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Social Distancing among Medical Students during the 2019 Coronavirus Disease Pandemic in China: Disease Awareness, Anxiety Disorder, Depression, and Behavioral Activities

Author

Listed:
  • Huidi Xiao

    (Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China
    These authors contributed equally to this work.)

  • Wen Shu

    (Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China
    These authors contributed equally to this work.)

  • Menglong Li

    (Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China)

  • Ziang Li

    (Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China)

  • Fangbiao Tao

    (Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China)

  • Xiaoyan Wu

    (Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China)

  • Yizhen Yu

    (Department of Child and Women Health Care, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China)

  • Heng Meng

    (Department of Child and Women Health Care, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China)

  • Sten H. Vermund

    (Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06520, USA
    Department of Pediatrics, Yale School of Medicine, New Haven, CT 06520, USA)

  • Yifei Hu

    (Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China)

Abstract

Background: During the coronavirus disease (COVID-19) pandemic, harsh social distancing measures were taken in China to contain viral spread. We examined their impact on the lives of medical students. Methods: A nation-wide cross-sectional survey of college students was conducted from 4–12 February 2020. We enrolled medical students studying public health in Beijing and Wuhan to assess their COVID-19 awareness and to evaluate their mental health status/behaviors using a self-administered questionnaire. We used the Patient Generalized Anxiety Disorder-7 and Health Questionnaire-9 to measure anxiety disorders and depression. We used multivariable logistic regression and path analysis to assess the associations between covariates and anxiety disorder/depression. Results: Of 933 students, 898 (96.2%) reported wearing masks frequently when going out, 723 (77.5%) reported daily handwashing with soap, 676 (72.5%) washed hands immediately after arriving home, and 914 (98.0%) reported staying home as much as possible. Prevalence of anxiety disorder was 17.1% and depression was 25.3%. Multivariable logistic regression showed anxiety to be associated with graduate student status (odds ratio (aOR) = 2.0; 95% confidence interval (CI): 1.2–3.5), negative thoughts or actions (aOR = 1.6; 95% CI: 1.4–1.7), and feeling depressed (aOR = 6.8; 95% CI: 4.0–11.7). Beijing students were significantly less likely to have anxiety than those in the Wuhan epicenter (aOR = 0.9; 95% CI: 0.8–1.0), but depression did not differ. Depression was associated with female students (aOR = 2.0; 95% CI: 1.2–3.3), negative thoughts or actions (aOR = 1.7; 95% CI: 1.5–1.9), and anxiety disorder (aOR = 5.8; 95% CI: 3.4–9.9). Path analysis validated these same predictors. Conclusions: Despite medical students’ knowledge of disease control and prevention, their lives were greatly affected by social distancing, especially in the Wuhan epicenter. Even well-informed students needed psychological support during these extraordinarily stressful times.

Suggested Citation

  • Huidi Xiao & Wen Shu & Menglong Li & Ziang Li & Fangbiao Tao & Xiaoyan Wu & Yizhen Yu & Heng Meng & Sten H. Vermund & Yifei Hu, 2020. "Social Distancing among Medical Students during the 2019 Coronavirus Disease Pandemic in China: Disease Awareness, Anxiety Disorder, Depression, and Behavioral Activities," IJERPH, MDPI, vol. 17(14), pages 1-13, July.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:14:p:5047-:d:384103
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    References listed on IDEAS

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    1. Cuiyan Wang & Riyu Pan & Xiaoyang Wan & Yilin Tan & Linkang Xu & Cyrus S. Ho & Roger C. Ho, 2020. "Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China," IJERPH, MDPI, vol. 17(5), pages 1-25, March.
    2. Najla Dar-Odeh & Hamzah Babkair & Shaden Abu-Hammad & Sary Borzangy & Abdalla Abu-Hammad & Osama Abu-Hammad, 2020. "COVID-19: Present and Future Challenges for Dental Practice," IJERPH, MDPI, vol. 17(9), pages 1-10, April.
    3. María B. Martos-Cabrera & Emilio Mota-Romero & Raúl Martos-García & José L. Gómez-Urquiza & Nora Suleiman-Martos & Luis Albendín-García & Guillermo A. Cañadas-De la Fuente, 2019. "Hand Hygiene Teaching Strategies among Nursing Staff: A Systematic Review," IJERPH, MDPI, vol. 16(17), pages 1-13, August.
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