Association of perceived isolation and resilience with self-rated mental health among undergraduate medical students in Nepal during the COVID-19 pandemic
AbstractBackground: The COVID-19 pandemic has devastatingly affected the entire world and destroyed the equilibrium of every sphere of life. Like other groups of people, medical students of Nepal have been facing the conditions of lockdown and social isolation that have arisen because of the pandemic.
Objective: We aimed to see the relationship of perceived isolation and resilience with self-rated mental health among undergraduate medical students in Nepal.
Materials and methods: A web-based online survey was carried out in July 2020 using a semi-structured questionnaire in Google form. Data analysis was performed in SPSS vs 20. Ordered logistic regression analysis was performed to examine the effects of perceived isolation, resilience and background characteristics on self-rated mental health.
Results: Out of 515 participants, 44.9% were male.31.4% reported having fair/poor mental health status and 21.9% reported feeling stressed often due to the COVID-19 pandemic. An increment of 1SD in perceived isolation is associated with about a 5% reduction in the odds of having better mental health (exp (−0.048) = 0.95; p=0.026). Similarly, an increment of 1SD in resilience is associated with about 13% lower odds of having better mental health (exp (−0.149) = 0.862 ; p<0.001).
Conclusion: This study is an early step towards the assessment of perceived isolation and mental health among undergraduate medical students amid the COVID-19 pandemic in Nepal. There is a need to conduct regular counselling sessions and strengthen the coping skills of medical students duringthe pandemic.
Aboalshamat, K.T., Alsiyud, A.O., Al-Sayed, R.A., Alreddadi, R.S., Faqiehi, S.S., &Almehmadi, S.A.(2018). The relationship between resilience, happiness, and life satisfaction in dental and medical students in Jeddah. Saudi Arabia Niger Journal of Clinical Practice, 21(8), 1038–43.
Arafat, S.M.Y., Papadopoulos, K., Mullick, M.S., & Uddin, M. (2019). The vulnerability and resiliency of childhood. Glob Psychiatry, 2(2), 113-20.
Bennett, S.J., Perkins, S.M., Lane, K.A., Deer, M., Brater, D.C., & Murray, M.D. (2001). Social support and health-related quality of life in chronic heart failure patients. Quality of Life Research, 10(8), 671-682.
Brummett, B.H., Barefoot, J.C., Siegler, I.C., Clapp-Channing, N.E., Lytle, B.L., Bosworth, H.B., ... Mark, D.B. (2001). Characteristics of Socially Isolated Patients with Coronary Artery Diseases Who are at Elevated Risk for Mortality. Psychosomatic Medicine, 63, 267-272.
Cacioppo, J.T., Hughes, M.E., Waite, L.J., Hawkley, L.C., &Thisted, R.A.(2006). Loneliness as a Specific Risk Factor for Depressive Symptoms: Cross-Sectional and Longitudinal Analyses. Psychology and Aging, 21, 140–51.
Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research, 287, 112934.
Clay, R. (2020). COVID-19 and suicide. American Psychological Association-COVID-19 Special Report, 51(4). https://www.apa.org/monitor/2020/06/covid-suicide.
Cornwell, E.Y., & Waite, L.J.(2009). Social disconnectedness, perceived isolation, and health among older adults. Journal of health and social behaviour, 50(1), 31-48.
Elmer, T., Mepham, K., &Stadtfeld, C. (2020). Students under Lockdown: Comparison of students’ social networks and mental health before and during the COVID 19 crisis in Switzerland. PLoS ONE, 15(7), e0236337.
Giri, A.(2020). Cabinet Decides To Ease Lockdown In Phases. The Kathmandu Post, 2020 June 10. https://kathmandupost.com/national/2020/06/10/cabinet-to-discuss-ways-to-ease-lockdown.
Goldmann, E., & Galea, S.b(2014). Mental health consequences of disasters. Annual Review of Public Health, 35, 169-183.
Goothy, K.S.S., Goothy, S., Choudhary, A., GG, P., Purohit, M., Chakraborty, H., ... Mahadik, V.K. (2020). COVID-19 lockdown impact on the mental health of students: need to start a mental health cell. MedCrave, MOJ Anatomy and Physiology, 7(2).
Guragai, M.(2020). Nepalese Medical Students in the COVID-19 Pandemic: Ways Forward. Journal of the Nepal Medical Association, 58.
Helou, M.A., Keiser, V., Feldman, M., Santen, S., Cyrus, J.W., &Ryan, M.S. (2019). Student well-being and the learning environment. Clinical Teacher, 16(4), 362–6.
Hughes, M.E., Waite, L.J., Hawkley, L.C., & Cacioppo, J.T. (2004). A Short Scale for Measuring Loneliness in Large Surveys: Results from Two Population-Based Studies. Research on Aging, 26(6), 655–72.
Jahan, F., Siddiqui, M.A., Mitwally, M., Jasim Al Zubidi, N.S., &Jasim Al Zubidi, H.S. (2016). Perception of stress, anxiety, depression and coping strategies among medical students at Oman Medical College. Middle East Journal of Family Medicine, 14(7), 16-23.
Kim, N.E., & Cho, S.M.(2012). Quality of life of medical students during clinical clerkship. Korean Journal of Medical Education, 24(4), 353–7.
Levens, S., Elrahal, F., &Sagui-Henson, S. (2016). The Role of Family Support and Perceived Stress Reactivity in Predicting Depression in College Freshman. Journal of Social and Clinical Psychology, 35, 342-355.
Lim, M. (2020). Achieving Resilience during COVID-19: Psycho-social risk and protective factors amidst a pandemic in adolescents’. Oxford ARC study, Mental health research matters, 2020 April 29. http://mentalhealthresearchmatters.org.uk/achieving-resilience-during-covid-19-psycho-social-risk-protective-factors-amidst-a-pandemic-in-adolescents/.
Lin, Y.K., Lin, C., Lin, B.Y., & Chen, D-Y.(2019). Medical students’ resilience: a protective role on stress and quality of life in clerkship. BMC Medical Education, 19, 473.
Mian, A., & Khan, S. (2020). Medical education during pandemics: a UK perspective. BMC Medicine, 18(1), 100.
Mukhtar, S.(2020). Psychological health during the coronavirus disease 2019 pandemic outbreak’, International Journal of Social Psychiatry, 66(5), 512-516.
Mulvaney, D., Norah, E., Alegria, M., &Sribney, W. (2007). Social Cohesion, Social Support, and Health among Latinos in the United States. Social Science and Medicine, 64(2), 477–95.
Nepal Health Research Council, Government of Nepal.(2017). National Mental Health Survey, Nepal: (2017-2021). http://nhrc.gov.np/projects/nepal-mental-health-survey-2017-2018/.
Ozbay, F., Johnson, D.C., Dimoulas, E., Morgan III, C.A., Charney, D., & Southwick, S. (2007). Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont), 4(5), 35-40.
Perlman, D., & Peplau, L.A.(1981). Toward a social psychology of loneliness. Personal relationships in disorder. Chapter: 2:31–56. https://pdfs.semanticscholar.org/52d9/6cedd5fc0a7658e6e0a8a17d0dcab428850b.pdf.
Poudel, K., &Subedi, P.(2020). Impact of COVID-19 pandemic on socioeconomic and mental health aspects in Nepal. International Journal of Social Psychiatry, 66(8), 48–755.
Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y.(2020). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. General Psychiatry, 33(2), e100213.
Rogers, J.P., Chesney, E., Oliver, D., Pollak, T.A., McGuire, P., Fusar-Poli P, ... David, A.S. (2020). Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry, 7(7), 611-627.
Rehman, U., Shahnawaz, M.G., Khan, N.H., Kharshiing, K.D., Khursheed, M., Gupta, K., ... Uniyal, R. (2020). Depression, Anxiety and Stress among Indians in Times of Covid-19 Lockdown. Community Mental Health Journal, 1–7.
Richey, R., Barker, C., Shah, U., Peak, M., Nunn, A., Craig, J., ... Turner, M. (2013). Manipulation of medicines to deliver a required dose: development of a good practice guideline. Archives of Disease in Childhood, 98(6), e1.
Sahu, P. (2020). Closure of universities due to Coronavirus Disease 2019 (COVID-19): impact on education and mental health of students and academic staff. Cureus, 12(4).
Schwarzer, R., Knoll, N., &Rieckmann, N.(2004). Social support. In Kaptein, A., &Weinman, J. (Eds.). Health Psychology (pp. 158–182). Oxford, England: Blackwell.
Shi, M., Liu, L., Wang, ZY., & Wang, L. (2015). The mediating role of resilience in the relationship between big five personality and anxiety among Chinese medical students: a cross-sectional study’. PLoS One, 10(3), e0119916.
Shrestha, P.M. (2020). SEE postponed, public gatherings of more than 25 barred, and gyms, film halls closed. The Kathmandu post, 2020 march 19. https://kathmandupost.com/national/2020/03/19/see-postponed-public-gatherings-of-more-than-25-barred-and-gyms-film-halls-closed.
Singh, R., Baral, K.P., &Mahato, S.(2020). An urgent call for measures to fight against increasing suicides during COVID-19 pandemic in Nepal. Asian Journal of Psychiatry, 102259.
Singh, R., &Subedi, M.(2020). COVID-19 and stigma: social discrimination towards frontline healthcare providers and COVID-19 recovered patients in Nepal. Asian Journal of Psychiatry, 53, 102222.
Smith, B.W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., & Bernard, J. (2008). The brief resilience scale: Assessing the ability to bounce back. International Journal of Behavioral Medicine,15(3), 194-200.
Son, C., Hegde, S., Smith, A., Wang, X., &Sasangohar, F. (2020). Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study. Journal of Medical Internet Research, 22(9), e21279.
Sun, S., Goldberg, S., Qiao, S., Lin, D., &Operario, D. (2021). Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China. Global Health, 17, 15.
The Himalayan Times (2020). Prohibitory order in Kathmandu valley extended till September 2. The Himalayan Times, 2020 August 26. https://thehimalayantimes.com/kathmandu/prohibitory-order-in-kathmandu-valley-extended-till-september-2/.
Thoits, P.A., & Hewitt, L.N. (2001). Volunteer Work and Well-Being. Journal of Health and Social Behavior, 42, 115-31.
Tugade, M.M., & Fredrickson, B.L. (2004). Resilient individuals use positive emotions to bounce back from negative emotional experiences. Journal of Personality and Social Psychology, 86(2), 320-333.
Vogel, L.(2018). Medicine is one of the loneliest professions. CMAJ: Canadian Medical Association journal- journal de l’ Association medicalecanadienne, 190(31), E946.
World Health Organization WHO.(2020a). Mental Health and COVID-19’ World health Organization, 2020. https://www.who.int/teams/mental-health-and-substance-use/covid-19.
World Health Organization WHO.(2020b). Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)’.World health Organization.https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov).
Wu, M., Xu, W., Yao, Y., Zhang, L., Guo, L., Fan, J., & Chen, J. (2020). Mental health status of students’ parents during COVID-19 pandemic and its influence factors. General Psychiatry, 33(4), e100250.
Yildirim, M., Arslan, G., & Wong, P.T.P. (2021). Meaningful living, esilience, affective balance, and psychological health problems among Turkish young adults during coronavirus pandemic. Current Psychology, 1-12. doi: 10.1007/s12144-020-01244-8.
Yildirim, M., Özaslan, A., & Arslan, G. (2020). Perceived Risk and Mental Health Problems Among Healthcare Professionals During COVID-19 Pandemic: Exploring the Mediating Effects of Resilience and Coronavirus Fear. International Journal of Mental Health and Addiction, 16, 1-11.
Yildirim, M., &Solmaz, F. (2020). COVID-19 Burnout, COVID-19 Stress and Resilience: Initial Psychometric Properties of COVID-19 Burnout Scale. Death Studies, 1-25.
Zhao, F., Guo, Y., Suhonen, R., &Leino-Kilpi, H. (2016). Subjective well-being and its association with peer caring and resilience among nursing vs medical students: a questionnaire study. Nurse Education Today, 37, 108–13.
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