Quantitative and qualitative analysis of medical students’ symptoms and feelings during a catastrophic event

Abstract

Background: Due to the COVID-19 pandemic, traditional face-to-face teaching has been disrupted. Social restrictions and isolation during this period may have contributed to various physical and emotional disorders. We aimed 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 mixed methods study involving students in their 1st to 4th years of medicine at a 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) and participated in an online focus group. Results:313 students finished the questionnaires, and 200 were involved in the focus group. Women exhibited higher scores for anxiety (p=0.002) and depression (p=0.007); 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, such as anxiety, depression, tiredness, loneliness, difficulty managing time and others, 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 revealed positive aspects such as greater proximity to family and religiosity.