Anxiety in College Students a Quantitative Peer Reviewed Journal
Introduction
The COVID-19 disease is the worst pandemic outbreak in the new millennium. Caused past the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the first case was detected in Dec 2019 in Wuhan, Mainland china. Since then, the disease has spread to near every function of the world. The spread of the disease was so fast that on January xxx, 2020, the WHO declared COVID-19 to be a Public Health Emergency of International Concern. Every bit of April 2020, almost 3 million positive cases were confirmed worldwide, with almost 200,000 fatalities (1). In view of the high number of secondary cases arising from one chief case and the population being largely susceptible to infection, the WHO declared COVID-19 disease every bit a pandemic on March 12, 2020 (2). To control the spread of the disease, People's republic of china and many other countries imposed lockdowns, either nationwide or in places severely affected by the virus. Educational institutions, financial institutions, centers of economical activities, and amusement centers closed indefinitely (two, iii). It is estimated that equally of April 2020, more than than 300 million students were affected by COVID-19 globally (iv). Worldwide, many schools and colleges either airtight or resorted to distance learning. Public gathering and celebrations were prohibited. People with severe infection were treated in hospitals, and the less severe patients were placed in quarantine centers. These measures are similar to those that have previously proven effective during the H1N1 pandemic as reported by Sakaguchi et al. (5) and during SARS equally reported past Ries (6).
In the Kingdom of Kingdom of saudi arabia (KSA), the Ministry of Health (MOH) announced the first COVID-xix instance on March 2, 2020, and by the end of the month, 154 new COVID-19 cases were reported (vii). Anticipating widespread infection, government agencies swiftly implemented several control measures to combat the spread of the virus. In view of mass gatherings, Umrah in Mecca and visitations to the Prophet's Mosque in Madina were suspended immediately, and all the mosques in the land closed temporarily (eight–10). Quarantining of infected people and practicing social distancing became the norm. Universities and schools were closed, switching to virtual classes, to ensure uninterrupted pedagogy. Students were expected to go on studies from their place of residence. Despite the awareness campaigns and precautionary measures taken past the government, the number of cases continued to increase. Within three months, the confirmed cases escalated to 98,869, out of which 71,791 recovered, and 642 died (11).
In add-on to the risk of infection and possible decease, an epidemic also exerts tremendous psychological pressure on people worldwide (12–17). Several studies take discussed the brusk- and long-term effects of epidemics on the social and psychological well-being in the population (xviii–20). Those who were tested positive for a disease continue to be stigmatized and suffer from seclusion in their own society even after they have recovered (19, 21). Those quarantined experienced psychological stressors including "longer quarantine elapsing, infection fears, frustration, express supplies, insufficient communication, financial loss, and stigma" [21, p. 1]. Brooks et al. (22) expect that COVID-19 will outcome in drastic post-traumatic stress symptoms, confusion, and anger.
Moreover, anxiety level among college-level students is already a public wellness business concern. In fact, several previous researches take examined students' feet, depression, and stress and accept discussed factors that might affect students' mental health (23–32). Looking at students in the Kingdom of saudi arabia, Amr et al. (27) reported a twenty% level of anxiety among college-level Saudi students, while Al-Gelban (26) argued that xiv.iii% of secondary school students feel anxiety. In dissimilarity, Al-Gelban (25) and Al-Gelban et al. (33) reported a much higher anxiety level (48.nine and 66.2%, respectively) among high school students. Given that the spread of COVID-19 and the switch to virtual learning are unprecedented and unexpected experiences in Saudi arabia, we can await such circumstances to exist associated with major psychological challenges for the students. The fright of getting infected or losing loved ones to the disease while having to rapidly arrange to the new teaching and assessment procedures would have had a tremendous pressure on the students. At this fourth dimension, besides testing, planning, and implementing new teaching and learning environments, educational institutions need to assess the students' psychological well-being so that advisable measures can exist taken to help students cope with unprecedented changes. The purpose of this study is to assess the anxiety status of students in Saudi arabia during COVID-19 pandemic.
Research Methodology
Participants, Procedures, and Timeline of Survey
This written report examined the anxiety level amongst academy students in Kingdom of saudi arabia, specifically in Riyadh, at the fourth dimension of the COVID-19 pandemic. Riyadh is the majuscule of Saudi Arabia and 1 of the largest cities in the Kingdom, with an area of 1,798 km2 and a population estimated at 7,231,447 (34). The sample was chosen from one individual university. The total number of undergraduate students of both genders currently enrolled in this university is 5,057 students, comprising 3,085 female and ane,972 male students. An online questionnaire created in Google Forms was distributed via electronic mail to all undergraduate students at this academy. Information were collected from April twenty, 2020, to June six, 2020. Although this period is not ideal as it is at the cease of the bookish yr, the authors preferred to address this business organization while the COVID-xix concern is at its maximum instead of waiting until the stop of summer. The students were briefed on the purpose, and anonymity and confidentiality of their responses. Permission to conduct this study was obtained from the Institutional Review Board (IRB) of the university.
Research Musical instrument
In this study, the anxiety level was assessed using Zung'south self-rating feet questionnaire, a validated twenty-item self-report instrument (35) with reported Cronbach's alpha = 0.897 and internal correlation = 0.913 (36). The instrument employs a four-point Likert scale where: "1 = Never or very rare," "2 = Sometimes," "3 = Often," and "4 = Very Ofttimes or always." Questions 1–5 characterize the emotional pointers of anxiety, whereas questions 6–20 signify the physical symptoms of anxiety. For each respondent, the sum of the scores for xx items ranges from 20 to 80. The sum of scores are then converted to an "Anxiety Index" with values ranging from 25 to 100. Following the recommendations from Zung (37) and Dunstan and Scott (38), an Anxiety Alphabetize <45 indicates "Anxiety inside normal range," a value in the range of 45–59 indicates "Balmy to moderate feet," a value in the range of threescore–74 indicates "Marked to astringent anxiety," and values ≥75 indicates "Most extreme anxiety." Apart from Zung'southward cocky-rating anxiety scale, demographic information such as historic period, gender, year of report, bailiwick, and living arrangements during the pandemic were also recorded. Moreover, the participants had the chance to reverberate on their feelings through open-ended sections. Although Standard arabic is the mother tongue of the Saudi population, English is the language of instruction at this university. Hence, the instrument was used in its original language and was non translated.
Data Assay
The IBM SPSS version 22 software (39) was used in data analysis. Chi-foursquare and ordinal regression procedures were used to determine the factors associated with levels of feet. All the variables that were meaning at 0.25 level (40) in the chi-square tests were tested in ordinal logistic regression analysis.
Upstanding Clearance
Permission to conduct this study was obtained from the Institutional Review Lath (IRB) of the university.
Results
The aim of this written report was to examine the anxiety level of university students in Saudi arabia during the COVID-19 pandemic.
Demographic Characteristics
The questionnaire was sent to 5,057 undergraduate students, which incorporate the population of this university at that fourth dimension. A total of 400 responses were received, which represents an 8% response rate. Although this is a depression response charge per unit, it might be because the questionnaire was sent at the end of the semester and the showtime of final exams. The demographic characteristics of the respondents are shown in Table i. Out of the 400 respondents, 75.25% (301) were females, and 24.75% (99) were males and most of the respondents (93.5%). The skewed response rate toward females could be due to the fact that the females represent around 60% (3,085 female students) of the population of the university. Nigh of the respondents (93.five%) were in the age group of 19–25 years. Regarding their field of written report, about one-tertiary of the students were from the College of Business organisation Assistants, and around ane-sixth each were from the College of Constabulary and the College of Computer and Data Sciences. Most of the students (80%) were undergraduates, and 20% were in the Preparatory Year Program (PYP), which is a compulsory 1-year plan for all high school graduates. In terms of accommodation, 89.8% (359) were living at homes endemic by their parents, and simply effectually 10% were living at rented facilities. Moreover, 94.2% of the students were staying with their families at the time of the pandemic.
Table 1. Demographic characteristics of the respondents.
Levels of Anxiety
Amid the respondents, 21.5% (86), 8.8% (35), and 4.3% (17) experienced "minimal to moderate," "marked to astringent," and "most farthermost" levels of anxiety, respectively. For further analysis, respondents in the "marked to astringent" and "almost extreme" anxiety category were grouped together equally "severe to extreme" level of anxiety. A summary of the results is shown in Table 2.
Table 2. Anxiety levels based on Zung'due south classification.
Factors Associated With College Students' Anxiety During the Epidemic
Results From Univariate Assay
In the univariate analyses, chi-square tests were used to determine the associations between students'demographic variables and anxiety levels. The results are shown in Table 3. Amidst the demographic variables, gender, historic period, year of study, and living arrangement were meaning at a 0.25 level.
Table 3. Results of univariate analyses.
Results From Ordinal Regression Analysis
The variables of gender, age, year of written report, and living arrangement that were pregnant at the 0.25 level in the univariate analyses were further tested using ordinal logistic regression analysis. In this assay, just gender and year of study were significant (Tabular array four). Interestingly, female students were more decumbent to higher levels of anxiety compared to males (OR = 1.963, 95% CI = 1.160, three.322, P = 0.012). Students in their fourth year were more anxious compared to students in their fifth yr or final year (OR = 2.440, 95% CI = 1.150, 5.179, P = 0.020).
Table 4. Results from ordinal multivariate analysis.
Open-Ended Questions
In the Google form, the students were asked open up-concluded questions requiring them to reflect on their feelings and concerns regarding the COVID-19 pandemic. Some of the positive comments from the students were:
"Personally, I got a lot more than work done and a lot more slumber than usual."
"Information technology is cracking and much better than regular classes."
"Everything volition be OK."
"I'm using my time wisely during covid-xix."
"The freedom of learning from dwelling is very appealing to me."
Regarding the question on concerns, a majority of the concerns reported were financial in nature, such as about their ability to pay for the side by side semester, the possibility of increased tuition fees, and the loss of income for the provider of their family. Some students wanted the academy to decrease the fee for this semester to cope with the challenges. Some of the financial concerns as expressed by the students were:
"My family business got afflicted by the coronavirus, and I'yard having troubles in this regard."
"I'm afraid that [the college] might increase the fees to the point where I can't afford to finish my studies."
In addition to financial concerns, the students were also concerned about the uncertainties regarding assessments and how they would be graded.
Word
College students effectually the world suffer from psychological morbidity, particularly depression and anxiety, due to concerns virtually the future and academic pressure such as managing stressful tasks and assignments and pursuit to improve their academic performance (24, 29, 30, 32, 41–44). A diversity of studies take shown that college students in Saudi Arabia share the same symptoms of anxiety and stress and recorded a prevalence of depression and feet ranging from 14 to fifty% [eastward.g., (25–27)]. On the other hand, Inam (45) reported around 66 and 44% level of anxiety and depression in females and males, respectively, when looking at Saudi medical school students, while Al-Gelban et al. (33) argued that 66% of the female loftier school students in Saudi Arabia experienced some level of anxiety. Similarly, a study by Bahhawi et al. (28) showed that students experienced some symptoms of depression (53.6%) and anxiety (65.7%) among the samples. In addition, Al Salman et al. (46) examined female secondary school students during the academic year 2018–2019 and reported around 35% level of moderate anxiety and ten% of severe anxiety.
The presence of COVID-19 is an boosted factor for students to be stressed and anxious about (15). Several studies have addressed psychological well-being during the COVID-xix pandemic [due east.g., (15, 47–49)] and other past epidemics [eastward.1000., (half dozen, 50–52)], either on students [e.g., (47)] or others [e.thousand., (21, 53–55)], who postulated that psychological wellness during pandemics must be addressed. Based on the findings of the electric current study, around 35% of the students experienced some level of anxiety, with 13% having astringent to extreme levels. This is consequent with the inquiry washed past Alyami et al. (47), which looked at the feet level of the Saudi society during COVID-19 and reported 26% level of anxiety. Moreover, it is more or less similar to what was reported virtually students in Kingdom of saudi arabia before COVID-nineteen (25, 27, 28, 33). This indicates that the level of anxiety was nigh consequent with pre-pandemic status. In fact, Bahhawi et al. (28) reported a college level of anxiety. Looking exterior Saudi Arabia, Cao et al. (48) found that 0.nine% of higher students experienced severe feet during COVID-19, while around 24% experienced mild to moderate levels, which presents a low level of feet compared to previous literature on higher students in general. Yet, considering that Cao et al. (48) report was conducted on college students in China at the early stage of COVID-19, we can see that the lack of the full picture of this pandemic might accept contributed to these results.
The statement that females are more than vulnerable than men to disasters is not a new topic (56). The fact that the female students experienced higher levels of anxiety is besides not surprising. Previous studies show that college female person students study more stress than male students in general (28, 45, 57). In fact, comparing the 2 studies past Al-Gelban (25) and Al-Gelban (26) shows that using the same instrument on male and female students provided unlike results. While only 59.4% of the male person students had one of three symptoms, 73.4% of female person students had the aforementioned. We must continue in mind that the 2 studies are two years apart. Even at the mail-graduate level, Almalik et al. (58) argued that female students have a significantly college anxiety level than male students. Moreover, Huang et al. (59) argue that Chinese females experience more anxiety than males during COVID-19.
One surprising finding was the clan betwixt anxiety and the level of study; students in their fourth year were more than anxious compared to students in their fifth or final twelvemonth. However, one might wait that as a student progresses in his or her level of study, any consequences brought about by the pandemic would be nearly permanent and unfixable, and and then 5th-year students might be more than anxious than fourth-year students. Nevertheless, the fact that fifth-year students had less feet than their colleagues in the quaternary year is also justifiable. These students were either (one) in their cooperative training program (co-op), so their graduation or bookish attainment is not expected to be influenced by the virtual educational activity conclusion as most of the co-op companies have arranged for an online working/grooming environment, or (two) in their last semester of courses; in this case, given the implementation of a special grading scheme imposed past the Ministry of Education in Saudi Arabia, a depression class bespeak average for a student would non have an impact, regardless of the terminal results. Thus, these students were somehow more relaxed, at least with regard to their educational future. This caption is supported by the reflections from some of the fourth-yr respondents, such as:
"My top concern correct at present is whether nosotros will be returning to the university for the starting time semester. It is my final semester before coop and all my courses have labs which will be well-nigh impossible to achieve in online classes."
"I'm nervous about registering the side by side semester and might not have the courses that I planned to take to graduate."
Conclusions, Implications, and Futurity Research
COVID-19 has been a catastrophic experience; in the glimmer of an eye, this dreadful pandemic abruptly changed the way nosotros alive. As reported in the literature, pandemics are expected to have undesirable consequences not simply in terms of wellness but as well on economic, political, and educational systems (60, 61). Hence, information technology is imperative that the world cooperates to fight this pandemic. In that, educational institutions are advised to establish pre-outbreak policies and procedures to bargain with epidemics (62).
This study is function of a more comprehensive project that aims to address the psychological well-being of university students in several parts of the world during COVID-19. The results of this study requite valuable insights into the psychological status of students at a crucial time, and this, of grade, has its ain merit. Nonetheless, it is equally crucial that futurity researches focus on and suggest solutions to address whatsoever effects associated with pandemics. It is of import to identify advisable strategies that could help students non merely cope with adverse effects of the current pandemics but that can also enhance students' resilience to similar disasters in the future. Parents, educators, and the society as a whole should place ways to heighten students' adaptability skills that will enable them to cope in such situations.
Moreover, future research may utilise a mixed methodology approach or large-scale comparative studies with collaborations with other countries to look at potential coping strategies that have been proven to exist constructive in by pandemics or during the current i (63). This might guide policy makers to develop risk direction protocols equally part of their policy for the futurity to contain future pandemics (64). Well-nigh importantly, as much as we are convinced that COVID-xix is the electric current enemy of humanity, we must be aware of associated touch and exist able to respond effectively to all consequences.
Limitations
This written report aimed to elucidate the anxiety level of Saudi college-level students at the time of COVID-19. However, due to time constraints and to avoid a long protocol of obtaining IRB from several universities, this inquiry simply focused on 1 academy. Although this is a minor-sample study, the results can exist enlightening especially since such a pandemic is a novel experience for the Saudi population, so any data volition be welcomed. The results tin can, hence, guide time to come inquiry on COVID-19 or other epidemics.
Data Availability Statement
The raw data supporting the conclusions of this commodity will exist made available past the authors, without undue reservation.
Ideals Statement
The studies involving homo participants were reviewed and canonical by Enquiry and Initiative Heart at Prince Sultan University. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.
Author Contributions
HK, AA-South, and KK were responsible about data drove process. Data statistics was completed mainly past KC. The introduction, discussion, and determination parts were completed by all authors including HK, AA-S, KC, MN, SS, KK, GB, and SH. All authors contributed to the commodity and approved the submitted version.
Funding
The researchers would like to acknowledge Prince Sultan University for its support for this project through the PSU COVID-19 Emergency Research Program (Grant ID: COVID-19-CBA-2020-39).
Conflict of Involvement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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