Analysis of mental health and influencing factors of college students in the online learning period during the outbreak of COVID-19
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摘要:
目的 了解新型冠状病毒肺炎(Coronavirus Disease 2019, COVID-19)疫情下大学生在线学习期间的心理健康水平并分析其影响因素，为高校大学生心理健康教育提供科学依据。 方法 于2020年6—7月，采用整群抽样的方法选取安徽皖南地区医学与非医学高校各1所，对其中3 781名医学与非医学大学生进行抑郁-焦虑-压力量表(DASS-21)的网络问卷调查。 结果 医学院校大学生抑郁症状、焦虑症状和压力情绪检出率(30.03%，31.05%，14.50%)均低于非医学院校大学生(44.49%，46.22%，24.81%)，差异均有统计学意义(χ2值分别为81.49，88.26，63.08，P值均 < 0.05)。2所院校大学生线上学习期间抑郁症状和焦虑症状以中度为主(18.43%，20.68%)，压力以轻度(9.41%)和中度(5.29%)为主。多因素Logistic回归分析结果显示，非医学生、父母关系差、与父亲关系差、教师课前准备不充分、对线上教学不满意的大学生容易出现抑郁症状(OR值分别为1.84，1.28，1.63，1.75，1.24)、焦虑症状(OR值分别为1.79，1.22，1.65，1.77，1.19)和压力负性情绪(OR值分别为2.09，1.41，1.58，1.29，1.48)；女生相比较男生更不容易出现抑郁症状(OR=0.82)和焦虑症状(OR=0.74)；居住地在农村的大学生更容易出现焦虑症状(OR=1.27)；高年级学生更容易感到压力的存在(P值均 < 0.05)。 结论 在线学习期间大学生抑郁症状、焦虑症状与压力负性情绪检出率较高。家庭和学校应及时关注大学生线上学习期间的心理健康，并针对不同特征学生提供针对性的心理咨询。 Abstract:Objective To investigate the mental health and influencing factors of college students during online learning under the coronavirus disease 2019 (COVID-19) epidemic, and to provide a scientific basis for mental health education. Methods From June to July 2020, a cluster sampling method was used to select one medical and non-medical colleges and universities in southern Anhui Province. Among them, the Depression Anxiety and Stress Scale-21 (DASS-21) was used to conduct an online questionnaire survey among 3 781 medical and non-medical college students. Results The reporting rates of depression, anxiety and stress among medical college students (30.03%, 31.05% and 14.50%, respectively) were lower than those of non-medical college students(44.49%, 46.22%, 24.81%)(χ2=81.49, 88.26, 63.08, P < 0.05). During the online learning period of college students, the depression and anxiety were mainly moderate(18.43%, 20.68%), and the stress was mainly mild and moderate(9.41%, 5.29%). Multivariate Logistic regression analysis showed that non-medical students, poor parent relationships, poor relationships with fathers, teachers' inadequate preparation before class, and dissatisfaction with online teaching results were prone to depression(OR=1.84, 1.28, 1.63, 1.75, 1.24), anxiety (OR=1.79, 1.22, 1.65, 1.77, 1.19) and stress(OR=2.09, 1.41, 1.58, 1.29, 1.48)(P < 0.05). Girls were less prone to depression (OR=0.82) and anxiety(OR=0.74); College students who live in rural areas were more likely to have anxiety symptoms(OR=1.27); Senior students were more likely to feel stress(P < 0.05). Conclusion The detection rate of depression, anxiety and stress negative emotion in college students was higher during online study. Families and schools should pay attention to the mental health of college students during online learning, and provide targeted psychological counseling for different students. -
Key words:
- Mental health /
- Depression /
- Anxiety /
- Pressure /
- Regression analysis /
- Students
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表 1 医学与非医学大学生抑郁、焦虑和压力等级分布比较
Table 1. Comparison of depression, anxiety and stress between medical and non-medical college students
变量 专业 人数 正常 轻度 中度 重度 极度 Z值 P值 抑郁症状 医学 2 338 1 636(69.97) 237(10.14) 366(15.65) 54(2.31) 45(1.93) 9.55 < 0.01 非医学 1 443 801(55.51) 178(12.34) 331(22.94) 82(5.68) 51(3.53) 焦虑症状 医学 2 338 1 612(68.95) 135(5.77) 417(17.84) 88(3.76) 86(3.68) 9.76 < 0.01 非医学 1 443 776(53.78) 104(7.21) 365(25.29) 91(6.31) 107(7.42) 压力负性情绪 医学 2 338 1 999(85.50) 171(7.31) 100(4.28) 46(1.96) 22(0.94) 7.87 < 0.01 非医学 1 443 1 085(75.19) 185(12.82) 100(6.93) 49(3.40) 24(1.66) 注： ()内数字为构成比/%。 
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表 2 不同特征大学生在线学习期间抑郁、焦虑和压力负性情绪检出率比较
Table 2. Comparison of DASS-21 scores of students among different characteristics
组别 选项 人数 统计值 抑郁症状 焦虑症状 压力负性情绪 性别 男 1 950 782(40.10) 822(42.15) 385(19.74) 女 1 831 562(30.69) 571(31.19) 312(17.04) χ2值 36.49 48.83 4.59 P值 < 0.01 < 0.01 0.03 年级 大一 992 347(34.98) 379(38.21) 168(16.94) 大二 1 435 499(34.77) 513(35.75) 255(17.77) 大三 1 354 498(36.78) 501(37.00) 274(20.24) χ2值 1.41 1.54 4.83 P值 0.49 0.46 0.09 居住地 城市 889 291(32.73) 293(32.96) 174(19.57) 县城 981 336(34.25) 349(35.58) 157(16.00) 农村 1 911 717(37.52) 751(39.30) 366(19.15) χ2值 7.04 11.40 5.27 P值 0.03 0.00 0.07 学校 医学 2 338 702(30.03) 726(31.05) 339(14.50) 非医学 1 443 642(44.49) 667(46.22) 358(24.81) χ2值 81.49 88.26 63.08 P值 < 0.01 < 0.01 < 0.01 父母关系 好 2 924 898(30.71) 966(33.04) 451(15.42) 一般 695 352(50.65) 338(48.63) 177(25.47) 差 162 94(58.02) 89(54.94) 69(42.59) χ2值 134.74 82.52 103.37 P值 < 0.01 < 0.01 < 0.01 与父亲关系 好 2 869 871(30.36) 936(32.64) 430(14.99) 一般 801 394(49.19) 378(47.19) 218(27.22) 差 111 79(71.17) 79(71.17) 49(44.14) χ2值 160.25 115.02 112.54 P值 < 0.01 < 0.01 < 0.01 与母亲关系 好 3 272 1 055(32.24) 1 124(34.35) 546(16.69) 一般 474 264(55.70) 248(52.32) 133(28.06) 差 35 25(71.43) 21(60.00) 18(51.43) χ2值 119.25 65.59 61.19 P值 < 0.01 < 0.01 < 0.01 过去1年班级 中上等 1 521 474(31.16) 525(34.52) 267(17.55) 成绩 中等 1 571 536(34.12) 560(35.65) 249(15.85) 中下等 689 334(48.48) 308(44.70) 181(26.27) χ2值 64.43 22.80 35.90 P值 < 0.01 < 0.01 < 0.01 注： ()内数字为检出率/%。
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表 3 线上教学相关变量对大学生在线学习期间心理健康水平的影响
Table 3. Influence of online teaching related variables on the mental health of college students during online learning
变量 分组 人数 统计值 抑郁症状 焦虑症状 压力负性情绪 曾经参加线上 是 2 803 1 000(35.68) 1 052(37.53) 500(17.84) 学习 否 978 344(35.17) 341(34.87) 197(20.14) χ2值 0.08 2.21 2.56 P值 0.78 0.14 0.11 每天在线学习 < 2 353 182(51.56) 174(49.29) 94(26.63) 时间/h 2~ < 4 771 305(39.56) 322(41.76) 160(20.75) 4~6 1 815 602(33.17) 618(34.05) 311(17.13) >6 842 255(30.29) 279(33.13) 132(15.68) χ2值 59.57 42.60 24.82 P值 < 0.01 < 0.01 < 0.01 教师课前准备 满意 2 701 810(29.99) 843(31.21) 433(16.03) 一般 990 476(48.08) 495(50.00) 223(22.53) 不满意 90 58(64.44) 55(61.11) 41(45.56) χ2值 137.11 133.25 65.42 P值 < 0.01 < 0.01 < 0.01 线上教学满意 满意 1 449 422(29.12) 449(30.99) 208(14.35) 度 一般 1 801 675(37.48) 697(38.700) 328(18.21) 不满意 531 247(46.52) 247(46.52) 161(30.32) χ2值 59.92 45.38 65.99 P值 < 0.01 < 0.01 < 0.01 注： ()内数字为检出率/%。
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表 4 大学生抑郁、焦虑、压力影响因素的Logistic回归分析(n=3 781)
Table 4. Logistic regression analysis of the influencing factors of depression, anxiety and stress in college students(n=3 781)
因变量 自变量 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 抑郁 性别 -0.20 0.08 6.49 0.01 0.82(0.71~0.96) 学校 0.61 0.08 62.86 < 0.01 1.84(1.58~2.14) 父母关系 0.25 0.09 8.04 0.01 1.28(1.08~1.52) 与父亲关系 0.49 0.09 28.54 < 0.01 1.63(1.36~1.95) 与母亲关系 0.34 0.11 9.51 < 0.01 1.41(1.13~1.75) 过去1年班级成绩 0.35 0.05 47.09 < 0.01 1.42(1.28~1.56) 教师课前准备 0.56 0.07 56.10 < 0.01 1.75(1.51~2.02) 对线上教学满意度 0.21 0.06 13.61 < 0.01 1.24(1.11~1.38) 每天在线学习时间 -0.17 0.04 17.61 < 0.01 0.84(0.78~0.91) 焦虑 性别 -0.30 0.08 15.94 < 0.01 0.74(0.64~0.86) 学校 0.58 0.08 60.15 < 0.01 1.79(1.55~2.08) 父母关系 0.20 0.08 6.01 0.01 1.22(1.04~1.44) 与父亲关系 0.50 0.09 32.40 < 0.01 1.65(1.39~1.95) 过去1年班级成绩 0.18 0.05 12.48 < 0.01 1.19(1.08~1.31) 教师课前准备 0.57 0.07 60.27 < 0.01 1.77(1.53~2.04) 对线上教学满意度 0.18 0.06 9.66 < 0.01 1.19(1.07~1.33) 每天在线学习时间 -0.13 0.04 9.73 < 0.01 0.88(0.81~0.95) 居住地 县城 0.17 0.10 2.67 0.10 1.18(0.97~1.45) 农村 0.24 0.09 6.82 0.01 1.27(1.06~1.51) 压力 学校 0.74 0.09 66.33 < 0.01 2.09(1.75~2.49) 父母关系 0.35 0.09 13.91 < 0.01 1.41(1.18~1.70) 与父亲关系 0.46 0.10 21.44 < 0.01 1.58(1.30~1.91) 过去1年班级成绩 0.23 0.06 15.42 < 0.01 1.26(1.12~1.41) 教师课前准备 0.25 0.09 8.94 < 0.01 1.29(1.09~1.52) 对线上教学满意度 0.39 0.07 32.13 < 0.01 1.48(1.29~1.69) 每天在线学习时间 -0.12 0.05 5.83 0.02 0.89(0.81~0.98) 年级 大二 0.25 0.12 4.55 0.03 1.28(1.02~1.61) 大三 0.33 0.11 8.54 < 0.01 1.40(1.12~1.75)
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