Quantitative and qualitative analysis of medical students’ symptoms and feelings during COVID-19 pandemic

Abstract

Abstract Background Due to the COVID-19 pandemic, traditional face-to-face teaching was disrupted, leading to a transition to online activities. Social restrictions and isolation during this period may have contributed to various physical and emotional disorders, such as anxiety, depression, reduced perception of happiness, and a decline in overall quality of life. The objective of our study was to assess the perceptions of medical students regarding their emotions, anxiety and depression symptoms, and daily experiences during the pandemic. Methods We conducted a prospective study with both quantitative and qualitative components involving students in their 1st to 4th year of medicine at a private university in São Paulo, Brazil in 2020 and 2021. Participants completed online questionnaires, including the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Oxford Happiness Questionnaire (OHQ), and Medical Student Quality-of-Life Questionnaire (VERAS-Q). Additionally, they engaged in online focus group discussions. Results A total of 313 students completed the questionnaires, and 200 participated in the focus group. Women exhibited higher scores for anxiety (p = 0.002) and depression (p = 0.007), while men demonstrated better quality of life (p = 0.042). The students aged 18 to 24 years (p = 0.048) presented better quality of life and lower trait anxiety (p = 0.001). Both trait and state anxiety were strongly associated with depression (p < 0.01) and inversely related to quality of life, showing a moderate association with happiness (p < 0.01). Depression was strongly linked to both trait and state anxiety (p < 0.01) and moderately negatively correlated with happiness and quality of life (p < 0.01). The focus groups revealed recurring negative feelings among students, such as anxiety, depression, tiredness, discouragement, loneliness, difficulty managing time, poor sleep quality, exacerbation of harmful habits, and challenges in relationships, resulting in reduced mental and physical health during the pandemic. Coping strategies were discussed, including the adoption of new healthy habits, religious practices, and reconnection with family. Conclusion Depression and anxiety symptoms were more prevalent among females, while quality of life improved for younger and male students. The qualitative analysis enhanced our understanding of the determinants and consequences of students' recurring negative feelings, and also showed positive aspects like greater proximity to family and religiosity.