Research Article
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An Investigation of Stress, Anxiety And Depression States of University Students During The Covid-19 Pandemic

Year 2022, Volume: 6 Issue: 2, 495 - 505, 31.05.2022
https://doi.org/10.30621/jbachs.871615

Abstract

Abstract
Purpose: This study was planned to investigate the stress, anxiety, and depression states of university students during the COVID-19 pandemic.
Material and Methods: This research was designed as a descriptive and cross-sectional study. The research population comprised individuals over 18 years of age, living in Turkey, who volunteered to participate in the study, and who were attending university. An online survey was introduced to 540 university students (sample). An introductory information form, developed by the research authors, was used in the study along with the Depression, Anxiety, and Stress Scale (DASS-21).
Results: The majority of students were women (73.2%); undergraduate students comprised the majority of the sample (64.9%); more than half (54.8%) the participants were aged 20–21 years; more than 1/3 (34.6%) of the participants had a low or very low income level. The majority of the students (96.3%) stayed with their families during the pandemic, and one fifth lived in villages. As a result of the COVID-19 pandemic, most university students reported depression (79.7%), anxiety (61.4%), and stress (68.6%). Gender, income, chronic disease, presence of an at-risk individual (persons with a chronic disease, a health worker etc.), lack of hope for the future, and feeling unwell after sleep were found to be those factors affecting the students’ depression, anxiety, and stress levels. A positive correlation was found between both stress and employment anxiety, and between future anxiety and depression, anxiety, and stress.
Conclusion: The results of the present study suggest that the COVID-19 pandemic has a significant psychosocial effect on university students.

Thanks

The authors would like to thank all those participants who participated in the study.

References

  • REFERENCES 1. Banerjee DD. Psychological preparedness for the COVID-19 pandemic, perspectives from India. Psychiatry Res. 2020;288(112999). doi: 10.1016/j.psychres.2020.112999
  • 2. Ahmed H, Allaf M, Elghazaly H. COVID-19 and medical education. Lancet Infect Dis [Internet]. 2020;20(7):777–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32213335/ DOI:https://doi.org/10.1016/S1473-3099(20)30226-7
  • 3. Dhama K, Sharun K., Tiwari R, et al.. Coronavirus Disease 2019 – COVID-19. Preprints [Internet]. 2020;(April):1–75. Available from: https://www.preprints.org/manuscript/202003.0001/v2 doi: 10.20944/preprints202003.0001.v1
  • 4. Ahmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated Psychological Problems. Asian J Psychiatr [Internet]. 2020;51(March):102092. Available from: https://doi.org/10.1016/j.ajp.2020.102092
  • 5. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh P. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents J [Internet]. 2020;55(3):1–9. Available from: https://reader.elsevier.com/reader/sd/pii/S0924857920300674?token=6317ED0BF9E8AF2D0EB3974DDD3C61A92BAFEA526EFEA5A1598806DA897DCC66E776EB9D5DCDAA3A802ACB9C5C700092 https://doi.org/10.1016/j.ijantimicag.2020.105924
  • 6. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. DOI:https://doi.org/10.1016/S0140-6736(20)30183-5
  • 7. Epidemiology Working Group for NCIP Epidemic Response Chinese Center for Disease Control and Prevention. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145–51. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003
  • 8. Ghebreyesus T. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. 2020. Available from: https://www.who.int/dg/speeches/detail/who-directorgeneral-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
  • 9. Ministry Of Health [Sağlık Bakanlığı]. New Corona Virus, the Current Situation in Turkey [Yeni Corona Virüsü, Türkiye’de Güncel Durum] [Internet]. 2020. Available from: https://covid19.saglik.gov.tr/
  • 10. Xiao C. A novel approach of consultation on 2019 novel coronavirus (COVID-19)-related psychological and mental problems: Structured letter therapy. Psychiatry Investig. 2020;17(2):175–6. DOI: https://doi.org/10.30773/pi.2020.0047
  • 11. Chen Q, Liang M, Li Y, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry [Internet]. 2020;7(4):e15–6. Available from: https://pubmed.ncbi.nlm.nih.gov/32085839/ DOI:https://doi.org/10.1016/S2215-0366(20)30078-X
  • 12. Flahault A. COVID-19 cacophony: is there any orchestra conductor? Lancet [Internet]. 2020;395(10229):1037. Available from: http://dx.doi.org/10.1016/S0140-6736(20)30491-8 doi: 10.1016/S0140-6736(20)30491-8
  • 13. Aslan R. Endemic diseases in history [Tarihten günümüze pandemiler: Pandemiler ve Covid-19]. Ayrıntı Derg [Internet]. 2020;85(8):35–41. Available from: http://dergiayrinti.com/index.php/ayr/article/view/1353
  • 14. Bao W. COVID ‐19 and online teaching in higher education: A case study of Peking University . Hum Behav Emerg Technol. 2020;2(2):113–5. https://doi.org/10.1002/hbe2.191
  • 15. Council of Higher Education [Yüksek Öğretim Kurumu]. Assessment of Distance Education in Universities from Council of Higher Education Assessment of Distance Education in Universities from Council of Higher Education [Yüksek Öğretim Kurumu’nun Üniversitelerdeki Uzaktan Eğitime Yönelik Değerlendirme] [Internet]. 2020. Available from: https://www.yok.gov.tr/Sayfalar/Haberler/2020/uzaktan-egitime-yonelik-degerlendirme.aspx?fbclid=IwAR2KzZwUqqjE6InsGV1Ocbtz8pWDimPhI6arTMYEbVss2YtjuMUOs7WBrNM
  • 16. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy. 1995(33);335–43. doi: 10.1016/0005-7967(94)00075-u
  • 17. Henry JD, Crawford JR. The short-form version of the Depression anxiety stress scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology. 2005(44);227–39. DOI: 10.1348/014466505X29657
  • 18. Yıldırım A, Boysan M, Kefeli MC. Psychometric properties of the Turkish version of the Depression Anxiety Stress Scale-21 (DASS-21). Br J Guid Couns. 2018;46(5):582–95. https://doi.org/10.1080/03069885.2018.1442558
  • 19. Akın A, Çetin B. The Depression Anxiety and Stress Scale (DASS): The study of Validity and Reliability. Educ Sci Theory Pract [Internet]. 2007;7:1–28. Available from: https://toad.halileksi.net/sites/default/files/pdf/depresyon-anksiyete-stres-olcegi-toad.pdf
  • 20. Alfonsson S, Wallin E, Maathz P. Factor structure and validity of the Depression, Anxiety and Stress Scale-21 in Swedish translation. J Psychiatr Ment Health Nurs. 2017;24(2–3):154–62. DOI: 10.1111/jpm.12363
  • 21. Dong X, Li J, Bai J, et al. Epidemiological Characteristics of Confirmed COVID-19 Cases in Tianjin. Zhonghua Liu Xing Bing Xue Za Zhi [Internet]. 2020;41(5):638–42. Available from: http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0254-6450&year=2020&vol=41&issue=5&fpage=638 DOI: 10.3760/cma.j.cn112338-20200221-00146
  • 22. Ozamiz-Etxebarria N, Dosil-Santamaria M, Picaza-Gorrochategui M, Idoiaga-Mondragon N. Stress, anxiety, and depression levels in the initial stage of the COVID-19 outbreak in a population sample in the northern Spain. Cad Saude Publica. 2020;36(4):1–9. http://dx.doi.org/10.1590/0102-311x00054020
  • 23. Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res [Internet]. 2020;287(March):112934. Available from: https://doi.org/10.1016/j.psychres.2020.112934
  • 24. Townsend MC. Fundamentals of Mental Health and Psychiatric Nursing [Ruh Sağlığı ve Psikiyatri Hemşireliğinin Temelleri] [Internet]. Tangül Özcan C, Gürhan N, editors: 1–932, Ankara: Nobel Kitabevi; 2016. Available from: https://www.nobelkitabevi.com.tr/hemsirelik-ebelik/9564-ruh-sagligi-ve-psikiyatri-hemsireliginin-temelleri-9786059942416.html
  • 25. Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729. doi: 10.3390/ijerph17051729
  • 26. Dursun S, Aytaç S. Unemployment Anxiety Among University Students [Üniversite Öğrencileri Arasında İşsizlik Kaygısı]. Uludag J Econ Soc [Internet]. 2009;28(1):71–84. Available from: http://www.acarindex.com/dosyalar/makale/acarindex-1423935894.pdf
  • 27. Elmer T, Mepham K, Stadtfeld C. Students under lockdown: Assessing change in students’ social networks and mental health during the COVID-19 crisis. PsyArXiv [Internet]. 2020; Available from: https://psyarxiv.com/ua6tq https://doi.org/10.1371/journal.pone.0236337
  • 28. Kernan WD. Health-related impediments to learning among dental and oral surgery students. J Prev Interv Community [Internet]. 2019;47(1):32–44. Available from: https://doi.org/10.1080/10852352.2018.1547307
  • 29. Dalton L, Rapa E, Stein A. Protecting the psychological health of children through effective communication about COVID-19. Lancet Child Adolesc Heal [Internet]. 2020;4(5):346–7. Available from: http://dx.doi.org/10.1016/S2352-4642(20)30097-3
  • 30. Sintema EJ. Effect of COVID-19 on the Performance of Grade 12 Students: Implications for STEM Education. Eurasia J Math Sci Technol Educ. 2020;16(7):1–6. DOI: 10.29333/ejmste/7893
  • 31. Psychiatric Association of Turkey [Türk Psikologlar Derneği]. Mental Health During the COVID-19 Outbreak [COVID-19 Salgını Sırasında Ruh Sağlığı] [Internet]. 2020. Available from: http://www.psikolog.org.tr/tr/blog/www/covid-19-salgini-sirasinda-ruh-sagligi-x656/
  • 32. Bao Y, Sun Y, Meng S, Shi J, Lu L. 2019-nCoV epidemic: address mental health care to empower society. Lancet [Internet]. 2020;395(10224):e37–8. Available from: http://dx.doi.org/10.1016/S0140-6736(20)30309-3
  • 33. Lazarus RS, Folkman S. Stress, Appraisal, And Coping. New York: Springer Publishing Company; 1984.
Year 2022, Volume: 6 Issue: 2, 495 - 505, 31.05.2022
https://doi.org/10.30621/jbachs.871615

Abstract

References

  • REFERENCES 1. Banerjee DD. Psychological preparedness for the COVID-19 pandemic, perspectives from India. Psychiatry Res. 2020;288(112999). doi: 10.1016/j.psychres.2020.112999
  • 2. Ahmed H, Allaf M, Elghazaly H. COVID-19 and medical education. Lancet Infect Dis [Internet]. 2020;20(7):777–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32213335/ DOI:https://doi.org/10.1016/S1473-3099(20)30226-7
  • 3. Dhama K, Sharun K., Tiwari R, et al.. Coronavirus Disease 2019 – COVID-19. Preprints [Internet]. 2020;(April):1–75. Available from: https://www.preprints.org/manuscript/202003.0001/v2 doi: 10.20944/preprints202003.0001.v1
  • 4. Ahmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated Psychological Problems. Asian J Psychiatr [Internet]. 2020;51(March):102092. Available from: https://doi.org/10.1016/j.ajp.2020.102092
  • 5. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh P. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents J [Internet]. 2020;55(3):1–9. Available from: https://reader.elsevier.com/reader/sd/pii/S0924857920300674?token=6317ED0BF9E8AF2D0EB3974DDD3C61A92BAFEA526EFEA5A1598806DA897DCC66E776EB9D5DCDAA3A802ACB9C5C700092 https://doi.org/10.1016/j.ijantimicag.2020.105924
  • 6. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. DOI:https://doi.org/10.1016/S0140-6736(20)30183-5
  • 7. Epidemiology Working Group for NCIP Epidemic Response Chinese Center for Disease Control and Prevention. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145–51. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003
  • 8. Ghebreyesus T. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. 2020. Available from: https://www.who.int/dg/speeches/detail/who-directorgeneral-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
  • 9. Ministry Of Health [Sağlık Bakanlığı]. New Corona Virus, the Current Situation in Turkey [Yeni Corona Virüsü, Türkiye’de Güncel Durum] [Internet]. 2020. Available from: https://covid19.saglik.gov.tr/
  • 10. Xiao C. A novel approach of consultation on 2019 novel coronavirus (COVID-19)-related psychological and mental problems: Structured letter therapy. Psychiatry Investig. 2020;17(2):175–6. DOI: https://doi.org/10.30773/pi.2020.0047
  • 11. Chen Q, Liang M, Li Y, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry [Internet]. 2020;7(4):e15–6. Available from: https://pubmed.ncbi.nlm.nih.gov/32085839/ DOI:https://doi.org/10.1016/S2215-0366(20)30078-X
  • 12. Flahault A. COVID-19 cacophony: is there any orchestra conductor? Lancet [Internet]. 2020;395(10229):1037. Available from: http://dx.doi.org/10.1016/S0140-6736(20)30491-8 doi: 10.1016/S0140-6736(20)30491-8
  • 13. Aslan R. Endemic diseases in history [Tarihten günümüze pandemiler: Pandemiler ve Covid-19]. Ayrıntı Derg [Internet]. 2020;85(8):35–41. Available from: http://dergiayrinti.com/index.php/ayr/article/view/1353
  • 14. Bao W. COVID ‐19 and online teaching in higher education: A case study of Peking University . Hum Behav Emerg Technol. 2020;2(2):113–5. https://doi.org/10.1002/hbe2.191
  • 15. Council of Higher Education [Yüksek Öğretim Kurumu]. Assessment of Distance Education in Universities from Council of Higher Education Assessment of Distance Education in Universities from Council of Higher Education [Yüksek Öğretim Kurumu’nun Üniversitelerdeki Uzaktan Eğitime Yönelik Değerlendirme] [Internet]. 2020. Available from: https://www.yok.gov.tr/Sayfalar/Haberler/2020/uzaktan-egitime-yonelik-degerlendirme.aspx?fbclid=IwAR2KzZwUqqjE6InsGV1Ocbtz8pWDimPhI6arTMYEbVss2YtjuMUOs7WBrNM
  • 16. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy. 1995(33);335–43. doi: 10.1016/0005-7967(94)00075-u
  • 17. Henry JD, Crawford JR. The short-form version of the Depression anxiety stress scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology. 2005(44);227–39. DOI: 10.1348/014466505X29657
  • 18. Yıldırım A, Boysan M, Kefeli MC. Psychometric properties of the Turkish version of the Depression Anxiety Stress Scale-21 (DASS-21). Br J Guid Couns. 2018;46(5):582–95. https://doi.org/10.1080/03069885.2018.1442558
  • 19. Akın A, Çetin B. The Depression Anxiety and Stress Scale (DASS): The study of Validity and Reliability. Educ Sci Theory Pract [Internet]. 2007;7:1–28. Available from: https://toad.halileksi.net/sites/default/files/pdf/depresyon-anksiyete-stres-olcegi-toad.pdf
  • 20. Alfonsson S, Wallin E, Maathz P. Factor structure and validity of the Depression, Anxiety and Stress Scale-21 in Swedish translation. J Psychiatr Ment Health Nurs. 2017;24(2–3):154–62. DOI: 10.1111/jpm.12363
  • 21. Dong X, Li J, Bai J, et al. Epidemiological Characteristics of Confirmed COVID-19 Cases in Tianjin. Zhonghua Liu Xing Bing Xue Za Zhi [Internet]. 2020;41(5):638–42. Available from: http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0254-6450&year=2020&vol=41&issue=5&fpage=638 DOI: 10.3760/cma.j.cn112338-20200221-00146
  • 22. Ozamiz-Etxebarria N, Dosil-Santamaria M, Picaza-Gorrochategui M, Idoiaga-Mondragon N. Stress, anxiety, and depression levels in the initial stage of the COVID-19 outbreak in a population sample in the northern Spain. Cad Saude Publica. 2020;36(4):1–9. http://dx.doi.org/10.1590/0102-311x00054020
  • 23. Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res [Internet]. 2020;287(March):112934. Available from: https://doi.org/10.1016/j.psychres.2020.112934
  • 24. Townsend MC. Fundamentals of Mental Health and Psychiatric Nursing [Ruh Sağlığı ve Psikiyatri Hemşireliğinin Temelleri] [Internet]. Tangül Özcan C, Gürhan N, editors: 1–932, Ankara: Nobel Kitabevi; 2016. Available from: https://www.nobelkitabevi.com.tr/hemsirelik-ebelik/9564-ruh-sagligi-ve-psikiyatri-hemsireliginin-temelleri-9786059942416.html
  • 25. Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729. doi: 10.3390/ijerph17051729
  • 26. Dursun S, Aytaç S. Unemployment Anxiety Among University Students [Üniversite Öğrencileri Arasında İşsizlik Kaygısı]. Uludag J Econ Soc [Internet]. 2009;28(1):71–84. Available from: http://www.acarindex.com/dosyalar/makale/acarindex-1423935894.pdf
  • 27. Elmer T, Mepham K, Stadtfeld C. Students under lockdown: Assessing change in students’ social networks and mental health during the COVID-19 crisis. PsyArXiv [Internet]. 2020; Available from: https://psyarxiv.com/ua6tq https://doi.org/10.1371/journal.pone.0236337
  • 28. Kernan WD. Health-related impediments to learning among dental and oral surgery students. J Prev Interv Community [Internet]. 2019;47(1):32–44. Available from: https://doi.org/10.1080/10852352.2018.1547307
  • 29. Dalton L, Rapa E, Stein A. Protecting the psychological health of children through effective communication about COVID-19. Lancet Child Adolesc Heal [Internet]. 2020;4(5):346–7. Available from: http://dx.doi.org/10.1016/S2352-4642(20)30097-3
  • 30. Sintema EJ. Effect of COVID-19 on the Performance of Grade 12 Students: Implications for STEM Education. Eurasia J Math Sci Technol Educ. 2020;16(7):1–6. DOI: 10.29333/ejmste/7893
  • 31. Psychiatric Association of Turkey [Türk Psikologlar Derneği]. Mental Health During the COVID-19 Outbreak [COVID-19 Salgını Sırasında Ruh Sağlığı] [Internet]. 2020. Available from: http://www.psikolog.org.tr/tr/blog/www/covid-19-salgini-sirasinda-ruh-sagligi-x656/
  • 32. Bao Y, Sun Y, Meng S, Shi J, Lu L. 2019-nCoV epidemic: address mental health care to empower society. Lancet [Internet]. 2020;395(10224):e37–8. Available from: http://dx.doi.org/10.1016/S0140-6736(20)30309-3
  • 33. Lazarus RS, Folkman S. Stress, Appraisal, And Coping. New York: Springer Publishing Company; 1984.
There are 33 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Bilgin Kıray Vural 0000-0002-2136-8192

Gülay Yiğitoğlu 0000-0002-8075-7155

Publication Date May 31, 2022
Submission Date January 31, 2021
Published in Issue Year 2022 Volume: 6 Issue: 2

Cite

APA Kıray Vural, B., & Yiğitoğlu, G. (2022). An Investigation of Stress, Anxiety And Depression States of University Students During The Covid-19 Pandemic. Journal of Basic and Clinical Health Sciences, 6(2), 495-505. https://doi.org/10.30621/jbachs.871615
AMA Kıray Vural B, Yiğitoğlu G. An Investigation of Stress, Anxiety And Depression States of University Students During The Covid-19 Pandemic. JBACHS. May 2022;6(2):495-505. doi:10.30621/jbachs.871615
Chicago Kıray Vural, Bilgin, and Gülay Yiğitoğlu. “An Investigation of Stress, Anxiety And Depression States of University Students During The Covid-19 Pandemic”. Journal of Basic and Clinical Health Sciences 6, no. 2 (May 2022): 495-505. https://doi.org/10.30621/jbachs.871615.
EndNote Kıray Vural B, Yiğitoğlu G (May 1, 2022) An Investigation of Stress, Anxiety And Depression States of University Students During The Covid-19 Pandemic. Journal of Basic and Clinical Health Sciences 6 2 495–505.
IEEE B. Kıray Vural and G. Yiğitoğlu, “An Investigation of Stress, Anxiety And Depression States of University Students During The Covid-19 Pandemic”, JBACHS, vol. 6, no. 2, pp. 495–505, 2022, doi: 10.30621/jbachs.871615.
ISNAD Kıray Vural, Bilgin - Yiğitoğlu, Gülay. “An Investigation of Stress, Anxiety And Depression States of University Students During The Covid-19 Pandemic”. Journal of Basic and Clinical Health Sciences 6/2 (May 2022), 495-505. https://doi.org/10.30621/jbachs.871615.
JAMA Kıray Vural B, Yiğitoğlu G. An Investigation of Stress, Anxiety And Depression States of University Students During The Covid-19 Pandemic. JBACHS. 2022;6:495–505.
MLA Kıray Vural, Bilgin and Gülay Yiğitoğlu. “An Investigation of Stress, Anxiety And Depression States of University Students During The Covid-19 Pandemic”. Journal of Basic and Clinical Health Sciences, vol. 6, no. 2, 2022, pp. 495-0, doi:10.30621/jbachs.871615.
Vancouver Kıray Vural B, Yiğitoğlu G. An Investigation of Stress, Anxiety And Depression States of University Students During The Covid-19 Pandemic. JBACHS. 2022;6(2):495-50.