Impact of the Covid-19 pandemic and lockdowns on the education and mental health of physiotherapy students in France: a descriptive cross-sectional study with national online survey
DOI:
https://doi.org/10.2340/jrm.v56.18463Keywords:
COVID-19, Lockdown, Physiotherapy students, Mental Health, Physiotherapy educationAbstract
Objective: To determine the impact of the SARS-CoV-2 (COVID-19) pandemic and lockdowns on the mental health status, training, perceptions of the physiotherapy profession, and career plans of French physiotherapy students.
Design: A descriptive cross-sectional study was conducted, representing the first and only survey of its kind, using a national online survey.
Subjects: A total of 2678 French physiotherapy students participated in the study.
Methods: Mental health status was assessed using the validated French versions of established depression, anxiety, and insomnia scales.
Results: The survey revealed that female sex, age below 21 years, living alone, and having a psychiatric history or COVID-19 risk factors were associated with more severe symptoms of depression, anxiety, and insomnia in the surveyed students. In addition, stress, anxiety, and depression induced by the COVID-19 crisis were linked to apprehension about continuing practical training in physiotherapy. These factors also affected students’ perceptions of the profession and the initially envisioned mode of practice, particularly among fifth-year students (odds ratio (OR) = 2.25, 95% confidence interval (95% CI) = (1.69, 2.99), p < 0.001). Notably, the pandemic significantly reduced the desire of these students to pursue a career as physiotherapists (adjusted OR (aOR) 1.41 (1.06, 1.86)).
Conclusion: French physiotherapy students, especially those in their fifth year, have experienced significant impacts from the COVID-19 pandemic, affecting their mental health, education, perceptions of the physiotherapy profession, and career plans.
Downloads
References
Haines KJ, Berney S. Physiotherapists during COVID-19: usual business, in unusual times. J Physiother 2020; 66: 67-69.
https://doi.org/10.1016/j.jphys.2020.03.012 DOI: https://doi.org/10.1016/j.jphys.2020.03.012
Yang S, Kwak SG, Ko EJ, Chang MC. The mental health burden of the covid-19 pandemic on physical therapists. Int J Environ Res Public Health 2020; 17: 3723.
https://doi.org/10.3390/ijerph17103723 DOI: https://doi.org/10.3390/ijerph17103723
Chesterton P, Richardson M, Tears C. Student physiotherapists perceptions of online curriculum delivery during the COVID-19 pandemic. BMC Med Educ 2022; 22: 440.
https://doi.org/10.1186/s12909-022-03486-5 DOI: https://doi.org/10.1186/s12909-022-03486-5
Elmer T, Mepham K, Stadtfeld C. Students under lockdown: comparisons of students' social networks and mental health before and during the COVID-19 crisis in Switzerland. PLoS One 2020; 15: e0236337.
https://doi.org/10.1371/journal.pone.0236337 DOI: https://doi.org/10.1371/journal.pone.0236337
Choi I, Kim JH, Kim N, Choi E, Choi J, Suk HW, et al. How COVID-19 affected mental well-being: an 11- week trajectories of daily well-being of Koreans amidst COVID-19 by age, gender and region. PLoS One 2021; 16: e0250252.
https://doi.org/10.1371/journal.pone.0250252 DOI: https://doi.org/10.1371/journal.pone.0250252
Son C, Hegde S, Smith A, Wang X, Sasangohar F. Effects of COVID-19 on college students' mental health in the united states: interview survey study. J Med Internet Res 2020; 22: e21279.
https://doi.org/10.2196/21279 DOI: https://doi.org/10.2196/21279
Rodríguez-Hidalgo AJ, Pantaleón Y, Dios I, Falla D. Fear of COVID-19, stress, and anxiety in university undergraduate students: a predictive model for depression. Front Psychol 2020; 11: 591797.
https://doi.org/10.3389/fpsyg.2020.591797 DOI: https://doi.org/10.3389/fpsyg.2020.591797
Zolotov Y, Reznik A, Bender S, Isralowitz R. COVID-19 fear, mental health, and substance use among israeli university students. Int J Ment Health Addict 2022; 20: 230-236.
https://doi.org/10.1007/s11469-020-00351-8 DOI: https://doi.org/10.1007/s11469-020-00351-8
Ng L, Seow KC, MacDonald L, Correia C, Reubenson A, Gardner P, et al. eLearning in physical therapy: lessons learned from transitioning a professional education program to full elearning during the COVID-19 pandemic. Phys Ther 2021; 101: pzab082.
https://doi.org/10.1093/ptj/pzab082 DOI: https://doi.org/10.1093/ptj/pzab082
Benham A, Malone J, Duncan J. The experience of physiotherapy and occupational therapy students of pandemic teaching and its perceived impact on placement/practice. Physiother 2022; 114: e233-4.
https://doi.org/10.1016/j.physio.2021.12.226 DOI: https://doi.org/10.1016/j.physio.2021.12.226
Gębska M, Kołodziej Ł, Dalewski B, Pałka Ł, Sobolewska E. The influence of the covid-19 pandemic on the stress levels and occurrence of stomatoghnatic system disorders (SSDs) among physiotherapy students in Poland. J Clin Med 2021; 10: 3872.
https://doi.org/10.3390/jcm10173872 DOI: https://doi.org/10.3390/jcm10173872
Rossettini G, Geri T, Turolla A, Viceconti A, Scumà C, Mirandola M, et al. Online teaching in physiotherapy education during COVID-19 pandemic in Italy: a retrospective case-control study on students' satisfaction and performance. BMC Med Educ 2021; 21: 456.
https://doi.org/10.1186/s12909-021-02896-1 DOI: https://doi.org/10.1186/s12909-021-02896-1
Dario A, Simic M. Innovative physiotherapy clinical education in response to the COVID-19 pandemic with a clinical research placement model. J Physi-other 2021; 67: 235-237.
https://doi.org/10.1016/j.jphys.2021.08.008 DOI: https://doi.org/10.1016/j.jphys.2021.08.008
Etoom M, Aldaher KN, Abdelhaq AA, Alawneh A, Alghwiri AA. Predictors of distance learning in physiotherapy students during COVID-19 outbreak. Phy-siother Theory Pract 2023; 39: 1513-1518.
https://doi.org/10.1080/09593985.2022.2042438 DOI: https://doi.org/10.1080/09593985.2022.2042438
Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606-613.
https://doi.org/10.1046/j.1525-1497.2001.016009606.x DOI: https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Carballeira Y, Dumont P, Borgacci S, Rentsch D, de Tonnac N, Archinard M, et al. Criterion validity of the French version of Patient Health Questionnaire (PHQ) in a hospital department of internal medicine. Psychol Psychother Theory Res Pract 2007; 80: 69-77.
https://doi.org/10.1348/147608306X103641 DOI: https://doi.org/10.1348/147608306X103641
Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166: 1092.
https://doi.org/10.1001/archinte.166.10.1092 DOI: https://doi.org/10.1001/archinte.166.10.1092
Bastien C. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2001; 2: 297-307.
https://doi.org/10.1016/S1389-9457(00)00065-4 DOI: https://doi.org/10.1016/S1389-9457(00)00065-4
La formation aux professions de santé. (n.d.). Retrieved November 20, 2023. Available from : https://data.drees.solidarites-sante.gouv.fr/explore/dataset/491_la-formation-aux-professions-de-sante/information/
Gilliland D, Melfi V. A note on confidence interval estimation and margin of error. J Stat Educ 2010; 18: 1.
https://doi.org/10.1080/10691898.2010.11889474 DOI: https://doi.org/10.1080/10691898.2010.11889474
Vallée M, Kutchukian S, Pradère B, Verdier E, Durbant È, Ramlugun D, et al. Prospective and observational study of COVID-19's impact on mental health and training of young surgeons in France. Brit J Surg 2020; 107: e486-e488.
https://doi.org/10.1002/bjs.11947 DOI: https://doi.org/10.1002/bjs.11947
Chen T, Lucock M. The mental health of university students during the COVID-19 pandemic: an online survey in the UK. PloS One 2022; 17: e0262562.
https://doi.org/10.1371/journal.pone.0262562 DOI: https://doi.org/10.1371/journal.pone.0262562
World Physiotherapy. Immediate impact on students and the response to delivering physiotherapist entry level education. London, UK: World Physi-otherapy; 2020. Available from: https://world.physio/sites/default/files/2020-07/Education-Briefing-paper-3-Students-24-June-2020.pdf
Syed A, Ali SS, Khan M. Frequency of depression, anxiety and stress among the undergraduate physiotherapy students. Pak J Med Sci 2018; 34: 468-471.
https://doi.org/10.12669/pjms.342.12298 DOI: https://doi.org/10.12669/pjms.342.12298
van Vuuren ECJ, Bodenstein K, Nel M. Stressors and coping strategies among physiotherapy students: Towards an integrated support structure. Health SA 2018; 23: 1091.
https://doi.org/10.4102/hsag.v23i0.1091 DOI: https://doi.org/10.4102/hsag.v23i0.1091
Jull G, Moore A. Hands on, hands off? The swings in musculoskeletal physiotherapy practice. Man Ther 2012; 17: 199-200.
https://doi.org/10.1016/j.math.2012.03.009 DOI: https://doi.org/10.1016/j.math.2012.03.009
Malliaras P, Merolli M, Williams CM, Caneiro JP, Haines T, Barton C. 'It's not hands-on therapy, so it's very limited': Telehealth use and views among allied health clinicians during the coronavirus pandemic. Musculoskelet Sci Pract 2021; 52: 102340.
https://doi.org/10.1016/j.msksp.2021.102340 DOI: https://doi.org/10.1016/j.msksp.2021.102340
Lasheras I, Gracia-García P, Lipnicki DM, Bueno-Notivol J, López-Antón R, de la Cámara, C, et al. Prevalence of anxiety in medical students during the covid-19 pandemic: a rapid systematic review with meta-analysis. Int J Environ Res Public Health 2020; 17: 6603.
https://doi.org/10.3390/ijerph17186603 DOI: https://doi.org/10.3390/ijerph17186603
Kota M, Kudo H, Okita K. Relationships between motives to become a physical therapist, delayed graduation, and perceptions of school and internship learning among physical therapy students. J Phys Ther Sci 2018; 30: 136-139.
https://doi.org/10.1589/jpts.30.136 DOI: https://doi.org/10.1589/jpts.30.136
Stith JS, Butterfield WH, Strube MJ, Deusinger SS, Gillespie DF. Personal, interpersonal, and organizational influences on student satisfaction with clinical education. Phys Ther 1998; 78: 635-645.
https://doi.org/10.1093/ptj/78.6.635 DOI: https://doi.org/10.1093/ptj/78.6.635
Alameddine M, Baroud M, Kharroubi S, Hamadeh R, Ammar W, Shoaib H, et al. Investigating the job satisfaction of healthcare providers at primary healthcare centres in Lebanon: a national cross-sectional study. Health Soc Care Community 2017; 25: 1805-1816.
https://doi.org/10.1111/hsc.12454 DOI: https://doi.org/10.1111/hsc.12454
Pritchard, RD, Karasick BW. The effects of organizational climate on managerial job performance and job satisfaction. Organ Behav Hum Perform 1973; 9: 126-146.
https://doi.org/10.1016/0030-5073(73)90042-1 DOI: https://doi.org/10.1016/0030-5073(73)90042-1
Boehm MA, Lei QM, Lloyd RM, Prichard JR. Depression, anxiety, and tobacco use: Overlapping impediments to sleep in a national sample of college students. J Am Coll Health 2016; 64: 565-574.
https://doi.org/10.1080/07448481.2016.1205073 DOI: https://doi.org/10.1080/07448481.2016.1205073
Shanafelt T, Ripp J, Trockel M. Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA 2020; 323: 2133-2134.
https://doi.org/10.1001/jama.2020.5893 DOI: https://doi.org/10.1001/jama.2020.5893
Gas J, Bart S, Michel P, Peyronnet B, Bergerat S, Olivier J, et al. Prevalence of and predictive factors for burnout among French urologists in training. Eur Urol 2019; 75: 702-703.
https://doi.org/10.1016/j.eururo.2018.12.037 DOI: https://doi.org/10.1016/j.eururo.2018.12.037
Reger MA, Stanley IH, Joiner TE. Suicide mortality and coronavirus disease 2019-a perfect storm? JAMA Psychiatry 2020; 77: 1093-1094.
https://doi.org/10.1001/jamapsychiatry.2020.1060 DOI: https://doi.org/10.1001/jamapsychiatry.2020.1060
Srivastav AK, Sharma N, Samuel AJ. Impact of coronavirus disease-19 (COVID-19) lockdown on physical activity and energy expenditure among physi-otherapy professionals and students using web-based open E-survey sent through WhatsApp, Facebook and Instagram messengers. Clin Epidemiol Glob Health 2021; 9: 78-84.
https://doi.org/10.1016/j.cegh.2020.07.003 DOI: https://doi.org/10.1016/j.cegh.2020.07.003
Zhu Y, Wang Z, Zhou Y, Onoda K, Maruyama H, Hu C, et al Summary of respiratory rehabilitation and physical therapy guidelines for patients with CO-VID-19 based on recommendations of World Confederation for Physical Therapy and National Association of Physical Therapy. J Phys Ther Sci 2020; 32: 545-549.
https://doi.org/10.1589/jpts.32.545 DOI: https://doi.org/10.1589/jpts.32.545
Thomas P, Baldwin C, Bissett B, Boden I, Gosselink R, Granger CL, et al.Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother 2020; 66: 73-82.
https://doi.org/10.1016/j.jphys.2020.03.011 DOI: https://doi.org/10.1016/j.jphys.2020.03.011
Additional Files
Published
How to Cite
License
Copyright (c) 2024 Arnaud Delafontaine, Gabriel Saiydoun, Maxime Vallée , Laurent Fabeck, François-Régis Sarhan , Thomas Rulleau, Sylvain Gautier , Nicolas Pinsault
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized JRM contents is available freely online. The Foundation for Rehabilitation Medicine owns the copyright for all material published until volume 40 (2008), as from volume 41 (2009) authors retain copyright to their work and as from volume 49 (2017) the journal has been published Open Access, under CC-BY-NC licences (unless otherwise specified). The CC-BY-NC licenses allow third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
From 2024, articles are published under the CC-BY licence. This license permits sharing, adapting, and using the material for any purpose, including commercial use, with the condition of providing full attribution to the original publication.