Depression, Anxiety, and Stress among Female Undergraduate Students: Physical Health Concerns as Influencing Determinants

Background: During the COVID-19 pandemic, medical students and health-care professionals faced significant challenges, which had a negative impact on their mental health. Aims: This study aimed to assess the mental health of male and female undergraduate medical students and the psychological effects of the COVID-19 pandemic. Participants and the Methodologies: After receiving institutional ethical clearance and the informed consent of the participants, this study was carried out on 591 medical students from a peripheral medical college in West Bengal during the first and second waves of the COVID-19 pandemic. At intervals of 6 months, two surveys were conducted. The Depression Anxiety and Stress Scale-21 and Impact of Event Scale–Revised scale scores were evaluated in the Google Forms surveys. Using the t-test and the Chi-square test, the parameters of the two groups of students were compared. Results: On the initial assessment, neither group received a score that was significantly different from the other. Female students had significantly higher anxiety scores than male students on the second assessment. During the second pandemic wave, there was a significant gender difference in anxiety and stress levels (P = 0.001), with females experiencing higher levels of anxiety and stress. Conclusions: During the second wave of the COVID-19 pandemic, female undergraduate medical students had higher stress and anxiety levels than their male counterparts, according to the current study. Therefore, it is possible to draw the conclusion that the spread of the pandemic had a greater negative impact on the mental health of female undergraduate students.

Gender differences in university students’ well-being and mental health are prominent concerns in higher education. During the COVID-19 pandemic, male and female students have reported specific stressors that have impacted their well-being and mental health, including difficulty concentrating, concerns about academic performance, and classroom workload. All of these stressors could be mitigated by instructional quality in courses. This study sought to better understand the associations between instructional quality and mental health impairment, i.e., poor mental health and high psychological distress, among male and female undergraduate students during the COVID-19 pandemic. We asked whether perceived instructional quality has a protective effect on students’ mental health with regard to academic stress and academic satisfaction across genders. We used longitudinal data from an ethnically diverse sample of 209 students (68% females, 82% freshmen, 50% Asian, 32% Hispanic, 13% White, 5% other) from a public university in Southern California, United States. Data were assessed during the winter and spring quarters of the academic year 2019–2020, i.e., before and after the outbreak of the COVID-19 pandemic in the US. Associations between instructional quality and students’ mental health impairment did not differ across genders. The findings indicated that perceived instructional quality at the beginning of the spring quarter 2020 was indirectly related to male and female students’ mental health impairment at the end of this quarter. This association was mediated by academic satisfaction. This finding points to a protective effect of instructional quality on students’ mental health. However, no effect was found concerning changes to mental health. Gender differences occurred in the link between academic stress and mental health impairment. Academic stress was a stronger predictor of mental health impairment for female students compared to male students. Furthermore, for female students alone, academic stress predicted changes in mental health impairment. We discuss practical implications for higher education. First, our study highlighted that instructional quality in higher education courses might lead to academic satisfaction and thereby help protect university students’ mental health. Second, higher education might consider providing additional support for (female) students to improve their stress management. We argue that improving and enhancing the academic environment are more important than reducing the burden of stressors.

Differences in stress levels between junior high school students and college students during online learning

The study aimed at exploring and understanding undergraduate female students’ experiences of sexual harassment by male peers on and around university campuses. The hegemonic masculinity perspective and the socio-cultural model combined to inform the study. The population of the study consisted of a purposive sample of 20 female undergraduate students in two state universities. Qualitative in-depth interviews were done to obtain understanding of how peer sexual harassment was experienced by undergraduate female students. Data was collected through one-on-one audio recorded semi-structured interviews. Analysis of data was conducted using a narrative approach. Peer sexual harassment, perpetrated by male students, was a reality in the lives of female undergraduate students. Female students were raped. Sexual intercourse was taking place in the presence of female roommates. Videotaping of sexual encounters occurred without the knowledge of female partners. Sexual harassment of female students took place after female students had taken spiked drinks and drugged biscuits during welcome bashes. Unwanted, unwelcome and inappropriate touching of buttocks, breasts, thighs and in between the legs was experienced by female students. Unwanted kissing of female students was taking place. Verbal remarks of a sexual nature were directed at female students. The need for universities to invest their efforts in addressing the problem of peer sexual harassment cannot be over emphasized. Despite the fact that sexual harassment of female undergraduate students was taking place at the two state universities, victims seldom reported. Undergraduate female students need to be empowered to become more aware of the nature and extent of sexual harassment. A decrease in peer sexual harassment incidences is realizable if universities improve aspects of their climate and culture. The need for counselling to mitigate the negative impact of peer sexual harassment cannot be over emphasized.

Barriers to healthcare access are apparent in minority groups including ethnic, racial, gender, and sexual minorities. Most of the barriers experienced by these groups are centered on discrimination, cost, and lack of cultural competence which, in effect, leads to physical and mental health disparities. Multiple studies have reported the health concerns of gender diverse people, but few have discussed the concerns of gender diverse people who also identify as Hispanic/LatinE. As immigration rates continue to rise and gender minorities become more socially acceptable, the health concerns of this population become increasingly difficult to ignore. This proposal aims to answer the following research questions for Hispanic/LatinE gender minorities: 1) What physical health concerns are important to address? 2) What mental health concerns are important to address? Previous studies have suggested increasing education on gender identity for healthcare workers. Improving education within these services would result in greater gender affirming care while also aiding in closing the health disparities of these groups. Implementing support groups and increasing discussion is also necessary for improving the mental wellbeing of this population. Further research is needed to determine the importance of ethnicity in this population’s wellbeing. We predict physical health concerns will be largely focused on ethnic identity, and mental health concerns will be largely focused on gender identity. We propose recruiting Hispanic gender nonconforming participants for one-on-one semi-structured interviews. Coding methods for data analysis would reveal themes for health concerns specific to gender diverse LatinE individuals.

This chapter reports the results of a study conducted on Sultan Qaboos University (SQU) female undergraduate students’ intentions on becoming entrepreneurs and their perceptions towards entrepreneurship. This study employed predictive modelling to understand and predict the start of own business by female students in a developing country like Oman. The key research question addressed in this chapter is: What factors influence Sultan Qaboos University’s female students towards entrepreneurship? Using a questionnaire survey, data were collected from 200 undergraduate female students at the College of Economics and Political Science in 2015. The findings suggest that, while the general perceptions on factors that influence the entrepreneurial aspirations of female SQU undergraduate students are positive, a small portion of these students still hold ambivalent views towards entrepreneurship. This research has important implications for researchers, practitioners, policy makers and entrepreneurship educators.

PhysiCards have been co-designed to support an interactive, person-led approach to help people with mental health conditions identify and respond to cardiovascular disease and other physical health concerns. This study aimed to test the effectiveness of PhysiCards in assisting people accessing support from a community-managed mental health organization to identify and take action to address cardiovascular disease and other physical health concerns. This study was a parallel-group RCT. Participants (aged ≥18 years; N=154) were people accessing Flourish Australia services in New South Wales, Australia. Participants were randomly allocated to a control (physical health concerns discussed in line with usual support) or intervention condition (usual care and offered PhysiCards) delivered in a single session. Main outcome measures were assessed through support worker records of allocation delivery and participant self-report telephone surveys at baseline and 1-week and 4-month follow-ups (September 2022 to January 2024). Analysis was conducted in 2025. Primary outcomes were identifying at least 1 concern participants wanted support for that was a physical health concern, cardiovascular disease prevention concern, new (i.e., not previously raised with a health professional) physical health concern, and new cardiovascular disease prevention concern. Secondary outcomes included discussing a concern with a health professional, confidence to raise concerns, and acceptability of PhysiCards. The intervention group participants were significantly more likely to identify that they wanted support for a physical health concern (OR=16.7; 95% CI=5.14, 54.24, p<0.001), cardiovascular disease-related concern (OR=7.89, 95% CI=2.91, 21.39, p<0.001), and new health concern (OR=7.40, 95% CI=2.28, 24.05, p<0.001). PhysiCards were rated as highly acceptable. There was no significant difference in discussing concerns with a health professional or confidence in raising concerns. PhysiCards were effective in supporting people to identify cardiovascular disease and other physical health concerns. Future research is needed to consider additional strategies to enhance their impact on care seeking.

There is low level of physical activity among undergraduate. Participation in PE dwindles precipitously among both male and female undergraduate students. It has been noticed that Physical activity/physical exercise (PA/PE) rates tend to decline precipitously during the secondary school years leading to low physical activity and exercise(PA/PE) among undergraduate and college males and females students. This consequently led to pull of ill health, such as obesity (juvenile obesity) and arthritis (in older women), hyperlipidemia (excess fat), stress, fatigue and arteriosclerosis of the heart vessels. Sedentary behaviour is one of the strongest risk factors for many chronic diseases and conditions, including cardiovascular disease, hypertension, diabetes, obesity, osteoporosis, colon cancer, and depression. Due to the above the objectives of the study was to identify the relation between teacher led activity and the self efficacy of undergraduate students using self efficacy mode. Thus this study shows the impact of Teacher led physical exercise (PE) on the self efficacy of undergraduate male and female students in a private university in Ogun State, Nigeria. Materials and Methods: This cross-sectional study was conducted on 600 male and female first year undergraduate students in a private institution. It adopted a two arm quasi experimental research design. Participants completed questionnaire on the demographic, the self efficacy structured questionnaires as well as the physical activity questionnaire form to assess the physical activity practices and behaviour of undergraduate students at pre and post intervention. The results showed that participant's ages ranged from 15 to 22 years. Participants aged 16 and 17 were in the majority, 147(24.5%) and 218(36.3%) respectively. Female students were more involved in the study than their male counterpart. Majority 379(65.2%) were females and the mean age of the students across the group was 17±2.45 years. The self efficacy measured showed that majority 349 (58.2%) of the students said that they can-not do at all, moderately can do were 167 (27.8%) while self efficacy rating on those that can do highly were 84 (14%). Self Efficacy means score (SEMS) was 10.71±4.o4 and the SEMS at post was 17.94 ±5.98. The result tested at 95% confidence interval was significant (p=0.000). The increment in practice of Physical activity means score due to improved self efficacy at baseline was 19.72±6.96 and at Post intervention was 43.43±11.14 were significant.

This study examined the promiscuous behaviour of female undergraduate students and the various health issues related to it. It also investigated the relationship between the University lifestyles and female students’ promiscuous behaviour. The study adopted descriptive survey with a sample of one hundred and twenty (120) undergraduate female students selected using simple random sampling technique. A questionnaire titled “Sexual Promiscuity (SP) designed by the researcher was used to collect data for the study. Two hypotheses were formulated to guide the result of the study. The study revealed that there was a significant relationship between the female undergraduates’ promiscuous behaviour and their University lifestyles X2= 178.092&lt;0.05). Also, there was significant relationship between the promiscuous behaviour and sexually transmitted diseases (X2= 70.69&lt;0.05). It was therefore concluded that female undergraduate students of Adekunle Ajasin University were promiscuous because of their University lifestyles and that many were exposed to various sexually transmitted diseases that affect their health. Recommendations were based on the findings of the study that the University lifestyles of students should be modernized to discourage promiscuous behaviour among female undergraduate students. Besides, adequate health and counselling seminars should be organized on regular basis to intimate female students with the consequences of such promiscuous lifestyles.

The objective of this study was to assess the predictive association among the big five personality traits and psychological distress among undergraduate students. The study also explored the frequency of Psychological Distress among undergraduate students. The hypothesis of the study were a) big five personality traits would predict the level of psychological distress among undergraduate students. b) there would be a higher prevalence of psychological distress among undergraduate students c) the level of psychological distress would be higher among female undergraduate students as compared to their male counterparts. The sample of the study consisted of 480 participants within the age range of 18-24 years from various departments of the University of Karachi. Participants were selected using purposive-convenient sampling technique. The measures used in the study were demographic form, big five inventory (John et.al, 2008) and the depression anxiety stress scale (Lovibond &amp; Lovibond, 1995). With reference to the frequency of mental health problems, 52.70%, 67.70% and 40.62% undergraduate university students reported moderate to extreme level of depression, anxiety and stress, respectively. Findings are reflective of significant differences between male (M=45.5, SD= 22.8) and female (M=49.8, SD= 29.7) undergraduate students on the domain of Psychological distress (t (477) = 1.959, p&lt; .05) showing that the level of psychological distress is higher in female students as compared to male students. Regarding the predictive association among big five personality traits and psychological distress, findings reflect a significant predictive impact of agreeableness (R2= .028, F=13.7, P&lt;.001), conscientiousness (R2= .034, F=16.7, P&lt;.001) and neuroticism (R2= .158, F=89.8, P&lt;.001) on psychological distress among undergraduate students. In addition agreeableness and conscientiousness were found to be negative predictors causing 2.8 % and 3.4 % variance in the scores of psychological distress respectively. Conversely, neuroticism was found to be a positive predictor of psychological distress among undergraduate students causing 15.8 % variation. However extraversion (R2= .006, F=13.7, P&gt;.001) and openness to experience (R2= .000, F=.000, P&gt;.001) were found to be insignificant predictors of psychological distress among undergraduate students. The finding of the study highlights the importance of personality traits and its impact on the psychological well-being of students. These finding can be utilized for effective treatment planning in the domain of student counseling.

Background: Emergency Contraception (EC) is used after unprotected sexual intercourse, following sexual abuse, misuse of regular contraception or non-use of contraception. Seventeen percent of pregnancies in Kenya are unintended, potentially leading to unsafe abortion that contributes to the high maternal mortality rate in Country. According to 2016 Kenya Demographic and Health Survey (KDHS), the maternal mortality ratio was 362 maternal deaths per 100,000 live births. Female students in University or College are vulnerable to unplanned pregnancies and illegal abortions resulting in mortality, morbidity and psychosocial problems. Knowledge on EC is very important for students as they are not in stable relationships and not using regular contraception. Therefore, the aim of this study was to determine the knowledge and use of Emergency Contraception among female undergraduate students in the University of Nairobi.\nMaterials and Methods: We used an institution-based cross sectional, quantitative study to sample was employed among 383 female undergraduate students at the University of Nairobi. The University of Nairobi has six colleges and systematic random sampling was used to select study participants from each college. Data were collected using self-administered questionnaires and analysed using SPSS Version 16. Bivariate analysis and logistic regression were used to determine sample characteristics significantly associated with knowledge and utilisation of Emergency Contraception. Results: Most (53%) of the respondents were sexually active, and only 20% of the sexually active female students had ever used Emergency Contraception. Emergency Contraception awareness was high at 86.4%. However, based on a predefined criterion, accurate knowledge of Emergency Contraception was low at 42.6%.The majority (82.5%) of the respondents depended on mass media as a source of information on Emergency Contraception. Factors associated with Emergency Contraception knowledge on bivariate analysis were: age 20 years and above (p = 0.001), enrolment in college of health science (p = 0.001), being in year three of study and above (p = 0.0001) and having an insurance cover (p = 0.021). Ever use of Emergency Contraception was associated with enrolment in the College of health science (p = 0.025) and age 20 years and above (p = 0.050). In multivariate analysis, older age (Aor 1.885 p = 0.003) as well as being in the College of health science (Aor &lt; 0.001) were significantly associated with increased probability of being knowledgeable about Emergency Contraception.\nConclusion: Although University of Nairobi female undergraduate students are aware of the existence of Emergency Contraception, their specific knowledge on correct timing of taking EC after unprotected sex and on effectiveness is poor. EC use is also low, compounded by underutilisation of public facilities as a source of the EC and underutilisation of health workers as a source of EC information. Therefore, an educative forum may be needed to improve the knowledge of EC among University of Nairobi female students. Health education on the availability of EC in public facilities needs to be addressed. Possible use of informal sources of information such as peer education could be an area to explore in client education on EC knowledge and use. Further research is recommended to establish factors that influence utilisation of public health workers as a source of EC information.

The chapter examines Facebook usage among female undergraduate students of library and information science. Through a survey approach, the study drew on 154 female undergraduate Library and Information Science students from four universities. Questionnaire was used to gather data. Four research questions were developed and answered. The results revealed that the majority of the respondents (female undergraduates) use Facebook on a daily basis. Female undergraduates use Facebook to socialize, connect, and chat with friends, making it the highest purpose of using Facebook. While majority of female students use Facebook on a daily basis, the negative aspects of it were also revealed, including consumption of ones' precious time; the time they should use for other productive academic work is being channeled to Facebook, thereby making Facebook time consuming. Finally, erratic power supply was identified as the major problem of using Facebook by female LIS undergraduate students.

Background: Poor sleep quality is common among university students and may contribute to adverse reproductive health outcomes, including dysmenorrhea. However, limited evidence exists on whether chronic sleep disturbance independently predicts dysmenorrhea severity or menstrual-related functional impairment after accounting for key confounders. Objectives: We aimed to determine the prevalence of poor sleep quality among female university students and to examine its association with (1) severe dysmenorrhea and (2) menstrual-related functional impairment. Methods: A cross-sectional study was conducted among female undergraduate students at Ras Al Khaimah Medical and Health Sciences University (United Arab Emirates). Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and perceived stress was assessed using the Perceived Stress Scale (PSS-10). Dysmenorrhea severity was assessed using a 0-10 visual analog scale; functional impairment was defined as moderate/severe disruption in ≥1 life domain. Multivariable logistic regression models estimated adjusted odds ratios (aORs) for the association between sleep quality and menstrual outcomes after controlling for age, BMI, socioeconomic status, and stress. A component-level analysis examined independent effects of PSQI dimensions. Results: Of the 254 participants, 68.9% reported poor sleep quality and 48.8% reported severe dysmenorrhea. In adjusted models, moderate sleep problems (aOR = 2.00, 95% CI: 1.09-3.67, p = 0.024) and severe sleep problems (aOR = 3.63, 95% CI: 1.45-9.06, p = 0.006) were significantly associated with severe dysmenorrhea. Severe dysmenorrhea strongly predicted menstrual-related functional impairment (aOR = 4.81, 95% CI: 2.63-8.77, p < 0.001). Poor sleep quality remained independently associated with functional impairment (aOR = 1.96, 95% CI: 1.05-3.65, p = 0.035). In component analysis, sleep disturbance (PSQI Component 5) was the only independent predictor of severe dysmenorrhea (aOR = 2.11, 95% CI: 1.31-3.41, p = 0.002). Conclusions: Poor sleep quality, particularly sleep disturbance, is associated with increased odds of severe dysmenorrhea and menstrual-related functional impairment in female university students. Sleep fragmentation may represent a key mechanistic and modifiable contributor to menstrual pain severity. Integrating sleep assessment into dysmenorrhea management and evaluating sleep-focused interventions in longitudinal and interventional studies are warranted.

This study examined the predictive influence of spirituality and physical health on depression, anxiety, and stress among undergraduate students during their first full return to face-to-face learning after the COVID-19 pandemic. Anchored on the Biopsychosocial Model, SPIRE Model, and Health Hexagonal Model, a complex correlational design was employed using multiple linear regression analysis. Data were collected from 1,760 freshmen and sophomore students enrolled in 24 academic programs at a state university in the Philippines. Three validated instruments—the DASS-21, the Spirituality Scale, and the Physical Health Questionnaire—were administered. Findings revealed that spirituality, particularly the dimension of self-discovery, was a significant protective factor against depression, anxiety, and stress. In contrast, physical health concerns such as sleep disturbances, gastrointestinal problems, and respiratory infections were substantial risk factors across all three psychological outcomes. These results affirm the multifaceted nature of mental wellness and highlight the importance of integrating spiritual and physical dimensions in designing context-sensitive mental health interventions for higher education. The study contributes novel insights from the Philippine context to the growing global discourse on student mental health and underscores the value of holistic, culturally grounded approaches in supporting psychological well-being in post-pandemic academic transitions.

Background: Breast cancer is the most common cancer among women worldwide, claiming the lives of hundreds of thousands of women each year and affecting countries at all levels of modernization. It is one of the early noticing ways of breast cancer which involves the woman herself looking at and feeling each breast for possible mass, discharge, swelling, dimpling, and other abnormalities. Objective: To assess the knowledge and practice of breast self-examination among female undergraduate students at Addis Ababa University, College of Health Science. Method: Institutional based cross-sectional study was conducted among female undergraduate students in which departments were selected by using a lottery method and a simple random sampling technique was used to select 214 female students from each department. Data was collected by using a selfadministered, structured questionnaire from April to May 2022. The data was entered into Epidata and analyzed by Statistical Package for Social Science (SPSS) window software. Result: A total of 214 respondents were enrolled in the study giving a response rate of 100%. About 133(62.8%) of respondents had a good knowledge of Breast Self- Examination and Breast Cancer. Nearly half 106(48.5%) of the study participants have practiced breast self-examination at least once in their life. There were three main reasons for not doing the examination. Conclusion: This study discovered that more than half of the study participants have a piece of good knowledge about BSE. However, the vast majority of study subjects never engaged in BSE. The concerned bodies should create awareness about breast self-examination.