic

BACKGROUND

Adverse psychological effect of pandemic includes not only increased levels of stress, anxiety, and depression but also cyberchondria - the problematic online health research behavior. It is thought that the distress and uncertainty of pandemic clubbed with information overload and its ambiguity have paved the way for cyberchondria. Students being the vulnerable population, the present study was an effort at understanding cyberchondria in students.

AIM

The aim of the study is to assess cyberchondria and its association with depression, anxiety, stress, and quality of life (QOL) in dental students during the pandemic.

MATERIALS AND METHODS

An online questionnaire-based survey was carried out on dental students. The survey tool comprised a semi-structured pro forma, General Health Questionnaire-12, Depression Anxiety and Stress Scale 21, Cyberchondria Severity Scale 15, and European Health Interview Survey QOL 8.

RESULTS

The study revealed that 98.7% of the students were affected by one of the constructs of cyberchondria, viz., "excessiveness" (93.7%), followed by "distress" (84.3%) and "reassurance"-seeking behavior (83.7%). Cyberchondria affected girls more than boys and shared robust positive correlation with depression, anxiety, and stress but not QOL. Factors such as stress, anxiety, QOL, and changes in appetite were associated with higher severity of depression. Family financial losses, preexisting psychiatric illness, and media adverse effect shared robust positive associations with severity of depression, anxiety, and stress and an inverse association with QOL. 76.0% of the students expressed excessive worries regarding missing out on clinical exposure, and nearly half of the students were dissatisfied with eLearning. 78.3% of the students experienced changes in sleep; 68.7% had changes in appetite; and 89.0% reported reduction in the level of physical activity.

CONCLUSION

Cyberchondria is affecting the large majority of students. Educational institutions must put efforts to sensitize students about cyberchondria.