Sreeram M, Mundada M. A. Survey to Assess Perceived Causes of Stress, Its Manifestations and Coping Strategies Among Dental College Students in Maharashtra During COVID-19 Lockdown. Biomed Pharmacol J 2021;fourteen(i)

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Meenakshi Sreeram* and Mona. A. Mundada

Section of General Human Physiology and Biochemistry, MGV's KBH Dental College and Hospital, Nasik, Maharashtra University of Health Sciences, Maharashtra, India- 422 003.

Respective Author E-mail: s.meenakshi492@gmail.com

DOI : https://dx.doi.org/10.13005/bpj/2098

Abstract

Objectives: Various studies across the globe take emphasized the importance of monitoring stress levels amidst students pursuing professional courses, especially medical and dental students. The pandemic acquired by the novel Corona virus afflicted the lives of people and economies of almost all nations in a manner no one could have ever fathomed. Unexpected and unprecedented changes have occurred in the way we work, study, interact, travel and many aspects of the way we humans lead our lives.The catamenia of lockdown was a difficult menstruum for everyone, more and then for the youth, as they were forced to remain indoors, at present no longer being able to physically interact with their friends,go to higher, visit malls, socialize, pursue pass-times and hobbies or generally have a life that the younger generation is used to.Academic activities initially came to a standstill before shifting to online mode which was new to both, teachers and students. The objective of the current questionnaire-based written report was to find out the perceived stress levels during the COVID-19 lockdown amidst the students and how capable they call up they are to cope with these testing times.

Methods: This survey was undertaken among the students from first to terminal year of a dental higher in Nasik, Maharashtra in the kickoff phase of lockdown in India from 22 Mar 2020 to 14 April 2020. A pretested self-administered questionnaire using Google forms was used for the data collection after getting approving from the Institutional Ethical Committee.

Results and Conclusions:Students from all the iv years reported beingness stressed and academic factors were one of the most important stressors. During the lockdown, portion completion, delay in academic activities, uncertainties of the disease and the impending exams were the main causes of anxiety and stress. Continuous student engagement during the flow and the availability of a staff to discuss and talk out a trouble helped in a big style.It is suggested that mental health of college students should exist monitored during such unusual circumstances equally the pandemic. The introduction of stress management education into the curriculum could prove useful to the students to assist them deal with whatever such situation in the time to come.

Keywords

COVID-19; Lockdown; Mental health; Novel Corona Virus; Pandemic; Stress

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Sreeram One thousand, Mundada Chiliad. A. Survey to Assess Perceived Causes of Stress, Its Manifestations and Coping Strategies Among Dental College Students in Maharashtra During COVID-nineteen Lockdown. Biomed Pharmacol J 2021;14(1)

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Sreeram 1000, Mundada Thousand. A. Survey to Appraise Perceived Causes of Stress, Its Manifestations and Coping Strategies Amidst Dental Higher Students in Maharashtra During COVID-nineteen Lockdown. Biomed Pharmacol J 2021;14(1). Available from: https://scrap.ly/3vQkiQH

Introduction

College life is a very important part of the life of every student and something every student looks forrard to from his/ her schoolhouse days. Both, parents and their wards, go through a lot of difficult work and sacrifice to become the student admitted into a course and college of their choice. As well providing the student a caste to set forth into the world, it as well teaches him the skills needed to survive in the world, the ability to face up the challenges, to meet mentors who would give a new direction to life, to make lasting friendships, maybe see future life-partners, to discover aspects about one-self and many more than. Many observe a transition in themselves when they ready out of the cocooned temper of home and school into the college life.But this phase may also bring forth many types of stress in the lives of students as they try to residue a demanding curriculum and peer pressure.(Lakyntiew Pariat, et al, 2014).

The concept of stress was get-go introduced in 1936, by Hans Seyle, the late Hungarian-Canadian endocrinologist, who is considered the "father of stress research". The give-and-take stress was used to describe both an amanuensis and its consequences. Seyle called stress equally "the salt of life" just information technology has at present become synonymous with everything that is perceived as bad though stress tin as well exist experienced positively. Later on Seyle used the word "stressor" for the perceived threat and "stress" as the reaction of the organism.Stress manifests itself in different ways varying from mild irritation to severe problems that might outcome in a real breakdown of health. For a layman most any event or situation between these extremes may be described as stressful. All individuals vary in their capacities to perform, arrange and accommodate when they confront stress. But ultimately everyone a breaking betoken, and when stress becomes difficult to manage, performance suffers and can cause both physical and mental harm. Stress is a natural part of the biological response mechanism of the body. It does not simply mean being nervous or anxious, having as well much of work or also much to written report and it need not always be damaging and neither can it be completely avoided as it. (Sheena Johnson, et al, 2005)In our lives, stress can exist physical (due to illness/ illness), emotional (grief due to loss of loved 1, divorce, etc.), or psychological (fear due to war, assault, blow, etc.)(Bruce McEwen, et al, 2006)

Bookish stress could exist a class of "united nations-favorable stress" equally it can bear upon the ability to learn and is often associated negatively with a student'south bookish functioning. It is a common problem faced by the students and their perception and the way they handle itreflects on their day to 24-hour interval affairs including academics. Information technology is well accustomed that the stress is an indispensable part of the demanding nature of a student'southward life and a lot tin can be accomplished if the educatee learns to cope and achieve a balance. (Agolla, J. E, et al. 2009)High levels of stress during medical schoolhouse can consequence in exhaustion syndrome, which is characterized by a state of physical and mental exhaustion connected to piece of work or activities of intendance. Chronic stress can bring well-nigh the onset of many diseases. It is important to identify and develop adaptive coping mechanisms in students to prevent them from developing maladaptive strategies such equally alcohol consumption, isolation, anxiety, depression, etc. (ÍcaroJ.S.Ribeiro,et al. 2018)A certain level of stress is needed to push students towards optimum functioning, but it needs to be managed efficiently as inadequate resource to cope with the stress can accept distressing consequences both for the student likewise as the institution. (Reddy Thou.J, et al, 2018)

Reports indicate that students experience high academic stress at predictable times in each semester, and the culprits are preparing for and taking exams, class ranking competition and mastering huge amount of syllabus in a comparatively very pocket-sized corporeality of time(Rawson, H. E., et al. 1999; Linn, B.South, et al. 1984; Wintertime, K. G., et al. 2000) concluded that increased stress during the first year of higher can predict lower level of overall adjustment and tin brand the students more susceptible to many social and psychological problems, thus leading to a lower form point boilerplate (GPA) in the final year Williamson et al reported that when the youth are anxious and depressed, they are likely to experience stressful life events which in turn lead to low functioning in academics.(Williamson, D. E., et al., 2005)Thus, information technology is very important for staff to be on the lookout for alarm signs in the students and create an atmosphere where in the pupil feels complimentary and comfortable to discuss his/her issues or accept a advisor on campus to cater to the students' needs.

Coronavirus affliction or COVID-19 is the name given to an infectious illness which was firstdetected in Wuhan, China in December 2019. As the number of patients rose dramatically in China and many other countries began reporting similar cases, WHO declared the outbreak a Public Wellness Emergency of International Concern(PHEIC) on 30 January 2020. By 11 Mar 2020, the number of cases outside Communist china had increased 13- fold as the disease spread apace in many countries beyond the earth. The official number of cases was more than 118,000 cases in 114 countries with more than four,000 people dead and thousands more fighting for their lives forcing the WHO to declare COVID -nineteen a pandemic. (https://www.who.int) At that time, the pandemic was simply beginning to rear its head in India with 60 confirmed cases and a single expiry reported. (https://www.statista.com/statistics) COVID-19 is acquired by a coronavirus which has been named the novel corona virus (nCoV) or SARS-CoV-2 virus. It belongs to a large family unit of viruses that are common in people and besides in many unlike species of animals, including camels, cattle, cats, and bats. Like MERS-CoV and SARS-CoV, it has its origins in bats and can infect humans and so spread between people. (Meenakshi Sreeram, 2020)

On sixteen Mar 2020, WHO issued an advisory to all countries to test every suspected case of COVID-xix and to isolate not just the patient but too all those that they have been in close contact with up to 2 days before they developed symptoms. Testing, isolation and care were the three measures emphasized by the organization. (https:// www. who. int/emergencies/diseases/novel-coronavirus-2019)Governments and administrations took refuge of classical communal wellness measures to adjourn this epidemic, the chief goal of which was to forbid the person-to-person spread of affliction past keeping people autonomously to interrupt transmission. The available tools to implement this are isolation and quarantine, social distancing and community containment/Lockdown. The first footstep taken past the regime was to shut the schools and colleges of the land and ask students to vacate the hostels. In response to the guidelines given, our higher declared the closure of pedagogy and clinical activities from 17th Mar 2020 until further discover.  Due to this, many students hurriedly travelled to their hometowns and their home states to be in the safety and comfort of their homes.The Indian authorities was 1 of the first countries in the world to impose a lock downwards of three weeks from 25th March 2020, all over the country and bring all activities to a grinding halt. What looked like a short unexpected holiday for students suddenly seemed like a long phase of dubiety. Students were unsure about how their academic yr would progress, how would portion be completed and when would the pending college exams would be conducted and many such related issues.

Concerned about the students' well-existence and mental health, the authors designed a questionnaire to get to know virtually the perceived stress, information technology's furnishings and manifestations in the students, coping mechanisms during the lockdown and what they feel about the sudden transition to online teaching. At that point in time, Nasik was relatively unaffected by the disease but our students belong to diverse parts of Maharashtra and outside the country too. Maharashtra has been one of the worst affected states in the land with regard to the number of active cases and mortality due to COVID-19.

Material and Methods

The written report population are the students from showtime to concluding yr of a dental college in Nasik, Maharashtra surveyed when the second stage of lock down in India began from xvth Apr 2020. A pretested cocky-administered question naire using Google documents was used for the data collection subsequently getting approval from the Institutional Upstanding Committee. The survey document was sent out on 20 Apr 2020 and responses were accepted till 03 May 2020. Students were contacted using their corresponding class Whats App group. All participants voluntarily gave their informed consent to participate in the study after beingness informed about the purpose of the study. Students had to log in using their registered mail id and information technology was restricted to ane response per student.Ease of access to online link resulted in ameliorate response charge per unit and most of the information was collected in the first calendar week of administering the questionnaire. The approximate fourth dimension needed by each pupil to answer to the questionnaire was 20 minutes.The college has an intake of 100 students per yr and in all 361 of the 400 students responded. Some of the students reside in remote areas where internet connectivity is an upshot which resulted in some responses not being recorded. All data has been expressed in percentage.

Results

A total of 361 students responded to the questionnaire which is 90% of the students currently pursuing the grade at the institute, 74.v % of which were females.On a scale from 1 to 10, 2.5% rated stress levels equally one, 21% graded the stress level as 5, 19.one% graded it equally 6, 19.one% graded information technology as 7 and iv.2% rated their stress levels at the maximum of 10. (Graph ane) 88% of the students felt that problems related to studies was among the top causes of stress during a routine year while problems related to friends, family, issues with staff, fiscal problems and health were amongst the other chief causes.(Graph ii)Inquiry has demonstrated that dental students experience considerable stress during their training and that dental students are more anxious than the full general population. This loftier anxiety is worrying in its own correct, but it has too been suggested that dental students' stress negatively impacts their physical and mental health.(Piazza-Waggoner CA, et al., 2003).

When the students were asked non to come to college, only 7.eight% reported as being thrilled at the prospect, xi.ix% were distressed almost completion of syllabus, eighteen.3% were happy about getting to go abode, xx.2% were apprehensive about how and when they would exist able to fill test forms while 33.five% were frustrated at there being no clarity nearly how long this would final.(GRAPH 3) This could be because of two reasons: a) Students in professional person colleges are pretty much focused on their academics b) The college is indeed a wonderful identify for the students to learn and thrive.

89.8% of the students reported beingness worried about academics when lockdown was announced while only 68.iv% reported that they tried to revise the subjects on their ain. 61.v% of the students said that they needed to interact with their staff to articulate their doubts and an additional 31.ix% said they needed a instructor's help sometimes.(GRAPH four) One very reassuring answer is that 50.7 % reported that staff members were ever bachelor to help them out while 45.4% reported that some of the staff was available.(GRAPH 5) This reflects very positively on the institute that the staff is approachable and students feel comfy interacting with them fifty-fifty when distance separates them.41.half dozen% of the students said that i thing that they missed the near was meeting their friends and 32.7% missed coming to college. This over again bodes very well for the institute as it indicates that the students perceive information technology as a happy place where they enjoy spending time.

As expected, 66.5% said that they were really stressed virtually COVID-nineteen scenario while 29.1% admitted beingness some what stressed.(GRAPH half dozen) Each student experienced manifestation of stress during the lock downward in different ways similar sleeplessness, anxiety, headache, frustration, irritability, inability to concentrate, etc. 221 of the 361 surveyed said that the safety of self and family members was their prime business organization. Change in sleep blueprint (lx.4%) and change in eating habits (47.1%) were the prime psychological changes while 23.3% reported beingness hypervigilant and obsessed with hand washing. Change in appetite and headache were reported to be the master physical manifestations of stress while 35.7 % of those surveyed did not written report whatever effects. Difficulty in concentrating and limited attention span (48.8%) was the leading cognitive issue of stress reported in the students. Another reassuring fact was that 61.5% of the students said they did not detect any social changes in their behavior. The quality family time that the lock downwards provided and the comfort of being at home and sharing responsibilities and house work would have resulted in stronger bonding with family members. A vast majority reported listening to music (73.seven%) equally a favorite course of relieving stress while talking to friends (54.6%), talking to elders (48.8%), sleeping (45.8%) and pursuing their hobbies (39.1%) were the other preferences. Contrary to pop belief, only 29.half dozen% said they use social media to save stress.

68.four% reported trying to gather all data nigh COVID-nineteen in this period. (GRAPH vii) During the lock downwardly at that place was a spurt of online hobby classes and other academic courses. 82.5% reported having developed a new skill or hobby during the lock downwards though simply 36.6% reported pursuing any professional person enhancement or COVID-19 related courses. (GRAPH 8) Only thirty.7% replied in the affirmative when asked if they were motivated enough to study and prepare themselves for the exams while 54.six% said they could do information technology to some extent. (GRAPH 9)39.nine% said online teaching cannot supervene upon classroom teaching, 41.6% said it could to some extent and only 7.five % felt that online teaching would be the way forwards. (GRAPH x)

Vol14No1_Sur_Mee_Gra10 Graph 10: Pie chart showing student responses to whether online teaching tin can replace classroom educational activity.

Click hither to view graph

The last question was about how capable a educatee feels nearly existence able to handle stress on his own on a scale of 1 to ten. 23.v% of the students rated themselves at five or below. It is good to know that 39.1% of our students put themselves at 8 and above on this scale. (GRAPH 11).

Give-and-take

Feet, fright, and worry are some of the psychological effects of public health emergencies on college students.(Mei Southward.50., et al, 2011)Our survey found similar manifestations in our college students. 24.9% of college students experienced feet because of the COVID-19 outbreak in a survey conducted in Mainland china.(Wenjun Cao, et al, 2020)In our survey more than 65% of those surveyed reported being really anxious almost the COVID-19 state of affairs. Students were worried about portion completion and exams during the lock down, which have been reported in other studies equally well.College students' anxiety about COVID-19 may accept been related to the effect of the virus and the resulting scenario on their studies. (Cornine A, 2020)

An online Facebook survey conducted in Taiwan found 55.8% of the participants with slumber disturbance and x.viii% having suicidal thoughts which were because of the COVID-19 pandemic. Some of the causes which were reported as being significantly associated with slumber disturbance were increased worry most COVID-xix, more than severe impact of COVID-19 on social interaction, lower perceived social support, more severe academic/occupational interference due to COVID-nineteen, lower COVID-nineteen-specified support, and poorer self-reported concrete health. (Dian-Jeng Li, et al, 2020).

Studies have shown the negative impact of stress on the mental and concrete health of the students. The findings in regard to dental students' coping strategies are enlightening. Outset, students generally reported using more constructive and salubrious coping (eastward.1000., planning, positive reframing) than poor coping (eastward.chiliad., denial, substance use)(Piazza-Wag goner CA, et al., 2003)

The students' feet may have been caused by the gradually increasing physical distances between people due to the lock downwards. Anxiety disorders are more likely to occur and worsen in the absence of interpersonal communication(Xiao C., 2020)

Living with parents was a favorable cistron which helped our students to cope better. Psychological pressure during the epidemics tin can be eased if social back up is availableand it also changes the mental attitude of the person regarding social back up and help-seeking methods. (Wenjun Cao, et al, 2020).

Conclusions

Methods of guiding students to effectively and appropriately regulate their emotions during public health emergencies and avert losses acquired past crisis events take get an important event faced by colleges and universities.

Although the aim of this study wasn't to demonstrate the benefits of effective stress management, we believe that this kind of training incorporated in the curriculum could reduce the overall anxiety, improve bookish performance and technical skills, help students express and develop positive coping strategies and ultimately assist in evolution of a more confident individual. It is extremely important to place the stress provoking factors, whether academic or otherwise, which would be the commencement step towards advocating and implementing policy changes like modifications in curriculum and test blueprint, student support mechanisms, etc.These strategies would help to convalesce the stressors, thus enhancing the coping skills of a student. (Harikiran AG, et al, 2012)The mental health of higher students is significantly affected when faced with public wellness emergencies, and they crave attending, help, and support of the society, families, friends and college authorities. It is suggested that the government and colleges should collaborate to tackle this problem in order to provide good-quality, timely crisis- oriented psychological services to higher students.

Acknowledgement

The authors would like to thank all the students who participated whole-heartedly in this survey.

Conflict of interest

The authors declare no conflict of interest.

Funding sources

No funding has been received from any arrangement to conduct this survey.

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