Novel Coronavirus (COVID-19) Knowledge, Precaution Practice, and Associated Depression Symptoms among University Students in Korea, China, and Japan
Abstract
:1. Introduction
2. Methods
2.1. Participants
2.2. Procedure
2.3. Measures
- Demographic and physical health status data elicited from the respondents included gender, age, educational level, marital status, work status, self-assessed physical condition, chronic diseases, potential symptoms, travel abroad, and whether or not they were quarantined in the past 2 weeks.
- Knowledge of COVID-19 was assessed using items related to the transmission pathways (Agree, Disagree), the disease information (Yes, No), and the sources of COVID-19 information (Internet, TV, Radio, News, Family, Others). The questions on the perception of COVID-19 consisted of the history of contact (Yes, No/Not sure), information satisfaction (5 levels, ranging from “Dissatisfied” to “Satisfied”), diagnosis confidence (5 levels; “Not confident”—“Very confident”), probability of getting infected and surviving (5 levels; “Low—“High”), and concerns about family members and the disease (5 levels: “Low—“High”). High scores indicated a high level of certainty.
- Precautionary measures comprised of nine preventative practices. The norm was set by the degree of measures practiced on a daily basis (1 = “I never do this” to 5 = “I do this every day”), generating a total score of nine (9 × 1~9 × 5). Cronbach’s Alpha coefficient of preventive practices of the COVID-19 scale was 0.71.
- The PHQ-9, published by the American Psychiatric Association, was used to diagnose depressive symptoms based on the nine criteria for depression set by the Diagnostic and Statistical Manual of Mental Disorders [31]. Each item was rated on a 4-point scale ranging from 0 (“Not at all”) to 3 (“Almost every day”) [32]. The scoring criteria of PHQ-9 were divided into five groups: 0–4, 5–9, 10–14, 15–19, and 20–27, which corresponded to “minimal or none,” “mild,” “moderate,” “moderately severe,” and “severe” depression, respectively [33]. The higher the score, the more intense the level of depression. Cronbach’s Alpha coefficient of the scale in this study was 0.87.
2.4. Statistical Analysis
3. Results
3.1. General Demographic and Physical Health Data
3.2. Knowledge and Perception of COVID-19
3.3. Preventative Practices against COVID-19
3.4. Respondents’ Depressive States
4. Discussion
4.1. Knowledge and Preventative Practices
4.2. Depression Symptoms
4.3. Limitations and Future Research
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Items | Korea | China | Japan | Total (M = 305, F = 516) | χ2 | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Male (N = 162) | Female (N = 228) | Total (N = 390) | Male (N = 83) | Female (N = 198) | Total (N = 281) | Male (N = 60) | Female (N = 90) | Total (N = 150) | |||
Age | 24.05 ± 0.25 | 22.50 ± 0.16 | 23.14 ± 0.15 | 23.57 ± 0.41 | 23.66 ± 0.19 | 23.63 ± 0.18 | 24.49 ± 0.59 | 23.86 ± 0.60 | 24.13 ± 0.53 | 23.08 ± 4.78 | F = 3.248 * |
Educational level | |||||||||||
Undergraduate | 145 (89.51) | 215 (94.30) | 360 (92.31) | 66 (77.11) | 127 (64.14) | 191 (97.97) | 45 (75.00) | 76 (84.44) | 121 (80.67) | 672 (81.85) | 65.289 *** |
Graduate | 17 (10.49) | 13 (5.70) | 30 (7.69) | 19 (22.89) | 71 (35.86) | 90 (32.03) | 15 (25.00) | 14 (15.56) | 29 (19.33) | 149 (19.15) | |
Marital status | |||||||||||
Single | 160 (98.77) | 225 (98.68) | 385 (98.72) | 75 (90.36) | 191 (96.46) | 266 (94.66) | 58 (96.67) | 86 (95.56) | 144 (96.00) | 795 (96.83) | 9.177 * |
Married | 2 (1.23) | 3 (1.32) | 5 (1.28) | 8 (9.64) | 7 (3.54) | 15 (5.34) | 2 (3.33) | 4 (4.44) | 6 (4.00) | 26 (3.17) | |
Job Status | |||||||||||
Students | 155 (95.68) | 215 (94.30) | 370 (94.87) | 76 (91.57) | 173 (87.37) | 249 (88.61) | 53 (88.53) | 70 (77.78) | 123 (82.00) | 742 (90.38) | 36.212 *** |
Working | 4 (2.47) | 11 (4.82) | 15 (3.85) | 6 (7.23) | 20 (10.10) | 26 (9.25) | 5 (8.33) | 16 (17.78) | 21 (14.00) | 62 (7.55) | |
Other | 3 (1.85) | 2 (0.88) | 5 (1.28) | 1 (1.20) | 5 (2.53) | 6 (2.14) | 2 (3.33) | 4 (4.44) | 6 (4.00) | 17 (2.07) | |
Traveled abroad | |||||||||||
No | 159 (98.15) | 228 (100) | 387 (99.23) | 80 (96.39) | 195 (98.48) | 285 (97.86) | 57 (95.00) | 86 (95.56) | 143 (95.33) | 805 (98.05) | 8.689 * |
Yes | 3 (1.85) | 0 (0) | 3 (0.77) | 3 (3.61) | 3 (1.52) | 6 (2.14) | 3 (5.00) | 4 (4.44) | 7 (4.67) | 16 (1.95) | |
Self-quarantine | |||||||||||
No | 149 (91.98) | 204 (89.47) | 353 (90.51) | 34 (40.96) | 94 (47.47) | 128 (45.55) | 44 (73.33) | 70 (77.78) | 114 (76.00) | 595 (72.47) | 166.640 *** |
Yes | 13 (8.02) | 24 (10.53) | 37 (9.49) | 49 (59.04) | 104 (52.53) | 153 (54.45) | 16 (16.67) | 20 (22.22) | 36 (24.00) | 226 (17.53) | |
Several symptoms | |||||||||||
No | 118 (72.84) | 149 (65.35) | 267 (68.46) | 73 (87.95) | 181 (91.41) | 254 (90.39) | 39 (65) | 56 (62.22) | 95 (63.33) | 616 (75.03) | 55.329 *** |
Yes | 44 (27.16) | 79 (34.65) | 123 (32.54) | 10 (12.05) | 17 (8.59) | 27 (9.61) | 21 (35) | 34 (37.78) | 55 (36.67) | 205 (24.97) | |
Self-assessed physical condition | |||||||||||
Above good | 117 (72.22) | 166 (72.81) | 283 (72.56) | 73 (87.95) | 184 92.93) | 257 (91.46) | 44 (73.33) | 64 (71.11) | 108 (72.00) | 648 (78.93) | 40.356 *** |
Below fair | 45 (27.78) | 62 (27.19) | 107 (27.44) | 10 (12.05) | 14 (7.07) | 24 8.54) | 16 (26.67) | 16 (18.89) | 42 (28.00) | 173 31.07) | |
Chronic diseases | |||||||||||
No | 145 (89.51) | 210 (92.11) | 355 (91.03) | 74 (89.16) | 188 (94.95) | 262 (93.24) | 57 (95.00) | 91 (90.00) | 138 (92.00) | 755 (91.96) | 1.082 |
Yes | 17 (10.49) | 18 (7.89) | 35 (8.97) | 9 (10.84) | 10 (5.05) | 19 (6.76) | 3 (5.00) | 9 (10.00) | 12 (8.00) | 66 (8.04) |
Items | Korea | China | Japan | Total (N = 821) | χ2 (by) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Male (N = 162) | Female (N = 228) | Total (N = 390) | Male (N = 83) | Female (N = 198) | Total (N = 281) | Male (N = 60) | Female (N = 90) | Total (N = 150) | Nationality | Gender | ||
Transmission routes | ||||||||||||
Droplets (agree) | 153 (94.44) | 224 (98.25) | 377 (96.67) | 83 (100) | 197 (99.49) | 280 (99.64) | 59 (98.33) | 88 (97.78) | 147 (98.00) | 804 (97.93) | 7.145 * | 3.493 |
Objects (agree) | 121 (74.69) | 178 (78.07) | 299 (76.67) | 76 (91.57) | 184 (92.93) | 260 (92.53) | 52 (86.67) | 76 (84.44) | 128 (85.33) | 687 (83.68) | 30.448 *** | 1.477 |
Air (agree) | 71 (43.83) | 93 (40.79) | 164 (42.05) | 59 (71.08) | 128 (64.65) | 187 (66.55) | 17 (29.33) | 35 (38.89) | 52 (34.67) | 403 (49.09) | 54.487 *** | 0.514 |
Updated information | ||||||||||||
Infected case (yes) | 157 (96.91) | 222 (97.37) | 379 (97.18) | 83 (100) | 198 (100) | 271 (100) | 58 (96.67) | 89 (98.89) | 147 (98.00) | 807 (98.29) | 12.161 ** | 1.007 |
Death case (yes) | 153 (94.44) | 219 (96.05) | 372 (95.38) | 81 (97.59) | 198 (100) | 279 (99.29) | 58 (96.67) | 87 (96.67) | 145 (96.67) | 796 (96.96) | 8.482 * | 2.425 |
Recovered case (yes) | 135 (83.33) | 210 (92.11) | 345 (88.46) | 81 (97.59) | 196 (98.99) | 277 (98.58) | 40 (66.67) | 62 (68.89) | 102 (68.00) | 724 (88.19) | 87.810 *** | 8.416 ** |
Number of information sources | ||||||||||||
1~3 | 161 (99.38) | 223 (97.81) | 384 (98.46) | 73 (87.95) | 193 (92.42) | 256 (91.10) | 57 (95.00) | 70 (77.78) | 127 (84.67) | 767 (93.42) | 37.291 *** | 3.119 |
4~6 | 1 (0.62) | 5 (2.19) | 6 (1.54) | 10 (12.05) | 15 (7.58) | 25 (8.90) | 3 (5.00) | 20 (22.22) | 23 (15.33) | 54 (6.58) | ||
Contact history | 40.132 *** | 1.198 * | ||||||||||
No | 135 (83.33) | 185 (81.14) | 320 (82.05) | 81 (97.59) | 192 (96.57) | 273 (97.15) | 54 (90.00) | 66 (73.33) | 120 (80) | 713 (86.84) | ||
Yes/Suspected | 17 (16.66) | 43 (18.86) | 70 (17.95) | 2 (2.41) | 3 (2.92) | 8 (2.85) | 6 (10.00) | 14 (26.67) | 30 (20.00) | 108 (13.16) | ||
Information satisfaction | 150.837 *** | 0.032 | ||||||||||
Above satisfied | 115 (70.99) | 151 (66.23) | 266 (68.21) | 79 (95.18) | 191 (96.46) | 270 (96.09) | 30 (50.00) | 34 (37.78) | 64 (42.67) | 600 (73.08) | ||
Below satisfied | 47 (29.01) | 77 (33.77) | 124 (31.79) | 4 (4.82) | 7 (3.54) | 11 (3.91) | 30 (50.00) | 56 (62.22) | 86 (57.33) | 221 (16.92) | ||
Confidence in diagnosis | 31.733 *** | 0.059 | ||||||||||
Highly confident | 138 (85.19) | 195 (85.53) | 333 (85.38) | 66 (79.52) | 151 (76.26) | 217 (77.22) | 37 (61.67) | 58 (64.44) | 95 (63.33) | 645 (78.56) | ||
Lowly confident | 24 (14.81) | 33 (14.47) | 57 (14.62) | 17 (20.48) | 47 (23.74) | 64 (22.78) | 23 (38.33) | 32 (35.56) | 55 (36.67) | 176 (21.44) | ||
Perceived probability | ||||||||||||
Getting infected (high) | 48 (29.63) | 81 (35.53) | 129 (33.08) | 25 (30.12) | 31 (15.66) | 56 (19.93) | 43 (71.67) | 73 (81.11) | 116 (77.33) | 301 (36.66) | 142.894 *** | 0.392 |
Surviving after infection (high) | 130 (80.25) | 190 (83.33) | 320 (82.05) | 72 (86.75) | 173 (87.37) | 245 (87.19) | 55 (91.67) | 74 (82.22) | 129 (86.00) | 694 (84.53) | 3.599 | 0.027 |
Concerns about family members | 18.261 *** | 11.213 ** | ||||||||||
High | 29 (17.90) | 26 (11.40) | 335 (85.90) | 62 (74.70) | 156 (78.79) | 218 (77.58) | 58 (96.67) | 81 (90.00) | 139 (92.67) | 692 (84.29) | ||
Low | 133 (82.10) | 202 (88.60) | 55 (14.10) | 21 (25.30) | 42 (21.21) | 63 (22.42) | 2 (3.33) | 9 (10.00) | 11 (7.33) | 129 (15.71) | ||
Concerns about the disease | 6.404 * | 10.630 * | ||||||||||
High | 128 (79.01) | 206 (90.35) | 334 (85.64) | 70 (84.37) | 180 (90.91) | 250 (88.97) | 56 (93.33) | 84 (93.33) | 140 (93.33) | 724 (88.19) | ||
Low | 34 (20.99) | 22 (9.65) | 56 (14.36) | 13 (15.66) | 18 (9.09) | 31 (11.03) | 4 (6.67) | 6 (6.67) | 10 (6.67) | 97 (11.81) |
Items | Korea (N = 390) | China (N = 281) | Japan (N = 150) | Main Effect (by) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Nation | Gender | |||||||||||||
Mean ± S.D. | 95% Conf. Interval | Mean ± S.D. | 95% Conf. Interval | Mean ± S.D. | 95% Conf. Interval | F a | Korea × China b | Korea × Japan b | China × Japan b | t(M) c | ||||
1: Covering mouth when coughing and sneezing | 4.47 ± 0.91 | 4.38 | 4.56 | 4.38 ± 1.02 | 4.26 | 4.50 | 4.21 ± 1.18 | 4.02 | 4.40 | 3.031 * | 0.088 ± 0.076 | 0.256 ± 0.107 * | 0.167 ± 0.114 | −1.286 |
2: Wearing a mask regardless of the presence or absence of symptoms | 3.18 ± 1.48 | 3.04 | 3.33 | 4.25 ± 0.91 | 4.15 | 4.36 | 3.57 ± 1.50 | 3.33 | 3.82 | 69.781 *** | −1.071 ± 0.092 *** | −0.391 ± 0.144 * | 0.679 ± 0.134 *** | −2.125 * |
3: Washing hands with soap and water | 4.76 ± 0.59 | 4.70 | 4.82 | 4.60 ± 0.68 | 4.52 | 4.69 | 4.81 ± 0.63 | 4.71 | 4.91 | 6.203 ** | 0.151 ± 0.051 ** | −0.050 ± 0.058 | −0.202 ± 0.064 ** | −4.710 *** |
4: Washing hands immediately after coughing, rubbing nose or sneezing | 3.65 ± 1.20 | 3.53 | 3.77 | 3.99 ± 1.14 | 3.85 | 4.12 | 3.61 ± 1.375 | 3.38 | 3.83 | 8.099 *** | −0.337 ± 0.091 *** | 0.042 ± 0.128 | 0.379 ± 0.131 * | −1.342 |
5: Washing hands after touching contaminated objects | 4.71 ± 0.71 | 4.64 | 4.78 | 4.47 ± 0.80 | 4.38 | 4.56 | 4.27 ± 1.20 | 4.08 | 4.47 | 13.933 *** | 0.241 ± 0.060 *** | 0.437 ± 0.105 *** | 0.196 ± 0.109 | −2.315 * |
6: Avoiding public transportation | 4.43 ± 0.95 | 4.33 | 4.52 | 4.57 ± 0.74 | 4.49 | 4.66 | 4.43 ± 0.97 | 4.28 | 4.59 | 2.474 | −0.147 ± 0.065 | −0.008 ± 0.092 | 0.140 ± 0.090 | −3.167 ** |
7: Avoiding using elevators | 2.34 ± 1.51 | 2.19 | 2.49 | 4.12 ± 1.24 | 3.97 | 4.26 | 2.64 ± 1.66 | 2.37 | 2.91 | 149.119 *** | −1.779 ± 0.106 *** | −0.302 ± 0.156 | 1.477 ± 0.155 *** | −2.912 ** |
8: Sitting in one row while having a meal | 2.14 ± 1.43 | 1.99 | 2.28 | 4.19 ± 1.19 | 4.05 | 4.32 | 2.47 ± 1.63 | 2.21 | 2.74 | 216.586 *** | −2.049 ± 0.101 *** | −0.337 ± 0.151 | 1.712 ± 0.150 *** | −0.524 |
9: Avoiding meeting with more than 10 people | 4.23 ± 1.23 | 4.11 | 4.35 | 4.73 ± 0.68 | 4.65 | 4.81 | 4.37 ± 1.21 | 4.17 | 4.56 | 24.864 *** | −0.502 ± 0.074 *** | −0.136 ± 0.117 | 0.366 ± 0.107 ** | −1.98 * |
Questions Sum Scores | 33.90 ± 5.28 | 33.37 | 34.42 | 39.30 ± 5.46 | 38.66 | 39.94 | 34.39 ± 5.53 | 33.49 | 35.28 | 88.850 *** | −5.405 ± 0.421 *** | −0.489 ± 0.525 | 4.916 ± 0.557 *** | −3.793 *** |
Items | Korea (N = 390) | China (N = 281) | Japan (N = 150) | Total | Main Effect (by) | ||||
---|---|---|---|---|---|---|---|---|---|
Nationality | Gender (M) | ||||||||
Sum scores | 5.94 ± 5.44 (CI: 5.39–6.48) | 6.40 ± 5.12 (CI: 5.79–7.00) | 7.33 ± 6.20 (CI: 6.33–8.33) | 6.35 ± 5.50 | F a = 2.970 * | T b = −2.091 * | |||
0–4 (Non-depressed) | M: 96 (59.26) F:102 (44.74) | 198 (50.77) | M: 23 (27.71) F: 88 (44.44) | 111 (39.50) | M: 24 (40.00) F: 36 (40.00) | 60 (40.00) | 369 (44.95) | χ2 = 25.849 *** | χ2 = 10.630 * |
5–9 (Mild) | M: 41 (25.31) F: 64 (28.07) | 105 (26.92) | M: 39 (46.99) F: 73 (36.87) | 112 (39.86) | M: 18 (30.00) F: 23 (25.56) | 41 (27.33) | 258 (31.43) | ||
10–14 (Moderate) | M: 19 (11.73) F: 34 (14.91) | 53 (13.59) | M: 16 (19.28) F: 23 (11.62) | 39 (13.88) | M: 13 (21.67) F: 12 (13.33) | 25 (16.67) | 117 (14.25) | ||
15–19 (Moderately severe) | M: 3 (1.85) F: 22 (9.65) | 25 (6.41) | M: 4 (4.82) F: 10 (5.05) | 14 (4.98) | M: 3 (5.00) F: 13 (14.44) | 16 (10.67) | 55 6.69) | ||
20–27 (Severe) | M: 3 (1.85) F: 6 (2.63) | 9 (2.31) | M: 1 (1.20) F: 4 (2.02) | 5 (1.78) | M: 3 (3.33) F: 6 (6.67) | 8 (5.33) | 22 2.68) |
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Zhao, B.; Kong, F.; Aung, M.N.; Yuasa, M.; Nam, E.W. Novel Coronavirus (COVID-19) Knowledge, Precaution Practice, and Associated Depression Symptoms among University Students in Korea, China, and Japan. Int. J. Environ. Res. Public Health 2020, 17, 6671. https://doi.org/10.3390/ijerph17186671
Zhao B, Kong F, Aung MN, Yuasa M, Nam EW. Novel Coronavirus (COVID-19) Knowledge, Precaution Practice, and Associated Depression Symptoms among University Students in Korea, China, and Japan. International Journal of Environmental Research and Public Health. 2020; 17(18):6671. https://doi.org/10.3390/ijerph17186671
Chicago/Turabian StyleZhao, Bo, Fanlei Kong, Myo Nyein Aung, Motoyuki Yuasa, and Eun Woo Nam. 2020. "Novel Coronavirus (COVID-19) Knowledge, Precaution Practice, and Associated Depression Symptoms among University Students in Korea, China, and Japan" International Journal of Environmental Research and Public Health 17, no. 18: 6671. https://doi.org/10.3390/ijerph17186671