Jiang Shuhan, Zhang Weifang, Yang Tingzhong, Wu Dan, Yu Lingwei, Cottrell Randall R
School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China.
Key Laboratory of Oral Biomedical Research of Zhejiang Province, The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Public Health. 2022 Apr 8;10:845978. doi: 10.3389/fpubh.2022.845978. eCollection 2022.
The Internet changed the lives of average citizens in the early part of the twenty-first century, and it has now become an essential part of daily life. Many studies reported that accessibility of Internet use is associated with mental health. However, previous studies examining this association were confined to local and community subpopulations and limited at the individual level, which increases the potential bias from the selection effect at a different level. Regional variables would be a stable estimate of people's socioeconomic and cultural environments and how these variables affect mental health needed to be studied. The objective of this study was to evaluate the association between regional Internet access, and mental stress among university students.
Participants were 11,954 students, who were identified through a multistage survey sampling process conducted in 50 Chinese universities. Regional Internet access was retrieved from a national database, and mental stress was measured using the Perceived Stress Scale (Chinese Version) (CPSS). Both unadjusted and adjusted methods were considered in the analyses.
More than one-third 36.9% (95% CI: 24.4-49.5%) of university students in this study suffered from severe mental stress (SMR). The multilevel logistic regression model found that university students studied in low-level universities had 2.52 (95% C.I. 1.17 to 6.37) times the prevalence of SMR than those in high-level universities. Compared with small cities, students in a large city had a lower prevalence of SMR (OR 0.25; 95%C.I. 0.06 to 0.77). Most importantly, regional Internet access was negatively associated with students' SMR (OR 0.25; 95%C.I. 0.08 to 0.76).
This study indicated that regional Internet access and other environmental factors including city size and type of universities contribute to students' mental health. The findings underscore that efforts to control excessive mental stress among students in China should pay greater attention to environmental determinants of stress and particularly to improve internet access.
互联网在21世纪初改变了普通公民的生活，如今已成为日常生活的重要组成部分。许多研究报告称，互联网使用的可及性与心理健康有关。然而，以往研究这种关联的研究局限于当地和社区亚人群，且在个体层面存在局限性，这增加了不同层面选择效应带来的潜在偏差。区域变量将是对人们社会经济和文化环境的稳定估计，有必要研究这些变量如何影响心理健康。本研究的目的是评估区域互联网接入与大学生心理压力之间的关联。
参与者为11954名学生，通过在中国50所大学进行的多阶段调查抽样过程确定。区域互联网接入数据来自国家数据库，心理压力采用感知压力量表（中文版）（CPSS）进行测量。分析中考虑了未调整和调整两种方法。
本研究中超过三分之一（36.9%，95%CI：24.4 - 49.5%）的大学生患有严重心理压力（SMR）。多水平逻辑回归模型发现，在低水平大学就读的大学生患SMR的患病率是高水平大学学生的2.52倍（95%CI 1.17至6.37）。与小城市相比，大城市的学生患SMR的患病率较低（OR 0.25；95%CI 0.06至0.77）。最重要的是，区域互联网接入与学生的SMR呈负相关（OR 0.25；95%CI 0.08至0.76）。
本研究表明，区域互联网接入以及包括城市规模和大学类型在内的其他环境因素对学生心理健康有影响。研究结果强调，中国控制学生过度心理压力的努力应更加关注压力的环境决定因素，特别是要改善互联网接入情况。
