Perceived Stress, Burnout and Anxiety and Fear Related To Covid-19 in Romanian Medical Students – Experience from the State of Emergency in Romania

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Abstract
Crisis situations, which cause disturbances in the daily routine of the individual can contribute to the development of mental problems. On the 26th of February, 2020, the first confirmed case of COVID-19 was reported in Romania. On the 16th of March, the President of Romania declared The State of Emergency. The following day, by Order of the Ministry of the Internal Affairs medical students starting with the 4th year of study were to be recruited, on a voluntary basis, to support activities in the Emergency Rooms, if needed. Numerous medical students volunteered. The medical students were exposed to online learning and the possibility of being recruited as volunteers in COVID-19 units. In April 2020, we created and distributed an online survey via www.psysafe.org, which collected data on demographics, personal status of infection, and general mental health, including medication and substance use, sleeping problems in the previous week, perceived stress in the previous month, and burnout in the previous two months. We translated and adapted 2 questionnaires to assess the COVID-19 related anxiety and fear. The participants were Romanian medical students. Data was statistically analysed with SPSS 20. Out of 550 surveys filled, we analysed 545 valid surveys. The mean age of the respondents was 21.66 (±2.55) years, with 81.7% female (445) and 18.3% male (100). 91.6% of the respondents declared that they were never diagnosed with a psychiatric disorder. Coffee was used on a daily basis by 53.8% of the students, with tobacco coming in second in 19.4%. Female students perceived a higher level of stress and showed a higher level of burnout. Female students scored higher for the anxiety and fear related to Covid-19. Medical students with mental health history scored higher on perceived stress, burnout, anxiety and fear related to COVID-19. Perceived stress indicated a level of moderate stress regardless of the mental history status. For all students, the burnout value indicated that some attention was needed, as they might had been candidates to burnout. Moreover, students diagnosed with a psychiatric disorder during the pandemic showed signs that they were on the road to burnout, with changes needed to be done at the time. There were statistically significant positive correlation, of various degrees between perceived stress, burnout, anxiety and fear related to COVID-19, with the strongest one observed for the perceived stress and burnout, in Romanian medical students.

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