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Mediating role of psychological resilience in relationship between stress and anxiety symptoms of medical students in post COVID-19 period

[Background] In the post-pandemic period, attention has been paid to the study of psychological stage changes in various groups. Under the stress of pandemics, how to control negative emotions such as anxiety symptoms will have an important impact on medical students' professional identity and future professional competence. [Objective] This study is designed to explore the characteristics of stress and anxiety symptoms of medical students in different stages of the post COVID-19 period, and potential mediating role of psychological resilience in the relationship between stress and anxiety symptoms. [Methods] By convenience sampling method, 3 000 medical students from three medical colleges in Shaanxi Province were selected and completed an online survey reporting the SelfRating Anxiety Scale (SAS), Stress Scale for College Student (SSCS), and Resilience Scale of Adults (RSA) to assess their stress, psychological resilience, and anxiety symptoms in September and November 2020. SPSS 25.0 software was used to perform dependent-sample t test, variance analysis, Pearson correlation analysis, and mediating effect test (hierarchical regression analysis). [Results] A total of 2 894 valid questionnaires were recovered and the valid recovery rate was 96.5%. The overall scores of stress, psychological resilience, and anxiety symptoms of selected medical students were 56.61±17.17, 166.88±28.55, and 40.45±9.67, respectively in the post COVID-19 period. The positive rate of high stress was 72.2%, and the positive rate of anxiety symptoms was 16.0%. There were significant differences in anxiety symptoms scores between the high and the low stress level groups (42.16±9.92, 35.99±7.30) (P < 0.01). There were significant differences in scores of stress, psychological resilience, and anxiety symptoms among different grade groups (P < 0.01). The pearson correlation analysis results showed that the stress score was positively correlated with the anxiety symptom score (r=0.417, P < 0.01) and negatively correlated with the psychological resilience score (r=-0.344, P < 0.01);the psychological resilience score was negatively correlated with the anxiety symptom score (r=-0.495, P < 0.01). The hierarchical regression analysis results found that stress had a positive effect on anxiety symptoms (b=0.280, P < 0.01), and a negative effect on psychological resilience (b=-0.344, P < 0.01);psychological resilience negatively affected anxiety symptoms (b=-0.398, P < 0.01), and played a partial mediating role in the relationship between stress and anxiety symptoms (effect value was 0.137) that accounted for 32.8% of the total effect. [Conclusion] In the post COVID-19 period, medical students have a superposition of high stress and high anxiety symptoms. Psychological resilience is a protective factor for anxiety symptoms and plays a partial mediating role in the relationship between stress and anxiety symptoms.