Ego-resiliency, life satisfaction and symptoms of anxiety and depression among students of pro- health faculties during COVID-19 pandemic.

doi:10.21203/rs.3.rs-2991096/v1

Download PDF

Research Article

Ego-resiliency, life satisfaction and symptoms of anxiety and depression among students of pro- health faculties during COVID-19 pandemic.

https://doi.org/10.21203/rs.3.rs-2991096/v1

This work is licensed under a CC BY 4.0 License

Version 1

posted

You are reading this latest preprint version

Background: Ego-resiliency could play a protective role, especially in stressful situations. Such a situation is certainly the period of the COVID-19 pandemic. The beginning of the pandemic period have been a source of significant stress for many people. Students, especially of medical faculties, were one of the social groups that could be particularly affected by the reorganization of everyday functioning. Effective coping with stress during this period could have been important for minimizing its negative effects.

Aim: The aim of the study was to assess ego-resiliency as a factor enhancing life satisfaction and a protective factor against symptoms of anxiety and depression in a group of health students during COVID-19 pandemic.

Methods and Material: The study was conducted in the period from October 2020 to June 2021. The study group included 362 students of the medical faculty and 249 students of the Academy of Physical Education (APhE).

The Ego Resiliency Scale (ER89-R12), the Life Satisfaction Scale (SWLS) and the Anxiety and Depression Scale (HADS) were used in the study. Among the statistical methods, the Mann-Whitney U test and Spearman's rank correlation coefficient were used.

Results: In the study group, medical students obtained the average score of 34.96±5.19 points and 36.49±5.22 points for students of the APhE was obtained in the ER-89-R12, the difference was statistically significant (p=0.003). In the SWLS, the mean score was 23.65±5.9 points for medical students and 22.35±5.67 points for students of the APhE, the difference was also statistically significant (p=0.005). In the assessment of anxiety, medical students obtained an average of 8.43±4.34 points and students of the APhE 7.60±4.27 points, the difference was statistically significant (p=0.012). In the assessment of depression, medical students achieved 5.10±3.77 points and students of APhE obtained about 4.77±3.26 points, the difference was not statistically significant. There were significant, negative correlations in the scope of the results obtained in the ER-89-R12 with the results of anxiety and depression, and positive correlations with the results obtained in the SWLS scale for both groupS.

Conclusions: Life during the pandemic was assessed by students of pro-health faculties as moderately satisfactory. The severity of symptoms of anxiety and depression correlated negatively with life satisfaction. Ego-resiliency may be a factor enhancing life satisfaction and may be a protective factor against anxiety and depression symptoms.

Covid-19 pandemic

students

ego-resiliency

life satisfaction

symptoms of anxiety and depression

The term "resilience" comes from the Latin salire, which means spring, spring up; and resilire, which means spring back. There are two terms can be found in the literature: resilience and resiliency. The first one is identified with the process of successfully overcoming negative phenomena and life events. The second means a personality property or a relatively permanent resource of an individual and is defined in Polish as mental resilience [1]. This understanding of resilience refers to Block's theory of ego-resiliency [2], who treats it as a relatively permanent disposition, determining the process of flexible adaptation to constantly changing life requirements. Thus, Block perceives it as a personality trait, important in the process of struggling with both traumatic events and events occurring in everyday life. Resilience stands in opposition to both a lack of control (impulsiveness) and an excess of it (rigidity). This means that resilience is related to the ability of an individual to adjust the level of control to their own capabilities and the requirements of the situation. A person with a high level of resilience exhibits an optimal level of mobilization, adequate to the actions taken [3]. In this context, mental resilience can be treated as a mechanism of self-regulation, including cognitive, emotional and behavioral elements [4]. The former are characteristic of beliefs and expectations and concern the perception of reality as a challenge, as well as one's own competences. The emotional components of resilience are related to positive feelings and emotional stability. In turn, the behavioral components of resilience are expressed in the search for new experiences and the adoption of various and effective strategies for dealing with problems. Mental resilience will therefore foster perseverance and flexible adaptation to life requirements, facilitating the mobilization to take preventive actions in difficult situations, and will also increase the tolerance of negative emotions and failures [5]. The characteristics of people with high mental resilience is: close, cordial interpersonal contacts, self-confidence, a calm manner, the ability to control emotions, perseverance in pursuing goals and achieving them, independence, autonomy and emotional stability. A person with a high level of resilience has a positive attitude towards life, is able to effectively deal with the challenges of life and surprising situations that require flexible response [6]. They perceive the difficulties encountered more often as an opportunity to gain new experiences [7]. Mental resilience (ego-resiliency) could play a protective role, especially in stressful situations. Such a situation is certainly the period of the COVID-19 pandemic. The changes that have taken place in the surrounding reality, especially at the beginning of the pandemic period, have been a source of significant stress for many people. Students, especially of medical faculties, were one of the social groups that could be particularly affected by the reorganization of everyday functioning [8]. The sense of threat and uncertainty of tomorrow could significantly influence the change of lifestyle and generate anxiety and fear [9]. In addition, there were difficulties related to changes in academic learning, as well as direct contact with patients during clinical classes, where the potential risk of COVID-19 infection was much higher than in other circumstances. Polish medical students participated as volunteers performing swabs for the presence of the SARS-COV-2 infection, and also took part in the treatment of patients in the so-called temporary hospitals. Functioning in the conditions of the need to exercise extreme caution, wear protective clothing, constantly changing guidelines regarding procedures were factors that generated tension and had an impact on health and satisfaction with life [9, 10]. Effective coping with stress during this period could have been important for minimizing its negative effects, including long-term ones [11]. Ego-resiliency in this context may be a protective factor against the symptoms of tension related to changing living conditions, and at the same time may have a positive impact on its quality [12, 13].

The aim of the study was to assess ego-resiliency as a potential protective factor against anxiety and depressive symptoms and having a positive relationship with life satisfaction in a group of health students during the SARS-CoV-2 virus pandemic.

The study was conducted from October 2020 to June 2021. The study group included 362 medical students of Medical University of Silesia in Katowice aged 22.01 ± 2.90 years and 249 students of the Academy of Physical Education (APhE) in Katowice aged 21.40 ± 2.03 years. All respondents agreed to participate in the project. The sociodemographic characteristics of the respondents are presented in Table 1.

Table 1

Socio-demographic characteristics of the group (N = 611)
	Total (n = 611)	Students of APhE(n = 249)	Medical students (n = 362)
	f (rf)	f (rf)	f (rf)
Sex
Male	220 (36.1%)	89 (35.7%)	131 (36.1%)
Female	391 (63.9%)	160 (64.3%)	231 (63.9%)
Marital status
Single	329 (59.8%)	168 (67.5%)	161 (44.7%)
In a relationship	282 (40.2%)	81 (32.5%)	201 (55.3%)
Place of residence
Urban	472 (73.5%)	170 (68.5%)	302 (83.5%)
Rural	139 (26.5%)	79 (31.5%)	60 (16.5%)
Chronic diseases
Yes	153 (20.9%)	40 (16.0%)	113 (31.1%)
No	458 (79.1%)	209 (84.0%)	249 (68.9%)

Methods

The following tools and psychometric questionnaires were used to assess the parameters studied:

Original demographic data questionnaire. This questionnaire was designed to obtein sociodemographic variables. It consisted of questions about gender, age, place of residence or level of education.

The Ego Resiliency Scale (ER89-R12) is a tool used to measure mental resilience understood as a personality trait. Ego-resiliency is a dimension proving the human ability to dynamic, adequate and adaptive self-regulation, and therefore has a pro-health significance. This tool is a Polish adaptation of the Block and Kremen test popular abroad. The test consists of 12 questions assessed on a four-point scale, in which the answer 1 means "does not apply to me at all" and 4 "refers to me very strongly". The overall score, which defines mental resilience, is obtained by summing up the partial scores from all the items. The tool also allows for assessment in two subscales: optimal regulation and openness to life experience. The tool has good psychometric properties, under which validity and reliability were tested. The reliability of the tool was assessed using Cronbach's α coefficient and was 0.82 [14].

Satisfaction with Life Scale (SWLS). The scale by Diener, Emmons, Larson and Griffin in the Polish adaptation of Juczyński allows for the study of life satisfaction understood as a subjective assessment of the quality of functioning. It contains five items. The respondent is asked to respond to each of the statements by specifying to what extent each of them applies to his/her life so far, from "strongly agree" (7 points) to "strongly disagree" (1 point). The grades are summed up and the result determines the level of satisfaction with life. Scores range from 5 to 35 points. They can be converted to standardized units on the sten scale. Scores in the range of 1–4 sten were considered low, and in the range of 7–10 sten as high. Scores in the range of 5–6 sten correspond to average values. The reliability of the scale in Polish adaptation studies turned out to be good, Cronbach's alpha coefficient was 0.81 [15,16].

Anxiety and Depression Scale (HADS). The scale consists of two independent subscales containing 7 statements each, one of which assesses anxiety (HADS-A) and the other the severity of depression symptoms (HADS-D), taking into account the functioning of the respondent during the last week. Achieving 0–7 points in each of the subscales is considered normal [17].

The study was conducted online, during classes conducted in this form at both universities. Microsoft Forms were used in the study. The prepared form contained information for the participants about the purpose of the study and the method of completing the tests used was discussed.

Statistical analysis

Standard statistical procedures were used in the analyses. The Mann-Whitney U test was used to assess the significance of differences between the study groups. Spearman's rank correlation coefficient was used to assess the relationships between the data. The significance level of p < 0.05 was assumed as statistically significant. Calculations were made in Statistica version 13.3.

Ethics of conducted research

The Bioethics Committee of the Medical University of Silesia approved the study (PCN/0022/KBI/66/2).

The students were informed about the anonymity and confidentiality of the research. Moreover, they were informed that they could stop the study at any time. Information about the study and informed consent was included in the first part of the prepared form.

1. Ego-resiliency

In the study group, the average score of 34.96 ± 5.19 points was obtained for medical students and 36.49 ± 5.22 points for students of the Academy of Physical Education, the difference was statistically significant (p = 0.003) (Table 2,3).

Table 2

Descriptive statistics of variables for the whole group
N = 611	Mean	St. Dev.	Median	Min.	Max.
ER	35.584	5.689	36.000	32.000	40.000
SWLS	23.128	5.865	24.000	20.000	28.000
HADS-A	8.095	4.330	7.000	5.000	11.000
HADS-D	4.972	3.578	4.000	2.000	7.000
ER - Ego-resiliency, SWLS - The Satisfaction with Life Scale, HADS-A - The Hospital Anxiety and Depression Scale - Anxiety part, HADS-D - The Hospital Anxiety and Depression Scale - Depression part. St. Dev. - standard deviation

Table 3

Differences between medical students and students of the Academy of Physical Education (APhE)
	Medical students (n = 362)			Students of APhE (n = 249)		U-Mann Whitney
	Mean	St. Dev.	Median	Mean	St. Dev.	P
ER*	34.961	5.913	35.000	36.490	5.226	0.003
SWLS*	23.657	5.940	25.000	22.357	5.679	0.005
HADS-A*	8.434	4.345	8.000	7.602	4.270	0.012
HADS-D	5.105	3.777	4.000	4.779	3.266
ER - Ego-resiliency, SWLS - The Satisfaction with Life Scale, HADS-A - The Hospital Anxiety and Depression Scale - Anxiety part, HADS-D - The Hospital Anxiety and Depression Scale - Depression part. St. Dev. - standard deviation * statistically significant p < 0.05

2. Satisfaction with life

In SWLS, an average score of 23.65 ± 5.9 points was obtained for medical students and 22.35 ± 5.67 points for students of the Academy of Physical Education, the difference was statistically significant (p = 0.005) (Table 2,3).

3. Anxiety and depression symptoms (HADS scale)

In the anxiety assessment (HADS-A), medical students obtained about 8.43 ± 4.34 points and students of the Academy of Physical Education obtainded 7.60 ± 4.27 points, the difference was statistically significant (p = 0.012). In the assessment of depression (HADS-D), medical students achieved 5.10 ± 3.77 points and students of APhE 4.77 ± 3.26 points, the difference was not statistically significant (Table 2,3).

4. Analysis of relationships between the tested parameters

The analysis of relationships between the examined parameters was presented for both study groups together. Significant, negative correlations were noted in terms of the results obtained in the ego-resiliency scale with the results obtained in the anxiety and depression scale. Positive correlations were described in the ego-resiliency scale with the results obtained in the SWLS scale (Table 4).

Table 4

Relationships between ego-resiliency, life satisfaction and anxiety and depressive symptoms.
n = 611	ER	SWLS	HADS-A	HADS-D
ER	1.000	0.467**	-0.390**	-0.436*
SWLS		1.000	-0.466**	-0.572*
HADS-A			1.000	0.633***
HADS-D				1.000
ER - Ego-resiliency, SWLS - The Satisfaction with Life Scale, HADS-A - The Hospital Anxiety and Depression Scale - Anxiety part, HADS-D - The Hospital Anxiety and Depression Scale - Depression part. * statistically significant p < 0.05, p < 0.01, * p < 0.001

The quality of life is conditioned by many factors. Personality traits are among the significant determinants of life satisfaction. Some researchers emphasize that the relationship between the personality traits of an individual and the subjective sense of happiness may even be stronger than the relationship between psychological well-being and objective living conditions [18, 19]. Ego- resiliency is among the human personality traits associated with the quality of life [20]. Whatsmore, it can also be treated as a key factor in creating and implementing strategies for coping with stressful situations. Park et al. emphasize that the appropriate development of ego-resiliency can be a mechanism that compensates for excessive emotional sensitivity of an individual [21]. The role of mental resilience is important at every stage of human development, fulfilling a special role in periods of increased stress. A study by Labrague et al. indicates the important role of ego-resiliency in adaptation mechanisms during the COVID-19 pandemic [22]. Similar conclusions were reached by Chen Du et al. [23] in a large, multi-center study, and Thompson et al., emphasizing the need to strengthen ego-resiliency [24]. In this study, ego-resiliency among medical students and students of the Academy of Physical Education was compared in a specific period of the COVID-19 pandemic. A statistically significant higher average score on the scale evaluating ego-resiliency was obtained in the group of students of the Academy of Physical Education in comparison to the students of medicine. Different results were obtained by Calo et al., who in their study obtained lower results of mental resilience in this study group. However, the study was conducted before the COVID-19 pandemic and included physiotherapy students only [25]. Similar conclusions were reached by Biro - in her study also physiotherapy students achieved worse results in terms of mental resilience, compared to the results achieved by students of the APhE in our study [26]. In her study of tourism students, Unguren showed a satisfactory level of ego-resiliency in this study group and pointed to its role as a protective factor against fear of the coming future [27]. Few comparative studies concerned medical students, but studies of individual groups were usually based on different scales, which makes comparison difficult. Another Polish study, although it did not compare a group of medical students with others, indicated a low level of ego-resiliency in this study group, pointing to a probable relationship with a high level of occupational burnout during the pandemic [28]. Research also shows that in the professional group of doctors, the level of occupational burnout reaches a high level, affecting people already during medical studies and appearing during professional work at various stages [29, 30]. Perhaps high workload at every stage of life with reduced involvement in pro-health activities, such as physical activity, in this professional group may hinder the development of ego-resiliency. In this study, in the assessment of life satisfaction, it was the medical students who achieved more points than the students of the APhE. Perhaps this was due to the fact that as people associated with healthcare units, they had greater opportunities to move freely during the pandemic, some classes were also held stationary, which gives better conditions for social functioning compared to people who held their classes mainly online. In addition, taking into account the fact that the group of people studying at the Academy of Physical Education is probably strongly predisposed to undertake physical activity, hence the periods of lockdown could be particularly severe for these people and could affect the assessment of life satisfaction. In another study conducted at the same university, on first-year medical students, the participation of such factors as good health, adequate financial resources, and greater physical activity was emphasized as important for the perceived good quality of life [31]. The vast majority of studies conducted during the COVID-19 pandemic on the quality of life emphasize its worse assessment during this period, but none compared these two groups of students, as in our study [32,33]. In the assessment of depressive symptoms, the groups did not differ statistically, while the average score on the anxiety scale was statistically higher for medical students. This fact can be explained by the greater exposure of medical students to potential sources of infection with the SARS-CoV-2 virus compared to students of the Academy of Physical Education. Medical students often actively participated in helping COVID-19 patients in hospitals. In addition to the risk of infection, they also experienced death in form and frequency they had not experienced before. Similar results were obtained in a large American study by Halperin et al., in which 30% of medical students had anxiety disorders and almost 25% were depressed during the pandemic period [34]. Also Eleftheriou et al. in their study showed a similar degree of severity of depressive and anxiety symptoms in this study group, additionally emphasizing the presence of significant sleep problems [35]. Moreover, in our study, by analyzing the relationship between the examined factors, which were estimated in both groups, positive correlations of ego-resiliency with life satisfaction and negative correlations with anxiety and depressive symptoms were obtained. A similar relationship was noted in their studies by both Seo et al. and Rospenda et al. [36,37]. Noreen came to interesting conclusions, emphasizing that the development of ego-resiliency should be especially promoted in the group of medical students in order to reduce the potential consequences associated with increased stress [38]. Similar conclusions were reached by Maheri in an Iranian study on a large population of students [39]. Summing up, it can be concluded that ego-resiliency can be a protective factor against symptoms of anxiety and depression and enhancing the quality of life. Some studies indicate that ego-resiliency as an internal human resource can be developed and modified throughout life [40,41]. Therefore, it would be beneficial to develop resilience from childhood, and especially during studies, when people usually already have a greater insight into the course of their mental processes. Particularly useful methods could be psychotherapeutic techniques that arouse motivation to work on oneself, awaken awareness of one's own emotions experienced in conflict situations, teach to treat failures as challenges and stimulate students to overcome difficulties and change their behavior in the face of surprising or difficult situations.

Work restrictions

The presented study, like any study in which results were collected using the Internet, has some limitations. First of all, the collection of data via the Internet form makes it impossible to control the course of completing the questionnaires. The limitation of the work is also the collection of research material in two units, without creating comparative groups from other teaching units, which needs to be supplemented as part of the continuation of research. Data from two centers limits the possibility of generalizing the results. Due to the length of the article, the study did not describe the significance of differences in the scope of the studied variables resulting in the study group from socio-demographic differences, although the authors are aware that they exist.

Life during the pandemic was assessed by students as moderately satisfactory.
The intensity of symptoms of anxiety and depression correlated negatively with life satisfaction.
Mental resilience may be a protective factor against anxiety and depressive symptoms and a factor enhancing life satisfaction.

Ethics approval and consent to participate

The study was conducted in accordance with the Declaration of Helsinki.

The Bioethics Committee of the Medical University of Silesia approved the study (PCN/CBN/0022/KB/252/21).

The patients or their guardians provided their written informed consent to participate in this study.

Consent for publication

Not applicable

Availability of data and materials

The datasets generated and/or analysed during the current study are not publicly available due privacy and data protection reasons but are available from Patryk Główczyński on reasonable request.

Competing interests

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. This manuscript has not been published nor is it being considered for publication elsewhere.There are no conflicts of interest to declare, associated with the publication of this manuscript.

Funding

Research was not funded by anyone.

Authors' contributions

KBB, PG, PD, MDJ: Conceptualization, methodology, writing original draft preparation, project administration, supervision. KBB, PG, PD: writing review and editing. KBB, PG, PD: formal analysis, writing review and editing, supervision. All authors read and approved the final manuscript.

Acknowledgement

We would like to thank all students participated in the study.

Ogińska-Bulik N, Zadworna-Cieślak M. The Role of Resiliency in Coping with Stress Related to the Matriculation Examination. PrzeglÄ d Badań Edukacyjnych (Educational Studies Review. 2015;2(19):7–24.
Block J, Kremen AM. IQ and Ego-Resiliency: Conceptual and Empirical Connections and Separateness. J Personal Soc Psychol;1996:70 (2), 349–61.
Ma Y, Zhang B, Meng Y, Cao Y, Mao Y, Qiu C. Perceived stress and depressive symptoms among Chinese college students: A moderated mediation model of biorhythm and ego resilience. Front Public Health 2022 Aug 4;10:951717.
Ogińska-Bulik N, Juczyński Z. Skala Pomiaru Prężności. Pol Tow Psychologiczne. 2008;1:1–5.
Havnen A, Anyan F, Hjemdal O, Solem S, Gurigard Riksfjord M, Hagen K. Resilience Moderates Negative Outcome from Stress during the COVID-19 Pandemic: A Moderated-Mediation Approach. Int J Environ Res Public Health 2020 Sep 4;17(18):6461.
Ran L, Wang W, Ai M, Kong Y, Chen J, Kuang L. Psychological resilience, depression, anxiety, and somatization symptoms in response to COVID-19: A study of the general population in China at the peak of its epidemic. Soc Sci Med. 2020 Oct;262:113261.
Ogińska-Bulik N, Juczyński Z, Osobowość. stres a zdrowie (wyd. II uzupełnione), Wyd. Warszawa: Difin; 2010.
Tempski P, Arantes-Costa FM, Kobayasi R, Siqueira MAM, Torsani MB, Amaro BQRC, Nascimento MEFM, Siqueira SL, Santos IS, Martins MA. Medical students' perceptions and motivations during the COVID-19 pandemic. PLoS ONE. 2021 Mar 17;16(3).
Smith K, Larson MJ. Quality of life assessments by adult substance abusers receiving publicly funded treatment in Massachusetts American. J Drug Alcohol Abuse. 2003;19:323–35.
Gilan D, Röthke N, Blessin M, Kunzler A, Stoffers-Winterling J, Müssig M, Yuen KSL, Tüscher O, Thrul J, Kreuter F, Sprengholz P, Betsch C, Stieglitz RD, Lieb K. Psychomorbidity, Resilience, and Exacerbating and Protective Factors During the SARS-CoV-2 Pandemic. Dtsch Arztebl Int. 2020 Sep;18(38):625–30.
Heizman-Benatov J, Ochnik D, Rogowska AM, Arzenšek A, Mars Bitenc U. Prevalence and Sociodemographic Predictors of Mental Health in a Representative Sample of Young Adults from Germany, Israel, Poland, and Slovenia: A Longitudinal Study during the COVID-19 Pandemic. Int J Environ Res Public Health. 2022 Jan 25;19(3):1334.
Bisconti T, Bergeman CS. The role of dispositional resilience in regaining life satisfaction after the loss of spouse Death Studies, 31 (10) (2007), pp. 863–83.
Llistosella M, Castellvi P, Miranda-Mendizabal A, Recoder S, Calbo E, Casajuana-Closas M, Leiva D, Manolov R, Matilla-Santander N, Forero CG. Low Resilience Was a Risk Factor of Mental Health Problems during the COVID-19 Pandemic but Not in Individuals Exposed to COVID-19: A Cohort Study in Spanish Adult General Population. Int J Environ Res Public Health. 2022 Nov 21;19(22):15398.
Ogińska-Bulik N. Juczyński Skala pomiaru prężności – SPP-25. Nowiny Psychologiczne. 2008;4:39–56.
Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction With Life Scale. J Pers Assess. 1985;49(1):71–5.
Juczyński Z. Narzędzia pomiaru w promocji i psychologii zdrowia. Skala Satysfakcji z Życia. Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego. 2001;4:134–8.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–70.
Costa PT Jr, McCrae RR. Influence of extraversion and neuroticism on subjective well-being: happy and unhappy people. J Personal Soc Psychol. 1980;38:668–78.
Czapiński J. Osobowość szczęśliwego człowieka. In: Czapiński J, editor. Psychologia Pozytywna. Warszawa: PWN; 2004. pp. 359–79.
Dunkel CS, van der Linden D, Kawamoto T, Oshio A. The General Factor of Personality as Ego-Resiliency. Front Psychol. 2021 Nov;22:12:741462.
Park YH, Kim IH, Jeong YW. Stress, and coping strategy of university students during COVID-19 in Korea: The mediating role of ego-resiliency. Acta Psychol (Amst). 2022;227:103615.
Labrague LJ, De Los Santos JAA, Falguera CC. Social and emotional loneliness among college students during the COVID-19 pandemic: The predictive role of coping behaviors, social support, and personal resilience. Perspect Psychiatr Care. 2021 Oct;57(4):1578–84.
Du C, Zan MCH, Cho MJ, Fenton JI, Hsiao PY, Hsiao R, Keaver L, Lai CC, Lee H, Ludy MJ, Shen W, Swee WCS, Thrivikraman J, Tseng KW, Tseng WC, Doak S, Folk SYL, Tucker RM. The Effects of Sleep Quality and Resilience on Perceived Stress, Dietary Behaviors, and Alcohol Misuse: A Mediation-Moderation Analysis of Higher Education Students from Asia, Europe, and North America during the COVID-19 Pandemic. Nutrients. 2021 Jan;29(2):442.
Thompson G, McBride RB, Hosford CC, Halaas G. Resilience Among Medical Students: The Role of Coping Style and Social Support. Teach Learn Med. 2016;28(2):174–82.
Calo M, Peiris C, Chipchase L, Blackstock F, Judd B. Grit, resilience and mindset in health students. Clin Teach. 2019 Aug;16(4):317–22.
Bíró É, Veres-Balajti I, Kósa K. Social support contributes to resilience among physiotherapy students: a cross sectional survey and focus group study. Physiotherapy. 2016 Jun;102(2):189–95.
Üngüren E, Kaçmaz YY. Does COVID-19 pandemic trigger career anxiety in tourism students? Exploring the role of psychological resilience. J Hosp Leis Sport Tour Educ. 2022 Jun;30:100369.
Forycka J, Pawłowicz-Szlarska E, Burczyńska A, Cegielska N, Harendarz K, Nowicki M. Polish medical students facing the pandemic-Assessment of resilience, well-being and burnout in the COVID-19 era. PLoS One 2022 Jan 24;17(1):e0261652.
Lacy BE, Chan JL. Physician Burnout: The Hidden Health Care Crisis. Clin Gastroenterol Hepatol. 2018 Mar;16(3):311–7.
Thun-Hohenstein L, Höbinger-Ablasser C, Geyerhofer S, Lampert K, Schreuer M, Fritz C. Burnout in medical students. Neuropsychiatr 2021 Mar;35(1):17–27.
Szemik S, Gajda M, Gładyś A, Kowalska M. The Association between COVID-19 Pandemic and the Quality of Life of Medical Students in Silesian Voivodeship, Poland. Int J Environ Res Public Health 2022 Sep 20;19(19):11888.
Nugraha D, Salamah S, Luke K, Wibowo ZK, Witarto AP, Deswima C, Kloping NA, Witarto BS, Syamlan AT, Irzaldy A, Rochmanti M, Sari DR, Sakina S, Alkaff FF. Evaluation of Health-Related Quality of Life and Mental Health in 729 Medical Students in Indonesia During the COVID-19 Pandemic. Med Sci Monit. 2023 Feb;9:29:e938892.
Jhajj S, Kaur P, Jhajj P, Ramadan A, Jain P, Upadhyay S, Jain R. Impact of Covid-19 on Medical Students around the Globe. J Community Hosp Intern Med Perspect. 2022 Jul;4(4):1–6.
Halperin SJ, Henderson MN, Prenner S, Grauer JN. Prevalence of Anxiety and Depression Among Medical Students During the Covid-19 Pandemic: A Cross-Sectional Study. J Med Educ Curric Dev. 2021 Feb;15:8:2382120521991150.
Eleftheriou A, Rokou A, Arvaniti A, Nena E, Steiropoulos P. Sleep Quality and Mental Health of Medical Students in Greece During the COVID-19 Pandemic. Front Public Health. 2021 Nov;19:9:775374.
Seo EH, Yang HJ, Kim SG, Yoon HJ. Ego-resiliency moderates the risk of depression and social anxiety symptoms on suicidal ideation in medical students. Ann Gen Psychiatry. 2022 Jun 18;21(1):19.
Rospenda KM, Halpert J, Richman JA. Effects of social support on medical students’ performances. Acad Med. 1994;69:496–500. 10.1097/00001888-199406000-00018.
Noreen A, Iqbal N, Hassan B, Ali SA. Relationship between psychological distress, quality of life and resilience among medical and non-medical students. J Pak Med Assoc. 2021 Sep;71(9):2181–5.
Maheri M, Alipour M, Rohban A, Garmaroudi G. The association of resilience with health-related quality of life (HRQoL) in adolescent students. Int J Adolesc Med Health. 2019 Oct 30;34(1).
Chen Q, Gao W, Chen BB, Kong Y, Lu L, Yang S. Ego-Resiliency and Perceived Social Support in Late Childhood: A Latent Growth Modeling Approach. Int J Environ Res Public Health. 2021 Mar;14(6):2978.
Kubo T, Sugawara D, Masuyama A. The effect of ego-resiliency and COVID-19-related stress on mental health among the Japanese population. Pers Individ Dif 2021 Jun;175:110702. doi: 10.1016/j.paid.2021.11070.

No competing interests reported.

Download PDF

Version 1

posted

You are reading this latest preprint version

Ego-resiliency, life satisfaction and symptoms of anxiety and depression among students of pro- health faculties during COVID-19 pandemic.

Status:

Version 1

Abstract

Introduction

Material

Statistical analysis

Results

Discussion

Conclusions

Declarations

References

Additional Declarations

Status:

Version 1