Determining the Mental Status,Sleep Quality,and Eating Behaviors of University Students During the COVID-19 Pandemic: A Cross-Sectional Study

Abstract

BACKGROUND:

The COVID-19 pandemic has resulted in adverse effects on individuals’ physical and mental health worldwide, with university students also being adversely affected by this process.

OBJECTIVES:

This research aimed to determine the mental condition, sleep quality, and eating behaviors of university students during the COVID-19 process.

METHOD:

This cross-sectional study was conducted with 1,065 university students. Study data were collected with an online questionnaire including a personal information form, the Depression Anxiety Stress Scale, the Pittsburgh Sleep Quality Index, and the Dutch Eating Behavior Scale.

RESULTS:

Students’ poor sleep quality was determined to be 69.5%. It was also determined that students’ depression and stress levels were moderate that their anxiety levels were low, their eating behaviors were generally problematic, and more than half had poor sleep quality. In addition, eating disorders and poor sleep quality increased as depression, anxiety, and stress levels increased, and eating disorders increased as poor sleep quality increased (p < .05).

CONCLUSIONS:

The results emphasize the importance of the strengthening of students’ mental health, particularly by improving their sleep quality and eating habits. Evidence-based interventions regarding the effects of the pandemic should be made for students under the leadership of a psychiatric nurse, and effective strategies must be developed accordingly.

Keywords

COVID-19 university students mental status sleep quality eating behaviors

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References

Ağargün

M. Y.

Kara

Anlar

(1996). The validity and reliability Pittsburgh sleep quality index. Turkish Journal of Psychiatry, 7(2), 107–115.

Aguilera-Hermida

A. P.

(2020). College students’ use and acceptance of emergency online learning due to COVID-19. International Journal of Educational Research Open, 1, 100011. https://doi.org/10.1016/j.ijedro.2020.100011

Alafif

N. O.

Abdelfattah

E. H.

Alhadi

R. A.

Alanazi

S. B.

Alkabaa

R. I.

Alsalem

F. A.

Aljeldah

T. M.

Aldriweesh

K. K.

Albati

A. A.

(2021). Effect of quarantine on eating behaviors and weight change among King Saud University students in Riyadh. Journal of King Saud University—Science, 33(8), 101609. https://doi.org/10.1016/j.jksus.2021.101609

Altena

Baglioni

Espie

C. A.

Ellis

Gavriloff

Holzinger

Schlarb

Frase

Jernelöv

Riemann

(2020). Dealing with sleep problems during home confinement due to the COVID-19 outbreak: Practical recommendations from a task force of the European CBT-I Academy. Journal of Sleep Research, 29(4), e13052. https://doi.org/10.1111/jsr.13052

Anbari

Mikaeili

Hajloo

(2020). Modification of the dual pathway model of binge eating among women: Evaluation of fear of negative evaluation and self-esteem as two new extensions. Journal of Advanced Pharmacy Education & Research, 10(S1), 89–95.

Belen

(2022). Fear of COVID-19 and mental health: The role of mindfulness in during times of crisis. International Journal of Mental Health and Addiction, 20(1), 607–618. https://doi.org/10.1007/s11469-020-00470-2

Bozan

Baş

Aşçı

F. H.

(2011). Psychometric properties of Turkish version of Dutch Eating Behaviour Questionnaire (DEBQ). A preliminary results. Appetite, 56(3), 564–566. https://doi.org/10.1016/j.appet.2011.01.025

Buysse

D. J.

Reynolds

C. F.

III Monk

T. H.

Berman

S. R.

Kupfer

D. J.

(1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4

Caldwell

A. E.

Sayer

R. D.

(2019). Evolutionary considerations on social status, eating behavior, and obesity. Appetite, 132, 238–248. https://doi.org/10.1016/j.appet.2018.07.028

10.

Cao

Fang

Hou

Han

Dong

Zheng

(2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research, 287, 112934. https://doi.org/10.1016/j.psychres.2020.112934

11.

Cardinali

D. P.

Srinivasan

Brzezinski

Brown

G. M.

(2012). Melatonin and its analogs in insomnia and depression. Journal of Pineal Research, 52(4), 365–375. https://doi.org/10.1111/j.1600-079X.2011.00962.x

12.

Chen

Zhou

Wang

D. W.

(2020). SARS-CoV-2: A potential novel etiology of fulminant myocarditis. Herz, 45(3), 230–232. https://doi.org/10.1007/s00059-020-04909-z

13.

Dinler

Badat

Kocamaz

Yakut

(2020). Evaluation of the physical activity, sleep quality, depression, and life satisfaction of university students during the COVID-19. International Journal of Disabilities Sports and Health Sciences, 3(2), 128–139. https://doi.org/10.33438/ijdshs.770346

14.

Düz

Aytekeli

S. T.

(2020). Determination the level of physical activity and eating behaviors of university students. Asian Journal of Education and Training, 6(1), 65–71. https://doi.org/10.20448/journal.522.2020.61.65.71

15.

Fawaz

Samaha

(2021). E-learning: Depression, anxiety, and stress symptomatology among Lebanese university students during COVID-19 quarantine. Nursing Forum, 56(1), 52–57. https://doi.org/10.1111/nuf.12521

16.

Franceschini

Musetti

Zenesini

Palagini

Scarpelli

Quattropani

M. C.

Lenzo

Freda

M. F.

Lemmo

Vegni

Borghi

Saita

Cattivelli

Gennaro

L. D.

Plazzi

Riemann

Castelnuovo

(2020). Poor sleep quality and its consequences on mental health during the COVID-19 lockdown in Italy. Frontiers in Psychology, 11, Article 3072. https://doi.org/10.3389/fpsyg.2020.574475

17.

Gaş

Ekşi Özsoy

Cesur Aydın

(2021). The association between sleep quality, depression, anxiety and stress levels, and temporomandibular joint disorders among Turkish dental students during the COVID-19 pandemic. The Journal of Craniomandibular & Sleep Practice. Advance online publication, 1–6 https://doi.org/10.1080/08869634.2021.1883364

18.

Ghazawy

E. R.

Ewis

A. A.

Mahfouz

E. M.

Khalil

D. M.

Arafa

Mohammed

Hassan

E. E.

Hamid

S. A.

Ewis

S. A.

Mohammed

A. E. N. S.

(2021). Psychological impacts of COVID-19 pandemic on the university students in Egypt. Health Promotion International, 36(4), 1116–1125. https://dx-doi-org.web.bisu.edu.cn/10.1093/heapro/daaa147

19.

Higher Education Board. (2020, March 18). [News release]. https://www.yok.gov.tr/Sayfalar/Haberler/2020/universitelerde-uygulanacak-uzaktan-egitime-iliskin-aciklama.aspx

20.

Huang

Lei

Liu

(2020). Emotional responses and coping strategies in nurses and nursing students during COVID-19 outbreak: A comparative study. PLOS ONE, 15(8), Article e0237303. https://doi.org/10.1371/journal.pone.0237303

21.

Husky

M. M.

Kovess-Masfety

Swendsen

J. D.

(2020). Stress and anxiety among university students in France during COVID-19 mandatory confinement. Comprehensive Psychiatry, 102, 152191. https://doi.org/10.1016/j.comppsych.2020.152191

22.

Islam

M. A.

Barna

S. D.

Raihan

Khan

M. N. A.

Hossain

M. T.

(2020). Depression and anxiety among university students during the COVID-19 pandemic in Bangladesh: A web-based cross-sectional survey. PLOS ONE, 15(8), Article e0238162. https://doi.org/10.1371/journal.pone.0238162

23.

Jarrin

D. C.

Chen

I. Y.

Ivers

Morin

C. M.

(2014). The role of vulnerability in stress-related insomnia, social support and coping styles on incidence and persistence of insomnia. Journal of Sleep Research, 23(6), 681–688. https://doi.org/10.1111/jsr.12172

24.

Johansson

Côté

Hogg-Johnson

Rudman

Holm

L. W.

Grotle

Jensen

Sundberg

Edlund

Skillgate

(2021). Depression, anxiety and stress among Swedish university students before and during six months of the COVID-19 pandemic: A cohort study. Scandinavian Journal of Public Health, 49, 741–749. https://doi.org/10.1177/14034948211031402

25.

Kim

S. E.

Jeong

H. S.

Shin

S. U.

Kim

T. H.

Kim

U. J.

Kang

S. J.

Jang

H. C.

Jung

S. I.

Park

K. H.

(2020). Viral kinetics of SARS-CoV-2 in asymptomatic carriers and presymptomatic patients. International Journal of Infectious Diseases, 95, 441–443. https://doi.org/10.1016/j.ijid.2020.04.083

26.

Wang

Jiang

Valdimarsdóttir

U. A.

Fall

Fang

Song

Zhang

(2021). Psychological distress among health professional students during the COVID-19 outbreak. Psychological Medicine, 51(11), 1952–1954. https://doi.org/10.1017/S0033291720001555

27.

Liu

Zhong

(2020). Psychological state of college students during COVID-19 epidemic. https://dx-doi-org.web.bisu.edu.cn/10.2139/ssrn.3552814

28.

Lovibond

P. F.

Lovibond

S. H.

(1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-U

29.

Macht

(2008). How emotions affect eating: A five-way model. Appetite, 50(1), 1–11. https://doi.org/10.1016/j.appet.2007.007.002

30.

Martínez-de-Quel

Ó.

Suárez-Iglesias

López-Flores

Pérez

C. A.

(2021). Physical activity, dietary habits and sleep quality before and during COVID-19 lockdown: A longitudinal study. Appetite, 158, 105019. https://doi.org/10.1016/j.appet.2020.105019

31.

Naja

Hamadeh

(2020). Nutrition amid the COVID-19 pandemic: A multi-level framework for action. European Journal of Clinical Nutrition, 74(8), 1117–1121. https://doi.org/10.1038/s41430-020-0634-3

32.

Nakhostin-Ansari

Sherafati

Aghajani

Khonji

M. S.

Aghajani

Shahmansouri

(2020). Depression and anxiety among Iranian medical students during COVID-19 pandemic. Iranian Journal of Psychiatry, 15(3), 228–235. https://doi.org/10.18502/ijps.v15i3.3815

33.

Nashwan

A. J.

Villar

R. C.

Al-Qudimat

A. R.

Kader

Alabdullah

Abujaber

A. A.

Al-Jabry

M. M.

Harkous

Philip

Ali

Chandra

Yassin

M. A.

Shraim

Singh

(2021). Quality of life, sleep quality, depression, anxiety, stress, eating habits, and social bounds in nurses during the coronavirus disease 2019 pandemic in Qatar (The Protector Study): A cross-sectional, comparative study. Journal of Personalized Medicine, 11(9), 918. https://dx-doi-org.web.bisu.edu.cn/10.3390/jpm11090918

34.

Odriozola-González

Planchuelo-Gómez

Á.

Irurtia

M. J.

de Luis-García

(2020). Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university. Psychiatry Research, 290, 113108. https://doi.org/10.1016/j.psychres.2020.113108

35.

Official Gazette. (2020). Additional measures for public employees within the scope of Covid-19 (Issue: 31225 Circular 2020/11). https://www.resmigazete.gov.tr/eskiler/2020/08/20200826-5.pdf

36.

Republic of Turkey Directorate of Communications. (2020). https://hayatevesigar.saglik.gov.tr/

37.

Rodgers

R. F.

Lombardo

Cerolini

Franko

D. L.

Omori

Fuller-Tyszkiewicz

Linerdon

Courtet

Guillaume

(2020). The impact of the COVID-19 pandemic on eating disorder risk and symptoms. International Journal of Eating Disorders, 53(7), 1166–1170. https://doi.org/10.1002/eat.23318

38.

Saadeh

Almobaideen

Al Refaei

Shewaikani

Al Fayez

R. Q.

Khawaldah

Abu-Shanab

Al-Hussaini

(2021). Effect of COVID-19 quarantine on the sleep quality and the depressive symptom levels of university students in Jordan during the Spring of 2020. Frontiers in Psychiatry, 12, Article 131. https://doi.org/10.3389/fpsyt.2021.605676

39.

Sánchez

B. J.

Oda-Montecinos

Cova Solar

Hemmelmann Fuentes

Betancourt Peters

Beyle Sandoval

(2020). Estilos de ingesta de estudiantes universitarios chilenos:¿ qué hay de nuevo? Nutrición Hospitalaria, 37(4), 807–813. https://dx-doi-org.web.bisu.edu.cn/10.20960/nh.02656

40.

Sankhi

Marasine

N. R.

(2020). Impact of COVID-19 pandemic on mental health of the general population, students, and health care workers. Europasian Journal of Medical Sciences, 2, 64–72. https://doi.org/10.46405/ejms.v2i2.131

41.

Serin

Koç

M. C.

(2020). Examination of the eating behaviours and depression states of the university students who stay at home during the coronavirus pandemic in terms of different variables. Progress in Nutrition, 22(1), 33–43. https://doi.org/10.23751/pn.v22i1-S.9780

42.

Shrestha

Adhikari

S. P.

Rawal

Budhathoki

Pokharel

Adhikari

Rokaya

Raut

(2021). Sleep quality among undergraduate students of a medical college in Nepal during COVID-19 pandemic: An online survey. F1000Research, 10, 505. https://doi.org/10.12688/f1000research.53904.2

43.

Şirin

Özkan

(2020). COVID-19 epidemiology: In the world and Turkey. Journal of Otorhinolaryngology and Head and Neck Surgery, 28(2), 6–13. http://doi.org/10.24179/kbbbbc.2020-76607

44.

Somma

Marelli

Gialdi

Castelnuovo

Momberlli

Ferini-Strambi

Fossati

(2020). Latent changes in perceived quality of sleep related to the COVID-19 quarantine measures in Italian university students: Understanding the role of personality and internalizing symptoms. Mediterranean Journal of Clinical Psychology, 8(3). https://doi.org/10.6092/2282-1619/mjcp-2550

45.

Sun

Goldberg

S. B.

Lin

Qiao

Operario

(2021). Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China. Globalization and Health, 17(1), Article 15. https://doi.org/10.1186/s12992-021-00663-x

46.

Sze

K. Y.

Lee

E. K.

Chan

R. H.

Kim

J. H.

(2021). Prevalence of negative emotional eating and its associated psychosocial factors among urban Chinese undergraduates in Hong Kong: A cross-sectional study. BMC Public Health, 21(1), Article 283. https://doi.org/10.1186/s12889-021-10531-3

47.

Torun

S. D.

(2020). The psychological impact of the COVID-19 pandemic on medical students in Turkey. Pakistan Journal of Medical Sciences, 36(6), 1355–1359. https://doi.org/10.12669/pjms.36.6.2985

48.

Turkish Dietetic Association. (2020). http://www.tdd.org.tr/index.php/duyurular/70-corona-klinik-rehberi

49.

Turkish Psychiatric Nursing Association. (2020). https://phdernegi.org/kordep-kapsaminda-hizmet-verilmeye-baslandi/

50.

Uğurlu

K. Y.

Değirmenci

M. D.

Durgun

Uğur

G. H.

(2021). The examination of the relationship between nursing students’ depression, anxiety and stress levels and restrictive, emotional, and external eating behaviors in COVID-19 social isolation process. Perspectives in Psychiatric Care, 57(2), 507–516. https://doi.org/10.1111/ppc.12703

51.

van Santen

Vreeburg

S. A.

Van der Does

A. W.

Spinhoven

Zitman

F. G.

Penninx

B. W.

(2011). Psychological traits and the cortisol awakening response: Results from the Netherlands Study of Depression and Anxiety. Psychoneuroendocrinology, 36(2), 240–248. https://doi.org/10.1016/j.psyneuen.2010.07.014

52.

Van Strien

Frijters

J. E.

Bergers

G. P.

Defares

P. B.

(1986). The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. International Journal of Eating Disorders, 5(2), 295–315. https://doi.org/10.1002/1098-108X(198602)5:2<295::AID-T2260050209>3.0.CO;2T

53.

Wang

Z. H.

Yang

H. L.

Yang

Y. Q.

Liu

Z. H.

Zhang

X. R.

Zhang

Y. J.

Shen

Chen

P. L.

Song

W. Q.

Wang

X. M.

X. B.

Yang

X. F.

Mao

(2020). Prevalence of anxiety and depression symptom, and the demands for psychological knowledge and interventions in college students during COVID-19 epidemic: A large cross-sectional study. Journal of Affective Disorders, 275, 188–193. https://doi.org/10.1016/j.jad.2020.06.034

54.

Wathelet

Duhem

Vaiva

Baubet

Habran

Veerapa

Debien

Molend

Horn

Grandgenèvre

Notredame

C. E.

D’Hondt

(2020). Factors associated with mental health disorders among university students in France confined during the COVID-19 pandemic. JAMA Network Open, 3(10), e2025591. https://doi.org/10.1001/jamanetworkopen.2020.25591

55.

Weissman

R. S.

Bauer

Thomas

J. J.

(2020). Access to evidence-based care for eating disorders during the COVID-19 crisis. International Journal of Eating Disorders, 53(5), 639–646. https://doi.org/10.1002/eat.23279

56.

World Health Organization. (2020). Novel Coronavirus (2019-nCoV): Situation report-11. https://apps.who.int/iris/bitstream/handle/10665/330776/nCoVsitrep31Jan2020-eng.pdf

57.

Yıldırım

(2020). Out-of-hospital care in psychiatric disorders. In Oflaz

Yıldırım

(Eds.), Psychiatric Nursing Certificate Topics. Psychiatric Nursing Association Publication No:1 (pp. 289–303). Nobel Medical Bookstores.

58.

Yılmaz

Ö.

Boz

Arslan

(2017). The validity-reliability study of the Turkish short form of the Depression Anxiety Stress Scale (DASS 21). Journal of Finance, Economy and Social Research, 2(2), 78–91.

59.

Zhang

(2020). Mental health problems during the COVID-19 pandemics and the mitigation effects of exercise: A longitudinal study of college students in China. International Journal of Environmental Research and Public Health, 17(10), 3722. https://doi.org/10.3390/ijerph17103722

60.

Zhou

S. J.

Wang

L. L.

Yang

X. J.

Gao

Zhang

S. Y.

Zhang

L. G.

Yang

Chen

J. X.

(2020). Mental health problems and related factors in Chinese university students during the COVID-19 pandemic. Research Square. https://doi.org/10.21203/rs.3.rs-60938/v1