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24 June 2024 : Clinical Research  

Impact of COVID-19-Induced Academic Stress on Insomnia and Suicidal Ideation among Taiwanese Health Trainees and Junior Doctors

Po-Ching Huang ORCID logo1ACDEF, Chung-Ying Lin ORCID logo2345ABCDEFG*, Ru-Yi Huang67ABDEG, Jung-Sheng Chen8ADE, Marc N. Potenza91011121314ADE, Carol Strong15ABE, Hsiao-Wen Wang16ABE, Mark D. Griffiths17ADE, Chiung-Yu Chen1819ABE, Nai-Ying Ko20ADE, Shyh-Jou Shieh2122ABDE

DOI: 10.12659/MSM.944932

Med Sci Monit 2024; 30:e944932



BACKGROUND: Clinical training for allied health trainees (AHTs) and postgraduate-year (PGY) doctors needed to go online during the outbreak of coronavirus disease 2019 (COVID-19), which may have caused academic stress and consequent outcomes among this cohort.

MATERIAL AND METHODS: To evaluate academic-related stress, clinical confidence, psychological distress, and insomnia, an online survey-based study was conducted among Taiwanese AHTs and PGY doctors between July and December, 2022, during the COVID-19 pandemic. The survey included the 21-item Depression, Anxiety, and Stress Scale (DASS-21), the Insomnia Severity Index (ISI), and self-designed questions. It was distributed using convenience sampling and snowball sampling and was completed by 522 participants.

RESULTS: Structural equational modelling showed that academic stress was negatively associated with clinical confidence (standardized coefficient [β]=-0.382, p<0.001). Clinical confidence was negatively associated with psychological distress (β=-0.397, p<0.001), which was associated with insomnia (β=0.648, p<0.001). Additionally, clinical confidence and psychological distress were the significant mediators. Results indicated that higher academic stress was associated with higher level of insomnia via the mediation of clinical confidence and psychological distress.

CONCLUSIONS: Academic stress related to changes in clinical training may have led to insomnia among AHTs and PGY doctors during the pandemic. Factors to reduce academic stress should be investigated to promote good mental health while providing sufficient clinical training, especially during events that can cause increased stress (eg, epidemics, pandemics).

Keywords: COVID-19, Sleep Initiation and Maintenance Disorders, Students, Medical, suicidal ideation, Teaching

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Med Sci Monit 2024; 30:e945583


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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750