Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Mental Health of Medical Students After Combating the COVID-19 Epidemic: A Cross-sectional Study in Vietnam

  • Duc Minh Cap (Faculty of Public Health, Hai Phong University of Medicine and Pharmacy) ;
  • Anh Quang Nguyen (Faculty of Public Health, Hai Phong University of Medicine and Pharmacy) ;
  • Tham Thi Nguyen (Faculty of Public Health, Hai Phong University of Medicine and Pharmacy)
  • Received : 2024.02.28
  • Accepted : 2024.05.09
  • Published : 2024.07.31
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Abstract

Objectives: This study was conducted to investigate the prevalence of mental health (MH) symptoms and associated factors among medical students who were engaged in combating the coronavirus disease 2019 (COVID-19) epidemic in 4 provinces/cities of Vietnam. Methods: A cross-sectional study with 580 participants was conducted at a medical university in Northern Vietnam. MH was assessed using the 21-item Depression, Anxiety, and Stress Scale, which was previously standardized in Vietnam. Data were collected through a structured self-administered questionnaire. Multivariate logistic regression was employed to examine the association between MH symptoms and relevant factors. Results: Out of a total of 2703 medical students, 21.5% responded to the questionnaire. Among the 580 respondents, the prevalence rates of depression, anxiety, and stress were 43.3%, 44.0%, and 24.7%, respectively. Factors significantly associated with self-reported depression included being female and having a COVID-19 infection. Similarly, being female and having a COVID-19 infection were significantly associated with self-reported anxiety. Factors associated with self-reported stress included being female, having a personal or family history of MH symptoms, working more than 8 hr/day, and having a COVID-19 infection. Conclusions: COVID-19 has adversely impacted the MH of medical students. Our findings are valuable in their potential to motivate universities, MH professionals, and authorities to offer mental healthcare services to this group. Furthermore, there is a pressing need for training courses designed to equip future healthcare workers with the skills to manage crises effectively.

Keywords

Acknowledgement

We extend our gratitude to all individuals who participated in the study. Additionally, we sincerely thank the homeroom teacher for providing assistance with data collection.

References

  1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497-506. https://doi.org/10.1016/S0140-6736(20)30183-5
  2. World Health Organization. COVID-19 situation updates for week 21 (23-29 May 2021) [cited 2022 Mar 20]. Available from: https://www.emro.who.int/pandemic-epidemic-diseases/covid-19/covid-19-situation-updates-for-week-21-2329-may-2021.html
  3. Gewalt SC, Berger S, Krisam R, Breuer M. "Effects of the COVID19 pandemic on university students' physical health, mental health and learning, a cross-sectional study including 917 students from eight universities in Germany". PLoS One 2022;17(8):e0273928. https://doi.org/10.1371/journal.pone.0273928
  4. Campos R, Pinto V, Alves D, Rosa CP, Pereira H. Impact of COVID-19 on the mental health of medical students in Portugal. J Pers Med 2021;11(10):986. https://doi.org/10.3390/jpm11100986
  5. Peng P, Hao Y, Liu Y, Chen S, Wang Y, Yang Q, et al. The prevalence and risk factors of mental problems in medical students during COVID-19 pandemic: a systematic review and meta-analysis. J Affect Disord 2023;321:167-181. https://doi.org/10.1016/j.jad.2022.10.040
  6. Pham T, Bui L, Nguyen A, Nguyen B, Tran P, Vu P, et al. The prevalence of depression and associated risk factors among medical students: an untold story in Vietnam. PLoS One 2019;14(8):e0221432. https://doi.org/10.1371/journal.pone.0221432
  7. Quek TT, Tam WW, Tran BX, Zhang M, Zhang Z, Ho CS, et al. The global prevalence of anxiety among medical students: a meta-analysis. Int J Environ Res Public Health 2019;16(15):2735. https://doi.org/10.3390/ijerph16152735
  8. Mao Y, Zhang N, Liu J, Zhu B, He R, Wang X. A systematic review of depression and anxiety in medical students in China. BMC Med Educ 2019;19(1):327. https://doi.org/10.1186/s12909-019-1744-2
  9. Quynh AT, Dunne MP, Ngoc HL. Well-being, depression and suicidal ideation among medical students throughout Vietnam. Vietnam J Med Pharm 2014;6(3):23-30.
  10. Vuong DA, Van Ginneken E, Morris J, Ha ST, Busse R. Mental health in Vietnam: burden of disease and availability of services. Asian J Psychiatr 2011;4(1):65-70. https://doi.org/10.1016/j.ajp.2011.01.005
  11. ElHawary H, Salimi A, Barone N, Alam P, Thibaudeau S. The effect of COVID-19 on medical students' education and wellbeing: a cross-sectional survey. Can Med Educ J 2021;12(3):92-99. https://doi.org/10.36834/cmej.71261
  12. Wang J, Liu W, Zhang Y, Xie S, Yang B. Perceived stress among Chinese medical students engaging in online learning in light of COVID-19. Psychol Res Behav Manag 2021;14:549-562. https://doi.org/10.2147/PRBM.S308497
  13. Safa F, Anjum A, Hossain S, Trisa TI, Alam SF, Abdur Rafi M, et al. Immediate psychological responses during the initial period of the COVID-19 pandemic among Bangladeshi medical students. Child Youth Serv Rev 2021;122:105912. https://doi.org/10.1016/j.childyouth.2020.105912
  14. Nguyen DT, Ngo TM, Nguyen HL, Le MD, Duong ML, Hoang PH, et al. The prevalence of self-reported anxiety, depression, and associated factors among Hanoi Medical University's students during the first wave of COVID-19 pandemic. PLoS One 2022;17(8):e0269740. https://doi.org/10.1371/journal.pone.0269740
  15. Nguyen HT, Hoang AP, Vu LM, Tran DQ, Bui LK, Pham TT, et al. Prevalence of and risk factors associated with depression among nursing students acting on the frontline of COVID-19 pandemic: a cross-sectional study. Front Public Health 2023;10:1020419. https://doi.org/10.3389/fpubh.2022.1020419
  16. Khan AH, Sultana MS, Hossain S, Hasan MT, Ahmed HU, Sikder MT. The impact of COVID-19 pandemic on mental health & wellbeing among home-quarantined Bangladeshi students: a cross-sectional pilot study. J Affect Disord 2020;277:121-128. https://doi.org/10.1016/j.jad.2020.07.135
  17. Hosen I, Al-Mamun F, Mamun MA. Prevalence and risk factors of the symptoms of depression, anxiety, and stress during the COVID-19 pandemic in Bangladesh: a systematic review and meta-analysis. Glob Ment Health (Camb) 2021;8:e47. https://doi.org/10.1017/gmh.2021.49
  18. Ashiq MA, Gupta PS, Jubayer Biswas MA, Ahmed N, Sultana MS, Ghosh B, et al. Depression, anxiety, stress, and fear of COVID-19 among Bangladeshi medical students during the first wave of the pandemic: a mixed-methods study. Front Psychiatry 2023;14:1142724. https://doi.org/10.3389/fpsyt.2023.1142724
  19. Luo W, Mohammed J. Mental health status and coping strategies of Chinese university students during the COVID-19 pandemic: a rapid review. PLoS One 2023;18(12):e0296309. https://doi.org/10.1371/journal.pone.0296309
  20. World Health Organization. COVID-19 in Viet Nam situation report 70; 2021 [cited 2022 Apr 15]. Available from: https://www.who.int/vietnam/internal-publications-detail/covid-19-in-viet-nam-situation-report-70
  21. Vietnam Ministry of Health. Nearly hundreds of lecturers and students from Hai Phong University of Medicine and Pharmacy have set out to help Bac Giang in its fight against the COVID-19 epidemic; 2021 [cited 2022 Feb 17]. Available from: https://covid19.gov.vn/gan-tram-giang-vien-sinh-vien-dai-hoc-y-duoc-hai-phong-len-duong-chi-vien-cho-bac-giang-chong-dichcovid-19-1717338904.htm (Vietnamese).
  22. Vietnam Ministry of Health. More than 100 medical staff and students from Hai Phong have entered Binh Duong to fight the COVID-19 epidemic; 2021 [cited 2022 Feb 20]. Available from: https://moh.gov.vn/hoat-dong-cua-dia-phuong/-/asset_publisher/gHbla8vOQDuS/content/hon-100-can-bo-sinhvien-nganh-y-hai-phong-vao-binh-duong-chong-dich (Vietnamese).
  23. Haiphong University of Medicine and Pharmacy. Medical staff and students volunteer to participate in the fight against COVID-19 epidemic in Ho Chi Minh City [cited 2022 Mar 23]. Available from: http://hpmu.edu.vn/hpmu/news/TIN-TUC-SU-KIEN/Le-xuat-quan-dot-III-Doan-can-bo-sinh-vien-tinh-nguyentham-gia-chong-dich-tai-thanh-pho-Ho-Chi-Minh-2969/(Vietnamese).
  24. Hai NT, Thi HL, Tran Cong HT, Thi VT, Hua Thi LO, Vo Le TT, et al. Investigating effects of COVID-19 pandemic on the mental health of nursing students during remote learning: an experience from Dong A University, Vietnam. SAGE Open Nurs 2022;8:23779608221135437. https://doi.org/10.1177/23779608221135437
  25. Tran TD, Tran T, Fisher J. Validation of the depression anxiety stress scales (DASS) 21 as a screening instrument for depression and anxiety in a rural community-based cohort of northern Vietnamese women. BMC Psychiatry 2013;13:24. https://doi.org/10.1186/1471-244X-13-24
  26. Lovinbond SH, Lovinbond PF. Depression anxiety stress scales; 1995 [cited 2021 Apr 10]. Available from: https://doi.org/10.1037/t01004-000
  27. Ahmed SP, Bittencourt-Hewitt A, Sebastian CL. Neurocognitive bases of emotion regulation development in adolescence. Dev Cogn Neurosci 2015;15:11-25. https://doi.org/10.1016/j.dcn.2015.07.006
  28. Chang WW, Shi LX, Zhang L, Jin YL, Yu JG. The mental health status and associated factors among medical students engaged in online learning at home during the pandemic: a cross-sectional study from China. Front Psychiatry 2021;12:755503. https://doi.org/10.3389/fpsyt.2021.755503
  29. Lisiecka A, Chimicz D, Lewicka-Zelent A. Mental health support in higher education during the COVID-19 pandemic: a case study and recommendations for practice. Int J Environ Res Public Health 2023;20(6):4969. https://doi.org/10.3390/ijerph20064969
  30. Lisiecka A, Chimicz D, Lewicka-Zelent A. Mental health support in higher education during the COVID-19 pandemic: a case study and recommendations for practice. Int J Environ Res Public Health 2023;20(6):4969. https://doi.org/10.3390/ijerph20064969
  31. Khajavi M, Izadpanah M, Eslami K, Kouti L. Design, implementation and evaluation of a student mentoring program for pharmacy students based on facilitation by the pharmacist assistant website at the school of pharmacy of Ahvaz Jundishapur University of Medical Sciences. J Pharm Care 2021;9(2):61-66. https://doi.org/10.18502/jpc.v9i2.6608
  32. Goozee R, Papadatou-Pastou M, Barley E, Haddad M, Tzotzoli P. Survey to inform the development of an online support system for higher education students: higher education and online support. Health 2018;10(3):351-364. https://doi.org/10.4236/health.2018.103028
  33. Huarcaya-Victoria J, Elera-Fitzcarrald C, Crisol-Deza D, Villanueva-Zuniga L, Pacherres A, Torres A, et al. Factors associated with mental health in Peruvian medical students during the COVID-19 pandemic: a multicentre quantitative study. Rev Colomb Psiquiatr (Engl Ed) 2023;52(3):236-244. https://doi.org/10.1016/j.rcpeng.2021.06.014
  34. Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of depression in the community from 30 countries between 1994 and 2014. Sci Rep 2018;8(1):2861. https://doi.org/10.1038/s41598-018-21243-x
  35. Li SH, Graham BM. Why are women so vulnerable to anxiety, trauma-related and stress-related disorders? The potential role of sex hormones. Lancet Psychiatry 2017;4(1):73-82. https://doi.org/10.1016/S2215-0366(16)30358-3
  36. Kundakovic M, Rocks D. Sex hormone fluctuation and increased female risk for depression and anxiety disorders: from clinical evidence to molecular mechanisms. Front Neuroendocrinol 2022;66:101010. https://doi.org/10.1016/j.yfrne.2022.101010
  37. Guo AA, Crum MA, Fowler LA. Assessing the psychological impacts of COVID-19 in undergraduate medical students. Int J Environ Res Public Health 2021;18(6):2952. https://doi.org/10.3390/ijerph18062952
  38. Wathelet M, Horn M, Creupelandt C, Fovet T, Baubet T, Habran E, et al. Mental health symptoms of university students 15 months after the onset of the COVID-19 pandemic in France. JAMA Netw Open 2022;5(12):e2249342. https://doi.org/10.1001/jamanetworkopen.2022.49342
  39. Che H, Wu H, Qiao Y, Luan B, Zhao Q, Wang H. Association between long working hours and mental health among nurses in China under COVID-19 pandemic: based on a large cross-sectional study. BMC Psychiatry 2023;23(1):234. https://doi.org/10.1186/s12888-023-04722-y
  40. Le Thi Ngoc A, Dang Van C, Nguyen Thanh P, Lewycka S, Van Nuil JI. Depression, anxiety, and stress among frontline health workers during the second wave of COVID-19 in southern Vietnam: a cross-sectional survey. PLOS Glob Public Health 2022;2(9):e0000823. https://doi.org/10.1371/journal.pgph.0000823