Encore The Impact of Quarantine on Pharmacy Students' Stress Level and Mental Health: A Regional Analysis

Educators and student pharmacists adapted to online curriculum during the SARS-CoV-2 pandemic. The stress from COVID-19, quarantine, and virtual learning may impact student mental health. The magnitude of this stress may differ across the US due to some regions being affected more heavily by COVID-19 than others. We hypothesized there would be regional variation in pharmacy student stress before and during quarantine. During fall of 2020, US student pharmacists were invited to partake in an anonymous 40-question survey. The validated Perceived Stress Scale (PSS-10; Cohen, 1988) was incorporated to assess stress levels prior to and during quarantine. Additional demographic, quantitative, and qualitative free responses were captured, including CDC region. Blinded researchers (HB, QN) coded free response answers into common themes of stress while lead researcher (CH) adjudicated discrepancies. Descriptive and inferential statistics were analyzed using SPSS (Version 25.0, Armonk, NY). Analyses between PSS-10 and region prior to and during quarantine were made using Cochrane's Q test and Wilcoxon Signed-Rank and Friedman post hoc tests. 488 self-reported responses were received from 7 of 10 regions. Of these, 407 were eligible for analysis. All regions except region 9 showed an increase in PSS-10 scores during quarantine compared to before quarantine (6.2 ± 12.5; p ≤ 0.001). Region 8 had the greatest magnitude (38.5%). 67% of subjects reported an increase in stress while 22% reported a decrease in stress, and 11% had no change in stress. 70 free responses were coded into five themes: mental compartmentalization (37%), learning environment (27%), technology academic isolation (14%), accessibility (13%), and personal isolation (9%). These results support our hypothesis that there is regional variation in student pharmacist stress before and during quarantine. Overall, these data suggest potential stressors of students that educators should consider in mental health outcomes.