11 June 2024 : Clinical Research
[In Press] Impact of COVID-19-Induced Academic Stress on Insomnia and Suicidal Ideation among Taiwanese Health Trainees and Junior Doctors
Po-Ching Huang![ORCID logo](https://jours.isi-science.com/images/id_icon_32.png)
![ORCID logo](https://jours.isi-science.com/images/id_icon_32.png)
DOI: 10.12659/MSM.944932
Med Sci Monit In Press; DOI: 10.12659/MSM.944932
Available online: 2024-06-11, In Press, Corrected Proof
Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule
Abstract
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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