Lifestyles and Academic Stress in University Students of Health Sciences: A Mixed-Methodology Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Procedures
2.2. Study Population
2.3. Instruments
2.4. Data Analysis
2.5. Ethical Considerations
3. Results
3.1. Descriptive Findings
3.2. Quantitative Results
3.3. Qualitative Results
“I feel that the social aspect was in decline because it was very difficult to socialize with people, and education changed completely.”(Male nursing student)
“Personally, the isolation affected my psychological side as it took me a while to get used to that way of life.”(Female medical student)
“It mainly influenced the concern about not having a stable internet network, which resulted in sometimes not being able to attend classes or not being able to fully understand a class due to the failure in connectivity.”(Male physiotherapy student)
“I have a lot of social anxiety, embarrassment and too many nerves to be able to express myself freely and my academic performance is what depresses me the most every day.”(Female clinical laboratory student)
“Face-to-face because it forces me to stay busier away from situations and put aside other thoughts, concentrating on my studies.”(Male dentistry student)
“Face-to-face because I feel that everything, they give me can be done in a certain practical way and there won’t be as many complications as there were virtually, this thing that the internet went out or you couldn’t clearly hear what they were teaching us.”(Female clinical psychology student)
4. Discussion
Limitations and Suggestions for Future Studies
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Son, H.-E.; Hong, Y.-S.; Son, H. Association between Changes in Daily Life due to COVID-19 and Depressive Symptoms in South Korea. Healthcare 2024, 12, 840. [Google Scholar] [CrossRef]
- United Nations Educational, Scientific and Cultural Organization. COVID-19 Impact on Education. 2020. Available online: https://en.unesco.org/covid19/educationresponse (accessed on 21 June 2024).
- Underwood, E.; Horita, R.; Imamura, N.; Fukao, T.; Adachi, M.; Tajirika, S.; Izurieta, R.; Yamamoto, M. Changes in Mental Health among Japanese University Students during the COVID-19 Era: Differences by College Department, Graduate Level, Sex, and Academic Year. Healthcare 2024, 12, 902. [Google Scholar] [CrossRef]
- Huang, H.-M.; Fang, Y.-W. Stress and Coping Strategies of Online Nursing Practicum Courses for Taiwanese Nursing Students during the COVID-19 Pandemic: A Qualitative Study. Healthcare 2023, 11, 2053. [Google Scholar] [CrossRef]
- Yücel, Ö.Ü.; Yücel, M. Changes in diet, lifestyle, and Orthorexia Nervosa tendency during the COVID-19 pandemic: A web-based study. Clin. Nutr. ESPEN 2022, 49, 241–245. [Google Scholar] [CrossRef]
- Vásquez-Aguilar, F.; Vergara-Jiménez, M.; Figueroa-Salcido, O.G.; Arámburo-Gálvez, J.G.; Cárdenas-Torres, F.I.; Ontiveros, N.; Martínez-López, E.; Barrón-Cabrera, E. The role of diet and physical activity in shaping COVID-19 severity: Design, validation, and application of a retrospective questionnaire. Healthcare 2024, 12, 813. [Google Scholar] [CrossRef] [PubMed]
- Fowler, K.; Wholeben, M. COVID-19: Outcomes for trauma-impacted nurses and nursing students. Nurse Educ. Today 2020, 93, 104525. [Google Scholar] [CrossRef] [PubMed]
- Maben, J.; Bridges, J. COVID-19: Supporting nurses’ psychological and mental health. J. Clin. Nurs. 2020, 29, 2742–2750. [Google Scholar] [CrossRef] [PubMed]
- Alfano, V.; Ercolano, S. The Efficacy of Lockdown against COVID-19: A Cross-Country Panel analysis. Appl. Health Econ. Health Policy 2020, 18, 509–517. [Google Scholar] [CrossRef]
- Son, C.; Hegde, S.; Smith, A.; Wang, X.; Sasangohar, F. Effects of COVID-19 on college students’ mental health in the United States: Interview Survey study. J. Med. Internet Res. 2020, 22, e21279. [Google Scholar] [CrossRef]
- Motevalli, M.; Drenowatz, C.; Wirnitzer, K.; Tanous, D.; Wirnitzer, G.; Kirschner, W.; Ruedl, G. Changes in physical activity during the COVID-19 lockdown based on the sociodemographic profile of 5569 students and academic staff of Austrian universities. Public Health 2023, 219, 102–109. [Google Scholar] [CrossRef]
- Savitsky, B.; Findling, Y.; Ereli, A.; Hendel, T. Anxiety and coping strategies among nursing students during the COVID-19 pandemic. Nurse Educ. Pract. 2020, 46, 102809. [Google Scholar] [CrossRef]
- Beauvais, A.M.; Stewart, J.G.; DeNisco, S.M.; Beauvais, J. Factors related to academic success among nursing students: A descriptive correlational research study. Nurse Educ. Today 2014, 34, 918–923. [Google Scholar] [CrossRef] [PubMed]
- Santos, M.L.D.; Uftring, M.; Stahl, C.A.; Lockie, R.G.; Alvar, B.A.; Mann, J.B.; Dawes, J. Stress in academic and Athletic performance in Collegiate Athletes: A narrative review of sources and monitoring strategies. Front. Sport. Act. Living 2020, 2, 42. [Google Scholar] [CrossRef]
- Picard, M.; McEwen, B.S. Psychological Stress and Mitochondria: A Conceptual framework. Psychosom. Med. 2018, 80, 126–140. [Google Scholar] [CrossRef]
- Orta, O.R.; Tworoger, S.S.; Terry, K.L.; Coull, B.A.; Gelaye, B.; Kirschbaum, C.; Sanchez, S.E.; Williams, M.A. Stress and hair cortisol concentrations from preconception to the third trimester. Stress 2018, 22, 60–69. [Google Scholar] [CrossRef]
- Yang, C.; Chen, A.; Chen, Y. College students’ stress and health in the COVID-19 pandemic: The role of academic workload, separation from school, and fears of contagion. PLoS ONE 2021, 16, e0246676. [Google Scholar] [CrossRef] [PubMed]
- Ruiz-Robledillo, N.; Vela-Bermejo, J.; Clement-Carbonell, V.; Alcocer-Bruno, C. Impact of COVID-19 pandemic on academic stress and perceived classroom climate in Spanish university students. Int. J. Environ. Res. Public Health 2022, 19, 4398. [Google Scholar] [CrossRef]
- Suliman, W.A.; Abu-Moghli, F.; Khalaf, I.; Zumot, A.; Nabolsi, M. Experiences of nursing students under the unprecedented abrupt online learning format forced by the national curfew due to COVID-19: A qualitative research study. Nurse Educ. Today 2021, 100, 104829. [Google Scholar] [CrossRef]
- Aristovnik, A.; Keržič, D.; Ravšelj, D.; Tomaževič, N.; Umek, L. Impacts of the COVID-19 pandemic on life of Higher education students: A Global perspective. Sustainability 2020, 12, 8438. [Google Scholar] [CrossRef]
- Sanad, H.M. Stress and Anxiety among Junior Nursing Students during the Initial Clinical Training: A Descriptive Study at College of Health Sciences, University of Bahrain. Am. J. Nurs. Res. 2019, 7, 995–999. [Google Scholar]
- Baloran, E.T. Knowledge, Attitudes, Anxiety, and Coping Strategies of Students during COVID-19 Pandemic. J. Loss Trauma 2020, 25, 635–642. [Google Scholar] [CrossRef]
- Rafati, F.; Nouhi, E.; Sabzevari, S.; Dehghan-Nayeri, N. Coping strategies of nursing students for dealing with stress in clinical setting: A qualitative study. Electron. Physician 2017, 9, 6120–6128. [Google Scholar] [CrossRef] [PubMed]
- Ramos-Morcillo, A.J.; Costa, C.L.; García, J.E.M.; Ruzafa-Martínez, M. Experiences of Nursing Students during the Abrupt Change from Face-to-Face to e-Learning Education during the First Month of Confinement Due to COVID-19 in Spain. Int. J. Environ. Res. Public Health 2020, 17, 5519. [Google Scholar] [CrossRef] [PubMed]
- Kunaviktikul, W.; Ang, E.; Baridwan, N.S.; Bernal, A.B.S.; Dones, L.B.P.; Flores, J.L.; Freedman-Doan, R.; Klunklin, A.; Lee, W.L.; Lin, C.-C.; et al. Nursing students’ and faculty members’ experiences of online education during COVID-19 across Southeast Asia: A Photovoice study. Nurse Educ. Today 2022, 111, 105307. [Google Scholar] [CrossRef] [PubMed]
- Córdova, A.; Caballero-García, A.; Drobnic, F.; Roche, E.; Noriega, D.C. Influence of stress and emotions in the learning process: The example of COVID-19 on University Students: A Narrative review. Healthcare 2023, 11, 1787. [Google Scholar] [CrossRef]
- Bhurtun, H.D.; Turunen, H.; Estola, M.; Saaranen, T. Changes in stress levels and coping strategies among Finnish nursing students. Nurse Educ. Pract. 2021, 50, 102958. [Google Scholar] [CrossRef]
- Comparcini, D.; Tomietto, M.; Cicolini, G.; Dickens, G.L.; Mthimunye, K.D.T.; Marcelli, S.; Simonetti, V. Pre-registration nursing students’ anxiety and academic concerns after the second wave of COVID-19 pandemic in Italy: A cross-sectional study. Nurse Educ. Today 2022, 118, 105520. [Google Scholar] [CrossRef] [PubMed]
- Arimori, H.; Abiru, N.; Morimoto, S.; Nishino, T.; Kawakami, A.; Kamada, A.; Kobayashi, M. Association between Lifestyle Factors and Weight Gain among University Students in Japan during COVID-19 Mild Lockdown: A Quantitative Study. Healthcare 2023, 11, 2630. [Google Scholar] [CrossRef]
- Walker, S.N.; Sechrist, K.R.; Pender, N.J. The Health-Promoting Lifestyle Profile Development and Psychometric Characteristics. Nurs. Res. 1987, 36, 76–81. [Google Scholar] [CrossRef] [PubMed]
- Jalali, A.; Ziapour, A.; Ezzati, E.; Kazemi, S.; Kazeminia, M. The Impact of Training based on the Pender Health Promotion Model on Self-Efficacy: A Systematic Review and Meta-Analysis. Am. J. Health Promot. 2023. [Google Scholar] [CrossRef]
- León-Reyna, P.L.; Lora-Loza, M.; Rodriguez-Vega, J. Relationship between lifestyle and work stress in nursing staff in times de COVID-19. Leon Reyna|Revista Cubana De Enfermería 2021, 37. Available online: https://revenfermeria.sld.cu/index.php/enf/article/view/4043 (accessed on 15 December 2023).
- Ruiz-Camacho, C.; Barraza-Macías, A. Validation of the SISCO SV-21 Inventory in Spanish university students. ResearchGate 2020, 40–65. [Google Scholar]
- Cohen, S.; Kamarck, T.W.; Mermelstein, R.J. A global measure of perceived stress. J. Health Soc. Behav. 1983, 24, 385–396. [Google Scholar] [CrossRef] [PubMed]
- Sveinsdóttir, H.; Flygenring, B.G.; Svavarsdóttir, M.H.; Þorsteinsson, H.; Kristófersson, G.K.; Bernharðsdóttir, J.; Svavarsdóttir, E.K. Predictors of university nursing student’s burnout at the time of the COVID-19 pandemic: A cross-sectional study. Nurse Educ. Today 2021, 106, 105070. [Google Scholar] [CrossRef] [PubMed]
- Larzabal-Fernandez, A.; Ramos-Noboa, M. Psychometric properties of the Perceived Stress Scale (pss-14) in high school students from the province of Tungurahua (Ecuador). Ajayu 2019, 17, 269–282. Available online: http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S2077-21612019000200003&lng=es&tlng=es (accessed on 5 October 2023).
- Miles, M.B.; Huberman, A.M. Qualitative Data Analysis: A Sourcebook of New Methods; Sage: Newcastle upon Tyne, UK, 1984; p. 263. [Google Scholar]
- Souza, T.C.; Oliveira, L.A.; Daniel, M.M.; Ferreira, L.G.; Della Lucia, C.M.; Liboredo, J.C.; Anastácio, L.R. Lifestyle and eating habits before and during COVID-19 quarantine in Brazil. Public Health Nutr. 2021, 25, 65–75. [Google Scholar] [CrossRef] [PubMed]
- Di Renzo, L.; Gualtieri, P.; Pivari, F.; Soldati, L.; Attinà, A.; Cinelli, G.; Leggeri, C.; Caparello, G.; Barrea, L.; Scerbo, F.; et al. Eating habits and lifestyle changes during COVID-19 lockdown: An Italian survey. J. Transl. Med. 2020, 18, 229. [Google Scholar] [CrossRef] [PubMed]
- Gadi, N.; Saleh, S.S.; Johnson, J.-A.; Trinidade, A. The impact of the COVID-19 pandemic on the lifestyle and behaviours, mental health and education of students studying healthcare-related courses at a British university. BMC Med. Educ. 2022, 22, 115. [Google Scholar] [CrossRef] [PubMed]
- Chick, R.C.; Clifton, G.T.; Peace, K.M.; Propper, B.W.; Hale, D.F.; Alseidi, A.; Vreeland, T.J. Using technology to maintain the education of residents during the COVID-19 pandemic. J. Surg. Educ. 2020, 77, 729–732. [Google Scholar] [CrossRef] [PubMed]
- Sultana, N.; Asaduzzaman, M.; Mubarak, M.; Hosen, I.; Kaggwa, M.M.; Al-Mamun, F.; Mamun, M.A. The impact of the COVID-19 pandemic on lifestyle patterns: Does gender matter? Front. Public Health 2022, 10, 920694. [Google Scholar] [CrossRef]
- Lovrić, R.; Farčić, N.; Mikšić, Š.; Včev, A. Studying During the COVID-19 Pandemic: A qualitative inductive content analysis of nursing students’ perceptions and experiences. Educ. Sci. 2020, 10, 188. [Google Scholar] [CrossRef]
- Wallace, S.; Schuler, M.; Kaulback, M.; Hunt, K.J.; Baker, M.P. Nursing student experiences of remote learning during the COVID-19 pandemic. Nurs. Forum 2021, 56, 612–618. [Google Scholar] [CrossRef] [PubMed]
- Bdair, I.A. Nursing students’ and faculty members’ perspectives about online learning during COVID-19 pandemic: A qualitative study. Teach. Learn. Nurs. 2021, 16, 220–226. [Google Scholar] [CrossRef]
- Masha’al, D.; Rababa, M.; Shahrour, G. Distance Learning–Related Stress Among Undergraduate Nursing Students During the COVID-19 Pandemic. J. Nurs. Educ. 2020, 59, 666–674. [Google Scholar] [CrossRef] [PubMed]
- Saddik, B.; Hussein, A.; Sharif-Askari, F.S.; Kheder, W.; Temsah, M.-H.; Koutaich, R.A.; Haddad, E.S.; Al-Roub, N.M.; Marhoon, F.A.; Hamid, Q.; et al. Increased Levels of Anxiety Among Medical and Non-Medical University Students during the COVID-19 Pandemic in the United Arab Emirates. Risk Manag. Healthc. Policy 2020, 13, 2395–2406. [Google Scholar] [CrossRef] [PubMed]
- Cao, W.; Fang, Z.; Hou, G.; Han, M.; Xu, X.; Dong, J.; Zheng, J. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res.-Neuroimaging 2020, 287, 112934. [Google Scholar] [CrossRef]
- Rood, L.; Tanzillo, T.; Madsen, N. Student nurses’ educational experiences during COVID-19: A qualitative study. Nurse Educ. Today 2022, 119, 105562. [Google Scholar] [CrossRef]
Variable | Frequency | % | M (SD) |
---|---|---|---|
Age * | |||
18–25 | 2449 | 89.5 | 21.6 (2.52) |
26–32 | 277 | 10.1 | |
33–40 | 6 | 0.2 | |
41+ | 2 | 0.1 | |
Sex | |||
Women | 1938 | 70.9 | |
Man | 796 | 29.1 | |
Programs | |||
Nursing | 393 | 14.37 | |
Medicine | 678 | 24.80 | |
Physiotherapy | 410 | 15.00 | |
Clinical Laboratory | 315 | 11.52 | |
Dentistry | 562 | 20.56 | |
Clinical psychology | 376 | 13.75 | |
Semester | |||
First | 342 | 12.5 | |
Second | 233 | 8.5 | |
Third | 256 | 9.4 | |
Fourth | 301 | 11.0 | |
Fifth | 365 | 13.4 | |
Sixth | 281 | 10.3 | |
Seventh | 237 | 8.7 | |
Eighth | 305 | 11.2 | |
Nineth | 143 | 5.2 | |
Tenth | 165 | 6.0 | |
Rotating Internship | 106 | 3.9 | |
Academic average * | |||
Excellent (9–10) | 399 | 14.6 | 8.24 (0.73) |
Very Good (8–8.9) | 1583 | 57.9 | |
Good (7–7.9) | 553 | 20.2 | |
Failed (<7) | 199 | 7.3 | |
Internet access | |||
Excellent | 264 | 9.7 | |
Well | 2156 | 78.9 | |
Bad | 314 | 11.5 | |
Technological equipment | |||
Mobile phone | 185 | 6.8 | |
Laptop | 622 | 22.8 | |
Desktop computer | 703 | 25.7 | |
Tablets | 6 | 0.2 | |
More than one | 1218 | 44.6 | |
Technological equipment conditions | |||
Excellent | 352 | 12.9 | |
Good | 2194 | 80.2 | |
Bad | 188 | 6.9 |
Variable Lifestyle | Association ANOVA | Intersection PROGRAMS + SEMESTER * ANCOVA | ||||
---|---|---|---|---|---|---|
M (SD) | F (df) | Post Hoc CI 95% | M | F | Post Hoc CI 95% | |
Programs | ||||||
Nursing | 114.76 (23.21) | 3.20 (5); p = 0.007 ** | 114.241 a | 3.25; p = 0.006 ** | ||
Medicine | 116.13 (23.72) | 4.70 (0.82 to 8.59) p = 0.006 ** | 116.332 a | 4.94 (1.01 to 8.86) p = 0.003 ** | ||
Physiotherapy | 112.06 (23.62) | 112.110 a | ||||
Clinical Laboratory | 113.22 (21.87) | 113.488 a | ||||
Dentistry | 111.42 (23.23) | (−4.70) (−8.59 to 0.82) p = 0.006 ** | 111.388 a | (−4.94) (−8.86 to −1.01) p = 0.003 ** | ||
Clinical Psychology | 113.21(22.78) | 113.025 a |
Variable Academic Stress | Association ANOVA | Intersection PROGRAMS + SEMESTER * ANCOVA | ||||
---|---|---|---|---|---|---|
M (SD) | F (df) | Post Hoc CI 95% | M | F | Post Hoc CI 95% | |
Programs | ||||||
Nursing | 59.75 (24.92) | 7.54 (5; 2728) p = 0.001 ** | 6.70 (1.47 to 11.94) p = 0.004 ** | 59.045 a | 7.44 p = 0.001 ** | |
Medicine | 60.38 (25.09) | 7.33 (2.63 to 12.0) p = 0.001 ** | 60.965 a | 7.62 (2.90 to 12.35) p = 0.001 ** | ||
Physiotherapy | 53.04 (27.02) | (−9.51) (−14.4 to −4.59) p = 0.001 ** | 53.337 a | (−9.33) (4.45 to −4.45) p = 0.001 ** | ||
Clinical Laboratory | 59.30 (24.62) | 58.896 a | ||||
odontology | 62.56 (25.81) | 9.51 (4.59 to 14.43) p = 0.001 ** | 62.672 a | 9.33 (1.01 to 14.21) p = 0.001 ** | ||
Clinical Psychology | 56.87 (26.81) | (−5.68) (−10.71 to −0.66) p = 0.016 ** | 57.286 a | (−5.38) (−10.39 to −0.37) p = 0.024 |
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Salazar-Granizo, Y.E.; Hueso-Montoro, C.; Caparros-Gonzalez, R.A. Lifestyles and Academic Stress in University Students of Health Sciences: A Mixed-Methodology Study. Healthcare 2024, 12, 1384. https://doi.org/10.3390/healthcare12141384
Salazar-Granizo YE, Hueso-Montoro C, Caparros-Gonzalez RA. Lifestyles and Academic Stress in University Students of Health Sciences: A Mixed-Methodology Study. Healthcare. 2024; 12(14):1384. https://doi.org/10.3390/healthcare12141384
Chicago/Turabian StyleSalazar-Granizo, Yolanda E., Cesar Hueso-Montoro, and Rafael A. Caparros-Gonzalez. 2024. "Lifestyles and Academic Stress in University Students of Health Sciences: A Mixed-Methodology Study" Healthcare 12, no. 14: 1384. https://doi.org/10.3390/healthcare12141384