| 摘要: | 背景: 2020 年，世界衛生組織宣布 COVID-19 大流行引發了自二戰以來最 嚴重的健康危機。在疫情期間，自殘、自殺、暴力和謀殺等故意傷害行為明 顯增加。作為脆弱群體之一，國際學生可能會因限制措施對他們的海外學習 經歷產生負面影響而受到更嚴重的影響。然而，對於國際學生的留學經歷對 其心理和生理狀態的影響尚未得到明確研究，以制定未來的預防和治療策 略。
目的: 研究留學對於碩士研究生的心理狀態(包括抑鬱、焦慮、壓力、孤 獨感以及自我傷害的想法和行為)和生理狀態是否具有顯著影響。此外，檢 驗這種影響的效應大小是否受到 COVID-19 限制措施的變化和其他相關風險 因素(如學業和財務困境)的影響。
方法: 本回溯性隊列研究比較了印度尼西亞留學的碩士研究生和在本國學 習的學生在疫情期間(2020-2022 年)的情況。參與者通過雪球抽樣方式招 募，並通過在線調查收集數據。符合條件的參與者需要年齡在 20 歲以上並 在疫情爆發期間開始攻讀碩士學位。使用 DASS-21(抑鬱、焦慮和壓力量 表)、UCLA 孤獨量表、自傷思維行為訪談(SITBI)的兩個問題以及國際 身體活動問卷(IPAQ)來評估結果。社會人口學和學習變量進行了描述性 分析，使用卡方檢驗、Wilcoxon 秩和檢驗和相關分析檢驗了兩組之間的差 異，並通過皮爾森檢驗和線性回歸來測量學業和財務困境對影響的影響。這 項研究獲得了臺北醫學大學的研究倫理許可(TMU-JIRB No.: N202209024)。
結果:統計分析顯示，在生理活動結果方面存在顯著差異(p<0.05)，具體 表現在身體活動方面，留學生比在本國學習的學生更加積極參與體育活動。 在本國學習的學生群體中，壓力、焦慮、自殺思想和非自殺自傷(NSSI)的 平均分數較高。如預期，留學生群體表現出更高的抑鬱和孤獨感水平。與壓 力、焦慮和抑鬱相關的學業困境顯著增加(p<0.01)，並且更容易產生自殺 思想、NSSI 和身體活動不足。此外，學生的財務困擾與較高水平的壓力有 關(p<0.05)。
結論:在疫情期間實施的政策變化對國際學生的心理狀態產生了顯著影響，
特別是在自殘思想和行為方面。這些政策變化還對他們的身體活動產生了顯
著影響，並與學業和財務困難等風險因素顯示出顯著相關性，相較於在本國
學習的學生。
Background: In 2020, the World Health Organization announced that the COVID- 19 pandemic caused the worst health crisis since World War II. Intentional injuries, including self-harm, suicide, violence, and murder, were known to have increased during the pandemic. International students, being one of the vulnerable populations, may experience exacerbated impacts due to the adverse effects of restriction measures on their overseas studying experience. However, the impact of studying abroad on the psychological and physiological state of international students has not been clearly examined yet in order to develop a plan for future prevention and treatment strategies.
Objective: To investigate whether studying abroad has a significant impact on the psychological state (including depression, anxiety, stress, loneliness, and self- injurious thoughts and behaviors) and physiological state of postgraduate students. Additionally, to examine whether the effect size of this impact is influenced by changes in COVID-19 restrictions and other relevant risk factors such as academic and financial predicaments.
Methods: This retrospective cohort study analyzed Indonesian postgraduate students studying abroad (200) and Indonesian students studying in home country (193) during the pandemic period (2020-2022). Participants were recruited by snowball sampling, and data were collected through an online survey. Eligible students were required to be older than 20 and to have commenced their postgraduate studies during the outbreak. Outcomes were assessed using the DASS- 21 (Depression, Anxiety, and Stress Scale), the UCLA Loneliness Scale, two questions from the Self-Injury Thought-Behavior Interview (SITBI), and the International Physical Activity Questionnaire (IPAQ). Sociodemographic and study variables were analyzed descriptively, and differences between the two groups were examined using the chi-square test, Wilcoxon rank-sum test, and correlation analysis, with the academic and financial predicaments impact measured through Pearson test and linear regression. Ethical approval for this study was granted by Taipei Medical University (TMU-JIRB No.: N202209024).
Results: The statistical analysis revealed significant differences (p<0.05) in physiological outcomes, specifically in terms of physical activity, with students studying abroad being more physically active compared to students studying in home country. In phycological outcomes, they were exhibited higher levels of depression and loneliness. The group of students studying in home country demonstrated higher mean scores for stress, anxiety, suicide ideation, and non- suicidal self-injury (NSSI). Academic predicaments significantly increased (p<0.01) in relation to stress, anxiety, and depression among students, along with an increased likelihood of suicide ideation, NSSI, and physical inactivity. Furthermore, students' financial concerns were found to be associated with higher levels of stress (p<0.05).
Conclusion: The policy changes implemented during the pandemic period have a significant impact on the psychological state of international students, particularly in terms of self-injury thoughts and behaviors. These changes also have a significant impact on their physical activity and show a significant correlation with risk factors such as academic and financial difficulties, in comparison to students who were studying in their home country. |
