Anxiety

1
ANXIETY, DEPRESSION AND STRESS CHALANGES FOR MEDICAL DTUDENT

DURING COVID-19 PANDAMIC
Students names and ID’s
1)Ahmad Ibrahim Khalid Alali 1635071
2) Rawan Hisham Alsa’di 1630131
3) Rami Alsulaihat 1930014
4)Basil Alnatshih 1635643
5)Haitham Ahmad ALkharabshih 1637444
Committee members:
Chair : DR Joel fuller vaughan
Member: DR Eman Adnan
Member : DR Ja’far Alshiab

2
Abstract
Background: The serious acute respiratory coronavirus syndrome (SARS-CoV-2) was first
identified in December 2019 in Wuhan, China, but the first case identified in Jordan was March
2, 2020, according to the Ministry of Health of Jordan. Quarantine measures included
lockdowns, home restriction, cancelation of public and social activities, and travel restrictions
have been adopted by most countries around the world, intended to prevent the transmission of
this extremely infectious disease[1]. Medical students have reported that quarantine has caused
them to feel isolated from families and friends and it reduced their work output and time of the
study[12]. A study reveals that the prevalence of depression and anxiety during the COVID-19
outbreak which targeted different populations was 50.7% and 44.7%, respectively [5].
Methods: Anxiety, depression and stress symptoms will be assessed with a descriptive cross-
sectional study the DASS-21, a quantitative self-administered questionnaire with a 21-Point
Likert Scale will be used for this study to collect the information among medical students in
jordan. Using a random sampling method, students will be randomly selected from each class
from first to final year. Students will be asked to complete the questionnaire in an online format
3
in Google forms. Demographic variables are age, gender, marital status, children, living place,
number of siblings, family income. The aim of this study is to assess the prevalence and
incidence of stress, anxiety, and depression that develop or increased during coronavirus
pandemic in medical student.
Expected results: having the correct measure of the prevalence of medical students who are
experiencing anxiety, depression, or stress during this pandemic. Understand the psychological
challenges for medical student and the causes of it
Key words : depression ,stress, E-learning, prevalence, anxiety, COVID-19,medical
students
INTRODUCTION:
On December 31, 2019 AD, the WHO Regional Office in China was informed of cases of
pneumonia that cause an unknown disease that was discovered in Wuhan, Hubei Province,
China, and the new Corona virus was announced as the virus that causes these cases by the
Chinese authorities on 7 January 2020.

4
The Corona virus that causes severe acute respiratory syndrome (SARS) moved from civet cats
to humans in China in 2002 AD, and the Corona virus that causes Middle East respiratory
syndrome (Mers) was transmitted from camels to humans in Saudi Arabia in 2012. The last
(Corona) virus, COVID-19, was also transmitted from the Coronavirus family, and it had a link to
a marine and animal market in Wuhan, China. There are many other known (Corona) viruses’
strains that are circulating among animals without infection from them to humans yet.
Coronavirus, from the new Corona virus family; Most of the cases of it appeared in the Chinese
city of Wuhan at the end of December 2019 in the form of acute pneumonia. The new Corona
virus is believed to be related to animals; As most of the initial cases were linked to a marine
and animal market in Wuhan. the virus is transmitted between humans from an infected person
to another person through contact near without protection.
Coronavirus has affected our lives in general in all social, economic, practical and scientific
fields. As medical students, this pandemic affected our psyche negatively, as it caused us a lot
of frustration and anxiety about our future and our family. In our research the main thing that
we will discuss is the psychological impacts for this pandemic on medical students in Jordan .
Objectives :
1- Estimate the prevalence and incidence of stress, anxiety and depression that develop or
increased during corona virus pandemic in medical student.

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2- Assess the impact of this pandemic on medical student's health behaviors including: diet,
use of various drugs (including tobacco and alcohol) and any other self-reported disease
developed during the pandemic.
3- Compare the changes that happened in their physical exercises.
4- Find a new ways to improve the ability to adapt the psychological challenges during and
after the quarantine, in order to take the positive impact of the quarantine in developing new
ways in learning and improve the quality of family time
Importance of the study:
A lot of medical students couldn’t adapt this new stress regarding online learning instead of
clinical learning, quarantine and isolation from their families and friends. Medical students have
reported that quarantine has caused them to feel isolated from families and friends and it reduced
their work output and time of study [12].
Health personnel, including doctors, nurses, paramedics and medical students, are at high risk in
the COVID-19 pandemic, which raises stress [2] ,so we will provide an new way to all medical
student in the world to adapt with this new pandemic challenges regarding anxiety, stress and
depression. This is new research never done before in Jordan which aims to provide
recommendations that help decision makers in the university to develop to develop better
guidelines that regulate this crisis and any potential crises could happen in the future
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Chapter 2 :
Literature Review
The serious acute respiratory coronavirus syndrome (SARS-CoV-2) was first identified in
December 2019 in Wuhan, China. Extremely high potential for transmission culminated in a
global coronavirus disease pandemic in 2020 (COVID-19) and it causes great public health and
socioeconomic harm. The first case identified in Jordan was March 2, 2020, according to the
Ministry of Health of Jordan.
Quarantine measures included lockdowns, home restriction, cancelation of public and social
activities, and travel restrictions have been adopted by most countries around the world,
intended to prevent the transmission of this extremely infectious disease [1]
Health personnel, including doctors, nurses, paramedics, and medical students, are at high risk
in the COVID-19 pandemic, which raises stress[2].
Stress can be arising from many factors, such as academic, socio-cultural, environmental, and
psychological attributes [3].
Academic stress was the most cause of anxiety followed by physical, social, and emotional.
There is a high level of poor self-stem and depression among students with this kind of
stress[4].
A study reveals that the prevalence of depression and anxiety during the COVID-19 outbreak
which targeted different populations was 50.7% and 44.7%, respectively [5].
Universities must take action to prevent, identify and address mental health issues among
students in the event of major stressors[5].

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Studies have shown that stress can have a significant effect on the psychological and physical
health of a person [6].
Studies reported that SARS induced anxiety and depression among people in different regions
[7]
Also, MERS has the same results as in SARS Psychological responses[8].
During the COVID-19 outbreak, fifth-generation ( 5 G) mobile networks in China allowed
mental health professionals to provide online mental health services and interviews that are
safer than regular face to face [5].
Neither research concluded that online learning was less effective than offline learning, but it
is considered adapted to the needs of students [9].

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After clinical education was canceled, the online education of medical students was forced.
Easily adapted to web format after COVID-19 pandemics using online platforms such as
Microsoft teams and zooming [10]
There were concerns about the mental health of medical students and how they can adapt
months of online education in addition to concerns about their readiness to become a doctor
[11].
Medical students have reported that quarantine has caused them to feel isolated from families
and friends, and it reduced their work output and time of the study [12].
Direct patient treatment involvement by the medical student during this pandemic has been
heavenly limited, but online virtual surgical video-based education has been developed for
medical students showed a great acceptance. Head and Neck Surgery virtual Otolaryngology
and outpatient discussions were done at the University of Pennsylvania for medical students
[13].
Medical students have more spare time to prep for the professional residency exam, they are
now forming new hobbies, things as creating fresh recipes, playing music, reading novels,
relaxation and leisure time, also, universities offered free internet for students [14].
Students are conscious of the emerging educational online media and its effect on their
learning experience years ago; they are well trained to utilize technology in structured contexts
and are also use these resources to help their method of learning [15].
Studies at the Liaquat College of Medicine and Dentistry found that 77% of students had
unfavorable views about online learning, and 76% of students use mobile devices for their
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online learning. Students still did not favor online education over face-to-face instruction also
Faculty leaders should take steps appropriate to enhance e-teaching [16].
A study showed that the relation between anxiety and grade point level is inverse, the low
anxiety test was B+ on average, and the higher anxiety test was B [17].
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Students experience anxiety at different levels. Approximately 15–20 percent of the student’s
become impaired at the exam [18]
A lot of college students experience stress, and some of them may get a high level of stress
especially during exams. A study shows that 10-35 percent of college students have a high level
of stress, which affects their function. [19]
A study at Indian medical school among first-year students found that men have more
academic stress than women, but women have more interpersonal stress [20].
Around 30% of medical students in all universities have anxiety with a prevalence rate that is
substantially higher than the general population, medical students from the Middle East and
Asia show a higher prevalence of Anxiety [21].
In 11 studies, a systematic review of anxiety among medical students outside North America
found a prevalence of a broad range between 7.7 and 65.5 percent [22].
Symptoms of anxiety include exhaustion, vomiting, nausea, dizziness, headache, pain in the
abdomen, palpitations, shortness of breath and urinary [22].
Medical students with anxiety are showed less enthusiastic and less empathetic when caring
for patients with chronic illness[23].
Most of the educational programs in all counters shut down because of the Covid-19
pandemic which rises challenges in education style especially for students.[16].
The government of Jordan has taken the chance of high technology as a substitute for the
traditional face to face education in schools and universities. Online learning has gained a lot of
acceptance because it is user friendly, better control over people's contact, and not expensive.
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Yet there are also a few drawbacks, such as loneliness, less student engagement, and long-term
deterioration of some of the communication skills [24].

12
Pandemics are worldwide disasters that are causing significant disruptions to education, social
welfare, the environment, and the industry. Medical students training could be prepared for
disaster scenarios especially if planed with the great specialist training, also, coronavirus
(COVID19) pandemic has explained the need for better preparation training for medical
students in such disaster scenarios [25].
There is an immediate need for medical school educational programs to educate medical
students to have a better response in such a crisis. These programs should integrate disaster
training into their curricula [26].
Medical students in the UK have been planned to participate in this pandemic as volunteers to
the NHS by the UK Health Secretary, Matt Hancock.
During the COVID-19 pandemic, adaptability is the new challenge. UWSMPH and MCW
Adapting a new online method to allow their students to meet their program objectives. COVID-
19 gave positive lessons to have bitter networking and online learning among classrooms,
clinical sitting and home quarantine.[56]The new challenge of COVID-19 pandemic inhibit
students from engagement in their education experience and having better life balance.[27]
The COVID-19 Pandemic have varies effects One of which is medical student's learning tools
like hospital, clinical learning, Volunteering opportunities, Sharing and exchange knowledge
between students and their doctors .also, their exams are being changed into open book exams.
[28]
Medical Schools are very stressful environment. Usually students experience a greater level of
anxiety and depression then normal population. A Brazilian study showed that there are gendar
and religious effect influence the mental health Of medical students.[29][30]An Albanian study
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showed that Both University students and their family members are affected in the quarantine
at different levels[31]
Further actions should be taken to improve the shift from the traditional education to the online
education to enhance the pandemic’s impacts, and prepare the medical students to be the Doctors
of the future. [32]

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Now, most universities in the world have taken intense measurement to protect students from
this highly infectious disease. Also, Compass, workshops, events and even sports have been
suspended or cancelled. [33]
A study showed that barely 30 percent of the participants preferred to continue with the online
studying programs.[34].
But online education has big limitations. One of which is lack of the hands on clinical
Experience. Fortunately, many Medical schools started better interactive and motivating online
education videos to give the medical education a better value. [35]
Research hypothesis :
H1: There is a positive relation between COVID-19 pandemic and its quarantine and increase
anxiety, depression, and stress among medical students.
H2: If this pandemic stays longer, medical student will challenge more psychological stress,
anxiety and depression, because the quarantine is keeping them away from their family, friends
and clinical learning at hospitals.
H0: (Null hypothesis): COVID-19 pandemic and the quarantine of it didn’t increase anxiety,
depression, and stress among medical students

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Chapter 3 :
Methods
Anxiety, depression and stress symptoms will be assessed with a descriptive cross-sectional
study the DASS-21, a quantitative self-administered questionnaire with a 21-Point Likert
Scale will be used for this study to collect the information among medical students. DASS-
21 has excellent reliability and validity [36].
Cronbach’s alpha values of 0.81, 0.89 and 0.78 for the subscales of depressive, anxiety
and stress respectively. The depression and anxiety subscales of DASS-21 has good state
trait anxiety inventory. And self-rating depression scale [37].
DASS has psychometric features appropriate for health care workers used to
rule out depression and anxiety disorder and students with mental health
problems [38].This questionnaire takes 5 minutes to complete. This data will be collected
from medical student in Jordan as online survey, paper survey and phone interview.
One-way ANOVA will be applied for comparison of anxiety and depression at different
times of session.
16
Chi-Square and Fisher’s exact test for qualitative variables will be applied to analyze
independent variables with anxiety and depression, t-test. Tukey HSD (Multiple
comparison test) will be applied where the difference is statistically significant.
Using random sampling method, students will be randomly selected from each class from
first to final year , The students will be asked to complete the questionnaire in online
format in Google forms , The participants will be asked not to put names or other
identifying marks on the questionnaire to identify them and they will be asked if they want
to participate or not , if they agree the online survey will show up, and if any student
decided not to participate he can chose disagree option and the online survey won't
proceed. There won't be any physical interventions, so there won't be any risks to the
participants. Demographic variables are: age, gender, marital status, children, living place,
number of siblings, family income, past medical history or past psychological consultation,
university name, and year of medical training.
This self-report scale consists of 21 items, 7 for depression, 7 for anxiety and 7 for stress.
Each item is rated on a scale from 0 to 3 , Each item is scored from 0 (did not apply to me
at all over the last week) to 3 (applied to me very much or most of the time over the past
one week). The minimum score is zero and the maximum score is 42 .A score of 0-4 is
considered as normal, 5-6 mild depression, 7-10 moderate depression, 11-13 severe
depression and 14+ is extreme depression. For anxiety 0-3 is considered as normal, 4-5
mild, 6-7 moderate, 8-9 severe and 10+ is extreme anxiety. For stress 0-7 is considered as
normal, 8-9 mild, 10-12 moderate, 13-16 severe and 17+ is extreme anxiety.
17
LIMITATIONS :
The research was carried out on students of all levels in every medical universities in Jordan,
therefore; the results of this research could apply to medical students in Jordan. However, our
study had several limitations including; lack of previous research studies on the topic, as there
were no sufficient papers addressing the objectives of this research, perhaps, in the future, this
research could help bring out the topic of health anxiety among health anxiety among healthcare
students into consideration of major researchers.
The issue of self-reported data has also been encountered in this research, because all data
was collected using an online survey, therefore this research deals with risk of potential memory
and habituation bias. Finally, the low response rate has also been a limitation in this research,
causing a lack of collected data and therefore; hindering the hypothesis testing process. It might
be a good idea to find a way of participant encouragement in order to collect sufficient data.
18
Chapter 4
Results
250 students have answered the questionnaire, all of the participants have agreed to answer
the survey.
50.8% of participants were female while 49% were males
GENDER
female
male
19
27.8 % were from Hashimiat Univercity,21.3% were from Jordan Univercity,19.5% were from
Yarmouk university,15.6% were from Technology And Science technology,11.1% were from
Motah Univercity and 4.7 % were from Balqa Univercity
Name of the university

30
25
20
Name of the univercity

15
10
0
Hashimiat Jordan yarmouk Technology motah balqa
and science
20
8.3% of participant were from the first year 17.1% were from the from the second year 13.3%
where from the third year 19.6% were from the fourth year 16.7% were from 5th year 25% were
from 6th year.

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The average age of participants were 22.3,74.4% of participant had siblings where 25.6 didn't
The average number of siblings for those who have is 4.
85% of participants didn't have any past medical illness while 15% had previous one that is
differentiated as 10% for hypertension 3.4% for migraine 65% for asthma 21.6% DM
PAST MEDICAL ILLNESS
HYPERTENSION
MIGRAIN
ASTHMA
DM
22
75.7% of participant had not consult a psychiatric before while 24.3% had consult one before .
The ones who consult a psychiatric was Differentiated 15.8 %percent for an anxiety 36.8 %for
depression 28.1% for Life stress and 19.3% for others
cause of consultation
anexiety
depression
Life stress
Others
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Then we asked in multiple choice question that the participant can choose more than one about
what the university can do to reduce the anxiety and depression during the pandemic and the
results were as follow: 30.5% said that planning for induction and support and supervision were
39% said that they have to increase the cleaning and safety measures inside hospitals and
universities were 56.4% said that they have to provide an application for technical support during
this pandemic were 37.7% said that provide is to provide devices and free internet access for
students during this pandemic were 40.7% said that to open a clinic in the university for
psychological support
24
what university should do during these
pandemic
palnning for induction support and supervision
increase cleaning and safety measures inside hospitals and uneversity

what university should do dur-
ing these pandemic
provide an application for technical support during lectures and exams
provide devices and free intrnet access for students
Open a clinic in the univercity for psychological support
0.00% 20.00%40.00%60.00%
123 student disagree that the online teaching is sufficient where 54 strongly agreed and 62 agree
where 11 strongly agree .
what if online teching is sufficient

140
120
100
80 what if online teching is sufficient
60
40
20
0
strongly disagree agree strongly agree
disagree
25
74% say that online teaching with the clinical teaching where 20% said that we have to go back
to traditional way with safety measures where 3% say that online teaching is the best and 3%
said that we have to find another solution
methods suggested for other than online

teaching
other
Online teaching is the best methods suggested for other

than online teaching
Back to traditional withsafety measures
Online teaching with clinicalteaching
0% 20% 40% 60% 80%

26
Then by using the depression and anxiety stress scale DASS 21 on the 250 students the following
result was appeared:
140
120
100
80
60
40
20
0
never
sometimes
often
almost always
27
140
120
100
80
60
40
20
never
0 sometimes
us x e t
ich ar
d
te
d
ela lu ep s often
r vo h
w f r w it a r b t k a
ne sin l o k fo ag t to and tha t I w almost always
f g l
to on foo oo n cu te
d g a
in h
a lo uati e a to l g etti d iffi ear yth h w
g it k g lf it h n it
sin rgy ut s ma hin y se n d w n- o fa nw
s u ne bo nd no to t t o
m ou do an ng
wa e ed a ic a ad u nd If elt e r
I
ri pan I h If l tti
hat r t I fo nto ge
t o t a i m
elt s w igh lt th as fro
If a m e I w e
Iw I If m
140
120
100
80
60
40
20
0 never
ni
c on rt ss sometimes
pa ers hea n t ngle often
to ap y o r ni
se s f m erti hea ea almost always
lo a o e se x , m
sc h as
a uc tion ical rea w
Iw m c s c
rth
a hy in ) ife
f elt o the f p ate eat atl
I tw f o r b th
sn’ r e o nce eart g a f elt
a e n
Iw
a w bs f h ssi I
le t as a e a e o mi
h s
If I w in t sen
g,
(e
28
Testing of hypotheses:
First hypotheses: H1: There is a positive relation between COVID-19 pandemic and its
quarantine and increase anxiety, depression, and stress among medical students.
Results: According to majority of participant there is a positive relation between covid-19
pandemic and it's according time with increase an anxiety depression and stress among medical
students.
Second hypotheses: H2: If this pandemic stays longer, medical student will challenge more
psychological stress, anxiety and depression, because the quarantine is keeping them away from
their family, friends and clinical learning at hospitals.
Results : According to most of the participant of the medical student if the pandemic stays longer
they will challenge more psychological stress and anxiety and depression as they are away from
their family friends and clinical learning at hospitals
Third hypothesis: H0: (Null hypothesis): COVID-19 pandemic and the quarantine of it didn’t
increase anxiety, depression, and stress among medical students.
Result : According to the majority of the student of the medical field this hypothesis is wrong
Chapter 4
29
Discussion
To the best of our knowledge, this study is one of the first too discuss the the effect of covid-19
on medical student on many aspects like their performance and psycological effect of this
pandemic go to the degree of satisfaction about their knowledge and clinical experiences that
they hae achieved during this pandemic
The results of this study revealed that the group of medical students achieved similar results.
The results showed that most of the students of the in the medical field are not satisfied about
their knowledge that and the clinical skills that they have achieved during this pandemic which
has a created enormous effect on their psychological behavior and a their fear on their own future
knowledge and their career.
The ongoing COVID-19 pandemic has affected nearly all aspects of life. The impact on mental
health is becoming an increasingly important aspect to consider, especially after the second wave of
the pandemic. Saying that, MSs are among the populations known to experience high-stress levels
caused by the nature of their studies, sleep disturbances due to the high workload, and continuous
exposure to patients in distress and are thus prone to be affected by the pandemic. Moreover,
several negative psychological consequences can be triggered by social isolation and uncertainty
about the future , conditions which are applicable to the long quarantine duration in the Kingdom of
Jordan. The current study assessed the level of fear amid the COVID-19 pandemic and examined
the association between fear and sleep quality. Also, the survey was administered during the most
critical phase of the second wave of the pandemic at times where the country was announcing
approximately 7000 newly confirmed cases per day. In our survey, around 70% of students
screened positive for AX and Dep, respectively. Similarly, 75% of Jordanian MSs surveyed during
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Spring 2020 using the Epidemiologic Studies-Dep Scale (CES-D) suffered from depressive
symptoms[38] . In comparison, only 24.3% and 30.6% of US MSs who were surveyed during April
2020 screened positive for Dep and AX, respectively[39], and nearly half of MSs in UAE reported
mild to severe levels of AX at the onset of the pandemic[40] . Moreover, the rates of AX and Dep
in Jordanian MSs are higher than those in other Asian countries such as Bangladesh, where around
66% had different levels of AX and 50% had Dep symptoms during May 2020 [41] . The
prevalence is also similar among Chinese college students, of which 56.8% reported Dep symptoms
during March 2020[42] . However, the high rates of Dep and AX symptoms among MSs in our
survey could not be completely traced to the current COVID-19 pandemic. In a survey of 600
Jordanian college students done before the pandemic in 2018, students showed a moderate level of
Dep and a severe level of AX as measured by the Dep, AX, and Stress Scale DASS-21 . Back in
2017, another survey reported that almost 55.7% of students exhibited a variable degree of
depressive symptoms[43], demonstrating the enduring prevalence of PD among college students in
Jordan. These reports suggest that the high rates of Dep and AX symptoms among Jordanian MSs is
actually a long-standing issue which got inflated from the added stress and influences imposed by
the current pandemic. As to SQ, 14.4% of respondents reported poor SQ on SQS, a prevalence that
is lower than that reported by several studies at the beginning of the pandemic. Comparably, the
prevalence of poor SQ in an earlier study done during spring 2020 on Jordanian MSs, which
assessed SQ using Pittsburgh’s Sleep Quality Index (PSQI), was 76%[38] . Also, an Italian study of
6519 adults during the lockdown at the beginning of the pandemic have assessed SQ using Medical
Outcomes Study–Sleep Scale (MOS-SS) and concluded that around 55% of respondents had poor
SQ() , and another study from China reported that about 36% of the general population were poor
sleepers during the beginning of the COVID-19 pandemic[45]. Fear is also expected to be
31
experienced during the current COVID-19 pandemic consequences[48]The mean score on the FCV-
19S was 14.62 (SD= 5.38), exceeding the midpoint for the total score range (= 14) to indicate a
high level of fear of the COVID-19 among the participants. Nevertheless, the mean score in our
study is relatively lower than several studies that assessed fear at the onset of the pandemic. Surveys
of 5423 MSs in Vietnam [49], 606 university students in Spain[50], 433 university students in UAE
[40] , and 228 university students in Russia and Belarus[52]
during April and May 2020 reported a mean score of 16.7 (SD= 5.3), 16.79 (SD = 6.04), 16.6
(SD= 6.3), and 18.0 (SD= 4.5), respectively, on FCV-19S. As our survey was administered
during the second wave after more than 1 year from the onset of the pandemic, the slightly lower
rates of fear and poor sleep in our study as compared to early studies can be explained by
adaptation, availability of the vaccines, and a better understanding of the situation with more
facts and fewer rumors promoted. The high alarming rates of PD obviously demonstrate the
persistent impact of the COVID-19 pandemic. Prolonged social distancing and quarantine that
precipitated further isolation may have an ongoing effect on the students, ultimately leading to
PD and fear, which did not significantly differ between junior and senior students. In contrast, a
recent study from Spain has shown that first-year students reported high significant levels of fear
of COVID-19 when compared with senior students Martínez-Lorca M, [53] . Although several
studies have shown higher rates of PD among females than males[38][39] our study has not
found significant gender differences in relation to Dep, AX, or poor SQ rates. Also, the personal
history and experience of mental illness affected neither the rates of PD nor the fear of COVID-
19. Poor SQ is a known risk factor for the development and progression of several psychiatric
32
diseases including AX and Dep[44] [47]). Consistently, a significant correlation was found in
our survey between PHQ-4, FCV-19S, and SQS scores. Expectedly, participants who screened
positive for Dep and/or AX had higher levels of fear of the COVID-19. Respondents with
excellent SQ showed significantly lower rates for AX and Dep as compared to those with good,
fair, and poor SQ, respectively. Hence, as non-pharmacological sleep interventions, such as
relaxation training, sleep restriction therapy, and biofeedback, were found to be effective in
reducing the severity of depressive symptoms [54] , they would be strongly recommended to
participants reporting poor SQ. Also, students screening positive for depression and/or anxiety
would be advised to seek counseling via professional mental health services including
telepsychiatry resources. Furthermore, multidisciplinary collaborative action should still be taken
to manage the PD and poor quality of sleep during this uncertain time amid the COVID-19
pandemic[46] . Over a year and a half have passed since the pandemic took hold and hit the
globe resulting in persistent disturbance across all levels of life. Fortunately, the COVID-19
vaccines were developed and approved by World Health Organization (WHO) for emergency
use in late 2020 [55], and the first became available in Jordan in January 2021 [56] . In addition,
the health care infrastructure in Jordan improved significantly since the onset of the pandemic.
With the availability of vaccines and improving health care facilities, the levels of fear and PD
are expected to decrease when compared to the levels at the onset of the pandemic.
33
Chapter 5
Conclusions
Jordanian Medical Students appear to be especially susceptible to the impact of the COVID-19
pandemic on mental health and reported high rates of positive screening for AX and Dep. The
demanding and extensive nature of medical education and the persistent higher rates of PD
among MSs as compared to the general population can place them as a vulnerable population
to the effects of the COVID-19 pandemic and the resultant quarantine. While fear of COVID-19
and PD are still considered high, it is remarkably lower than that reported in early studies.
These results will hopefully provide relevant information to guide policymakers and
universities’ administrators in responding to the pandemic’s consequences on Medical
Students’ mental health, and the authors would highly recommend supplying MSs with
resources such as counseling and peer advocacy and suggesting professional mental health care
to students who report poor SQ and/or symptoms of Depression and Anxiety

34
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1

ANXIETY, DEPRESSION AND STRESS CHALANGES FOR MEDICAL DTUDENT

DURING COVID-19 PANDAMIC

Students names and ID’s

1)Ahmad Ibrahim Khalid Alali 1635071

2) Rawan Hisham Alsa’di 1630131

3) Rami Alsulaihat 1930014

4)Basil Alnatshih 1635643

5)Haitham Ahmad ALkharabshih 1637444

Chair : DR Joel fuller vaughan

Member: DR Eman Adnan

Member : DR Ja’far Alshiab

2, 2020, according to the Ministry of Health of Jordan. Quarantine measures included

sectional study the DASS-21, a quantitative self-administered questionnaire with a 21-Point

pandemic in medical student.

challenges for medical student and the causes of it

Key words : depression ,stress, E-learning, prevalence, anxiety, COVID-19,medical

Chinese authorities on 7 January 2020.

to another person through contact near without protection.

increased during corona virus pandemic in medical student.

developed during the pandemic.

3- Compare the changes that happened in their physical exercises.

ways in learning and improve the quality of family time

Importance of the study:

their work output and time of study [12].

Ministry of Health of Jordan.

intended to prevent the transmission of this extremely infectious disease [1]

in the COVID-19 pandemic, which raises stress[2].

psychological attributes [3].

students in the event of major stressors[5].

health of a person [6].

Also, MERS has the same results as in SARS Psychological responses[8].

During the COVID-19 outbreak, fifth-generation ( 5 G) mobile networks in China allowed

safer than regular face to face [5].

is considered adapted to the needs of students [9].

Microsoft teams and zooming [10]

Faculty leaders should take steps appropriate to enhance e-teaching [16].

become impaired at the exam [18]

of stress, which affects their function. [19]

Asia show a higher prevalence of Anxiety [21].

abdomen, palpitations, shortness of breath and urinary [22].

for patients with chronic illness[23].

pandemic which rises challenges in education style especially for students.[16].

deterioration of some of the communication skills [24].

students in such disaster scenarios [25].

training into their curricula [26].

the NHS by the UK Health Secretary, Matt Hancock.

of the future. [32]

suspended or cancelled. [33]

education videos to give the medical education a better value. [35]

anxiety, depression, and stress among medical students.

and clinical learning at hospitals.

depression, and stress among medical students

study the DASS-21, a quantitative self-administered questionnaire with a 21-Point Likert

21 has excellent reliability and validity [36].

trait anxiety inventory. And self-rating depression scale [37].

comparison test) will be applied where the difference is statistically significant.

university name, and year of medical training.

students into consideration of major researchers.

50.8% of participants were female while 49% were males