International Journal of

ADVANCED AND APPLIED SCIENCES

EISSN: 2313-3724, Print ISSN: 2313-626X

Frequency: 12
line decor
  
line decor

 Volume 10, Issue 7 (July 2023), Pages: 195-202

----------------------------------------------

 Original Research Paper

Impact of COVID-19 pandemic on stress and coping strategies among medical students: A cross-sectional study

 Author(s): 

 Fahad Abdulaziz Alrashed 1, *, Tauseef Ahmad 2, Kamaran Sattar 2, Mishal M. Aldaihan 3, Muneera M. Almurdi 3, Leen Khalid Alrashed 2, Afaf A. M. Shaheen 3, Abdulrahman M. Alsubiheen 3

 Affiliation(s):

 1Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
 2College of Medicine, King Saud University, Riyadh, Saudi Arabia
 3Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia

  Full Text - PDF          XML

 * Corresponding Author. 

  Corresponding author's ORCID profile: https://orcid.org/0000-0001-5975-3275

 Digital Object Identifier: 

 https://doi.org/10.21833/ijaas.2023.07.021

 Abstract:

The COVID-19 pandemic has presented significant challenges and stressors for medical students, potentially affecting their emotional well-being. This study aimed to explore the influence of stress during and after the COVID-19 pandemic on medical students' sociodemographic characteristics and their coping strategies. A cross-sectional study was conducted among 1st to 5th-year medical students utilizing a self-administered questionnaire, alongside the Kessler 10 Psychological Distress questionnaire, to collect data on perceived stress and coping variables. The findings revealed a notable gender disparity in stress levels during the COVID-19 period, with female medical students experiencing significantly higher stress prevalence (38.5%) compared to their male counterparts (16.2%). However, in the post-COVID period, medical students reported slightly lower stress levels, with female students at 26.9% and male students at 12.8%, compared to the COVID-19 phase. Nonetheless, stress levels were found to be significantly higher post-COVID compared to the during-COVID period. Furthermore, the study identified that stress severity varied across different medical school years, with 3rd-year students experiencing the highest stress levels (OR=8.9; P<0.0001), followed by 5th-year (OR=6.6; P=0.0004), 1st-year (OR=3.9; P=0.008), and 4th-year (OR=2.4; P=0.01) students. Among the coping strategies adopted by medical students to manage moderate to severe stress, "Religious activities" emerged as the most effective approach (OR=0.44; P=0.0001). Furthermore, the study highlighted a noteworthy increase in stress levels among female students during the transitional year of medical school, i.e., the third medical year, which marks the transition from preclinical to clinical training. Considering the study's findings, a support program is proposed, aiming to integrate psychological, organizational, and instrumental assistance. This program aligns with the participatory model of intervention and is designed to address the unique stressors faced by medical students during and after the COVID-19 pandemic.

 © 2023 The Authors. Published by IASE.

 This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

 Keywords: COVID-19 pandemic, Medical students, Stress, Coping strategies, Psychological distress

 Article History: Received 15 December 2022, Received in revised form 26 May 2023, Accepted 8 June 2023

 Acknowledgment 

The authors extend their appreciation to the Deputyship for Research and Innovation, “Ministry of Education” in Saudi Arabia for funding this research (IFKSUOR3-063-1).

 Compliance with ethical standards

 Ethics approval and consent to participate

Institutional review board approval was obtained from the College of Medicine at KSU for the study protocol. Participants were required to consent to participate in the study before completing the questionnaires.

 Conflict of interest: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

 Citation:

 Alrashed FA, Ahmad T, Sattar K, Aldaihan MM, Almurdi MM, Alrashed LK, Shaheen AAM, and Alsubiheen AM (2023). Impact of COVID-19 pandemic on stress and coping strategies among medical students: A cross-sectional study. International Journal of Advanced and Applied Sciences, 10(7): 195-202

 Permanent Link to this page

 Figures

 No Figure

 Tables

 Table 1 Table 2 Table 3 

----------------------------------------------   

 References (44)

  1. Abdulghani AH, Ahmad T, and Abdulghani HM (2022a). The impact of COVID-19 pandemic on anxiety and depression among physical therapists in Saudi Arabia: A cross-sectional study. BMC Medical Education, 22: 751. https://doi.org/10.1186/s12909-022-03785-x   [Google Scholar] PMid:36320001 PMCid:PMC9623902
  2. Abdulghani H, Almndeel N, Almutawa A, Aldhahri R, Alzeheary M, Ahmad T, and Khamis N (2020b). The validity of the self-directed learning readiness instrument with the academic achievement among the Saudi medical students. International Journal of Medical Science and Public Health, 9(1): 44-50. https://doi.org/10.5455/ijmsph.2020.0925030102019   [Google Scholar]
  3. Abdulghani HM, Ahmad T, and Salah M (2014a). Current growth of information and communication technology in Saudi Arabia. Wulfenia Journal, 21(9): 216-223.   [Google Scholar]
  4. Abdulghani HM, Ahmed MM, Al-Rezqi AM, Althunayan SA, Mran AL, Alshaya AK, and Ahmad T (2021). Knowledge and awareness levels of diabetes mellitus risk factors among nondiabetic visitors of primary health care centers: A multicenter study. European Review for Medical and Pharmacological Sciences, 25(22): 7066-7077.   [Google Scholar]
  5. Abdulghani HM, Alballaa AI, Albishr NN, Alaqeel RA, Abdulghani AH, Abdulghani AH, and Marwa KI (2022b). Health professions education during the COVID-19 pandemic in four health colleges and students’ psychological well-being: A private university experience. International Journal of Medicine in Developing Countries, 6(8): 1022–1030. https://doi.org/10.24911/IJMDC.51-1653456584   [Google Scholar]
  6. Abdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, and Alfaris EA (2011). Stress and its effects on medical students: A cross-sectional study at a college of medicine in Saudi Arabia. Journal of Health, Population, and Nutrition, 29(5): 516-522. https://doi.org/10.3329/jhpn.v29i5.8906   [Google Scholar] PMid:22106758 PMCid:PMC3225114
  7. Abdulghani HM, Irshad M, Al Zunitan MA, Al Sulihem AA, Al Dehaim MA, Al Esefir WA, and Haque S (2014b). Prevalence of stress in junior doctors during their internship training: A cross-sectional study of three Saudi medical colleges’ hospitals. Neuropsychiatric Disease and Treatment, 10: 1879-1886. https://doi.org/10.2147/NDT.S68039   [Google Scholar] PMid:25328389 PMCid:PMC4196886
  8. Abdulghani HM, Sattar K, Ahmad T, and Akram A (2020a). Association of COVID-19 pandemic with undergraduate medical students' perceived stress and coping. Psychology Research and Behavior Management, 13: 871-881. https://doi.org/10.2147/PRBM.S276938   [Google Scholar] PMid:33154682 PMCid:PMC7608141
  9. Ahmad T, Sattar K, and Akram A (2020). Medical professionalism videos on YouTube: Content exploration and appraisal of user engagement. Saudi Journal of Biological Sciences, 27(9): 2287-2292. https://doi.org/10.1016/j.sjbs.2020.06.007   [Google Scholar] PMid:32884409 PMCid:PMC7451591
  10. Ahrens CE, Abeling S, Ahmad S, and Hinman J (2010). Spirituality and well-being: The relationship between religious coping and recovery from sexual assault. Journal of Interpersonal Violence, 25(7): 1242-1263. https://doi.org/10.1177/0886260509340533   [Google Scholar] PMid:19729675
  11. Al-Dabal BK, Koura MR, Rasheed P, Al-Sowielem L, and Makki SM (2010). A comparative study of perceived stress among female medical and non-medical university students in Dammam, Saudi Arabia. Sultan Qaboos University Medical Journal, 10(2): 231-240.   [Google Scholar]
  12. Alrashed FA, Alsubiheen AM, Alshammari H, Mazi SI, Al-Saud SA, Alayoubi S, and Dhiman G (2022). Stress, anxiety, and depression in pre-clinical medical students: Prevalence and association with sleep disorders. Sustainability, 14(18): 11320. https://doi.org/10.3390/su141811320   [Google Scholar]
  13. Alrashed FA, Sattar K, Ahmad T, Akram A, Karim SI, and Alsubiheen AM (2021). Prevalence of insomnia and related psychological factors with coping strategies among medical students in clinical years during the COVID-19 pandemic. Saudi Journal of Biological Sciences, 28(11): 6508-6514. https://doi.org/10.1016/j.sjbs.2021.07.022   [Google Scholar] PMid:34764766 PMCid:PMC8568835
  14. Anbari Z, Jamilian H, Rafiee M, Qomi M, and Moslemi Z (2013). The relationship between students’ satisfaction with major, mental health and academic achievement in Arak University of Medical Sciences. Iranian Journal of Medical Education, 13(6): 489-497.   [Google Scholar]
  15. Atherley AE, Hambleton IR, Unwin N, George C, Lashley PM, and Taylor CG (2016). Exploring the transition of undergraduate medical students into a clinical clerkship using organizational socialization theory. Perspectives on Medical Education, 5(20): 78-87. https://doi.org/10.1007/S40037-015-0241-5   [Google Scholar] PMid:26951164 PMCid:PMC4839013
  16. Awoke M, Mamo G, Abdu S, and Terefe B (2021). Perceived stress and coping strategies among undergraduate health science students of Jimma University amid the COVID-19 outbreak: Online cross-sectional survey. Frontiers in Psychology, 12: 639955. https://doi.org/10.3389/fpsyg.2021.639955   [Google Scholar] PMid:33859594 PMCid:PMC8042268
  17. CAPS (2020). Coping with the COVID-19 pandemic as a college student. University of Michigan Counseling and Psychological Services, Michigan, USA.   [Google Scholar]
  18. Cooke BD, Rossmann MM, McCubbin HI, and Patterson JM (1988). Examining the definition and assessment of social support: A resource for individuals and families. Family Relations, 37(2): 211-216. https://doi.org/10.2307/584322   [Google Scholar]
  19. Diehl K, Jansen C, Ishchanova K, and Hilger-Kolb J (2018). Loneliness at universities: determinants of emotional and social loneliness among students. International Journal of Environmental Research and Public Health, 15(9): 1865. https://doi.org/10.3390/ijerph15091865   [Google Scholar] PMid:30158447 PMCid:PMC6163695
  20. Fadhel SEB and Adawi TRT (2020). Perceived stress and coping strategies among university students. European Journal of Research in Medical Sciences, 8(1): 19–25.   [Google Scholar]
  21. Ferrel MN and Ryan JJ (2020). The impact of COVID-19 on medical education. Cureus, 12(3): e7492. https://doi.org/10.7759/cureus.7492   [Google Scholar] PMid:32368424 PMCid:PMC7193226
  22. Gao W, Ping S, and Liu X (2020). Gender differences in depression, anxiety, and stress among college students: A longitudinal study from China. Journal of Affective Disorders, 263: 292-300. https://doi.org/10.1016/j.jad.2019.11.121   [Google Scholar] PMid:31818792
  23. Grey I, Arora T, Thomas J, Saneh A, Tohme P, and Abi-Habib R (2020). The role of perceived social support on depression and sleep during the COVID-19 pandemic. Psychiatry Research, 293: 113452. https://doi.org/10.1016/j.psychres.2020.113452   [Google Scholar] PMid:32977047 PMCid:PMC7500407
  24. Haq AU, Li JP, Agbley BLY, Khan A, Khan I, Uddin MI, and Khan S (2022). IIMFCBM: Intelligent integrated model for feature extraction and classification of brain tumors using MRI clinical imaging data in IoT-healthcare. IEEE Journal of Biomedical and Health Informatics, 26(10): 5004-5012. https://doi.org/10.1109/JBHI.2022.3171663   [Google Scholar] PMid:35503847
  25. Haq AU, Li JP, Ahmad S, Khan S, Alshara MA, and Alotaibi RM (2021). Diagnostic approach for accurate diagnosis of COVID-19 employing deep learning and transfer learning techniques through chest X-ray images clinical data in e-healthcare. Sensors, 21(24): 8219. https://doi.org/10.3390/s21248219   [Google Scholar] PMid:34960313 PMCid:PMC8707954
  26. JHU (2020). COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). Johns Hopkins University, Baltimore, USA.   [Google Scholar]
  27. Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, and Zaslavsky AM (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6): 959-976. https://doi.org/10.1017/S0033291702006074   [Google Scholar] PMid:12214795
  28. Khan S (2021). Visual data analysis and simulation prediction for COVID-19 in Saudi Arabia using SEIR prediction model. International Journal of Online and Biomedical Engineering, 17(8): 154-167. https://doi.org/10.3991/ijoe.v17i08.20099   [Google Scholar]
  29. Mohammed AA, Uddin MS, and Saidi AM (2020). COVID-19 and movement control order: Stress and coping strategies of students observing self-quarantine. International Journal of Academic Research in Business and Social Sciences, 10(5): 788–802. https://doi.org/10.6007/IJARBSS/v10-i5/7249   [Google Scholar]
  30. Murray E, Krahé C, and Goodsman D (2018). Are medical students in prehospital care at risk of moral injury? Emergency Medicine Journal, 35(10): 590-594. https://doi.org/10.1136/emermed-2017-207216   [Google Scholar] PMid:29945983 PMCid:PMC6173814
  31. Peterlini M, Tibério IF, Saadeh A, Pereira JC, and Martins MA (2002). Anxiety and depression in the first year of medical residency training. Medical Education, 36(1): 66-72. https://doi.org/10.1046/j.1365-2923.2002.01104.x   [Google Scholar] PMid:11849526
  32. Polizzi C, Lynn SJ, and Perry A (2020). Stress and coping in the time of COVID-19: Pathways to resilience and recovery. Clinical Neuropsychiatry, 17(2): 59-62.   [Google Scholar]
  33. Rahman A, Bairagi A, Dey BK, and Nahar L (2012). Loneliness and depression in university students. The Chittagong University Journal of Biological Science, 7(1-2): 175-189.   [Google Scholar]
  34. Rose S (2020). Medical student education in the time of COVID-19. JAMA, 323(21): 2131-2132. https://doi.org/10.1001/jama.2020.5227   [Google Scholar] PMid:32232420
  35. Saravanan C and Wilks R (2014). Medical students’ experience of and reaction to stress: the role of depression and anxiety. The Scientific World Journal, 2014: 737382. https://doi.org/10.1155/2014/737382   [Google Scholar] PMid:24688425 PMCid:PMC3929074
  36. Schwartz KD, Exner-Cortens D, McMorris CA, Makarenko E, Arnold P, Van Bavel M, and Canfield R (2021). COVID-19 and student well-being: Stress and mental health during return-to-school. Canadian Journal of School Psychology, 36(2): 166-185. https://doi.org/10.1177/08295735211001653   [Google Scholar] PMid:34040284 PMCid:PMC8114331
  37. Seetan K, Al-Zubi M, Rubbai Y, Athamneh M, Khamees AA, and Radaideh T (2021). Impact of COVID-19 on medical students’ mental wellbeing in Jordan. PLOS ONE, 16(6): e0253295. https://doi.org/10.1371/journal.pone.0253295   [Google Scholar] PMid:34138964 PMCid:PMC8211263
  38. Teagle AR, George M, Gainsborough N, Haq I, and Okorie M (2017). Preparing medical students for clinical practice: Easing the transition. Perspectives on Medical Education, 6(4): 277-280. https://doi.org/10.1007/S40037-017-0352-2   [Google Scholar] PMid:28397007 PMCid:PMC5542891
  39. UNESCO (2020a). Report COVID-19 and higher education: Today and tomorrow; Impact analysis, policy responses and recommendations. UNESCO IESALC, United Nations Educational, Scientific and Cultural Organization, Paris, France.   [Google Scholar] 
  40. UNESCO (2020b). Global education coalition. United Nations Educational, Scientific and Cultural Organization, Paris, France.   [Google Scholar]
  41. WBG (2020). The global economic outlook during the COVID-19 pandemic: A changed world. World Bank Group, Washington, USA.   [Google Scholar]
  42. WHO (2020a). Mental health and COVID-19. World Health Organization, Geneva, Switzerland‎.   [Google Scholar]
  43. WHO (2020b). WHO announces COVID-19 outbreak a pandemic. World Health Organization, Geneva, Switzerland‎.   [Google Scholar]
  44. Ye Z, Yang X, Zeng C, Wang Y, Shen Z, Li X, and Lin D (2020). Resilience, social support, and coping as mediators between COVID‐19‐related stressful experiences and acute stress disorder among college students in China. Applied Psychology: Health and Well‐Being, 12(4): 1074-1094. https://doi.org/10.1111/aphw.12211   [Google Scholar] PMid:32666713 PMCid:PMC7405224