Coping strategies during COVID-19 pandemic: Experience of undergraduate medical students

Dear Editor,

Medical students experienced significant increase in stress and anxiety during the COVID-19 pandemic.[1,2] However, limited studies focused on these students’ coping mechanisms. Our study aimed to explore the choice of coping mechanism utilized by medical students.

Qualitative research was conducted among second year MBBS students of a private Medical College in western Maharashtra, India in 2022. After an interactive discussion on mental health that is part of regular curriculum, all 150 students of that batch were sent an online survey to elicit detailed information of their coping strategies during the pandemic. The survey also collected data on individual and family-level contextual factors like family members being healthcare professionals involved in treating COVID-19 patients, family members or self-contracting COVID infection, vaccination status, and perceived stress. Thematic content analysis inductive method, was used using MAXQDA.

Of 150 students, 107 (70.33%) responded. The qualitative analysis revealed six primary themes as follows [Table 1]:

Table 1.

Themes and codes identified with supporting excerpts

Theme	Codes	Proportion of responses n (%)	Supporting excerpts (Participant no.)
Physical well-being	Exercise and Physical Activity	32 (29.91)	“Exercise and home workout kept me distracted whenever I felt low.” (Participant: 69)
Engaging in hobbies	Creative Arts	27 (25.23)	“Hobbies like painting, cooking, and writing poetry helped.” (Participant: 14)
	Reading Books and Novels	20 (18.69)	“Reading self-help books, novels were beneficial for me.” (Participant: 23)
	Music	15 (14.02)	“Listening to music and working out became my stress relievers.” (Participant: 75)
Social Support	Talking to Family and Friends	23 (21.5)	“Talking to close ones and distracting mind was my go-to strategy.” (Participant: 36) “I used to talk to my brother. He would listen to me, and we watched movies together to stay positive.” (Participant: 97)
Emotional and psychological well-being	Practicing Positivity and Patience	11 (10.28)	“Being positive all the time and not panicking was my approach.” (Participant: 48)
	Avoiding Negative Information	5 (4.67)	“Did not watch news because it used to make us anxious.” (Participant: 86)
Spiritual activities	Meditation and Yoga	15 (14.02)	"Meditation, breathing, and self-care." (Participant: 52)
	Religious and Spiritual Practices	6 (5.61)	"Meditation and prayers, talking to parents about whatever troubled me." (Participant: 44) “Engaging in religious practices helped me stay busy and learn new things." (Participant 63)
Personal targets	Maintaining a Routine	7 (6.54)	"Making a monthly schedule and listing down objectives for that month." (Participant: 48)

1. Physical well-being: Exercise and physical activity were the most frequently reported coping mechanisms by nearly one-third of the students.

2. Engagement in hobbies: The second most common coping strategy was engaging in hobbies. One-fourth of the students reported engaging in creative arts, reading books and novels (18.69%), and listening to music (14.02%).

3. Social support: Over one-fifth of the students reported social support and interpersonal communication.

4. Emotional and psychological well-being: A small proportion of participants reported practicing positivity and patience (10.28%), while fewer reported avoiding negative information (4.67%).

5. Spiritual activities: Few reported practicing yoga and meditation (14.02%) and religious and spiritual practices (5.61%).

6. Personal targets: Some students set personal targets that provide opportunities for academic and self-improvement (6.54%).

Approximately one-third (31.78%) of the participating students’ parents or close family members were healthcare professionals treating COVID-19 patients and nearly two-thirds (60.75%) had contracted COVID-19. About one-third (28.97%) of the students had contracted COVID infection. All students were vaccinated, with about two-thirds (67.29%) receiving both doses. Almost three-forth (75.70%) of the students perceived stress one month prior to the survey, and one-third (32.71%) perceived inability to cope with daily routine.

The student’s perceived anxiety, may be attributable to the involvement of family members in treating COVID patients and the infection reaching the families. Yet majority of the students were aware of the preventive measure, i.e., vaccination and proactively undertook coping measures. Coping has been categorized as problem-focused, emotion-focused, meaning-focused and support-seeking.[3] Other studies from India,[4,5] South Africa,[6] Vietnam,[7] and Saudi Arabia[8] by using various scales reported similar coping strategies including engagement in hobbies for distraction, positive reframing, social support, and religious activities.

This was an online study conducted, among second year students of a single medical college. Yet the study findings provide insights to the multifaceted approaches used for coping. Although the pandemic has officially ended, integrating the study findings in medical curriculum like providing structured physical and mental health program, facilitating peer support groups, providing space for personal hobbies, supportive learning environment, is recommended. This would support developing the resilience and responsiveness in the medical students.

Authors contribution

All authors contributed to conceptualization, data collection, analysis, writing, and editing the manuscript

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.