Introduction
Destructive feelings are a wide range of painful and ugly experiences that people understand, with the commonest adverse feelings being melancholy, nervousness, and stress.1 Medical school college students are often nonetheless maturing bodily and psychologically, and they’re extra more likely to expertise adverse feelings similar to nervousness, melancholy, and psychological misery as a result of extremely specialised and academically difficult medical occupation and present intense employment competitiveness.2,3 The coronavirus illness 2019 (COVID-19) epidemic has unfold to virtually all nations and areas of the world. Nations world wide urged the general public to take responsive care, together with hand washing, sporting masks, sustaining bodily distance, and avoiding massive gatherings and assemblies.4 Lowering the blending of prone and infectious people by early ascertainment of instances or discount of contact is likely one of the most necessary methods.5 Nonetheless, through the COVID-19 pandemic, these stringent measures (eg, lockdowns) not solely induced financial penalties,6 but in addition affected particular person existence and psychological well being.7 Through the COVID-19 pandemic, people utilized social media way more continuously to stay updated with current health-related info.8,9 The vast majority of Chinese language faculties applied insurance policies requiring college students to reduce pointless mobility, which has prompted school college students to show to make use of social media to maintain related and knowledgeable.10 In the meantime, some faculties have applied on-line modes of schooling to maintain schooling.11 Drastic adjustments within the existence and studying kinds of scholars throughout main public well being emergencies could enhance the incidence of adverse feelings similar to nervousness and depression12,13 and negatively have an effect on bodily and psychological well being, well-being, and tutorial efficiency.7 Moreover, the extended presence of adverse feelings can simply set off particular person bodily and psychological disorders14,15 and result in emotional outbursts that may have adverse penalties (eg, suicidal conduct).16 The research of adverse feelings in medical school college students can be utilized to supply assist and help to this inhabitants, and contribute to enhancing the medical schooling and coaching system to create a studying setting that’s extra conducive to the bodily and psychological well being of medical school college students. Due to this fact, it’s essential to research the mechanisms underlying adverse feelings in medical school college students through the COVID-19 pandemic.
Social Media Use and Destructive Feelings
Whereas quite a few components can contribute to adverse feelings,17 there may be growing curiosity within the potential results of social media use on psychological well being. Social media, which may be outlined as “Web-based functions that let the creation and trade of user-generated content material”,18 have turn out to be an integral a part of connecting with family and friends, sharing private content material, and getting access to information and leisure.19,20 In accordance with research, the frequency with which people use social media can have a adverse influence on their shallowness and well-being.21,22 People are motivated to take care of a optimistic self-presentation on social media; nonetheless, steady publicity to optimistic content material posted by others could end result within the distortion of notion, lack of management, and frustration in social comparisons.22–24 Moreover, for these with excessive narcissistic character scores and low shallowness,25 this may end up in adverse feelings similar to envy and melancholy. As well as, in response to the COVID-19 pandemic, China applied strict insurance policies proscribing public gatherings and occasions. Because of this illness management method (eg, spatial distance, social distance), people relied closely on media, and social media specifically (eg, Weibo and WeChat), to maintain up with the newest information and keep in contact.8–10 In comparison with conventional media, social media has performed many optimistic roles in info trade through the COVID-19 pandemic, together with spreading health-related recommendation, enhancing interpersonal connectivity, offering psychological first help,26 and showcasing public attitudes, notion of the illness, and sentiments towards governments and regulatory our bodies;27 nonetheless, in addition they contributed to the speedy unfold of misinformation and rumors, inflicting confusion and panic amongst audiences.28 Utilizing social media, younger adults usually tend to work together with disaster-related experiences.29,30 In accordance with the Differential Susceptibility to Media Results Mannequin (DSMM),31 media use influences the cognitive, emotional, physiological, and behavioral outcomes of the viewers, which in flip influences the viewers’s character, growth, and social variables, forming a recursive loop. Catastrophe protection in media could induce adversarial bodily and psychological reactions in audiences.32 The indispensability and complexity of social media could exacerbate the adversarial mentaleffects of publicity to disasters.
Prior analysis has targeted on the direct relationship between social media use and adverse feelings amongst school college students or college students pursuing a single healthcare specialization.33,34 Nonetheless, few research have targeted on a diversified group of medical-related college students within the medical schooling setting at medical faculties. Because of illness management measures and the necessity to talk and entry well being info, the frequency and patterns of social media use amongst healthcare college students have modified considerably through the COVID-19 pandemic;35,36 due to this fact, additional analysis is critical to find out the connection between social media use and adverse feelings amongst medical school college students.
Concern of Lacking Out as a Potential Mediator
Along with offering info, social media additionally facilitate communication and social-emotional assist. In accordance with the idea of makes use of and gratifications,37 people actively devour, have interaction with, and take part in media to satisfy their wants and wishes. The analysis of social media utilization and gratifications has delivered to mild a broad vary of beforehand unidentified gratification, together with socializing, digital group, interpersonal utility, reciprocity, expressive info sharing, skilled development, profession alternatives, and psychological assist.38 In accordance with the compensatory motivation perspective of self-determination concept,39 people with insufficient social connectivity or social-emotional assist, in actuality, could flip to make use of social media to compensate for these wants. Though social media could initially alleviate social-emotional deficits, concomitantly to “actual world” points that stay unaddressed, theoretically it could additionally result in extra concern of lacking out (FoMO)-related ideas,40 as different folks is likely to be perceived to be having fun with a extra rewarding expertise than oneself.40,41 A scientific overview of short-term abstinence results throughout potential behavioral addictions has discovered that Web use can enhance FoMO ranges.42
Though it isn’t but clear whether or not FoMO causes adverse feelings,43 a research utilizing repeated measures designs has discovered some preliminary assist that FOMO drives adverse feelings over brief (1-week) intervals of time.44 Moreover, analysis signifies that greater than half of pharmacy college students reported utilizing their smartphones extra continuously due to considerations about lacking messages and/or alarms and that this problematic smartphone use was related to insomnia and nervousness.45 Though researchers have additionally demonstrated a optimistic correlation between social media use and FoMO and psychological well being issues amongst Chinese language nursing college students through the COVID-19 pandemic,36 it’s nonetheless unclear whether or not the outcomes may be generalized to the medical school pupil inhabitants following the pandemic as the first setting for these research was earlier than the COVID-19 pandemic. Due to this fact, this research hypothesizes that FoMO could mediate the connection between social media use and adverse feelings through the COVID-19 pandemic.
Resilience as a Potential Moderator
Resilience is a person attribute that’s each variable and steady, which displays a person’s capacity to adapt positively to adversity and get well rapidly.46,47 Normal resilience processes act as a buffer between stressors and adverse feelings.48 In comparison with others experiencing the identical degree of stress or adversity, resilience is manifested in superior problem-solving, the place the required problem-solving expertise embody narrative creativity, emotion regulation, and interpersonal collaboration.49 Enhancing hope resilience by the narrative Technique of Ordering Reminiscence is efficient in lowering melancholy and nervousness, and burnout in contributors.50 Prior analysis has additionally demonstrated that people with excessive ranges of resilience are more practical than these with low ranges of resilience at regulating and lowering the incidence of their adverse feelings.48 Excessive ranges of resilience are adversely related to adverse feelings,51 however low ranges of resilience could also be a main pathway to adverse feelings.52 Furthermore, empirical analysis has demonstrated a adverse correlation between resilience and adverse feelings.53 A research amongst school college students in China through the COVID-19 pandemic has discovered that resilience and social assist co-moderated the connection between FoMO and melancholy, nervousness, and stress.47 In different phrases, resilience can mitigate the adverse impact of threat components (eg, FoMO) on adverse feelings.
In accordance with the emotion regulation methods,54,55 people with inadequate self-regulation and resilience could not be capable to mitigate interpersonally primarily based fears and worries, which can conducive to FoMO and adverse feelings. Earlier analysis has demonstrated that resilience is important for assuaging psychological issues in people.56 Through the COVID-19 pandemic, school college students who require entry to outbreak-related info, communication, and social-emotional assist could select to have interaction with others on-line by way of social media.57 Throughout this time, school college students who’ve larger resilience may be capable to cope successfully with stressors and adversity, whereas these with much less resilience could turn out to be absorbed within the digital world of the Web, resulting in a propensity to expertise adverse feelings.58 These findings counsel that resilience could play a distinct position within the connection between FoMO and adverse feelings.
The Current Examine
Primarily based on a overview of the literature, we aimed to check a mannequin that examines the connection between social media use and adverse feelings amongst medical school college students, in addition to its inner mechanisms (ie, FoMO and resilience), through the COVID-19 pandemic, which can contribute to develop intervention and prevention methods for adverse feelings amongst medical school college students. As an built-in mannequin, this research was designed to check the next hypotheses (Determine 1). H1: Social media use is positively related to adverse feelings amongst medical school college students through the COVID-19 pandemic. H2: FoMO partially mediates the connection between social media use and adverse feelings amongst medical school college students. H3: Resilience moderates the impact of FoMO on adverse feelings amongst medical school college students.
Determine 1 Conceptual mannequin. Abbreviation: FoMO, concern of lacking out.
Supplies and Strategies
Members and Procedures
On this research, we decided the estimated pattern measurement to be 383 via the next components: , utilizing an influence of 80%, a confidence degree of 95%, and a margin of error of 5%.59,60 Accounting for potential invalid knowledge (ie, as much as 15% invalid), the minimal variety of contributors had been decided to be 450. We administered a sequence of self-reported questionnaires to 470 college students of medical school recruited from Qiqihar Medical College, China, between June 2, 2022, and June 15, 2022. A complete of 453 college students accomplished the questionnaires, 46 invalid responses had been excluded, and 407 (86.60%) had been successfully recovered. The pattern consisted of 131 male and 276 feminine college students aged 18–26 years (imply: 21.562 ± 2.167 years), together with 383 undergraduate and 24 postgraduate college students. There have been 104 nursing college students, 107 medical medication college students, 62 medical know-how college students, 97 pharmacy college students, and 37 college students from different medical-related disciplines. No contributors had been suspected, confirmed, or cured of SARS-CoV-2 infections.
The Human Analysis Ethics Committee of China Medical College accepted this research (ref no: 2019079). Earlier than the investigation, all contributors had been knowledgeable that the research can be carried out anonymously and that their info can be saved confidential. All contributors entered the research voluntarily with any incentive and will withdraw at any time.
Measures
Social Media Use
Ellison created the Fb Use Depth Scale to measure the depth of people’ social media use.61 The size has good reliability and validity.62 It has been utilized in a big physique of literature on social media in China and has proven its reliability and validity amongst younger residents. In view of the completely different precise use of mainstream social media networks within the Chinese language media setting, some related broadly used social media networks, similar to “Weibo”and “Qzone”, had been used as an alternative of “Fb” within the research among the many Chinese language inhabitants. The unique questionnaire was modified from “Fb” to “Weibo” with a Cronbach’s α of 0.9.63 Equally, Cronbach’s α for the “Qzone” utilization depth questionnaire was 0.87.64 Within the questionnaire for this research, “Fb” was changed with “social media” primarily based on the processing of earlier researchers.65 The revised scale contained eight objects (eg, “What number of days per 30 days do you employ social media on common?”) to measure the depth of social media use. All objects had been scored on a 5-point Likert scale (1 = utterly disagree, 5 = utterly agree), with increased scores indicating the next depth of social media use. The one-factor CFA mannequin additionally generated an excellent match for the Social Media Use Depth Scale: χ2/df = 2.163, p < 0.01, RMSEA = 0.054, SRMR = 0.028, GFI = 0.978, AGFI = 0.953, NFI = 0.978, RFI = 0.964, IFI = 0.988, TLI = 0.980, CFI = 0.988. Due to this fact, this scale had good assemble validity. Cronbach’s α was 0.880 on this research. FoMO FoMO was assessed by the FoMO Scale developed by Przybylski et al.41 Members from China utilized the size and demonstrated good reliability and validity.66 It consists of ten objects (eg, “It bothers me after I miss a possibility to fulfill up with associates”.) which can be rated on a 5-point Likert scale (1 = under no circumstances true, 5 = extraordinarily true), with increased scores indicating increased ranges of FoMO. Within the current research, Cronbach’s α was 0.912. Resilience Resilience was measured utilizing the Chinese language model of the Connor–Davidson Resilience Scale (CD-RISC) by Connor and Davidson.67,68 The size accommodates 25 objects (eg, “capable of adapt to vary”) that consider the three dimensions of resilience (tenacity, power, and optimism). All contributors had been instructed to reply on a 5-point Likert scale (1 = not true in any respect, 5 = true almost on a regular basis). Increased scores point out increased ranges of resilience. Cronbach’s α was 0.954 on this research. Destructive Feelings The 21-item Despair–Nervousness–Stress Scale, which was developed by Lovibond and Lovibond69 and subsequently revised in Chinese language, was used to look at the adverse feelings of medical school college students.70 It has demonstrated excessive reliability and validity in research amongst Chinese language school college students.71 A complete of 21 objects (eg, “I discovered it exhausting to wind down”.) are categorized into three dimensions (melancholy, nervousness, and stress). Every merchandise is scored on a 4-point Likert scale (0 = didn't apply to me in any respect, 3 = utilized to me very a lot or more often than not). The contributors are required to reply in keeping with the adverse emotional signs of the previous week. Increased complete scores replicate increased ranges of adverse emotional signs. Cronbach’s α was 0.975 on this research. Information Evaluation This research used Statistical Package deal for Social Sciences (SPSS 28.0 SPSS Inc, Armonk, NY, USA) and PROCESS macros ( http://www.afhayes.com ),72 specifically developed for assessing advanced fashions together with mediators and moderators, for knowledge entry and evaluation. First, knowledge screening revealed no outliers or lacking values. Second, descriptive statistics, correlational evaluation, and independent-sample t-tests had been calculated among the many main variables. Third, we used Mannequin 4 of the PROCESS macro for SPSS to look at the mediating results of FoMO within the relationship between social media use and adverse feelings.73 Fourth, Mannequin 14 of the PROCESS macro for SPSS was utilized to check the moderating results of resilience within the relationship between FoMO and adverse feelings. Furthermore, intercourse and age had been managed as a result of prior proof has proven that they're necessary confounders in adverse feelings.74 Primarily based on 5000 bootstrap samples, the bootstrap confidence intervals (CIs) decided whether or not the results in Mannequin 4 and 14 had been statistically vital. The 95% bias-corrected CIs didn't comprise zero, indicating that the impact was vital. All research variables had been standardized in Mannequin 4 and 14 earlier than knowledge analyses. P-values < 0.05 were considered statistically significant. Results Descriptive Statistics and Correlational Analysis The means, SDs, and Pearson correlations for the study variables are shown in Table 1. Social media use was positively associated with FoMO, and negative emotions and negatively associated with resilience. FoMO was correlated positively with negative emotions and negatively with resilience. Resilience was negatively associated with negative emotions. An independent-samples t-test revealed no significant differences between men and women for the variables of social media use (t = −1.886, p > 0.05), FoMO (t = −1.170, p > 0.05), resilience (t = 0.231, p > 0.05), and adverse feelings (t = 0.056, p > 0.05). There was a major adverse correlation between age and social media use (r = −0.477, p < 0.001), FoMO (r = −0.459, p < 0.001), and adverse feelings (r = −0.433 p < 0.001); nonetheless, there was a major optimistic correlation between age and resilience (r = 0.415, p < 0.001). Desk 1 Correlations and Technique of Examine Variables (N = 407) The Mediating Position of FoMO We examined the mediating results of FoMO on the connection between social media use and adverse feelings, with intercourse and age as covariates, utilizing Mannequin 4 of the PROCESS macro. All knowledge had been standardized. The overall impact of social media use on adverse feelings was vital (β = 1.101, SE = 0.079, p < 0.001). Social media use had no significant direct effect on negative emotions (β = 0.168, SE = 0.096, p > 0.05), however it had an oblique impact on adverse feelings by way of mediation of FoMO (β = 0.933, SE = 0.106, 95% CI: 0.731 to 1.149). Social media use affected adverse feelings solely via the mediating impact of FoMO, accounting for 84.782% of the entire impact. Thus, FoMO totally, slightly than partially, partially mediated the connection between social media use and adverse feelings (Determine 2).
Determine 2 The connection between social media use and adverse emotion. Abbreviation: FoMO, concern of lacking out. Notice: ***p < 0.001. The Moderating Impact of Resilience To research the moderating results of resilience, we employed Mannequin 14 of the PROCESS macro with intercourse and age as covariates. Resilience had a major moderating impact on the connection between FoMO and adverse feelings (β = −0.021, SE = 0.005, 95% CI: −0.032 to −0.012). We divided resilience into excessive (M + 1SD) and low (M - 1SD) teams with the intention to higher clarify its moderating results on FoMO and adverse emotion. Easy slope assessments instructed that FoMO had a major optimistic predictive impact on adverse feelings at each ranges of resilience (Determine 3; low resilience people: β = 1.079, SE = 0.076, t = 14.243, p < 0.001; excessive resilience people: β = 0.212, SE = 0.094, t = 2.256, p < 0.05), indicating that resilience decreased the results of FoMO on adverse feelings. Determine 3 The moderating impact of resilience. Abbreviation: FoMO, concern of lacking out. Dialogue We constructed a mediated moderating mannequin to research the potential mechanisms between social media use and adverse feelings amongst medical school college students through the COVID-19 pandemic. FoMO was a possible mediator, and resilience was a possible moderator in explaining the connection. Relationship Between Social Media Use and Destructive Feelings Social media use was considerably and positively related to adverse feelings amongst medical school college students through the COVID-19 pandemic, thereby supporting H1. That is in accordance with earlier analysis findings. As an illustration, some school college students’ frequent use of social media could result in melancholy, nervousness, and post-traumatic stress.75 Furthermore, elevated self-exposure on social media could enhance the probability of cyberbullying, leading to adverse feelings.76 Faculty college students have fewer outside actions and face-to-face communication alternatives due to the necessity to forestall the unfold of the COVID-19 pandemic. Consequently, using social media could also be considered one of their main technique of quickly assuaging interior vacancy and loneliness. When social networking websites are used as a main or secondary technique of relieving stress, loneliness, or melancholy, using social networking websites might also turn out to be problematic conduct.77 Moreover, our research revealed a fancy relationship between social media use and adverse feelings. The Mediating Position of FoMO The results of social media use on adverse feelings had been mediated by FoMO totally slightly than partially. In different phrases, medical school college students who continuously used social media had been extra more likely to expertise FoMO, conducive to adverse feelings. Though the outcomes didn't assist H2, we found that FoMO performed a extra vital position than anticipated within the relationship between social media use and adverse feelings, which is in keeping with earlier findings that FoMO could mediate the connection between social media use and melancholy.44 FoMO is one predictor of adverse feelings, and its enough mediating position revealed it to be a major threat issue for adverse feelings amongst medical school college students, confirming the findings of earlier analysis on school college students in China.44,78 On the one hand, FoMO is expounded to unmet wants for particular person social connection,41 which might conducive to adverse feelings (eg, loneliness and melancholy). Utilizing social media, people can obtain emotional assist and alleviate adverse feelings, similar to loneliness brought on by the COVID-19 pandemic. When school college students don't obtain enough emotional assist, they search it by way of social media. However, as these college students proceed to obtain emotional assist by way of social media, they'll come to anticipate and anticipate it. Therefore, these college students usually tend to concern that they'll miss out on this rapid emotional assist from their associates in the event that they quickly cease utilizing social media,79 which can promote elevated ranges of FoMO. FoMO could possibly be a supply of adverse feelings as a result of social media use is related to FoMO, which is expounded to adverse feelings.80 Subsequently, when these college students search extra emotional assist from social media through the COVID-19 pandemic, they might be afraid of lacking out on future social engagement, which can enhance the probability of adverse feelings. The Moderating Position of Resilience In line with H3, resilience considerably moderated the connection between FoMO and adverse feelings. As beforehand talked about, an absence of resilience could also be positively related to stress and melancholy,81 thereby making it extra more likely to lead to adverse experiences. In comparison with medical school college students with excessive ranges of resilience, FoMO predicted adverse feelings in these with decrease resilience with larger accuracy, indicating that FoMO could exert an elevated affect on the feelings of medical school college students with decrease resilience. In different phrases, through the COVID-19 pandemic, folks with decrease resilience usually tend to expertise adverse feelings as a consequence of their FoMO. This additionally helps the emotion regulation methods proposed by Min et al,54 specifically that self-regulation and resilience could alleviate adverse feelings. As an illustration, younger people with excessive ranges of resilience might be able to overcome the FoMO induced by social media use, partly by speaking concerning the expertise with others and having supportive friends;82 this alleviates adverse feelings. People with excessive ranges of resilience are much less more likely to expertise melancholy and stress as a consequence of their capacity to inhibit rumination and FoMO via inhibitory management.83,84 These findings are just like these of earlier research, which demonstrated that people with excessive ranges of resilience had been much less more likely to endure from melancholy and stress.85,86 Medical school college students with low ranges of resilience could also be unable to undertake applicable coping methods and finally show a propensity for adverse feelings.81 Due to this fact, whether or not through the COVID-19 pandemic or in pre-pandemic day by day life, the results of FoMO on adverse feelings may be mitigated by resilience. Limitations and Future Instructions A number of limitations must be taken under consideration when decoding the findings. First, by the point we collected the info, COVID-19 had been largely contained in China, and a few school college students had returned to high school. These knowledge could differ from different regional knowledge collected through the COVID-19 pandemic. Second, a cross-sectional research can not decide a causal relationship between social media use and adverse feelings. Nonetheless, when the mediation and moderation fashions are grounded in concept and are partially supported by prior analysis, cross-section mediation and moderation can present priceless info concerning the connection of variables. Future analysis ought to make the most of longitudinal designs to check this mediated moderating mannequin. Third, response bias could exist due to self-reporting, although we took measures to alleviate medical school college students’ considerations about collaborating, together with offering clear directions, informing them that there have been no proper or fallacious solutions, and emphasizing the confidentiality of the outcomes. Future analysis ought to incorporate experimental strategies for measuring variables or embody instructor and peer evaluations. Fourth, the present research tried to look at the depth of social media use and adverse emotional states, however separate pathways for every area of adverse emotional states, and associations between motivations for social media use and adverse feelings weren't assessed. Future analysis ought to examine the position of motivations for social media use and the relationships between adjustments in these motivations and the depth of social media use and adverse feelings, in addition to present a extra complete and express perception into well being points associated to adverse feelings. Lastly, medical school college students are the inhabitants measured within the present research. Though the present research confirmed related outcomes to earlier research of medical college students, nursing college students, and pharmacy college students, there may be some heterogeneity within the inhabitants of scholars of various specialties. Future analysis ought to broaden the pattern measurement of various specializations in faculties to look at variations in social media use and adverse feelings amongst college students of various specialties. Regardless of these limitations, the present research had each theoretical and sensible implications. Theoretically, the outcomes of this research supported a relationship between social media use and adverse feelings amongst medical school college students, enriching the literature on adverse feelings. As well as, an empirical framework is supplied by testing a mannequin of mediated moderating results of FoMO and resilience. These findings could make clear the underlying mechanisms of the connection between social media use and adverse feelings amongst medical school college students through the COVID-19 pandemic. From a sensible standpoint, our findings can help in designing efficient measures to cut back adverse feelings amongst school college students. As an illustration, enhancing college students’ resilience (eg, in search of assist from members of the family, academics, and friends) could assist enhance their adaptability, stimulate optimistic feelings, and scale back the danger of melancholy and nervousness. Moreover, medical educators and practitioners ought to pay extra consideration to college students with excessive ranges of FoMO. On the one hand, it’s vital to correctly perceive FoMO by growing a fundamental perspective understanding of the significance of the idea, its causes, signs, adverse results, and the best way to deal with it coping with the issue.87 However, checklists, self-talk, expectation administration, and protecting narratives can be utilized to develop strategies to reinforce hopeful resilience,50,82 which can assist college students forestall and address excessive ranges of FoMO. Conclusions The current research contributes to the literature by conducting a mediated moderating mannequin that gives perception into how social media use can contribute to adverse feelings amongst medical school college students through the COVID-19 pandemic. The outcomes demonstrated a optimistic correlation between social media use and adverse feelings amongst medical school college students. FoMO might mediate the connection between social media use and adverse feelings, and resilience might average the affiliation between FoMO and adverse feelings.
