Associations between demographic characteristics, perceived threat, perceived stress, coping responses and adherence to COVID‐19 prevention measures among Chinese healthcare students in China: A cross-sectional survey with implications for the control of COVID-19

Abstract

<b>Objectives</b> To investigate the associations between demographic characteristics, perceived threat, perceived stress, coping responses and adherence to COVID-19 prevention measures in Chinese Healthcare students.

<b>Design</b> A cross-sectional survey collecting data in Hong Kong and Fujian Province of China. Self-administered questionnaires were collected via online platform in April 2020.

<b>Participants</b> A convenience and snowball sample of 2706 students aged 18 years or older and studying a healthcare programme in Hong Kong or Fujian.

<b>Setting</b> Students were recruited in tertiary education institutions/universities in Hong Kong and Putian (a prefecture-level city in eastern Fujian province). The institutions offered various healthcare programmes in degree or sub-degree levels.

<b>Main outcome measures</b> Compliances to social distancing and personal hygiene measures were assessed by 10-item Social Distancing Scale and 5-item Personal Hygiene Scale respectively. Path analysis was performed to identify factors associated with the compliance outcomes.

<b>Results</b> The participants reported high compliances to both social distancing and personal hygiene measures. Confidence to manage the current situation, wishful thinking and empathetic responding directly predicted compliance to social distancing (β=-0.31, p<0.001; β=0.35, p=0.015; β=0.33, p<0.001 respectively) and personal hygiene measures (β==-0.16, p<0.001; β=0.21, p<0.001; β=0.16, p<0.001 respectively). Gender, geographical location, and clinical experience were the only three demographic variables having direct and/or indirect effects on social distancing and personal hygiene measures. The final model constructed demonstrated a very good fit to the data (Chi-square X²=27.27, df=17, P=0.044; X²/df=1.61; GFI=0.998, CFI=0.997, TLI=0.992, RMSEA=0.015).

<b>Conclusions</b> The predictive model constructed in this study is the first one to explore factors associating with the compliance to infection control measures in healthcare students amid the COVID-19 outbreak. The findings suggest that students who are male, habituate in Hong Kong, have more clinical experience and weak confidence to manage the threat tend to have lower compliance to social distancing and personal hygiene measures. Wishful thinking, contrasting to previous studies, was first found to positively associate with adherence to COVID-19 control measures.