Background:？The COVID-19 pandemic has affected the delivery of the curriculum of dental schools. The psychological impact and coping strategies of dental students in Trinidad and Tobago are a matter of concern. In this study, dental students were asked to evaluate their mental health and coping strategies regarding COVID-19. Methods: A survey was conducted using an online platform. Demographic data was collected and the psychological impact was assessed. Participants were also questioned on their coping strategies. Descriptive statistics, Chi-square test, Mann-Whitney test and a logistic regression were performed.Results:？A total of 108 out of 137 students participated.？Their mean age was 22.96 years. High levels of stress (59.26%), anxiety(64.81%) and depression (76.85%) were observed among dental students. Nationality and gender played a significant role in the students’ mental health scores. Female students were more likely to experience stress, anxiety and depression than males (exp[β] = -0.38,？-0.21, and？-2.31). There were various coping mechanisms deployed by dental students.Conclusion: The elevated levels of stress, anxiety and depression in these dental students emphasize the need for psychological intervention.
References
[1]
Adams, D. F. (2017). The Embedded Counseling Model: An Application to Dental Students. Journal of Dental Education, 81, 29-35.
https://doi.org/10.1002/j.0022-0337.2017.81.1.tb06244.x
[2]
Ahmad, M. S., Md Yusoff, M. M., & Abdul Razak, I. (2011). Stress and Its Relief among Undergraduate Dental Students in Malaysia. Southeast Asian Journal of Tropical Medicine and Public Health, 42, 996-1004.
[3]
Ahmed, M. A., Jouhar, R., Ahmed, N., Adnan, S., Aftab, M., Zafar, M. S., & Khurshid, Z. (2020). Fear and Practice Modifications among Dentists to Combat Novel Coronavirus Disease (COVID-19) Outbreak. International Journal of Environmental Research and Public Health, 17, Article No. 2821. https://doi.org/10.3390/ijerph17082821
[4]
Al-Rabiaah, A., Temsah, M. H., Al-Eyadhy, A. A., Hasan, G. M., Al-Zamil, F., Al-Subaie, S. et al. (2020). Middle East Respiratory Syndrome-Corona Virus (MERS-CoV) Associated Stress among Medical Students at a University Teaching Hospital in Saudi Arabia. Journal of Infection and Public Health, 13, 687-691.
https://doi.org/10.1016/j.jiph.2020.01.005
[5]
Al-Sowygh, Z. H., Alfadley, A. A., Al-Saif, M. I., & Al-Wadei, S. H. (2013). Perceived Causes of Stress among Saudi Dental Students. King Saud University Journal of Dental Sciences, 4, 7-15. https://doi.org/10.1016/j.ksujds.2012.11.002
[6]
Alzahem, A. M., Van der Molen, H. T., Alaujan, A. H., & De Boer, B. J. (2014). Stress Management in Dental Students: A Systematic Review. Advances in Medical Education and Practice, 5, 167-176. https://doi.org/10.2147/AMEP.S46211
[7]
Bashir, T. F., Hassan, S., Maqsood, A., Khan, Z. A., Issrani, R., Ahmed, N., & Bashir, E. F. (2020). The Psychological Impact Analysis of Novel COVID-19 Pandemic in Health Sciences Students: A Global Survey. European Journal of Dentistry, 14, S91-S96.
https://doi.org/10.1055/s-0040-1721653
[8]
Basudan, S., Binanzan, N., & Alhassan, A. (2017). Depression, Anxiety and Stress in Dental Students. International Journal of Medical Education, 8, 179-186.
https://doi.org/10.5116/ijme.5910.b961
[9]
Blane, D. (1995). Social Determinants of Health—Socioeconomic Status, Social Class, and Ethnicity. American Journal of Public Health, 85, 903-905.
https://doi.org/10.2105/AJPH.85.7.903
[10]
Boyles, J. D., & Ahmed, B. (2017). Does Student Debt Affect Dental Students’ and Dentists’ Stress Levels? British Dental Journal, 223, 601-606.
https://doi.org/10.1038/sj.bdj.2017.876
[11]
Burk, D. T., & Bender, D. J. (2005). Use and Perceived Effectiveness of Student Support Services in a First-Year Dental Student Population. Journal of Dental Education, 69, 1148-1160. https://doi.org/10.1002/j.0022-0337.2005.69.10.tb04016.x
[12]
Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020). The Psychological Impact of the COVID-19 Epidemic on College Students in China. Psychiatry Research, 287, Article ID: 112934. https://doi.org/10.1016/j.psychres.2020.112934
[13]
Chakraborty, T., Subbiah, G. K., & Damade, Y. (2020). Psychological Distress during COVID-19 Lockdown among Dental Students and Practitioners in India: A Cross- Sectional Survey. European Journal of Dentistry, 14, S70-S78.
https://doi.org/10.1055/s-0040-1719211
[14]
Charan, R. (2020, March 12). T&T Confirms First Case of Coronavirus, Breaking Top Story. Trinidad Express.
https://trinidadexpress.com/newsextra/t-t-confirms-first-case-of-coronavirus/article_5c05b35a-6495-11ea-8bd4-1bba999d27a3.html
[15]
CODA (Commission on Dental Association) (2016). Accreditation Standards for Dental Education Programs. Commission on Dental Association. http://www.ada.org/coda
[16]
Cooper, C. L., Watts, J., & Kelly, M. (1987). Job Satisfaction, Mental Health, and Job Stressors among General Dental Practitioners in the UK. British Dental Journal, 162, 77-81. https://doi.org/10.1038/sj.bdj.4806030
[17]
Divaris, K., Barlow, P. J., Chendea, S. A., Cheong, W. S., Dounis, A., Dragan, I. F. et al. (2008). The Academic Environment: The Students’ Perspective. European Journal of Dental Education, 12, 120-130. https://doi.org/10.1111/j.1600-0579.2007.00494.x
[18]
Fangyuan, T., Li, H., Tian, S., Yang, J., Shao, J., & Tian, C. (2020). Psychological Symptoms of Ordinary Chinese Citizens Based on SCL-90 during the Level I Emergency Response to COVID-19. Psychiatry Research, 288, Article ID: 112992.
https://doi.org/10.1016/j.psychres.2020.112992
[19]
Ge, Z. Y., Yang, L. M., Xia, J. J., Fu, X. H., & Zhang, Y. Z. (2020). Possible Aerosol Transmission of COVID-19 and Special Precautions in Dentistry. Journal of Zhejiang University-SCIENCE B, 21, 361-368. https://doi.org/10.1631/jzus.B2010010
[20]
Hakami, Z., Khanagar, S. B., Vishwanathaiah, S., Hakami, A., Bokhari, A. M., Jabali, A. H. et al. (2021). Psychological Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Dental Students: A Nationwide Study. Journal of Dental Education, 85, 494-503. https://doi.org/10.1002/jdd.12470
[21]
Harrison, J., Barrow, S., Gask, L., & Creed, F. (1999). Social Determinants of GHQ Score by Postal Survey. Journal of Public Health, 21, 283-288.
https://doi.org/10.1093/pubmed/21.3.283
[22]
Henry, J. D., & Crawford, J. R. (2005). The Short-Form Version of the Depression Anxiety Stress Scales (DASS-21): Construct Validity and Normative Data in a Large Non-Clinical Sample. British Journal of Clinical Psychology, 44, 227-239.
[23]
Holland, D. (2016). College Student Stress and Mental Health: Examination of Stigmatic Views on Mental Health Counseling. Michigan Sociological Review, 30, 16-43.
[24]
Holmes, E. A., O’Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L. et al. (2020). Multidisciplinary Research Priorities for the COVID-19 Pandemic: A Call for Action for Mental Health Science. Lancet Psychiatry, 7, 547-560.
https://doi.org/10.1016/S2215-0366(20)30168-1
[25]
Hoyte, T., Henry, K., Kowlessar, A., Ali, A., & Mahabir, A. (2021). Factors Affecting the Career and Speciality Preferences of Dental Students in Trinidad and Tobago: A Cross-Sectional Survey. Creative Education, 12, No. 8, 1792-1804.
https://doi.org/10.4236/ce.2021.128136
[26]
Iyer, P., Aziz, K., & Ojcius, D. M. (2020). Impact of COVID-19 on Dental Education in the United States. Journal of Dental Education, 84, 718-722.
https://doi.org/10.1002/jdd.12163
[27]
Joutsenniemi, K., Martelin, T., Martikainen, P., Pirkola, S., & Koskinen, S. (2006). Living Arrangements and Mental Health in Finland. Journal of Epidemiology & Community Health, 60, 468-475. https://doi.org/10.1136/jech.2005.040741
[28]
Kelly, H. (2011). The Classical Definition of a Pandemic Is Not Elusive. Bulletin of the World Health Organization, 89, 539-540. https://doi.org/10.2471/BLT.11.088815
[29]
Klaassen, H., Ashida, S., Comnick, C. L., Xie, X. J., Smith, B. M., Tabrizi, M. et al. (2021). COVID-19 Pandemic and Its Impact on Dental Students: A Multi-Institutional Survey. Journal of Dental Education, 85, 1280-1286. https://doi.org/10.1002/jdd.12597
[30]
Kobbin, V., Jzui, N. W., Teo, M., Hui, T. X., & Halim, I. (2020). Fear, Anxiety and Coping Mechanism during COVID-19 Pandemic among Undergraduates. Intern. International Journal of Biomedical and Clinical Engineering, 5, 217-228.
[31]
Laurence, B., Williams, C., & Eiland, D. (2009). Depressive Symptoms, Stress, and Social Support among Dental Students at a Historically Black College and University. Journal of American College Health, 58, 56-63. https://doi.org/10.3200/JACH.58.1.56-63
[32]
Loh, L.-C., Ali, A. M., Ang, T.-H., & Chelliah, A. (2006). Impact of a spreading epidemic on Medical Students. The Malaysian Journal of Medical Sciences, 13, 30-36.
https://pubmed.ncbi.nlm.nih.gov/22589602
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349482/
[33]
Lovibond, S. H., Lovibond, P. F., & Psychology Foundation of Australia (1995). Manual for the Depression Anxiety Stress Scales. Psychology Foundation of Australia.
[34]
Meng, L., Hua, F., & Bian, Z. (2020). Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine. Journal of Dental Research, 99, 481-487. https://doi.org/10.1177%2F0022034520914246
[35]
Ozdede, M., & Sahin, S. (2020). Views and Anxiety Levels of Turkish Dental Students during the COVID-19 Pandemic. Journal of Stomatology, 73, 123-128.
https://doi.org/10.5114/jos.2020.96867
[36]
Phelan, A. L., Katz, R., & Gostin, L. O. (2020). The Novel Coronavirus Originating in Wuhan, China: Challenges for Global Health Governance. JAMA, 323, 709-710.
https://doi.org/10.1001/jama.2020.1097
[37]
Polychronopoulou, A., & Divaris, K. (2005). Perceived Sources of Stress among Greek Dental Students. Journal of Dental Education, 69, 687-692.
https://doi.org/10.1002/j.0022-0337.2005.69.6.tb03952.x
[38]
Skrlec, I., Talapko, J., Pustijanac, E., & Mestrovic, T. (2021). Depression, Anxiety, Stress and Physical Activity in Health-Related University Students during COVID-19. The 3rd International Electronic Conference on Environmental Research and Public Health, 1-6.
[39]
Sreeram, M., & Mundada, M. A. (2021). Survey to Assess Perceived Causes of Stress, Its Manifestations and Coping Strategies among Dental College Students in Maharashtra during COVID-19 Lockdown. Biomedical & Pharmacology Journal, 14, 53-60.
https://doi.org/10.13005/bpj/2098
[40]
Wang, X., Hegde, S., Son, C., Keller, B., Smith, A., & Sasangohar, F. (2020). Investigating Mental Health of US College Students during the COVID-19 Pandemic: Cross-Sectional Survey Study. Journal of Medical Internet Research, 22, e22817.
https://doi.org/10.2196/22817
[41]
World Health Organization (2020). WHO Timeline-COVID-19.
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline
[42]
Yildirm, T. T., & Atas, O. (2021). The Evaluation of Psychological State of Dental Students during the COVID-19 Pandemic. Brazilian Oral Research, 35, Article No. 0069.
https://doi.org/10.1590/1807-3107bor-2021.vol35.0069
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-83242021000100245&nrm=iso
[43]
Zhai, Y., & Du, X. (2020). Mental Health Care for International Chinese Students Affected by the COVID-19 Outbreak. The Lancet Psychiatry, 7, e22.
https://doi.org/10.1016/S2215-0366(20)30089-4
