ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Mental Health
This article is part of the Research TopicPublic Health Strategies to Improve Mental Health in the Education Sector: Perspectives and ApplicationsView all 27 articles
Quality of Life, Perceived Stress, and Use of School-based Stress Management Interventions in High School Students: A Mixed-methods Study during and after COVID-19
Provisionally accepted
Dennis John1*
Sebastian Otttmann1Karl-Hermann Rechberg1Teresa O'rourke2
Rüdiger Christoph Pryss3
Thomas Probst4- 1Evangelische Hochschule Nürnberg, Nuremberg, Germany
- 2Universitat fur Weiterbildung Krems, Krems an der Donau, Austria
- 3Julius-Maximilians-Universitat Wurzburg, Würzburg, Germany
- 4Paris Lodron Universitat Salzburg, Salzburg, Austria
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Key objectives of this study include understanding time trends in stress, understanding the associations of quality of life (QoL) and stress levels, and determining how these factors influence high school students' engagement with school-based stress management programs. To address these aims, two complementary studies were conducted. Study 1 included two survey waves (2020 and 2021) to examine stress and QoL among German high school students. Stress levels and QoL across psychological, social, familial, and academic domains were assessed using the Perceived Stress Scale (PSS-4) and the KIDSCREEN questionnaire. Study 2 used a mixed-methods approach (paper-based questionnaire and focus groups) to explore the relationship between PSS-4 scores, school-related QoL indicators, and voluntary participation in a school-based stress management intervention day conducted in 2023. Results show that stress levels among high school students increased during the COVID-19 pandemic and that low QoL in the school domain predicted higher stress. Moreover, low school-related well-being was associated with more frequent use of school-based stress management interventions. These findings suggest that demand-tailored stress management programs in high schools could help students better cope with high stress levels—particularly those experiencing low QoL in the school setting.
Keywords: Perceived stress scale, Stress levels, Quality of Life, COVID-19 pandemic, mixed-methods, Stress management interventions, school-based mental health promotion
Received: 02 Jul 2025; Accepted: 14 Nov 2025.
Copyright: © 2025 John, Otttmann, Rechberg, O'rourke, Pryss and Probst. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dennis John, dennis.john@evhn.de
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