Korean Medical Education Review (의학교육논단)

Yonsei university college of medicine (연세대학교 의과대학)
권호 표지
DOI QR코드

DOI QR Code

Medical Students' Perceived Changes in Life, Mental Health Problems, and Strategies for Coping with Stress during the COVID-19 Pandemic

코로나19 팬데믹 상황에서 국내 의과대학생이 경험한 일상생활 변화, 정신건강 문제 및 스트레스 대처

  • Kim, Hae Won (Department of Medical Education, Yonsei University College of Medicine) ;
  • Yeo, Sanghee (Center for Medical Education, School of Medicine, Kyungpook National University) ;
  • An, Shinki (Department of Medical Education, Yonsei University College of Medicine)
  • 김혜원 (연세대학교 의과대학 의학교육학교실) ;
  • 여상희 (경북대학교 의과대학 의학교육센터) ;
  • 안신기 (연세대학교 의과대학 의학교육학교실)
  • Received : 2022.04.25
  • Accepted : 2022.06.15
  • Published : 2022.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study aimed to examine the influence of the coronavirus disease 2019 (COVID-19) pandemic on areas of Korean medical students' lives, assess concerns, and investigate the strategies they used to cope with stress due to the pandemic. An online survey with a total of 53 items on the impact of COVID-19, concerns, and coping strategies was sent to medical students, and responses were collected from April 27, 2021 to May 30, 2021. In total, 1,329 students were included in the study. Analysis was performed using the chi-square test, independent-sample t-test, and one-way analysis of variance, and the post-hoc Scheffé test or Games-Howell test was performed for multiple comparisons. The main negative impacts of the pandemic were on hobbies/leisure activities and mental health, and medical students expressed the highest levels of concern regarding restriction of movement, returning to everyday life, and risk of infection for family and friends. Female students more strongly agreed that COVID-19 had increased their depressed mood and anxiety (p<0.001 and p=0.003, respectively). Furthermore, the negative impacts of the pandemic on different areas of life significantly affected current levels of depressed mood and anxiety. To cope with pandemic-related stress, students used several strategies such as talking with family or friends (91.5%), sleeping (83.1%), exercising (72.8%), using social networking services (60.8%), drinking alcohol (37.8%), and practicing meditation/mindfulness (24.4%); the effectiveness of these strategies ranged from 3.45 to 4.19 on a 5-point Likert-type scale (1-5). The study findings suggest that COVID-19 has influenced the mental health of medical students and raised concerns in many areas of their lives. Students used various strategies to cope with the pandemic-related stress; since the effectiveness of frequently used approaches varied, it is essential to guide medical students to develop effective coping strategies.

Keywords

Acknowledgement

이 연구는 2021년도 한국의학교육학회 학술연구비 지원으로 이루어졌다.

References

  1. Xiong J, Lipsitz O, Nasri F, Lui LM, Gill H, Phan L, et al. Impact of COVID-19 pandemic on mental health in the general population: a systematic review. J Affect Disord. 2020;277:55-64. https://doi.org/10.1016/j.jad.2020.08.001
  2. Elbay RY, Kurtulmus A, Arpacioglu S, Karadere E. Depression, anxiety, stress levels of physicians and associated factors in COVID-19 pandemics. Psychiatry Res. 2020;290:113130. https://doi.org/10.1016/j.psychres.2020.113130
  3. Salazar de Pablo G, Vaquerizo-Serrano J, Catalan A, Arango C, Moreno C, Ferre F, et al. Impact of coronavirus syndromes on physical and mental health of health care workers: systematic review and meta-analysis. J Affect Disord. 2020;275:48-57. https://doi.org/10.1016/j.jad.2020.06.022
  4. Tam CW, Pang EP, Lam LC, Chiu HF. Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: stress and psychological impact among frontline healthcare workers. Psychol Med. 2004;34(7):1197-204. https://doi.org/10.1017/S0033291704002247
  5. Khalid I, Khalid TJ, Qabajah MR, Barnard AG, Qushmaq IA. Healthcare workers emotions, perceived stressors and coping strategies during a MERS-CoV outbreak. Clin Med Res. 2016;14(1):7-14. https://doi.org/10.3121/cmr.2016.1303
  6. Lee SM, Kang WS, Cho AR, Kim T, Park JK. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Compr Psychiatry. 2018;87:123-7. https://doi.org/10.1016/j.comppsych.2018.10.003
  7. Mosheva M, Hertz-Palmor N, Dorman Ilan S, Matalon N, Pessach IM, Afek A, et al. Anxiety, pandemic-related stress and resilience among physicians during the COVID-19 pandemic. Depress Anxiety. 2020;37(10):965-71. https://doi.org/10.1002/da.23085
  8. Galbraith N, Boyda D, McFeeters D, Hassan T. The mental health of doctors during the COVID-19 pandemic. BJPsych Bull. 2021;45(2):93-7. https://doi.org/10.1192/bjb.2020.44
  9. Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934. https://doi.org/10.1016/j.psychres.2020.112934
  10. Li Z, Yi X, Zhong M, Li Z, Xiang W, Wu S, et al. Psychological distress, social support, coping style, and perceived stress among medical staff and medical students in the early stages of the COVID-19 epidemic in China. Front Psychiatry. 2021;12:664808. https://doi.org/10.3389/fpsyt.2021.664808
  11. Wu S, Li Z, Li Z, Xiang W, Yuan Y, Liu Y, et al. The mental state and risk factors of Chinese medical staff and medical students in early stages of the COVID-19 epidemic. Compr Psychiatry. 2020;102:152202. https://doi.org/10.1016/j.comppsych.2020.152202
  12. O'Byrne L, Gavin B, Adamis D, Lim YX, McNicholas F. Levels of stress in medical students due to COVID-19. J Med Ethics. 2021 Mar 3 [Epub]. https://doi.org/10.1136/medethics-2020-107155.
  13. Arima M, Takamiya Y, Furuta A, Siriratsivawong K, Tsuchiya S, Izumi M. Factors associated with the mental health status of medical students during the COVID-19 pandemic: a cross-sectional study in Japan. BMJ Open. 2020;10(12):e043728. https://doi.org/10.1136/bmjopen-2020-043728
  14. Nishimura Y, Ochi K, Tokumasu K, Obika M, Hagiya H, Kataoka H, et al. Impact of the COVID-19 pandemic on the psychological distress of medical students in Japan: cross-sectional survey study. J Med Internet Res. 2021;23(2):e25232. https://doi.org/10.2196/25232
  15. Pelissier C, Viale M, Berthelot P, Poizat B, Massoubre C, Tiffet T, et al. Factors associated with psychological distress in French medical students during the COVID-19 health crisis: a cross-sectional study. Int J Environ Res Public Health. 2021;18(24):12951. https://doi.org/10.3390/ijerph182412951
  16. Zhao L, Sznajder K, Cheng D, Wang S, Cui C, Yang X. Coping styles for mediating the effect of resilience on depression among medical students in web-based classes during the COVID-19 pandemic: cross-sectional questionnaire study. J Med Internet Res. 2021;23(6):e25259. https://doi.org/10.2196/25259
  17. Lyons Z, Wilcox H, Leung L, Dearsley O. COVID-19 and the mental well-being of Australian medical students: impact, concerns and coping strategies used. Australas Psychiatry. 2020;28(6):649-52. https://doi.org/10.1177/1039856220947945
  18. Wieczorek T, Kolodziejczyk A, Ciulkowicz M, Maciaszek J, Misiak B, Rymaszewska J, et al. Class of 2020 in Poland: students' mental health during the COVID-19 outbreak in an academic setting. Int J Environ Res Public Health. 2021;18(6):2884. https://doi.org/10.3390/ijerph18062884
  19. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91. https://doi.org/10.3758/BF03193146
  20. Wang X, Hegde S, Son C, Keller B, Smith A, Sasangohar F. Investigating mental health of US college students during the COVID-19 pandemic: cross-sectional survey study. J Med Internet Res. 2020;22(9):e22817. https://doi.org/10.2196/22817
  21. Kecojevic A, Basch CH, Sullivan M, Davi NK. The impact of the COVID-19 epidemic on mental health of undergraduate students in New Jersey, cross-sectional study. PLoS One. 2020;15(9):e0239696. https://doi.org/10.1371/journal.pone.0239696
  22. Korean Society for Traumatic Stress Studies; Ministry of Health and Welfare. 2020 National Mental Health Survey report. Seoul: Korean Society for Traumatic Stress Studies; 2021.
  23. Daegu Regional Mental Health Welfare Center. COVID-19-related Mental Health Survey report. Daegu: Daegu Regional Mental Health Welfare Center; 2020.
  24. Shin JH, Kim HC, Jung CH, Kim JB, Jung SW, Cho HJ, et al. The Standardization of the Korean version of the Patient Health Questionnaire-2. J Korean Neuropsychiatr Assoc. 2013;52(3):115-21. https://doi.org/10.4306/jknpa.2013.52.3.115
  25. Ahn JK, Kim Y, Choi KH. The psychometric properties and clinical utility of the Korean version of GAD-7 and GAD-2. Front Psychiatry. 2019;10:127.
  26. Moon SB. Successful dissertations and theses: a practical and comprehensive guide to content and process. Seoul: Hakjisa; 2003.
  27. Lynn MR. Determination and quantification of content validity. Nurs Res. 1986;35(6):382-5.
  28. Lee EH. Psychometric property of an instrument 1: content validity. Korean J Women Health Nurs. 2021;27(1):10-3. https://doi.org/10.4069/kjwhn.2021.01.31
  29. Benham G. Stress and sleep in college students prior to and during the COVID-19 pandemic. Stress Health. 2021;37(3):504-15. https://doi.org/10.1002/smi.3016
  30. Hall SS, Zygmunt E. "I hate it here": mental health changes of college students living with parents during the COVID-19 quarantine. Emerg Adulthood. 2021;9(5):449-61. https://doi.org/10.1177/21676968211000494
  31. Gallegos MI, Zaring-Hinkle B, Bray JH. COVID-19 pandemic stresses and relationships in college students. Fam Relat. 2022;71(1):29-45. https://doi.org/10.1111/fare.12602
  32. Seetan K, Al-Zubi M, Rubbai Y, Athamneh M, Khamees A, Radaideh T. Impact of COVID-19 on medical students' mental wellbeing in Jordan. PLoS One. 2021;16(6):e0253295. https://doi.org/10.1371/journal.pone.0253295
  33. Guse J, Weegen AS, Heinen I, Bergelt C. Mental burden and perception of the study situation among undergraduate students during the COVID-19 pandemic: a cross-sectional study and comparison of dental and medical students. BMJ Open. 2021;11(12):e054728. https://doi.org/10.1136/bmjopen-2021-054728
  34. Byrnes YM, Civantos AM, Go BC, McWilliams TL, Rajasekaran K. Effect of the COVID-19 pandemic on medical student career perceptions: a national survey study. Med Educ Online. 2020;25(1):1798088. https://doi.org/10.1080/10872981.2020.1798088
  35. Balingit M. A new doctor's fast track from med student to COVID-19 fighter, in a hospital filled with loss. The Washington Post [Internet]. 2020 May 5 [cited 2022 May 30]. Available from: https://www.washingtonpost.com/education/2020/05/05/med-students-graduate-early-coronavirus/.
  36. Sharif SP. UK medical students graduating early to work during the COVID-19 pandemic. Psychol Med. 2021;51(11):1951. https://doi.org/10.1017/S0033291720001488
  37. Park J, Park H, Lim JE, Rhim HC, Lee YM. Medical students' perspectives on recommencing clinical rotations during coronavirus disease 2019 at one institution in South Korea. Korean J Med Educ. 2020;32(3):223-9. https://doi.org/10.3946/kjme.2020.170
  38. Wurth S, Sader J, Cerutti B, Broers B, Bajwa NM, Carballo S, et al. Medical students' perceptions and coping strategies during the first wave of the COVID-19 pandemic: studies, clinical implication, and professional identity. BMC Med Educ. 2021;21(1):620. https://doi.org/10.1186/s12909-021-03053-4
  39. Rose S, Hartnett J, Pillai S. Healthcare worker's emotions, perceived stressors and coping mechanisms during the COVID-19 pandemic. PLoS One. 2021;16(7):e0254252. https://doi.org/10.1371/journal.pone.0254252