Association between psychological distress, lifestyle and career planning on health-related quality of life among the university students during school closure of COVID-19 pandemic in China

The COVID-19 pandemic and associated school closures presented unprecedented challenges to university students' well-being, highlighting an urgent need to understand the factors influencing their health-related quality of life. This study aimed to explore the association between psychological distress, lifestyle, and career planning on the health-related quality of life of university students during the school closure period in China. A cross-sectional study was conducted, collecting data from 1965 Chinese college students locked down in campus during COVID-19 using a snowball sampling method via an online questionnaire platform (Wenjuan.com). Psychological distress and the health-related quality of life were measured by scales. Descriptive analysis, Chi-squared test and logistic regression analysis were employed to analyze the data. The mean physical component summary score was 47.5, while the mean mental component summary score was 36.8. Students who were women (OR=1.444, P = 0.003), having a boy or girl friend (OR=1.379, P = 0.008), with rural hukou (OR=1.446, P = 0.004), with low psychological distress (OR=4.589, P < 0.001), high physical activity intensity (OR=3.909, P < 0.001), a regular studying schedule arrangement (OR=2.553, P = 0.008), clear career planning (OR=1.570, P = 0.001) during COVID-19 were more likely to report a good physical component summary. For mental component summary, lower psychological distress (OR=8.330, P < 0.001), a regular studying schedule arrangement (OR=2.892, P = 0.001) and keeping same job-hunting pressure (OR=1.852, P = 0.003) were positive influencing factors, whereas having a boy or girl friend (OR=0.774, P = 0.032) and having no clear career planning (OR=0.752, P = 0.020) during COVID-19 were negative influencing factors. In conclusion, while health-related quality of life was generally good, lower psychological distress, healthier lifestyle habits, and clearer career planning were significantly associated with better health-related quality of life among university students during the pandemic-related school closure. These findings underscore the importance of integrating mental health support, lifestyle guidance, and career planning services into student support systems during public health crises. Future studies should develop and evaluate interventions targeting these modifiable factors.