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We examined the trends in students\u2019 stress levels during and after China\u2019s first wave of COVID-19 outbreaks by analyzing their demographics, behavior, mental health status, career confidence, and Chinese Perceived Stress Scale (CPSS) scores. Our findings indicate an increase in students\u2019 stress levels since the COVID-19 onset, with more students experiencing higher stress levels after the first outbreak than during it (OR\u2009=\u20092.03, 95% CI 1.79, 2.30). Several factors were identified as being associated with higher CPSS scores, including higher class levels, residence in rural or town areas, low family income, and lack of familiarity with COVID-19, among others. Our study highlighted the urgency of developing and implementing effective strategies to cope with students\u2019 stress during and after a global pandemic.<\/jats:p>","DOI":"10.1177\/13591053241246620","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T04:51:48Z","timestamp":1714020708000},"page":"736-748","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Changes of college students\u2019 psychological stress during the COVID-19 pandemic in China: A two-wave repeated survey"],"prefix":"10.1177","volume":"30","author":[{"given":"Xinxin","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Sports Science, Zhejiang University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4776-6639","authenticated-orcid":false,"given":"Junmeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Bloomberg School of Public Health, Johns Hopkins University, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huanju","family":"Liu","sequence":"additional","affiliation":[{"name":"Women\u2019s Hospital and Institute of Genetics, Zhejiang University School of Medicine, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xutong","family":"Zheng","sequence":"additional","affiliation":[{"name":"Fujian University of Traditional Chinese Medicine, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Nursing, Xiamen Medical College, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenhai","family":"Fu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Respiratory Disease, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanxia","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shijiazhuang Medical College, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiansha","family":"Wang","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Guizhou Medical University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanni","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Second Hospital of Zhangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cong","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Sports Science, Zhejiang University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-022-07497-2"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2021.113863"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-16328-7"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-02874-x"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239696"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-10-139"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10755-021-09552-y"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.924609"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0153454"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2020.1825914"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17124441"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1098\/rsos.200644"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10235564"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i04"},{"key":"e_1_3_3_16_1","article-title":"Medical student stress and burnout: Before and after COVID-19","volume":"11","author":"Stacey A","year":"2020","unstructured":"Stacey A, D\u2019Eon M, Madojemu G (2020) Medical student stress and burnout: Before and after COVID-19. 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