Mental Health Of Medical Students Research Articles

Flourishing or Languishing? Predictors of Positive Mental Health in Medical Students during the COVID-19 Pandemic

During the COVID-19 pandemic, medical students were burdened with high levels of stress, anxiety, and depression. The objective of the present study was to investigate predictors of positive mental health among medical students during the COVID-19 pandemic. We conducted an online survey from September 2021 to March 2022. We applied the snowball recruitment technique involving medical students from the University of Catania, Italy. We administered, anonymously, a questionnaire about demographic characteristics, the Depression Anxiety Stress Scale (DASS-21), the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A), and the short form of the Mental Health Continuum (MHC-SF). Participants showed moderate anxiety, depression, and stress levels, and more than half had positive mental health status overall. This finding was inversely related to age, depression severity, cyclothymic, and depressive temperaments. Our results showed that medical students with depressive and cyclothymic temperaments were more at risk of worsening mental health status during the pandemic. Our findings may allow for further developments about the impact of personological characteristics on students' mental health to enable more efficient support for the most vulnerable.

Factors affecting the mental health of medical students during the COVID-19 pandemic: A cross-sectional study.

The coronavirus disease 2019 outbreak has impacted many educational institutions by imposing restrictions on offline or in-person lessons. Many students were stressed by "the loss of everyday life" due to the pandemic, and it is important to examine the impact of this loss on adolescents' mental health. This study aimed to investigate the factors that affect students' mental health during the pandemic from various perspectives. A total of 166 medical students participated in this study. Participants completed questionnaires about their demographics, life stress, mental health, and stress factors during in-person and online lecture days. Participants were divided into 2 groups, those with low and high mental health. The researchers compared independent variables between the groups using the χ2 test or Fisher's exact test. Multiple logistic regression analysis was performed, with mental health as the dependent variable. The multiple logistic regression analysis indicated that increased time spent online was significantly associated with mental health (P < .05). Human relations and the inability to meet/talk with friends trended toward a significant association with mental health (P < .1). The students who were not stressed about the increased time spent online were at a risk of low mental health. The students who appreciated interacting with others experienced more stress during the lockdown. To reduce students' stress on online days, teachers should devise a lecture style with frequent breaks and introduce active learning. The findings of this study will contribute to addressing students' low mental health and reducing their stress during the coronavirus disease 2019 pandemic.

The Influence of Family Factors on The Mental Health of Medical Students and Suggestions

The Mental health of medical students is of great importance, but medical students are faced with interpersonal confusion, lack of self-confidence, reverse psychology, anxiety and depression, Internet addiction, and other prominent problems, The mental health problems of medical students are closely related to their family economic conditions, family structure, parent's education level, especially the parent-child relationship, including the parenting style of the family. Parents should realize the importance of family mental health education, create a good family environment, provide a high level of family support, and work together with the school and society to maintain the healthy growth of medical students.

Prevalence of psychological symptoms and their correlates among physiotherapy clinical students: A cross-sectional study.

Mental health in medical students is well researched, with physiotherapy students receiving less attention even though psychiatry is a recognised specialty within physiotherapy. To assess the prevalence and correlates of depression, anxiety and stress among physiotherapy clinical students. A descriptive cross-sectional study design was employed on 402 physiotherapy clinical students aged 17-40 years using a convenience sampling method. The data were collected using the self-administered 42-items Depression, Anxiety and Stress scale (DASS) and the data were analysed using a Chi-square test and binary logistic regression analysis. The prevalence of depression, anxiety and stress among these students was 79.9%, 85.6% and 81.6%, respectively. The results indicate that financial status and social life influenced depression by 20.6% (odds ratio [OR] [95%] = 1.206 [1.110, 1.311]) and 36% (OR [95%] = 1.360 [1.050, 1.764]), respectively. Fear of repeating a class influenced anxiety by eight times (OR [95%] = 8.330 [6.643, 10.422]). Fear of repeating a class, financial status and academic performance influenced stress by eight times (OR [95%] = 8.360 [6.677, 10.470]), 17.5% (OR [95%] = 1.175 [1.083, 1.275]) and 18.1% (OR [95%] = 1.181 [1.083, 1.276]), respectively. Our study concluded that there was a high prevalence of depression, anxiety and stress among physiotherapy clinical students. These outcomes suggest that more attention needs to be given to improving physiotherapy clinical students' mental health, which will ultimately improve learning outcomes. The long-term effects of psychological distress could potentially impact students' academic performance. It may also have long-lasting effects after graduation. Therefore, students who are at risk of developing psychological symptoms are needed to be thoroughly examined and then receive early required interventions.

Medical education during the coronavirus disease pandemic and students’ mental health: A one-year follow-up

BackgroundThe coronavirus disease (COVID-19) pandemic has affected medical education and psychosomatic health of medical students. In this follow-up study, conducted 1 year after the transition to online learning (OL), we aimed to investigate changes in student mental health and identify factors associated with academic burnout and changes in medical education caused by the pandemic.Materials and methodsThis study compares the burnout rate and psychosomatic status (depression, anxiety, somatic symptoms) of medical students at Astana Medical University using an online questionnaire-based repeated cross-section design of the pre-pandemic period (September–November 2019), the initial period of the pandemic (April 2020), and the current study (March 9–30, 2021). In the pre-pandemic period, students studied only in a face-to-face format. Moreover, the current study (March, 2021) analyzed factors associated with academic burnout and changes in medical education caused by the pandemic. Statistical methods included mean comparison, frequency, and regression analysis.ResultsData from a representative sample of undergraduate students were analyzed (n = 975, 58% of them participated in the previous study). The burnout rate was found to be lower compared with the period of traditional education (pre-COVID-19) and did not significantly differ from the initial period of the introduction of online learning (the initial period of the COVID-19 pandemic). The levels and prevalence of depression and anxiety also showed similar patterns. The prevalence of somatic symptoms has increased compared to the initial period of the pandemic, although it has not reached the level obtained in the pre-COVID-19 period. The negative changes caused by OL in medical education and learning effectiveness have been associated with burnout. Factors associated with burnout, learning effectiveness, dissatisfaction with the quality of OL organization, and deterioration of medical education have been identified.ConclusionThe medical education and mental health of medical students has undoubtedly undergone changes in the transition to OL due to the COVID-19 pandemic. Factors such as changing the content of education, the organization of the educational process and support from the school, the nature of student-teacher, student-school and student-student relationships, the possibility of mastering various skills and financial problems caused by the pandemic, played a significant role in the academic life of students. The results obtained have potential applications in organizing and improving the quality of continuing medical education in an era of global healthcare crises such as the COVID-19 pandemic.

Prevalence of pharmacological and non-pharmacological coping mechanisms for anxiety management during the COVID-19 pandemic: investigating the transition to online learning among medical students

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic had a devastating effect on college students worldwide. Here, the authors aimed to determine the prevalence of anxiety and its related coping strategies, provide a theoretical basis for understanding self-prescription, and identify the factors contributing to stress and anxiety in medical students during the pandemic.MethodsThe authors conducted a cross-sectional study among medical students in Saudi Arabia from September to November 2020. They assessed anxiety using the GAD-7 scale based on seven core symptoms. The authors also examined perceived psychological stress using a single-item measure of stress, the factors contributing to stress during the transition to online learning and examinations, and related coping strategies. The Statistical Package for Social Sciences (SPSS) version 26.0 was used to examine the data for both descriptive and inferential analyses. Chi-square test, one-way ANOVA, and univariate linear regression were used to test the research hypotheses.ResultsThe authors collected and analyzed data from 7116 medical students distributed across 38 medical colleges. Among them, 40% reported moderate to severe anxiety symptoms. Pre-clinical and female students experienced more stress than clinical and male students. 12.19% (n = 868) of respondents reported using medication during their college years. Among those, 58.9% (n = 512) had moderate to severe anxiety, and the most commonly used drug was propranolol (45.4%, n = 394). Among the studied sample, 40.4% (n = 351) decreased their medication use after switching to online teaching. Most students used these medications during the final exam (35.8%, n = 311) and before the oral exam (35.5%, n = 308). In terms of coping strategies, males were much more likely to use substances than females, who mainly resorted to other strategies.ConclusionsThis study provides a national overview of the impact of COVID-19 on the mental health of medical students. The results indicated that the pandemic is associated with highly significant levels of anxiety. These findings can provide theoretical evidence for the need for supportive psychological assistance from academic leaders in this regard.

The effect of COVID-19 vaccination on the menstrual pattern and mental health of the medical students: A mixed-methods study from a low and middle-income country.

To assess the effect of COVID-19 vaccination on menstrual patterns and mental health of medical students and to explore the students' perspective regarding this effect. This mixed-method study was conducted on the medical and dental students of the private and public sector institutions of Peshawar from September 2021 to March 2022. A Menstrual symptom questionnaire (MSQ) and hospital anxiety and depression scale (HADS) were used. This was followed by qualitative interviews with the students who faced problems in their menstruation after the COVID-19 vaccination. A total of 953 students were included, with a mean age of 20.67±1. 56 years. More than half (n = 512, 53.7%) experienced menstrual cycle abnormalities post-vaccination. The majority having disturbances in their menstrual cycle had significantly higher levels of anxiety (p = 0.000). Results on the menstrual symptom questionnaire, anxiety, and depression subtype of HADS showed a negative and statistically significant relationship with changes after COVID-19 vaccination (p&lt;0.05). In the qualitative interviews, 10 (58.8%) students each had problems with frequency and flow, followed by 7 (41.2%) students, who had dysmenorrhea. Seven (41.2%) consulted a gynecologist for management. The majority (n = 14, 82.4%) stated that these issues had an adverse impact on their mental health and almost half (n = 8, 47.1%) suggested consulting a gynecologist while facing such situations. This study showed the impact of the COVID-19 vaccine on women`s menstrual patterns and subsequent mental health status. Although the majority of the students experienced menstrual cycle abnormalities and subsequent mental health adversities post COVID-19 vaccination but these were temporary and self-limiting and were attributed to the psychological impact of the vaccination. Therefore, it is imperative to alert health care professionals about possible side effects and prior counseling is expected to play an important role in this context.

A Comprehensive Framework and Approaches for Enhancing Mental Health in Medical Students

Research suggests that medical students frequently experience mental health problems such as stress, burnout, and depression, which may, in turn, affect suicidal ideation and behaviors. Since mental health problems profoundly impact academic achievement and professionalism, it is vital to understand factors influencing students’ mental health and identify strategies to provide the necessary support. Some relevant influencing factors range from the personal level, including gender, personality traits, perfectionism, and social support, to the environmental level, including the grading system, educational phases, exposure to patients’ death, mistreatment, and culture of medicine. In this regard, a comprehensive mental health support system that encompasses environmental interventions, as well as personal-level support, is needed. Simultaneously, proactive approaches that address the improvement of self-care and alleviation of systemic burdens are essential, together with the predominant reactive approaches focusing on problems and deficits. Altogether, we proposed a framework for enhancing mental health constructed by four categories (personal-reactive, environmental-reactive, personal-proactive, environmental-proactive) based on the intervention level and goal of support. All four categories have important implications, and one cannot replace the other, but expanding environmental-proactive support will allow more students to learn how to pursue health independently. We expect that this comprehensive framework for enhancing mental health could expand support systems for medical students’ personal and professional development.

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

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&lt;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.

Assessment of Level of Stress in Undergraduate Medical Students of a Private Medical College in Pakistan

Background: Extensive and demanding medical curriculum manifests itself as stress in medical students. Different individuals perceive stress differently. Stress greatly affects academic performance and mental health of medical students. Levels of stress vary with gender, year of study and living conditions of students. Objective: This study was performed to evaluate stress levels of undergraduate medical students in Pakistan. Study Design: Descriptive cross-sectional study. Duration: Two months from December 2021 to January 2022. Setting: Multan Medical and Dental College, Multan, Pakistan. Methods: First year, second year, third year, fourth year and final year MBBS students from Multan Medical and Dental College (MMDC), Pakistan were selected through census sampling. Students were asked to fill Perceived Stress Scale Questionnaire (PSSQ-10). After quantitative data was analyzed through descriptive studies, all students were divided into three groups: low stress, moderate stress, and high stress bearers. Results: Among 427 students, 54 (12.65%) students had low stress, 311 (72.83%) students had moderate stress and 62 (14.52%) students had high stress. Females were more stressed compared to males. Among high stress group, 18% females were affected compared to 9% males. 73.94% females had moderate stress compared to their male counterparts i.e., 71.08%. Male boarders were less stressed compared to female boarders. Students of first year had lowest perceived stress (M=9, SD=3.82), whereas final year students had highest stress (M=30.5, SD= 2.8), followed by third year, fourth year, second year and first year students. Practical implication: This study is intended to give an insight into level of stress that medical students are encountering. Early intervention by concerned authorities for high levels of stress can enable students to handle stress in a better way in years to come and prevent them from developing any psychiatric disorders. Students with mild and moderate stress levels can be helped to prevent more serious stress conditions. A less stressful environment is congenial for students for academics and mental health. Conclusion: The study highlights the issue of prevalence of perceived stress among medical students, which is affecting their academic performance and health. Keywords: Moderate Stress, Under-Graduate Perceived Stress Scale ,, Discomfort, Academic,

Physical Activity and Mental Health of Medical Students from Poland and Belarus-Countries with Different Restrictive Approaches during the COVID-19 Pandemic.

COVID-19 pandemic has struck all of us suddenly and unexpectedly; it deprived the society of a sense of control over their lives on different levels. In a short period of time, it led to a number of changes in everyday life of people all over the world. In particular, these changes affected medical staff, who, all of a sudden, were burdened with new work-related responsibilities and duties. This situation may have had a detrimental effect on their mental health. Due to the unpredictability of the COVID-19 pandemic, we attempted to assess its consequences in terms of mental health and physical fitness of university students from countries in which different approaches to these issues were adopted. A total of 779 medical students (374 students from John Paul II University of Applied Sciences (ABNS) in Biala Podlaska, Poland, and 405 students from Yanka Kupala State University of Grodno (YKSUG), Belarus) took part in the survey. Three standardised psychometric tools were used in the study: The Satisfaction With Life Scale (SWLS), The General Health Questionnaire (GHQ-28) and Stress Coping Inventory (Mini-COPE). In addition, the International Physical Activity Questionnaire (IPAQ) was applied. The vast majority of students both from Poland and Belarus demonstrated high levels of physical activity. However, students from ABNS manifested significantly higher levels of physical activity compared to their counterparts from YKSUG. Students from Biala Podlaska had greater satisfaction with life during the COVID-19 pandemic, whereas their peers from Grodno exhibited higher levels of mental distress. The COVID-19 pandemic resulted in a significant exacerbation of mental health issues among medical students. In order to alleviate negative effects of the pandemic, it seems necessary for universities to monitor the physical and mental health state of students and to implement prevention programmes.

Effect of Online Metacognitive Training on Health Anxiety and Mental Health of Medical Students During the COVID-19 Pandemic: A Randomized Clinical Trial

Objectives Students are the spiritual assets of each country. Anxiety and mental health problems negatively affect their performance. This study aims to assess the effect of online group metacognitive training on the medical students’ health anxiety and general health during the COVID-19 pandemic. Methods This a randomized clinical trial. Participants were 56 students of Mashhad University of Medical Sciences aged 18-30 years who were selected by a convenience sampling method and were randomly divided into two groups of intervention and control. The intervention group received online metacognitive training at 8 sessions, each for one hour, while the control group did not receive any intervention. At three stages of pre-test, post-test, and one-month follow-up, they completed Salkovskis and Warwick’s short health anxiety inventory and the 28-item general health questionnaire. Data were analyzed in SPSS software, version 23. Using the repeated measures analysis of variance (ANOVA) test. Results Metacognitive training was effective in reducing health anxiety and improving general health of students (P&lt;0.05). The results remained significant one month after the intervention. Conclusion Metacognitive training online can reduce health anxiety and improve general health of medical students during the COVID-19 pandemic.

An assessment and correlation of emotional Intelligence and mental health of medical students

Introduction: Emotions like joy, anger, grief, jealousy, love, fear make our life worthwhile. Whatever we do, incites some emotion in us. If we are able to enjoy our emotions, without them having excessive control over us, then we can make ours as well as others’ lives better. Aim of the study was to assess and correlate emotional Intelligence with mental health. Methods: Type of study: Descriptive type of cross sectional study. Sampling: Simple random sampling. Study population: Under graduate students in a private medical college in western Uttar Pradesh. Study duration: 1/07/2019 to 1/09/2019. Sample size: 246. Results: The average emotional intelligence score was 26.82 with standard deviation of ±5.80. Average emotional intelligence among males was 27.04(±6.72) and was 26.63(±5.07) among females. Spearman Rank correlation coefficient “r” =0.789, showed highly positive correlation between ranks from both the score. (p=0.0000). Conclusions: The medical students showing higher scores of emotional intelligence are less likely to be mentally stressed.

The Impact of COVID-19 on Mental Health in Medical Students: A Cross-Sectional Survey Study in Italy.

Background: This study aimed to assess the impact of the COVID-19 pandemic in terms of the prevalence of anxiety, depression and stress symptoms in Italian medical students and to identify the associated factors. Design and Methods: A cross-sectional online survey was administered to second-sixth year medical students of the University of Torino, collecting data on the students’ sociodemographics, COVID-19 exposure, anxiety, depression and stress symptoms. Three hierarchical regressions adjusted for age, gender and year of study were executed. Results: The sample size was 1359. The prevalence of anxiety, depression symptoms, moderate perceived stress and severe perceived stress was 47.8%, 52.1%, 56.2% and 28.4%, respectively. The factors associated with mental health symptoms were: being a woman, a family history of psychiatric disorders, living off-site, competitive/hostile climates and unsatisfying friendships among classmates, poor relationships with cohabitants, negative judgment of medical school choice, fear of COVID-19 infection, feelings of loneliness, distressing existential reflections, and a worsening psychological condition related to the pandemic. Being in the fourth or sixth year constituted a protective factor for depression symptoms. Conclusions: Mental health in medical students was associated with both COVID-independent and COVID-related factors. Accessibility to effective interventions must be increased to counteract these changes.

Asociación entre ansiedad y depresión en estudiantes de Medicina de la Universidad Ricardo Palma durante el año 2021

The mental health of medical students around the world has been affected by the presence of anxiety and depression. According to the World Health Organization, more than 260 million people suffer from anxiety and approximately 300 million people suffer from depression. Objective: To determine the association between anxiety and depression in medical students at Ricardo Palma University during the 2021-II academic year. Materials and Methods: Observational, analytical, cross-sectional and quantitative study. From a population of 2046 medical students from the first to the seventh year of studies, the size of the sample obtained was 110 students. The data obtained was collected through Google Forms. Results: Of the medical students, 85.46% manifested some degree of anxiety and 50% manifested some degree of depression. These pathologies occurred more frequently in the female sex, low socioeconomic level and in those who had clinical courses. A statistically significant association was found between anxiety and depression (p: 0.038), and between low socioeconomic status and depression (p: 0.004). No statistically significant association was found between female sex and depression, nor between pre-clinical courses and depression. Conclusions: High prevalences of anxiety and depression were found in medical students at the Ricardo Palma University. In addition, a statistically significant association between anxiety and depression was evidenced (p: 0.038). For this reason, it is recommended to implement a psychological accompaniment throughout the medical university career.

Mental health in medical and biomedical doctoral students during the 2020 COVID-19 pandemic and racial protests.

Concerns about the mental health of students, trainees and staff at universities and medical schools have been growing for many years. Recently, these have been exacerbated by the COVID-19 pandemic and a period of heightened reckoning and protests about systemic racism in the United States in 2020. To better understand the mental health of medical students and biomedical doctoral students at the University of North Carolina at Chapel Hill during this challenging period, we performed a cross-sectional study (n=957) using institutional annual survey data on measures of depression, anxiety, hazardous alcohol use, problems related to substance use, and suicidal ideation. These data were collected in 2019 and 2020, and were analyzed by type of training program, race/ethnicity, gender, sexual orientation, and survey year. Results indicated significant differences for rates of depression, anxiety, and suicidal ideation, with biomedical doctoral students showing greater incidence than medical students, and historically excluded students (e.g., people of color, women, LGBQ+ trainees) showing greater incidence compared to their peers. Of note, mental health remained poor for biomedical doctoral students in 2020 and declined for those belonging to historically excluded populations. The high rates of depression, anxiety, and suicidal ideation reported suggest that training environments need to be improved and support for mental health increased.

Intersection of anxiety and negative coping among Asian American medical students.

PurposeAsian Americans comprise 21% of matriculating medical students in the United States but little is known about their mental health. With the growing focus on addressing the mental health of medical students, this systematic, nationwide survey assesses the relationship between anxiety and depression symptoms and coping skills among Asian American medical students.Materials and methodsA survey tool comprised of Patient Health Questionnaire-9, General Anxiety Disorder-7, and questions related to coping were emailed to members of the Asian Pacific American Medical Students Association enrolled in a United States medical school during the 2016–2017 academic year. We evaluated associations between anxiety and coping as well as depression and coping.ResultsA total of 511 Asian American medical students completed the survey. Anxiety symptoms were positively correlated with an increase in negative coping skills. Depressive symptoms were not correlated with an increase in negative coping skills.ConclusionProfessionals and medical schools that aim to improve the mental health of medical students should be aware of the needs of specific populations. Asian American students who experience anxiety were more likely to utilize avoidant or negative coping strategies. In addition, Asian American students who experience depressive symptoms were not more likely to utilize these negative coping strategies. Further research must be done to evaluate the factors that influence the use of negative coping strategies to better address anxiety within the Asian American medical student population.

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

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

The Appraisal of Self-Care Agency Scale-Revised (ASAS-R): Reliability and Validity among Portuguese Medical Students.

Self-care agency plays an important role in an individual’s health. Considering the particularities of their education, it can be a protective factor for the mental health of medical students. This study aims to validate the Portuguese version of the Appraisal of Self-care Agency Scale-Revised (ASAS-R) in Portuguese medical students. A cross-sectional, quantitative, and analytical online study was conducted between 23 April 2021, and 15 July 2021. Exploratory factor analysis (EFA) was performed to test the internal structure of the ASAS-R. Correlations with the SHS (Subjective Happiness Scale), SWLS (Satisfaction with Life Scale), and MHI (Mental Health Inventory) were calculated using Pearson’s coefficient so as to test convergent validity. Internal consistency was evaluated using inter-item correlation, corrected item-total correlation, and Cronbach’s alpha. The total sample included 781 individuals. EFA yielded a 3-factor solution accounting for 53.9% of the explained variance. Pearson’s coefficients obtained between the 3 factors of ASAS-R and the total scores of the 3 construct-related scales demonstrated adequate convergent validity. Total Cronbach’s alpha value was 0.85, while the Cronbach’s alpha of the three factors was 0.81, 0.55, and 0.83, respectively. This study demonstrated that ASAS-R is a valid and reliable instrument for measuring self-care agency among Portuguese medical students.

Impact of COVID-19 pandemic on education and mental health of medical students: a nation-wide survey in India

Background: The purpose of this study was to investigate the impact of COVID-19 pandemic on the education and mental health of undergraduate medical students in India.Methods: A cross-sectional web-based study was conducted among MBBS students of all five years (n=604) selected by random sampling. Participants were administered questionnaires consisting of perceived stress scale (PSS-10), generalised anxiety disorder (GAD-7) for mental health assessment. A COVID-19 impact on medical education (CIME) questionnaire was developed for evaluating the impact on education. Bivariate logistic regression analyses were performed to examine the socio-demographic correlates.Results: The mean score of COVID-19 impact on education, stress and anxiety were 26.2±5.2, 24.5±6.0 and 10.7±6.1 and their overall prevalence were 70.1% (66.4-73.8%), 38.9% (35.0-42.9%) and 54.1% (50.1-58.2%) respectively. There was positive correlation between CIME and stress (r=0.382, p&lt;0.01) and anxiety (r=0.321, p&lt;0.01). Internship [aOR=3.5 (1.5-8.3), p=0.003], not having romantic partner [aOR=1.4 (1.1-1.9)], stress [aOR=2.3 (1.4-3.7)] and anxiety [aOR=1.6 (1.1-2.5)] were positive predictors (p&lt;0.05) of severe impact on education.Conclusions: There was a severe impact of the pandemic on education of majority of the students. The stress and anxiety levels during the pandemic were relatively higher than usual indicating generalized worsening. Poor mental health outcomes and negative impact on education were evident positive predictors and correlates of each other.