Background: This study investigated the correlation between depression, anxiety, and stress among college students engaged in online learning during the coronavirus disease 2019 (COVID-19) pandemic and self-directed learning (SDL) ability, which could provide a scientific basis for mental health education of the college students.Methods: A cross-sectional study was conducted among 5,558 students from two universities in Anhui province, East China. The Depression, Anxiety, and Stress Scale-21 (DASS-21) and the Self-directed Learning Ability Scale were used to conduct an online questionnaire survey.Results: A total of 35.15, 36.32, and 17.24% of college students reported symptoms of depression, anxiety, and stress, respectively. Males and nonmedical students were at higher risks to suffer from depression, anxiety, and stress. In adjusted model, compared with Q1 of self-management ability, the odds ratio (OR) of the Q2, Q3, and Q4 were as follows: 0.635 (0.531–0.759), 0.504 (0.415–0.611), and 0.312 (0.248–0.392) for depression; 0.639 (0.535–0.764), 0.653 (0.540–0.789), and 0.421 (0.338–0.525) for anxiety; and 0.649 (0.523–0.805), 0.579 (0.457–0.733), and 0.482 (0.364–0.637) for stress. For information capability, decrease in risk was even more pronounced: Q2 (0.654, 0.540–0.794), Q3 (0.560, 0.454–0.690), and Q4 (0.233, 0.181–0.301) for depression; Q2 (0.781, 0.646–0.945), Q3 (0.616, 0.501–0.757), and Q4 (0.276, 0.216–0.353) for anxiety; and Q2 (0.444, 0.357–0.553), Q3 (0.454, 0.357–0.578), and Q4 (0.272, 0.202–0.368) for stress. Compared with the Q2 group of cooperation learning ability, cooperation learning ability quartiles were positively associated with depression (Q1: 1.382, 95% CI: 1.138–1.678), anxiety (Q4: 1.260, 95% CI: 1.008–1.576), and stress (Q1: 2.002, 95% CI: 1.583–2.532; Q3: 1.600, 95% CI: 1.252–2.044; Q4: 1.674, 95% CI: 1.243–2.255).Conclusion: The prevalence of depression, anxiety, and stress among college students was high for those studying online at home during the COVID-19 pandemic, especially among nonmedical students and males. SDL ability was negatively associated with negative emotions of the college students during this period of online learning.

Objective Anxiety and depression are great public health concerns among college students. The purpose of this study was to explore whether sleep quality and quality of life (QoL) play mediating roles in anxiety and depression among Chinese college students. Method A total of 2757 college students (mean age = 19.07; SD = 1.14) completed the questionnaires, including a brief demographic survey. The 2-item General Anxiety Disorder (GAD-2) and the 2-item Patient Health Questionnaire (PHQ-2) were used to assess the symptoms of anxiety and depression, respectively. And the Pittsburgh Sleep Quality Index (PSQI) and the Short-Form 36 Health Survey (SF-36) were used to evaluate college students’ sleep quality and QoL, respectively. Mediation analyses were conducted by using PROCESS macro in the SPSS software. Result Anxiety had both direct and indirect effects on depression. Sleep quality and QoL were not only independent mediators in the relationship between anxiety and depression but also chain mediators. Conclusion The results of the current study highlight the crucial role of early intervention for depression with a focus on college students with anxiety, more especially, on those with poorer sleep quality and lower QoL.

ObjectivesThis study explores the relationship between the perception of the learning environment and self-directed learning (SDL) ability among nursing undergraduates.Design, setting and participantsA cross-sectional study was conducted in December 2020 with 1096 junior and senior undergraduate nursing students (aged 16–22) from Wannan Medical College in Anhui Province, China.Outcome measuresThe Chinese version of the Dundee Ready Educational Environment Measure questionnaire and a validated Chinese version of college students’ SDL ability scale were used to assess students’ perceptions about their learning environment and their SDL ability. Canonical correlation analysis was performed to evaluate their correlation.ResultsThe total score for the learning environment was 120.60 (scoring rate: 60.30%), and the score for SDL ability was 89.25 (scoring rate: 63.75%). Analysis indicated that the first canonical correlation coefficient was 0.701 and the contribution rate was 94.26%. The perception of the learning environment was mainly determined by students’ perception of learning (SPL) and academic self-perceptions (SASP), with SDL ability mainly determined by self-management ability and cooperative learning ability. SPL and SASP were positively correlated with self-management ability and cooperative learning ability. Multiple linear regression analysis revealed that SPL, SASP, students’ perceptions of atmosphere and students’ social self-perceptions had a significant impact on SDL ability.ConclusionsThe SDL ability of nursing undergraduates was not high. SPL and SASP were positively correlated with self-management ability and cooperative learning ability. Nursing educators can improve students’ SDL ability by changing their learning environment, using, for example, new student-centred teaching methods.

Background The seminar-case learning (SCL) method is a case-oriented teaching model, with teachers and students as the main body of teaching, characterized by communication, interaction, and mutual inspiration. This study explored the effects of the SCL method versus traditional lecture-based learning (LBL) in the statistics curriculum for undergraduate students majoring in preventive medicine. Research questions were: 1) whether the scores of students in the experimental group (the SCL model) were higher than those in the control group (the LBL model); 2) whether the students’ satisfaction in the experimental group was better than that in the control group; and 3) whether the self-report benefit of students in the experimental group was better than that in the control group. Methods We conducted a two-armed cluster-randomized education intervention trial in practice teaching of health statistics among undergraduates majoring in preventive medicine. Two administrative classes (classes 1–4 and classes 5–8) were divided into the experimental group and the control group according to the principle of drawing lots. The students in two groups received the same statistical theory course. For the arrangement of statistical practice course, the experimental group adopted the SCL model, and the control group used the LBL model. The teaching effect was evaluated via an examination and an anonymous questionnaire survey. Results Scores for noun explanation questions in the experimental group showed no statistical significance with that of the control group(U = 2911.0, P = 0.964). The scores of single choice, calculation, and case analysis questions, and the total scores were significantly higher than that of the control group (P < 0.05). Students’ satisfaction with arrangements of the practice course in the experimental group (92.41%) was significantly higher than that of in the control group (77.03%), the difference was statistically significant (χ2 = 7.074, P = 0.008). The self-report benefit of students in the experimental group was better than that in the control group (P < 0.05). Conclusion As an effective method of high-quality education, the SCL model is worthy of further promotion in the practice teaching of preventive medicine.

Objective To translate the career success in nursing scale (CSNS) into Chinese and evaluate its psychometric properties. Background A lower sense of career success seriously affects the enthusiasm of nurses and increases their turnover rate. Therefore, an accurate assessment of the career success level of nurses is necessary. However, China does not have a professional tool for assessing the career success of nurses. Methods The stratified sampling method was used to recruit participants from 22 hospitals of different grades in 5 cities in China. A total of 650 and 348 subjects were selected for item analysis and reliability and validity tests, respectively, of the translated initial scale. Results The Chinese version of the CSNS (C-CSNS) with 33 items had good psychometric properties. Cronbach’s α was 0.960, split-half reliability was 0.893, and ICC within two weeks was 0.981. Exploratory factor analysis extracted 5 common factors that explained 63.73% of the total variance, and confirmatory factor analysis supported acceptable construct validity. Conclusion The C-CSNS has adequate construct validity and excellent psychometric properties and can be used for accurate assessment of nurses’ career success. Implications for nursing management A new tool that is more suitable for the Chinese hospital nursing context is available for evaluating Chinese clinical nurses’ career success. Nursing managers can formulate appropriate management strategies according to the evaluation results to assist nurses in career development planning, thereby improving their career success level.