*2.4. Data Analysis*

In this study, poor mental health was defined using the symptom severity cutoff scores for high stress (PSS scores ≥ 27), moderate-to-severe anxiety (GAD-7 scores ≥ 10), and moderate-to-severe depression (PHQ-9 scores ≥ 10). Coping mechanisms were categorized into dichotomous variables using the following cutoff scores: CD-RISC-10 scores ≥ median of 29 (high resilience); Spirituality Support Scale scores ≥ median of 36 (high spiritual support); and family APGAR scores ≥ 8 (high family functioning).

Descriptive statistics summarized sample characteristics and key study variables. Wilcoxon signed-rank tests were performed to compare the median scores of high stress, moderate-to-severe anxiety, and moderate-to-severe depression before and during the lockdown. Kendall's tau correlation procedures were performed to explore potential correlations between the dichotomous variables of poor mental health, coping mechanisms, and demographic variables. Statistically significant demographic variables and coping mechanisms were entered into multivariate logistic regression models to explore the

influence of coping mechanisms as predictors of poor mental health. All statistical analyses were performed using SPSS software, version 26.0 (IBM Corporation, Armonk, NY, USA). The level of significance level was set at *p*-value < 0.05, and all tests were two-tailed.

#### **3. Results**

#### *3.1. Sample Characteristics*

Of 447 students invited, 173 completed the survey and were included in the statistical analysis (38.7% participation rate). The average age was 25 years old, and most were female (93.1%). More than half were white (57.8%) and pre-licensure undergraduate students (76.8%). Almost a quarter (23.1%) were registered nurses enrolled in graduate programs or a baccalaureate degree completion program. About 14 percent had worked with COVID-19 patients, while three quarters had experienced quarantine or self-isolation during the pandemic (75.7%). For coping mechanisms, the median (IQR) scores of resilience, spiritual support, and family functioning were 29 (25, 32), 36 (33, 43), and 9 (6.5, 10), respectively.
