Depression, anxiety, and stress among undergraduate health sciences students during COVID-19 pandemic in a low resource setting: a cross-sectional survey from Nepal

Bhoj Raj Kalauni; Yadav Prasad Joshi; Kiran Paudel; Biplav Aryal; Lava Karki; Rajan Paudel

doi:10.1097/MS9.0000000000000517

Depression, anxiety, and stress among undergraduate health sciences students during COVID-19 pandemic in a low resource setting: a cross-sectional survey from Nepal

Ann Med Surg (Lond). 2023 Apr 12;85(5):1619-1625. doi: 10.1097/MS9.0000000000000517. eCollection 2023 May.

Authors

Bhoj Raj Kalauni¹, Yadav Prasad Joshi^{2

3}, Kiran Paudel⁴, Biplav Aryal¹, Lava Karki¹, Rajan Paudel^{1

5}

Affiliations

¹ Central Department of Public Health, Institute of Medicine, Tribhuvan University.
² Manmohan Memorial Institute of Health Sciences.
³ Faculty of Science Health and Technology, Nepal Open University, Lalitpur, Nepal.
⁴ Nepal Health Frontiers, Tokha-5, Kathmandu.
⁵ Unit of Health Sciences, Tampere University, Tampere, Finland.

Abstract

Mental health is an important issue for students during the time of the COVID-19 pandemic and uncertainty. Students suffer from mental health issues due to delayed academic years and prolong stay at home during the lockdown. This study aimed to identify factors associated with depression, anxiety, and stress among undergraduate health sciences students of different medical institutions in Nepal.

Materials and methods: A web-based cross-sectional survey was conducted among 493 health sciences students between 14 July and 16 August 2020. Depression, anxiety, and stress were measured using the Depression, Anxiety, Stress Scale-21 (DASS-21). Multivariable logistic regression analysis was performed to determine the risk factors of mental health outcomes.

Results: Overall, 50.5, 52.5, and 44.6% of students had symptoms of depression, anxiety, and stress, respectively. Significantly higher odds of experiencing stress symptoms [adjusted odds ratio (AOR): 2.166; 95% CI: 1.075-4.363] were found with the participants whose relatives were infected with COVID-19. Participants with age less than or equal to 21 years among undergraduate health sciences students were significantly associated with higher odds of experiencing symptoms of stress (AOR: 1.626; 95% CI: 1.110-2.383) and anxiety (AOR: 1.6251; 95% CI: 1.110-2.379) in comparison with age above 21. Staying in quarantine was significantly associated with higher odds of experiencing depressive symptoms (AOR: 2.175; 95% CI: 1.142-4.143). Participants who had internet facilities at the residence had less likely to have depressive symptoms than those who are lacking internet services (AOR: 0.420; 95% CI: 0.195-0.905).

Conclusions: Staying in quarantine had higher odds of having depression and students who had internet facilities had lower odds of having depression. While staying in quarantine or isolation, it would be better to provide things to engage like the internet. A focus on improving the mental well-being of health sciences students should be initiated immediately after such a pandemic and lockdown.

Keywords: anxiety; burnout; depression; mental health outcome; psychological distress; stress.