Journal of Loss and Trauma International Perspectives on Stress & Coping ISSN: 1532-5024 (Print) 1532-5032 (Online) Journal homepage: https://www.tandfonline.com/loi/upil20 Knowledge, Attitudes, Anxiety, and Coping Strategies of Students during COVID-19 Pandemic Erick T. Baloran To cite this article: Erick T. Baloran (2020): Knowledge, Attitudes, Anxiety, and Coping Strategies of Students during COVID-19 Pandemic, Journal of Loss and Trauma, DOI: 10.1080/15325024.2020.1769300 To link to this article: https://doi.org/10.1080/15325024.2020.1769300 Published online: 22 May 2020. Submit your article to this journal Article views: 5365 View related articles View Crossmark data Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=upil20 JOURNAL OF LOSS AND TRAUMA https://doi.org/10.1080/15325024.2020.1769300 Knowledge, Attitudes, Anxiety, and Coping Strategies of Students during COVID-19 Pandemic Erick T. Baloran College of Teacher Education, University of Mindanao – Bansalan College, Bansalan, Philippines ABSTRACT ARTICLE HISTORY COVID-19 is a global concern affecting Higher Education Institutions (HEIs). This pandemic led to a strong reaction among students who experiences anxiety. This cross-sectional study aimed to examine students’ knowledge, attitudes, anxiety, and coping strategies during the COVID-19 pandemic. Results showed that students possessed sufficient knowledge and high-risk perceptions. Non-medical prevention measures were perceived as highly effective. Students were satisfied with the government’s actions to mitigate problems. However, an unwillingness with the online-blended learning approach was observed. Students utilized various ways to cope up with mental health challenges. It is necessary to address students’ mental health during this COVID-19 pandemic among HEIs. Received 11 May 2020 Accepted 12 May 2020 KEYWORDS Knowledge; attitude; satisfaction; support; anxiety; coping strategies; COVID-19 pandemic Introduction In January 2020, the WHO declared the outbreak of novel coronavirus infection, COVID-19, as a public health emergency of worldwide concern (World Health Organization, 2020a). The first recorded death outside Wuhan, China, was in the Philippines on February 20, 2020, and WHO declared COVID-19 in March 2020 as a pandemic (World Health Organization, 2020b). In the Philippines, WHO has been working with the Department of Health (DOH) and other national stakeholders and partners to increase the country’s capability to address the COVID-19 pandemic (World Health Organization, 2020c). Besides, the DOH participated in the WHO Solidarity trial to assist in COVID-19 global response (World Health Organization, 2020d). Moreover, Enhanced Community Quarantine (ECQ) was implemented by the government to help the country’s efforts to curb the adverse impacts of the COVID-19 pandemic (David et al., 2020). In the context of social impact, the COVID-19 crisis in the country appears that the effect is on the lower-income classes (National Economic and Development Authority, 2020). CONTACT Erick T. Baloran erickbaloran.research@gmail.com Mindanao – Bansalan College, Bansalan, Philippines. ß 2020 Taylor & Francis Group, LLC College of Teacher Education, University of 2 E. T. BALORAN Since the start of the COVID-19 pandemic, the psychological and emotional impact is also evident. Its emergence and spread create a lot of concern for people leading to increased levels of anxiety (Roy et al., 2020). COVID-19 crisis has also made an impact on the context of Philippine Education. Classes were postponed due to lockdown. The majority of colleges and universities also faced current challenges with virtual learning (Talidong & Toquero, 2020). In particular, Higher Education Institutions (HEIs) are prompted to establish management approaches regarding pandemics to encourage positive health behavior among students (Akan et al., 2010). Considering the relevance of all the above conditions, this study aimed to assess knowledge, attitudes, anxiety, and personal coping strategies of college students during the COVID-19 pandemic in Southern Philippines. Methods This was a cross-sectional study conducted among two local private colleges in the province of Davao del Sur, Southern Philippines, from April 25 – May 8, 2020. The researcher conducted this study during the increasing rate of COVID-19 pandemic cases in the Philippines, where Davao del Sur was under Enhanced Community Quarantine. Student respondents were determined using the snowball technique who answered the online survey developed through Google forms with an appended consent form. The survey link was sent to the student respondents via social media. The set of questions was adapted from the study of Akan et al. (2010), Khalid et al. (2016), and Roy et al. (2020) and was modified to suit in the context of the study. The study involved only those students who had access to the internet. There were a total of 530 students, including college and senior high school, who responded in the online survey. Results and discussion Among the 530 students who answered the questionnaire, 312 (58.87%) were female, 200 (37.73%) were male, and 18 (3.40%) were members of the LGBTQ þ community. The majority of the students belong to the age group of 20 to 25-years-old (282 or 53.21%) and were single (502 or 94.72%), with below ten thousand Philippine peso monthly family income (350 or 66.04%). Moreover, the majority of the students’ courses were in the field of law enforcement (121 or 22.83%). In view of students’ knowledge about COVID-19, a full 73.58% (390/ 530) of the students knew that the COVID-19 could spread through touching, sneezing, kissing, and food. They were aware that the primary symptom of the COVID-19 infection is fever (517/530 or 97.55%). Also, 91.70% JOURNAL OF LOSS AND TRAUMA 3 (486/530) of the students understood the importance of staying at home as a precautionary measure to stop the spread of the virus in the community. Previous studies provided evidence that COVID-19 is mainly transmitted through social contact with symptomatic persons (Burke et al., 2020; Chan et al., 2020; Huang et al., 2020; Li et al., 2020; Liu et al., 2020; Ong et al., 2020); with mild to severe symptoms (World Health Organization, 2020f), and through asymptomatic transmission (World Health Organization, 2020e). Besides, older persons (Kluge, 2020) and children (Dong et al., 2020; Lu et al., 2020) are at a considerably increased risk of serious illness after infection from COVID-19. In terms of the perceptions of students on the risks of COVID-19 and the effectiveness of precautionary measures, 332/530 (62.64%) perceived a high-risk level of becoming infected. Also, students have seen the following as highly effective: social distancing and wearing a face mask (60%), hand washing and sanitizing (66.42%), and staying at home (84.72%). 74.15% (393/530) agreed on mass testing, and 90.19% (478/530) agreed with the implementation of Enhanced Community Quarantine (ECQ). Likewise, David et al. (2020) of the University of the Philippines emphasized that the implementation of the ECQ is effective in dropping the rate of transmission of the virus, which includes guidelines such as general physical distancing, mass testing and contact tracing, and strict home quarantine. Given students’ attitudes toward COVID-19 vaccination, the vast majority of student respondents (431/530 or 81.32%) stated that they were willing to be vaccinated against COVID-19, while only 18.68% (99/530) said they wouldn’t be. Among those students who were unwilling to be vaccinated, 45.45% (45/99) said that it is not safe since it could have health risks or side effects. This is comparable to the findings of the study of Akan et al. (2010), which revealed that the main concerns of college students are related to the vaccination’s safety during the pandemic influenza A/H1N1. Moreover, 55.85% (296/530) had very high satisfaction with the services rendered by the local frontline workers, 41.51% (220/530) had very high satisfaction and confidence with the information dissemination done by the government, and 40.94% (217/530) were highly satisfied with the government’s mitigations and actions to stop the spread of the virus. This is in parallel with the results of the study conducted by Hanrahan (2020), which exposed that seven in 10 Australians were generally satisfied with governments’ actions in handling the COVID-19 pandemic. Concerning the attitudes of students toward schooling during the COVID-19 pandemic, Table 1 showed that 80.38% (426/530) agreed with the stoppage of schools, and 65.85% (349) approved with the extension of the opening of classes for the next semester due to COVID-19 pandemic situation. However, 59.25% (314/530) disagreed with the conduct of the 4 E. T. BALORAN Table 1. Students’ attitudes toward schooling during COVID-19 pandemic (n ¼ 530). Yes, n (%) Do you agree with the stoppage of schools during the 426 (80.38) COVID-19 pandemic? Do you agree with the extension of the opening of 349 (65.85) classes for the next semester? Do you agree with the conduct of the Online-Blended 169 (31.89) Learning Approach during the community quarantine? The reasons for saying “YES” to Online-Blended Learning a. I want to finish my academic requirements b. I don’t want to quit school c. I am bored at home, and I miss doing academic tasks d. Online classes and modules are more convenient and practical than going to school e. It is about time to use online-blended education in college especially during a crisis like this f. It would be safe to study at home than to go to school Total The reasons for saying “NO” to Online-Blended Learning a. I don’t have an internet connection b. I don’t have personal computers and smartphones c. I find online class and modules challenging to do d. I would still prefer learning inside the classrooms e. I find online classes and modules boring f. I cannot learn through online class and modules g. I don’t have a personal interaction with my teacher and classmates h. I don’t have budget or finances for an online class and online submissions of requirements/tasks Total No, n (%) 37 (6.98) I don’t know, n (%) 67 (12.64) 93 (17.55) 88 (16.60) 314 (59.25) 47 (8.87) n 136 92 48 71 (%) (80.47) (54.44) (28.40) (42.01) 90 (53.25) 137 (81.07) 169 (100) 227 124 130 194 41 112 84 179 (72.29) (39.49) (41.40) (61.78) (13.06) (35.67) (26.75) (57.01) 314 (100) Online-Blended Learning Approach. The primary reason for these students was poor internet connection (227/314 or 72.29%). Besides, the study conducted by Ja’ashan (2015) revealed that the majority of students who undergone online-blended learning expressed negative impressions due to slow internet connectivity. Additionally, the majority of the students displayed anxiety during the entire period of lockdown. 62.64% (332/530) were worried about food and financial resources, and about 54% to 56% of the students avoid social contact, large meetings, and gatherings (Table 2). This confirmed the research of Roy et al. (2020), which reported individuals were worried for themselves and their families during the on-going pandemic. People could have limited social contact and avoided mass meetings. Besides, Lee (2020) affirmed that the COVID-19 pandemic affects students’ mental health. For the ways to cope up with the anxiety during the COVID-19 pandemic, students responded common personal coping strategies, as shown in Table 3. 90.19% (478) followed strict personal protective measures and about 80% avoid going out in public places to reduce exposure from COVID-19. This is line with the study of various authors (Faye et al., 2015; Khalid et al., 2016) which revealed that during virus outbreak, it is crucial for individuals to follow very stringent infection control practices with standard precautions and minimized public exposure. JOURNAL OF LOSS AND TRAUMA 5 Table 2. Students’ anxiety related to COVID-19 pandemic (n ¼ 530). For the last week 1. I often think about COVID-19 pandemic 2. I often feel paranoid about contacting the novel Corona Virus infection 3. I often avoid partying 4. I usually avoid social contact 5. I typically avoid large meetings and gatherings 6. I usually avoid doing physical exercise outside the home 7. I often avoid ordering food online 8. I usually avoid buying food in public markets and foodservice establishments 9. I usually have talked with friends about the corona pandemic 10. I often had difficulty sleeping by being worried about the Corona Virus pandemic 11. I often feel affected by the posts on social media about Corona Virus infection 12. I often feel affected by the talks of novel Corona Virus pandemic on the newspaper and news channels 13. I often feel the need to buy and stock all essentials at home 14. I often get afraid if anyone in my social circle or friends reports of being sick 15. I often feel the need to use the sanitizer/gloves 16. I often feel the need to wash my hands constantly 17. I often feel worried about myself and my family regarding the spread of COVID19 Viral Infection 18. I usually use a mask without any apparent signs and symptoms of the infection 19. The Idea of Novel Corona Viral Infection often makes me nervous leading to inappropriate behaviors with anyone 20. The Idea of Novel Corona Viral Infection often makes me nervous that leads me to post on social media 21. I often consider anybody I encounter as positive of the virus 22. I am usually worried about my studies because of the lockdown 23. I am often concerned about our food and financial resources during the lockdown n (%) 269 (50.75) 143 (26.98) 234 (44.15) 297 (56.04) 287 (54.15) 189 (35.66) 118 (22.26) 178 (33.58) 154 (29.06) 98 (18.49) 176 (33.21) 123 (23.21) 169 185 198 243 274 (31.89) (34.91) (37.36) (45.85) (51.70) 199 (37.55) 101 (19.06) 67 (12.64) 99 (18.68) 256 (48.30) 332 (62.64) Table 3. Students’ personal coping strategies during COVID-19 pandemic (n ¼ 530). During the community quarantine 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Follow strict personal protective measures (e.g., mask, handwashing, etc.) Read about COVID-19, its prevention and mechanism of transmission Avoid going out in public places to minimize exposure from COVID-19 Do relaxation activities, for example, involved in meditation, sports, exercise, music, etc. Praying, worshiping and Bible study Chat with family and friends to relieve stress and obtain support Use social media and social networks such as Facebook, Twitter, Tiktok, Youtube, etc. Play online games and computer games Talk and motivate myself to face the COVID-19 outbreak with a positive attitude Get help from family physicians or other doctors to reduce my stress and get reassurance Try to be busy at home in activities that would keep my mind away from COVID-19 Avoid media news about COVID-19 and related fatalities Vent emotions by crying, screaming, etc. n (%) 478 365 426 119 207 259 312 153 154 63 247 80 47 (90.19) (68.87) (80.38) (22.45) (39.06) (48.87) (58.87) (28.87) (29.06) (11.89) (46.60) (15.09) (8.87) Conclusion and recommendations The COVID-19 pandemic posed significant concerns among students, especially among communities in the Southern Philippines. Based on the findings of this study, the students were aware of the COVID-19 pandemic and possessed sufficient knowledge about this global concern even though there were still gaps in various points. Students understood how the virus is spread, its symptoms, and the precautionary measures needed to be done by both individuals and the general community. They also professed the 6 E. T. BALORAN need to conduct mass testing and maintain enhanced community quarantine in every local community. Considering WHO’s recommendation, students abide by the idea toward the COVID-19 vaccine, although a considerable percentage of some students showed distrust. In the context of education, students were reluctant toward the implementation of onlineblended learning approach due to technological and financial constraints. During this COVID-19 pandemic, students were responsive and satisfied with the government’s initiatives to limit the spread of infection. Though there was increased anxiety felt by students regarding getting the COVID-19 infection, there is still enough evidence that students among two local colleges in Southern Philippines practice measures to deal with anxiety during this threat of global health security. In the future, HEIs should strengthen its plans on management strategies concerning outbreaks and pandemics, which may affect local communities. HEIs should also develop an innovative and helpful approach to promote and address the mental health issues of students during a pandemic. More importantly, though the Philippines is still at the stage of embracing the paradigm shift in pedagogical delivery, schools should start training students and teachers on the application of online-blended learning approach and improve Information and Communication Technology (ICT) resources and capacities of both teachers and students. The government subsidy and educational support in the future should include capacitating Filipino learners in using online tools considering health challenges like this or other community emergencies during any future. Notes on contributor Erick T. Baloran is the Research Coordinator and a faculty of the College of Teacher Education of the University of Mindanao – Bansalan College. He finished his Master’s Degree in Education major in Language Teaching at Davao del Sur State College, Digos City, Philippines, and is presently pursuing his Ph.D. Degree in Education major in Applied Linguistics at the University of the Immaculate Conception, Davao City, Philippines. His research interests include Social Science researches such as case studies on crime, Educational Management, English Language Teaching, Linguistics, and currently on the impact of COVID-19 to students, teachers, and community. References Akan, H., Gurol, Y., Izbirak, G., Ozdatli, S., Yilmaz, G., Vitrinel, A., & Hayran, O. (2010). Knowledge and attitudes of university students toward pandemic influenza: A cross-sectional study from Turkey. BMC Public Health, 10(1), 1–8. https://doi.org/10.1186/14712458-10-413 Burke, R. M., Midgley, C. M., Dratch, A., Fenstersheib, M., Haupt, T., & Holshue, M. (2020). Active monitoring of persons exposed to patients with confirmed COVID-19 — JOURNAL OF LOSS AND TRAUMA 7 United States, January–February 2020. Morbidity and Mortality Weekly Report, 69(9), 245–246. https://doi.org/10.15585/mmwr.mm6909e1externalicon. Chan, J., Yuan, S., Kok, K., To, K. K.-W., Chu, H., Yang, J., Xing, F., Liu, J., Yip, C. C.-Y., Poon, R. W.-S., Tsoi, H.-W., Lo, S. K.-F., Chan, K.-H., Poon, V. K.-M., Chan, W.-M., Ip, J. D., Cai, J. P., Cheng, V. C. C., Chen, P. H., … Hui, C. K.-M. (2020). A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: A study of a family cluster. The Lancet, 395(10223), 514–523. https://doi. org/10.1016/S01406736(20)30154-9 David, G., Rye, R. S., Agbulos, M. A. (2020, April 22). COVID-19 forecasts in the Philippines: Insights for policy making (Updated as of April 22, 2020). UP Media and Public Relations Office. https://www.up.edu.ph/covid-19-forecasts-in-the-philippinesinsights-for-policy-making-updated-as-of-april-22-2020/ Dong, Y., Mo, X., & Hu, Y. (2020). Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. Advance online publication. https://doi.org/10.1542/peds.2020-0702 Faye, O., Boelle, P. Y., Heleze, E., Faye, O., Loucoubar, C., Magassouba, N., Soropogui, B., Keita, S., Gakou, T., Bah el, H. I., Koivogui, L., Sall, A. A., & Cauchemez, S. (2015). Chains of transmission and control of Ebola virus disease in Conakry, Guinea, in 2014: An observational study. The Lancet, 15(3), 320–326. https://doi.org/10.1016/S14733099(14)71075-8 Hanrahan, C. (2020, April 16). Coronavirus response wins support — but we’re less happy with other Aussies’ behaviour. ABC News. https://www.abc.net.au/news/2020-04-16/coronavirus-numbers-government-support-survey-data/12147292 Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., … Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan. The Lancet, 395(10223), 497–506. https://doi.org/10.1016/S0140-6736(20)30183-5 Ja’ashan, M. (2015). Perceptions and attitudes towards blended learning for English courses: A case study of students at University of Bisha Mohammed. English Language Teaching, 8(9), 40–50. Khalid, I., Khalid, T., Qabajah, M., Barnard, A., & Qushmaq, I. (2016). Healthcare workers emotions, perceived stressors and coping strategies during a MERS-CoV outbreak. Clinical Medicine & Research, 14(1), 7–14. https://doi.org/10.3121/cmr.2016.1303 Kluge, H. H. (2020, April 2). Statement – Older people are at highest risk from COVID-19, but all must act to prevent community spread. World Health Organization. http://www. euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/statements/statem ent-older-people-are-at-highest-risk-from-covid-19,-but-all-must-act-to-prevent-communi ty-spread. Lee, J. (2020). Mental health effects of school closures during COVID-19. The Lancet. Advance online publication. https://doi.org/10.1016/S2352-4642(20)30109-7 Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., Ren, R., Leung, K. S. M., Lau, E. H. Y., Wong, J. Y., Xing, X., Xiang, N., Wu, Y., Li, C., Chen, Q., Li, D., Liu, T., Zhao, J., Liu, M., … Feng, Z. (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. New England Journal of Medicine, 382(13), 1199–1207. https://doi.org/10.1056/NEJMoa2001316 Liu, J., Liao, X., Qian, S., Yuan, J., Wang, F., Liu, Y., Wang, Z., Wang, F.-S., Liu, L., Zhang, Z. (2020). Community transmission of severe acute respiratory syndrome coronavirus 2, Shenzhen, China. Emerging Infectious Diseases. Advance online publication. Doi: doi.org/ https://doi.org/10.3201/eid2606.200239. 8 E. T. BALORAN Lu, X., Zhang, L., Du, H., Zhang, J., Li, Y. Y., Qu, J., Zhang, W., Wang, Y., Bao, S., Li, Y., Wu, C., Liu, H., Liu, D., Shao, J., Peng, X., Yang, Y., Liu, Z., Xiang, Y., Zhang, F., … Wong, G. W. K. (2020). Chinese Pediatric Novel Coronavirus Study Team. SARS-CoV-2 infection in children. The New England Journal of Medicine, 382(17), 1663–1665. https://doi.org/10.1056/NEJMc2005073 National Economic and Development Authority. (2020, March 19). Addressing the social and economic impact of the COVID-19 pandemic. NEDA. http://www.neda.gov.ph/wpcontent/uploads/2020/03/NEDA_Addressing-the-Social-and-Economic-Impact-of-the-CO VID-19-Pandemic.pdf Ong, S. W. X., Tan, Y. K., Chia, P. Y., Lee, T. H., Ng, O. T., Wong, M. S. Y., & Marimuthu, K. (2020). Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA, 323(16), 1610. https://doi.org/10.1001/jama.2020.3227 Roy, D., Tripathy, S., Kar, S., Sharma, N., Verma, S., & Kaushal, V. (2020). Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 Pandemic. Asian Journal of Psychiatry, 51, 102083–102087. https://doi.org/ 10.1016/j.ajp.2020.102083 Talidong, K. J. B., & Toquero, C. M. D. (2020). Philippine teachers’ practices to deal with anxiety amid COVID-19. Journal of Loss and Trauma. Advance online publication. https://doi.org/10.1080/15325024.2020.1759225 World Health Organization. (2020a, March 18). Mental health and psychosocial considerations during the COVID-19 outbreak. WHO. https://www.who.int/docs/default-source/ coronaviruse/mental-health-considerations.pdf World Health Organization. (2020b, May 13). Rolling updates on coronavirus disease (COVID-19). WHO. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/ events-as-they-happen World Health Organization. (2020c, March 18). WHO supports the Philippine government in COVID-19 response. WHO. https://www.who.int/docs/default-source/coronaviruse/ mental-health-considerations.pdf World Health Organization. (2020d, April 22). PH Solidarity trial for COVID-19 treatments receives green light from ethics review body. WHO. https://www.who.int/philippines/news/ detail/22-04-2020-ph-solidarity-trial-for-covid-19-treatments-receives-green-light-from-et hics-review-body World Health Organization. (2020e, April 2). Coronavirus disease 2019 (COVID-19) Situation Report – 73. WHO. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf?sfvrsn=5ae25bc7_2 World Health Organization. (2020f). Coronavirus. WHO. https://www.who.int/healthtopics/coronavirus#tab=tab_3