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Chekol AT, Reta Y, Ayinewa F, Hailu L, Tesema M, Wale MA. Determinants of premenstrual dysphoric disorder and associated factors among regular undergraduate students at Hawassa University Southern, Ethiopia, 2023: institution-based cross-sectional study. BMC Public Health 2024; 24:1390. [PMID: 38783237 PMCID: PMC11119308 DOI: 10.1186/s12889-024-18798-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is a condition causing severe emotional, physical, and behavioral symptoms before menstruation. It greatly hinders daily activities, affecting academic and interpersonal relationships. Attention is not given to premenstrual disorders among female students in higher education. As a result, students are susceptible to stress, and their academic success is influenced by various factors, including their menstrual cycle, and the long-term outcomes and consequences are poorly researched. Even though PMDD has a significant negative impact on student's academic achievement and success limited research has been conducted in low- and middle-income countries including Ethiopia, especially in the study setting. Therefore, a study is needed to assess premenstrual dysphoric disorder and associated factors among regular undergraduate students at Hawassa University. METHODS An institutional-based cross-sectional study was conducted among 374 regular undergraduate female students at Hawassa University, College of Medicine and Health Sciences. A self-administered structured premenstrual symptoms screening tool for adolescents was used to assess premenstrual dysphoric disorder. The collected data were loaded into a statistical package for the social science version 25 and analyzed using it. Both bivariate and multivariate logistic regression were used to identify factors associated with premenstrual dysphoric disorder. Each independent variable was entered separately into bivariate analysis, and a variable with a p-value less than 0.25 were included in the multivariate analysis to adjust the possible confounders. Statistically significant was declared at a 95% confidence interval when variable with a p-value less than 0.05 in the multivariate analysis with premenstrual dysphoric disorder. RESULTS The magnitude of premenstrual dysphoric disorder in this study was 62.6% (95% CI 57.4-67.5). Having severe premenstrual pain (AOR = 6.44;95%CI 1.02-40.73), having irregular menstrual cycle (AOR = 2.21; 95% CI 1.32-3.70), students who had poor social support (AOR = 5.10;95%CI, (2.76-12.92) and moderate social support (AOR = 4.93;95%CI (2.18-11.18), and students who used contraception (AOR = 3.76;95%CI, 2.21-6,40) were statistically significant factors with the outcome variable. CONCLUSION The prevalence of premenstrual dysphoric disorder was high as compared to other studies. There was a strong link between irregular menstrual cycle, severe menstrual pain (severe dysmenorrhea), poor social support, and contraception use with premenstrual dysphoric disorder. This needs early screening and intervention to prevent the complications and worsening of the symptoms that affect students' academic performance by the institution.
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Affiliation(s)
- Aklile Tsega Chekol
- Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, 1560, Hawassa, Ethiopia.
| | - Yared Reta
- Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, 1560, Hawassa, Ethiopia
| | - Fikadu Ayinewa
- Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, 1560, Hawassa, Ethiopia
| | - Lielina Hailu
- Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, 1560, Hawassa, Ethiopia
| | - Mulualem Tesema
- Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, 1560, Hawassa, Ethiopia
| | - Mastewal Aschale Wale
- Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, 1560, Hawassa, Ethiopia
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Çınar Tanrıverdi E, Yılmaz S, Çayır Y. Evaluation the validity and reliability of the perceived medical school stress scale in Turkish medical students. PLoS One 2023; 18:e0288769. [PMID: 37566581 PMCID: PMC10420339 DOI: 10.1371/journal.pone.0288769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 07/04/2023] [Indexed: 08/13/2023] Open
Abstract
Medical education can be a challenging and stressful process. Additional stressors can make the medical education process even more complex and impair a student's attention and concentration. To the authors' knowledge, there is no valid and reliable scale to measure medical school stress in Turkish medical students. Therefore, this study aimed to determine the validity and reliability of the Perceived Medical School Stress (PMSS) Scale in Turkish medical students. The Perceived Medical School Stress Scale is a self-assessment tool developed to measure medical school-induced stress in medical students. It consists of 13 items divided into two subdimensions. Scale items are answered using a four-point (0-4) Likert system The total score that can be obtained from the PMSS ranges from 0 to 52, with higher scores indicating higher levels of perceived stress. First, the scale was applied as a pilot to 52 students by performing the scale's back-and-forth translation into Turkish. Then, the scale was applied to 612 volunteer medical students to ensure validity. Convergent validity and confirmatory factor analysis are used to assess the construct validity of a scale. Test-retest, item correlations, and Cronbach's alpha coefficients are used to evaluate the reliability of a scale. As a result of confirmatory factor analysis, the two-factor structure of the original scale was confirmed. The fit indices of the model obtained showed excellent fit. The Generalized Anxiety Disorder-7 (GAD-7) Scale was used for convergent validity. The GAD-7 is a self-assessment tool that measures the level of generalized anxiety. It is answered with a four-point Likert scale for the last two weeks. The score that can be obtained from the scale is between 0-21. A score of ten or more indicates possible anxiety disorder. The students' mean perceived medical school stress score was 39.80±8.09, and their GAD-7 score was 11.0±5.5. A significant positive relationship was found between the total scores of the scales (r = .48, P < .001). The Cronbach's alpha value of the scale was .81, and test-retest reliability was significant for all scale items (P < .001 for all). No item was deleted according to Cronbach's alpha values and item-total correlations. There was no significant relationship between Turkish version of the PMSS and GAD-7 scores and age, sex, income status, tobacco use, or exercise (P>.05). The Turkish version of the Perceived Medical School Stress Scale is a valid and reliable scale that can be used to investigate the medical school-specific stress of students.
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Affiliation(s)
- Esra Çınar Tanrıverdi
- Faculty of Medicine, Department of Medical Education, Atatürk University, Erzurum, Türkiye
| | - Sinan Yılmaz
- Faculty of Medicine, Department of Public Health, Atatürk University, Erzurum, Türkiye
| | - Yasemin Çayır
- Faculty of Medicine, Department of Family Medicine, Atatürk University, Erzurum, Türkiye
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Young C, Juliani M. Universal Brief Mental Health Screenings for First-Year Medical Students: A 6-Year Retrospective of the Keck Checks Program. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:782-787. [PMID: 36780668 DOI: 10.1097/acm.0000000000005169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Medical students are at elevated risk for mental health difficulties and may struggle to ask for help. Innovative outreach programs are warranted to reduce barriers and ensure that students receive the professional care they need and deserve. This article provides a 6-year retrospective of the Keck Checks program, a well-established initiative that offered universal 15-minute mental health screenings to every first-year medical student at the Keck School of Medicine of the University of Southern California from fall 2016 to fall 2022. This early detection program was designed to combat barriers to seeking mental health care by normalizing the concept of all students meeting with a psychologist early in their academic careers. The Keck Checks program showed promising feasibility, with a single full-time clinician successfully hosting appointments for entire classes of first-year medical students (mean of 189 students per class) during approximately 4 months, in addition to other work duties. Participation rates were high, with 715 eligible students (76.3%) choosing to attend their Keck Check. Students were frequently referred to follow-up services during the Keck Check, including mental health care (n = 360 [50.4%] referred), occupational therapy (n = 72 [10.1%] referred), and academic support services (n = 60 [8.4%] referred). Next steps include possible expansion of similar programs to medical students in years 2 to 4, residents, and physicians, as well as understanding the effect of brief mental health screenings on long-term help-seeking, adherence to mental health treatment plans, and general educational or professional success. Brief, universal mental health screenings are a relatively low-cost, high-impact approach for medical schools to consider in supporting the mental health of their student body.
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Affiliation(s)
- Chantal Young
- C. Young is director of medical student well-being, director, Office of Well-being, and assistant professor of clinical medical education and psychiatry, Keck School of Medicine of the University of Southern California, Los Angeles, California; ORCID: http://orcid.org/0000-0001-7271-5417
| | - Maria Juliani
- M. Juliani is associate director of medical student well-being and associate professor of clinical medical education and psychiatry, Keck School of Medicine of the University of Southern California, Los Angeles, California; ORCID: https://orcid.org/0000-0001-6660-1149
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Kaiser H, Grice T, Walker B, Kaiser J. Barriers to help-seeking in medical students with anxiety at the University of South Carolina School of Medicine Greenville. BMC MEDICAL EDUCATION 2023; 23:463. [PMID: 37344832 PMCID: PMC10286385 DOI: 10.1186/s12909-023-04460-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/16/2023] [Indexed: 06/23/2023]
Abstract
Anxiety levels in medical students have been reported as higher than the aged-matched general population, yet medical students are less likely to seek care for mental health issues. Medical students carry high levels of self-stigma about their own mental health and fear the negative consequences of seeking care. The purpose of this study was to examine the student population at the University of South Carolina School of Medicine Greenville (UofSC SOMG) for anxiety levels and determine the self-stigma attitudes this population carries. UofSC SOMG students were surveyed using the GAD7, questions about mental health stigma, and open-ended questions on barriers to mental health care in medical students. Anxiety levels were compared to student responses. 31% of students reported moderate-severe anxiety levels. Stigma was the most frequently listed barrier to care, however, students with moderate-severe anxiety were more likely to report cost as a barrier to care than students with minimal anxiety levels. Despite free and accessible mental health care, medical students at UofSC SOMG still have anxiety at rates higher than the general population. Future work should help to provide interventions to the barriers of care, so medical students can better utilize mental health care resources.
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Affiliation(s)
- Helen Kaiser
- University of South Carolina School of Medicine Greenville, Greenville, SC, 29605, USA.
| | - Tori Grice
- University of South Carolina School of Medicine Greenville, Greenville, SC, 29605, USA
| | - Brittany Walker
- Prisma Health Upstate, 701 Grove Road Balcony Suite 5, Greenville, SC, 29605, USA
| | - Jacob Kaiser
- Prisma Center for Psychiatry, 109 Physicians Dr. Ste B, Greer, SC, 29650, USA
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Wallace MM. Strategies for Improving Mental Health in Physician Assistant Students. J Physician Assist Educ 2023; 34:157-159. [PMID: 37133898 DOI: 10.1097/jpa.0000000000000507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Michelle M Wallace
- Michelle M. Wallace, DMSc, PA-C, is a clinical professor and Director of Didactic Education in the Physician Associate Program, Wichita State University, Wichita, Kansas
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Avila-Carrasco L, Díaz-Avila DL, Reyes-López A, Monarrez-Espino J, Garza-Veloz I, Velasco-Elizondo P, Vázquez-Reyes S, Mauricio-González A, Solís-Galván JA, Martinez-Fierro ML. Anxiety, depression, and academic stress among medical students during the COVID-19 pandemic. Front Psychol 2023; 13:1066673. [PMID: 36710743 PMCID: PMC9874103 DOI: 10.3389/fpsyg.2022.1066673] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/22/2022] [Indexed: 01/13/2023] Open
Abstract
Background The social distancing policies implemented by the health authorities during the COVID-19 pandemic in Mexico and elsewhere led to major changes in teaching strategies for college undergraduates. So far, there is limited data regarding the impact of the lockdown on the academic stress and mental health of these students. Objective To assess the occurrence of academic difficulties, anxiety, depression, and academic stressors resulting in somatization with subsequent coping strategies linked to the pandemic. Materials and methods A cross-sectional study was conducted with 728 medical students (years 1-5). A purposely designed questionnaire to assess academic difficulties associated with the pandemic was administered electronically. The validated Goldberg anxiety and depression scale was also used, as well as the SISCO-II inventory on academic stress. Results Screening for anxiety and depression led to a prevalence of 67.9 and 81.3%, respectively. Most relevant stressors, reported always or nearly always, included professors' evaluations (63.9%), and reading overload of academic papers (50.6%). Factorial analyses showed that women were more prone to stress than men (p < 0.001). Somatization symptomatology included drowsiness or increased need of sleep, anxiety, anguish, desperation, chronic fatigue, and sleep disorders. Common coping strategies included practicing a hobby, done always or nearly always by 65% of students with high stress, and 34% of those with low stress (p < 0.001). Conclusion There was a relevant impact of the mandatory lockdown during COVID-19 pandemic on the mental health of medical students reflected in the high prevalence rates of anxiety, depression, and stressors in the studied population pointing to the need for designing and implementing preventive strategies to deal with the effects of lockdowns.
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Affiliation(s)
- Lorena Avila-Carrasco
- Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University, Zacatecas, Mexico,*Correspondence: Lorena Avila-Carrasco, ✉
| | - Daisy Lorena Díaz-Avila
- Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University, Zacatecas, Mexico
| | - Adrian Reyes-López
- Pathology and Molecular Diagnosis Laboratory, Academic Unit of Chemical Sciences, Zacatecas Autonomous University, Zacatecas, Mexico
| | - Joel Monarrez-Espino
- Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University, Zacatecas, Mexico,Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University, Zacatecas, Mexico
| | - Idalia Garza-Veloz
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University, Zacatecas, Mexico
| | - Perla Velasco-Elizondo
- Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University, Zacatecas, Mexico,Academic Unit of Electric Engineering, Zacatecas Autonomous University, Zacatecas, Mexico
| | - Sodel Vázquez-Reyes
- Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University, Zacatecas, Mexico,Academic Unit of Electric Engineering, Zacatecas Autonomous University, Zacatecas, Mexico
| | - Alejandro Mauricio-González
- Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University, Zacatecas, Mexico,Academic Unit of Electric Engineering, Zacatecas Autonomous University, Zacatecas, Mexico
| | - Jorge Alfonso Solís-Galván
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University, Zacatecas, Mexico
| | - Margarita L. Martinez-Fierro
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Zacatecas Autonomous University, Zacatecas, Mexico,Margarita L. Martinez-Fierro, ✉
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Braun P, Schwientek AK, Angerer P, Guthardt L, Icks A, Loerbroks A, Apolinário-Hagen J. Investigating information needs and preferences regarding digital mental health services among medical and psychology students in Germany: A qualitative study. Digit Health 2023; 9:20552076231173568. [PMID: 37256006 PMCID: PMC10226173 DOI: 10.1177/20552076231173568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 04/17/2023] [Indexed: 06/01/2023] Open
Abstract
Background Since 2020, physicians and psychotherapists in Germany can prescribe digital mental health services (dMHSs). However, even future healthcare professionals (HCPs), such as medical and psychology students, remain reluctant to use dMHSs, although they are a risk group for mental health issues themselves. Reasons include scepticism and lacking awareness of dMHSs, which can be addressed by acceptance-facilitating interventions (AFIs) such as information strategies. To date, though, little is known about their information needs. Methods Semi-structured interviews with n = 21 students were conducted between August and September 2021. Students of legal age studying psychology or medicine at a German university could participate. Interview recordings were transcribed verbatim and content-analyzed according to Mayring, using deductive and inductive coding. Results Most students reported having little experience with dMHSs. Digital health has barely been raised in their study, even though it was perceived as crucial for personal needs as well as in preparation for their work as HCPs. Students favoured receiving information on and recommendations for dMHSs from their university via, e.g. social media or seminars. Among others, information about data safety, scientific evidence base and application scope were preferred. Additionally, information on costs as well as user reviews seemed to be essential components of information strategies because students were concerned that high costs or low usability would hinder uptake. Conclusions The results give first insights on how future HCPs would like to be informed on dMHSs. Future research should focus on systematic variations of AFIs' components mimicking real-world decision scenarios to increase the adoption of dMHSs.
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Affiliation(s)
- Pia Braun
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Ann-Kathrin Schwientek
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
- Department of Psychiatry and
Psychotherapy, University Hospital rechts der Isar, School of Medicine, Technical
University of Munich, Munchen, Germany
| | - Peter Angerer
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Lisa Guthardt
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research
and Health Economics, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Jennifer Apolinário-Hagen
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
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Mohmand S, Monteiro S, Solomonian L. How are Medical Institutions Supporting the Well-being of Undergraduate Students? A Scoping Review. MEDICAL EDUCATION ONLINE 2022; 27:2133986. [PMID: 36268575 PMCID: PMC9590426 DOI: 10.1080/10872981.2022.2133986] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Medical students experience significant stress and impacts on mood due to multiple factors. Unmitigated stress impacts both physical and mental health while increasing the risk of unethical behavior. It is important for medical institutions to identify strategies that effectively reduce perceived stress and improve the well-being of their students. METHODS The authors undertook a scoping review of the literature to identify strategies implemented by medical educational programs to improve the well-being of medical students. RESULTS Of 1068 articles identified, 19 studies met the inclusion criteria. Interventions were categorized as mindfulness-based programs, reflection groups, curriculum changes, and 'miscellaneous.' All studies assessed outcomes of student stress/resilience, as well as additional domains including academic performance, mental health, and interpersonal skills. Some also assessed the acceptability of the intervention to students. CONCLUSIONS Despite the heterogeneity of interventions and outcome measures, a clear theme emerged that institutionally-provided strategies to promote student well-being tend to be effective when students opt into the program. It was noted that adding mandatory content or activities to a medical program without creating adequate space or support for it can have the opposite effect. Further high quality intervention studies involving randomization, blinding and rigorous controls are warranted.
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Affiliation(s)
- Shakila Mohmand
- Research Department, Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Sasha Monteiro
- Research Department, Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Leslie Solomonian
- Research Department, Canadian College of Naturopathic Medicine, Toronto, ON, Canada
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Prevalence of pharmacological and non-pharmacological coping mechanisms for anxiety management during the COVID-19 pandemic: investigating the transition to online learning among medical students. BMC Psychiatry 2022; 22:704. [PMID: 36376882 PMCID: PMC9662775 DOI: 10.1186/s12888-022-04372-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/07/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic had a devastating effect on college students worldwide. Here, the authors aimed to determine the prevalence of anxiety and its related coping strategies, provide a theoretical basis for understanding self-prescription, and identify the factors contributing to stress and anxiety in medical students during the pandemic. METHODS The authors conducted a cross-sectional study among medical students in Saudi Arabia from September to November 2020. They assessed anxiety using the GAD-7 scale based on seven core symptoms. The authors also examined perceived psychological stress using a single-item measure of stress, the factors contributing to stress during the transition to online learning and examinations, and related coping strategies. The Statistical Package for Social Sciences (SPSS) version 26.0 was used to examine the data for both descriptive and inferential analyses. Chi-square test, one-way ANOVA, and univariate linear regression were used to test the research hypotheses. RESULTS The authors collected and analyzed data from 7116 medical students distributed across 38 medical colleges. Among them, 40% reported moderate to severe anxiety symptoms. Pre-clinical and female students experienced more stress than clinical and male students. 12.19% (n = 868) of respondents reported using medication during their college years. Among those, 58.9% (n = 512) had moderate to severe anxiety, and the most commonly used drug was propranolol (45.4%, n = 394). Among the studied sample, 40.4% (n = 351) decreased their medication use after switching to online teaching. Most students used these medications during the final exam (35.8%, n = 311) and before the oral exam (35.5%, n = 308). In terms of coping strategies, males were much more likely to use substances than females, who mainly resorted to other strategies. CONCLUSIONS This study provides a national overview of the impact of COVID-19 on the mental health of medical students. The results indicated that the pandemic is associated with highly significant levels of anxiety. These findings can provide theoretical evidence for the need for supportive psychological assistance from academic leaders in this regard.
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Kim YR, Park HJ, Koo BH, Hwang JY, Lee YH. A study on the mental health of students at a medical school during COVID-19 outbreak: a retrospective study. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2022; 39:314-321. [PMID: 35971621 PMCID: PMC9580054 DOI: 10.12701/jyms.2022.00437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022]
Abstract
Background In this study, the degree of anxiety, depression, and stress caused by coronavirus disease 2019 (COVID-19) was identified, as well as the need for psychological prevention measures among medical students in the Daegu region that was designated the first special disaster area due to the spread of COVID-19. Methods The subjects of this study were 318 medical students in Daegu who voluntarily participated in an online test using the Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised Korean version. As a result of the test, risk students received immediate telephone counseling, and the effect of this telephone counseling was analyzed. Results There were no differences in depression, anxiety, or stress according to gender and grade. As a result of immediate telephone counseling for risk students, significant differences were found in depression, anxiety, and stress, and the counseling was found to be effective. Conclusion For medical students who are easily exposed to stress, the importance of psychological prevention measures and effectiveness of non-face-to-face counseling should be recognized. In the field of medical education, we must do our best to build a system that can be used immediately at the appropriate time for these programs.
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Affiliation(s)
- Yu Ra Kim
- Department of Medical Humanities, Yeungnam University College of Medicine, Daegu, Korea
| | - Hye Jin Park
- Department of Medical Education, Eulji University School of Medicine, Daejeon, Korea
| | - Bon-Hoon Koo
- Department of Psychiatry, Yeungnam University College of Medicine, Daegu, Korea
| | | | - Young Hwan Lee
- Department of Medical Humanities, Yeungnam University College of Medicine, Daegu, Korea
- Corresponding author: Young Hwan Lee, MD, PhD Department of Medical Humanities, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea Tel: +82-53- 640-6999 • Fax: +82-53-629-2252 • E-mail:
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Nsubuga M, Opoka RO, Galukande M, Munabi IG, Mubuuke AG, Kiguli S. Perceptions of orthopaedic medicine students and their supervisors about practice-based learning: an exploratory qualitative study. BMC MEDICAL EDUCATION 2022; 22:705. [PMID: 36199134 PMCID: PMC9533535 DOI: 10.1186/s12909-022-03771-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/06/2022] [Accepted: 09/16/2022] [Indexed: 06/11/2023]
Abstract
BACKGROUND Practice-based learning is crucial in forming appropriate strategies for improving learning among the medical students that support the country's understaffed health sector. Unsatisfactory learning consequently results in poor performance of students and poor quality of health care workforce in the long run. Exploring the perceptions about the current practice-based learning system and how to improve is thus vital. This study set out to explore the perceptions of Orthopaedic medicine students and their supervisors about practice-based learning at a tertiary training hospital. METHODS This was an exploratory phenomenological qualitative study that involved in-depth interviews among 10 Orthopedic students during their rotation in the emergency ward of Mulago hospital and 6 of their supervisors. Interviews were audio-recorded, transcribed, and then imported into Atlas ti 8.3 for analysis. The data were coded and grouped into themes relating to perceptions of practice-based learning, general inductive analysis was used. The general inductive approach involved condensing the raw textual data into a brief and summary format. The summarized format was then analyzed to establish clear links between the perceptions of practice-based learning and the summary findings derived from the raw data. RESULTS The mean age of the students was 23 ± 1.5 years. Four out of the six supervisors were Orthopaedic officers while the remaining two were principal Orthopaedic officers, four out of the six had a university degree while the other two were diploma holders. The main themes arising were hands-on skills, an unconducive learning environment, the best form of learning, and having an undefined training structure. Particularly, the perceptions included the presence of too many students on the wards during the rotation, frequent stock-outs of supplies for learning, and supervisors being overwhelmed caring for a large number of patients. CONCLUSION Barriers to satisfactory practice-based learning were overcrowding on the wards and insufficient training materials. To improve practice-based learning, adequate learning materials are required and the number of students enrolled needs to be appropriate for the student - supervisor ratio.
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Affiliation(s)
| | - Robert O Opoka
- School of Medicine, College of Health Sciences, Makerere University, Makerere, Uganda
| | - Moses Galukande
- School of Medicine, College of Health Sciences, Makerere University, Makerere, Uganda
| | - Ian G Munabi
- School of Biomedical Sciences, College of Health Sciences, Makerere University, Makerere, Uganda
| | - Aloysius G Mubuuke
- School of Medicine, College of Health Sciences, Makerere University, Makerere, Uganda
| | - Sarah Kiguli
- School of Medicine, College of Health Sciences, Makerere University, Makerere, Uganda
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Prevalence of mental distress and associated factors among medical students of University of Gondar, Northwest Ethiopia: a cross-sectional study. BMC Psychiatry 2022; 22:523. [PMID: 35918673 PMCID: PMC9345005 DOI: 10.1186/s12888-022-04174-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental distress is the most common problem among medical students. This is associated with severe consequences of lack of empathy for their patients, committing medical errors, and suicidal ideations and attempts. However, there is limited data on this aspect where the study was conducted especially in this segment of the population. Considering its seriousness, this study will have pivotal input information to plan possible interventions for the future. So, this study is aimed at assessing the prevalence of mental distress and its associated factors among medical students of the University of Gondar, Northwest Ethiopia, 2021. METHODS An institutional-based cross-sectional study was conducted using a stratified random sampling technique to get a total of 438 study subjects from April 15-30/2021. Mental distress data were collected using a self-administrated questionnaire of the 10-item Kessler Psychological Distress Scale. Data was entered to Epi-data version 4.6.02 and cleaned, coded, and analyzed using STATA version 14. RESULTS The prevalence of mental distress among medical students was 193(45.95%) with 95% CI (41.2, 50.7). In multi-variable logistic regression being female sex (AOR = 4.5, 95% CI = 2.66, 8.12), lack of interest towards field of study (AOR = 4.4, 95%, CI = (2.18, 8.78), current alcohol use (AOR = 5.8, 95% CI = 3.03, 11.15), monthly pocket money < 735 Ethiopian birr (AOR = 3.1, 95% CI = 1.53, 6.04), extremely high test anxiety (AOR = 3.9, 95% CI = 1.27, 11.88), family history mental illness (AOR = 2.5 95% CI = 1.12, 5.53) and poor social support (AOR = 4.2, 95% CI = (1.94, 9.16) were significantly associated with mental distress. CONCLUSION AND RECOMMENDATION Prevalence of mental distress among medical students of University of Gondar was found to be higher when compared to previous studies among this population in Ethiopia. It is recommended that the school of medicine should give undue attention to address those identified factors by establishing counseling centers to minimize mental distress.
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Griffin L, Riley R. Exploring the psychological impact of working during COVID-19 on medical and nursing students: a qualitative study. BMJ Open 2022; 12:e055804. [PMID: 35738645 PMCID: PMC9226460 DOI: 10.1136/bmjopen-2021-055804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To identify the psychological impact of working during the COVID-19 pandemic on medical and nursing students' psychological well-being. To inform recommendations for the provision of future student well-being support. DESIGN An interpretative qualitative, semistructured interview study employing maximum variation sampling, snowball sampling and a thematic analysis. SETTING A large West Midlands (UK) university with medical and nursing undergraduate and postgraduate programmes. Study undertaken between January and May 2020. PARTICIPANTS A purposive sample of eight medical (six women and two men) and seven nursing (all women) students who worked >2 weeks in a healthcare setting during the COVID-19 pandemic (from 1 March 2020 onwards). RESULTS Four core themes with corresponding subthemes were identified: (1) COVID-19 sources of distress-working conditions, exposure to suffering, death and dying, relationships and teams, individual inexperience and student identity, (2) negative impact on mental health and well-being-psychological and emotional distress, delayed distress, exhaustion, mental ill health, (3) protective factors from distress-access to support, environment, preparation and induction, recognition and reward, time for breaks and rest and (4) positive experiences and meaningful outcomes. CONCLUSIONS Student pandemic deployment has had a significant negative impact on students' psychological well-being, as a result of demanding working conditions, unprecedented exposure to death and suffering and lack of preparation for new job roles. Universities and healthcare organisations must formally acknowledge this impact and provide well-being support for distressed students working in such challenging contexts. They must also establish more supportive and inclusive healthcare environments for medical and nursing students in future pandemic and postpandemic circumstances, through the implementation of support systems and adequate preparation.
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Affiliation(s)
- Louise Griffin
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Ruth Riley
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guilford, UK
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Martins JMS, Ferreira EAL, Valete COS, Gramasco HHF. Fantastic Lifestyle Questionnaire applied to undergraduate medical students during the COVID-19 pandemic: a factor analysis. Rev Assoc Med Bras (1992) 2022; 68:658-663. [DOI: 10.1590/1806-9282.20220026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/08/2022] [Indexed: 12/28/2022] Open
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Depression and suicidal ideation among medical students in a private medical college of Bangladesh. A cross sectional web based survey. PLoS One 2022; 17:e0265367. [PMID: 35486632 PMCID: PMC9053818 DOI: 10.1371/journal.pone.0265367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/28/2022] [Indexed: 11/19/2022] Open
Abstract
This study was done to investigate the prevalence of depression and suicidal ideation among private medical students in Bangladesh. A total of 237 medical students participated in this cross-sectional web-based survey by e-questionnaire using the Google Form. The study was conducted from November 2020 to December 2020 at Enam Medical College and Hospital which is situated in Savar, Dhaka, Bangladesh. Out of 237 medical students, prevalence of depression was found 58.6%, and prevalence of suicidal ideation was found 27.4% which is higher than the global prevalence. Bivariate and multivariate analysis and logistic regression-based odds ratios (ORs) was done to see the association between grade of depression and suicidal thoughts with different variables. Association between grade of depression with family problems (x2 = 16.716, P = 0.001), drug addiction (x2 = 16.601, P = 0.001), committed relationship status (x2 = 40.292, P = <0.001) were statistically significant. Whereas, the association between suicidal thoughts with family problems (x2 = 29.881, P = <0.001), failed any subject during study (x2 = 12.024, P = 0.007), alcohol uses (x2 = 15.977, P = 0.001), drug addiction (x2 = 22.633, P = <0.001), committed relationship status (x2 = 35.219, P = <0.001) were statistically significant. However, medical students whom had to earn other than their family income were 2.3 times (OR: 2.285, 95% CL: 0.897, 5.820) greater prone to be depressed than those who do not had to earn by themselves. On the contrary, medical students who are single were 2.35 times (OR: 2.352, 95% CL: 0.926, 5.973) greater prone to have suicidal thoughts than the married students. This study showed that a large percentage of Bangladeshi medical students have been suffering from depression and suicidal ideation. Our recommendation for the authority of the medical colleges are, to build a system with counselling facilities inside every medical colleges in Bangladesh.
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Shrestha B, Yadav S, Dhakal S, Ghimire P, Shrestha Y, Singh Rathaure E. Status of self-esteem in medical students at a college in Kathmandu: A descriptive cross-sectional study. F1000Res 2022; 10:1031. [PMID: 35464184 PMCID: PMC9021663 DOI: 10.12688/f1000research.72824.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Self-esteem is vital to living a happy, confident and content life. Medical students experience various forms of stress due to academic, financial and social pressures which could affect their levels of self-esteem. This study aims to study the status of self-esteem among undergraduates of a medical college at Tribhuvan University, Nepal. Methods: After receiving the ethical approval from the Institutional Review Committee (IRC) of NAIHS; we conducted a descriptive cross-sectional study among the first- to fifth-year medical students from December 2020 to April 2021. 190 were selected for the study using a stratified random sampling technique. This study used the Rosenberg self-esteem scale to measure self–esteem of the participants. A Google Forms questionnaire was sent to the participants via email. Then, the data obtained were entered in the Google sheet and later analyzed using SPSS 27. A Chi-square test was used to identify potential differences in self-esteem scores among different variables. A p-value of < 0.05 was considered statistically significant. Results: This study included a total of 180 participants, among which, 18.9% (13.19% to 24.61%; at 95% CI) students showed low self -esteem. 74.4% (68.02% to 80.78%; at 95% CI) students had normal self-esteem and 6.7% (3.05% to 10.35%; at 95% CI) students had high self-esteem. The mean self-esteem score was 19.19 (15.01 to 23.37; at 95% CI). Female participants suffered more than males from low self-esteem, and third-year students had the highest percentage of low self-esteem (30.77%). Conclusion: The majority (74.4%) of medical students had normal self-esteem. However, 18.9% students had low self-esteem, among which, third-year students suffered the most (30.77%). Likewise, females exhibited higher prevalence of low self-esteem compared to males. Interventions to boost the level of self-esteem should be carried out to help medical students become confident and efficient doctors.
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Affiliation(s)
- Bikal Shrestha
- Nepalese Army Institute of Health Sciences (NAIHS), Kathmandu, 44600, Nepal
| | - Stuti Yadav
- Nepalese Army Institute of Health Sciences (NAIHS), Kathmandu, 44600, Nepal
| | - Subodh Dhakal
- Nepalese Army Institute of Health Sciences (NAIHS), Kathmandu, 44600, Nepal
| | - Pooja Ghimire
- Nepalese Army Institute of Health Sciences (NAIHS), Kathmandu, 44600, Nepal
| | - Yubika Shrestha
- Nepalese Army Institute of Health Sciences (NAIHS), Kathmandu, 44600, Nepal
| | - Ela Singh Rathaure
- Epidemiology and Disease control division, USAID, Kathmandu, 44600, Nepal
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Association of internet addiction with depression, anxiety, stress, and the quality of sleep: mediation analysis approach in Serbian medical students. CURRENT RESEARCH IN BEHAVIORAL SCIENCES 2022. [DOI: 10.1016/j.crbeha.2022.100071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Sattar K, Yusoff MSB, Arifin WN, Yasin MAM, Nor MZM. Effective coping strategies utilised by medical students for mental health disorders during undergraduate medical education-a scoping review. BMC MEDICAL EDUCATION 2022; 22:121. [PMID: 35193564 PMCID: PMC8863569 DOI: 10.1186/s12909-022-03185-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/16/2022] [Indexed: 06/09/2023]
Abstract
BACKGROUND Coping denotes cognitive, emotional and behavioural struggles to tackle a troubled person-environment association. Therefore, coping strategies (CSs) are vital for mental well-being. Widespread research studies have explored this domain, targeting caregivers, nurses, physicians and medical teachers, but limited research has been done to explore the common CSs utilised by medical students at the undergraduate medical education level. Therefore, we aimed to identify the frequently occurring CSs and their effects on mental health disorders (MHDs) through the evidence available in the existing literature. METHODS For this scoping review, we searched the available literature (articles published from January 1, 1986, to March 31, 2021) on CSs at Google Scholar, PubMed and Scopus using the terms coping, medical students and undergraduate medical education. We included in our search all peer-reviewed journal articles whose central topics were the CSs employed by undergraduate medical students of any age, nationality, race and gender. RESULTS From among the 2,134 articles that were found, 24 were ultimately included in the study. The articles were authored in 14 countries, allowing us to gather broader data to answer our research question. The first identified theme (MHDs) had four subthemes: stress (55% of the articles), depression (30%), anxiety (25%) and burnout (15%). The second theme (CSs), on the other hand, had eight subthemes: support seeking (60%), active coping (40%), acceptance (40%), avoidance/denial (40%), substance abuse (35%), faith/religion (25%), sports (25%) and miscellaneous (40%). CONCLUSIONS Themes and subthemes were identified about the most common CSs utilised by undergraduate medical students to tackle common MHDs in the context of medical education. Among the most used CSs was support (social and emotional) seeking. Teaching medical students how to cope with challenging times is essential.
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Affiliation(s)
- Kamran Sattar
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | - Wan Nor Arifin
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohd Azhar Mohd Yasin
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Mohd Zarawi Mat Nor
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Jacobs RJ, Caballero J, Kane MN. Medical Students’ Confidence in Their Abilities and Barriers to Conducting Research: A Mixed-Methods Study. Cureus 2022; 14:e20896. [PMID: 35145801 PMCID: PMC8809207 DOI: 10.7759/cureus.20896] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2021] [Indexed: 11/05/2022] Open
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Al-Hasani ID, Salih HS, Wahid ATA, Jabarah M. The Impact of Social Support on Students’ Behavior in the Context of Iraqi Medical Education. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Mental health problems are reflected and linked to human behavior in many aspects. Medical students are susceptible to a wide variety of events that compromise their mental well-being, social life as well as their academic achievements.
AIM: This study aimed to find the impact of social support on medical students’ behavior in Iraq via assessing their depression, anxiety, and stress status.
METHODS: A cross-sectional online survey-based study targeted all medical students in Iraq. The employed questionnaires covered mental health status of participants by evaluating their perceptions of depression, anxiety, and stress using. Data were analyzed using the Statistical Analysis System.
RESULTS: The study revealed a significant influence of social support on students’ perceptions of depression and anxiety, but not of their perception of stress.
CONCLUSION: Lending social support to medical student is crucial to improve their depression and anxiety with all the positive results that the support brings to their behavior and social life. However, they need more than the social support to keep them safe from academic and daily life stressors.
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Ambiguity tolerance among medical students and its relationship with personality and participation in the mentoring program: A cross-sectional study. Ann Med Surg (Lond) 2021; 62:425-430. [PMID: 33643640 PMCID: PMC7889433 DOI: 10.1016/j.amsu.2021.01.068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 11/24/2022] Open
Abstract
Background Low ambiguity tolerance (AT) can lead to burnout and impact medical students' quality of life. Interventions are effective in increasing tolerance in ambiguous situations. Mentors can be facilitators in ambiguous situations. We aimed to determine the AT among Tehran University of medical sciences (TUMS) medical students and assess its relation with personality traits and mentor-seeking behavior. Methods A cross-sectional study was designed. We used Budner AT questionnaire and the Ten Item Personality Inventory in our study. Questionnaires were sent to 350 randomly selected TUMS medical students in different years of education. Two hundred six students completed the questionnaires. The response rate was 58.85%. Results The mean AT score was 59.77 among TUMS medical students. No significant difference was seen between different genders and students with different marital statuses. Also, AT was constant among students at different years at medical school and at different education levels (P > 0.05). Students who had participated in the mentoring program were significantly more intolerant of novel situations (P = 0.01). However, they did not have significantly different scores in other subscales of AT scale and its total score than those who had not participated in the mentoring program (P > 0.05). Conclusion Medical students are more intolerant of ambiguity at TUMS than medical students abroad, and there should be interventions to help them cope in ambiguous situations. Mentoring programs may also be considered for future interventions as participants who participate in the program are less tolerant of ambiguity in novel situations.
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Alsini A, Alkhodaidi I, Alsini Y, Alsseeni S, Alkhodaidi S, Alsini E, Alsini A, Sindi H, Alswat K. A National Survey of Self-Prescription of Beta-Blockers and Their Relation to Undiscovered Anxiety Among Medical and Pharmacological Students in Saudi Arabia. Neuropsychiatr Dis Treat 2021; 17:797-807. [PMID: 33762824 PMCID: PMC7982708 DOI: 10.2147/ndt.s289833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The development of beta-blocker (BB) medications is considered one of the most critical milestones of drug research. Several trials showed possible anti-anxiety effects of BBs. Our primary goal is to investigate the prevalence of anxiety disorder and the use of BBs as anxiolytic without medical prescription among medical and pharmacological students in Saudi Arabia. METHODS A cross-sectional study was conducted at multiple universities in Saudi Arabia. Students were given a questionnaire containing 44 questions that included demographic data, school location, BB usage behavior, GPA status before and after using BBs, and a GAD-7 anxiety screening questionnaire. RESULTS A total of 3326 mainly female senior students participated in the study with a mean age of 21.9±1.7 years. According to the GAD-7 score, half of the sampled students did not meet criteria indicative of anxiety disorder, and one-third were considered to have mild anxiety with a significant positive correlation between the BB usage and the GAD-7 score. A total of 6.4% of the sample reported usage of BBs. Therapeutics and Internal Medicine were the most common subjects for which BBs were used. When compared to pharmacy students, medical students were more likely to be male, smokers, diagnosed with psychiatric illness, having a higher mean GAD-7 score, report BB usage, and correctly identified common and serious BB side effects. CONCLUSION The inappropriate use of BB drugs without medical advice might have short- and long-term effects, and those may be more vulnerable to have psychological issues in the future. Our findings shed light on the need to identify students who are taking BBs as being at high risk of underlying anxiety disorders.
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Affiliation(s)
- Albaraa Alsini
- Resident, Department of Otolaryngology Head & Neck Surgery, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Ishraq Alkhodaidi
- Medical Student, Faculty of Medicine, Taif University, Taif, Saudi Arabia
| | - Yasir Alsini
- PharmD, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | | | - Shrooq Alkhodaidi
- Resident, Department of Dermatology, King Abdulaziz Hospital, Makkah, Saudi Arabia
| | - Ehsan Alsini
- PharmD, Medical Representative in Eli Lilly and Company, Taif, Saudi Arabia
| | - Asim Alsini
- Medical Intern, Faculty of Medicine, Taif University, Taif, Saudi Arabia
| | - Hamzah Sindi
- Medical Student, Faculty of Medicine, Umm AlQura University, Makkah, Saudi Arabia
| | - Khaled Alswat
- Professor of Medicine, Department of Medicine, School of Medicine, Taif University, Taif, 21944, Saudi Arabia
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Neres BSP, Aquino MLA, Pedroso VSP. Prevalence and factors associated to depression and suicidal behavior among medical students. JORNAL BRASILEIRO DE PSIQUIATRIA 2021. [DOI: 10.1590/0047-2085000000351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective: Depression and suicidal behavior have been described as major problems among medical students. The aim of this study was to assess the prevalence of depression and suicidal behavior among medical students of an institution and to investigate possible associated variables. Methods: The authors carried out a cross-sectional study through a self-administered questionnaire, including the Beck Depression Inventory (BDI) and the Beck’s Suicide Intent Scale (BSIS) instruments. The diagnosis of depression was based on an instrument adapted according to the DSM-IV and ICD-10 criteria. Logistic regression was performed to search for depression predictor variables. Results: In a total of 381 students, the prevalence of depression was 27.6%. Suicidal ideation of moderate to severe intensity was observed in 10.5% of the sample. About 6% of students had previously attempted suicide. Consumption of licit and illicit drugs was frequent among the participants, reaching 78% and 24% of the sample, respectively. The demand for specialized treatment was lower than expected among students with depression. Logistic regression revealed that female gender, reduced interpersonal contact with friends, reduced physical activity, difficulty in facing new situations and high perception of personal pressure were risk factors for depression. Conclusion: The prevalence of depression and suicidal behavior among medical students is higher than in the general population. There is a need for further studies to enable a better understanding of the risk factors and variables at play, which is fundamental for the development of early intervention strategies and support for students.
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Manzi J, Casapulla S, Kropf K, Baker B, Biechler M, Finch T, Gerth A, Randolph C. Responding to Racism in the Clinical Setting: A Novel Use of Forum Theatre in Social Medicine Education. THE JOURNAL OF MEDICAL HUMANITIES 2020; 41:489-500. [PMID: 31984454 DOI: 10.1007/s10912-020-09608-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Issues of race have traditionally been addressed in medical school curricula in a didactic manner. However, medical school curricula often lack adequate opportunity for the application of learning material relating to race and culture. When confronted with acts of racism in clinical settings, students are left unprepared to respond appropriately and effectively. Forum Theatre offers a dynamic platform by which participants are empowered to actively engage with and become part of the performance. When used in an educational context, Forum Theatre can be a powerful tool for students to interact with a wide variety of social issues. This paper describes the process by which one medical school designed a workshop in the Forum Theatre style to equip students to respond to racism observed in clinical settings. Based on real student experiences, the Responding to Racism in the Clinical Setting workshop was designed to give students an opportunity to combine cultural humility, communication theory and conflict resolution skills in order to prepare for interactions in clinical stages of medical education. As a result of workshop evaluations, surveys, and written reflections, the authors propose that Forum Theatre is a novel teaching modality for incorporating issues of race and culture into medical curriculum.
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Affiliation(s)
- Joel Manzi
- Ohio University Heritage College of Osteopathic Medicine-Cleveland, 4180 Warrensville Center Road, Warrensville Heights, OH, 44122, USA.
| | - Sharon Casapulla
- Office of Rural and Underserved Programs, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Katherine Kropf
- Department of Family Medicine, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Brandi Baker
- Office of Inclusion, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Merri Biechler
- Theater Division, School of Dance, Film, and Theater, Ohio University, Athens, OH, USA
| | - Tiandra Finch
- Ohio University Heritage College of Osteopathic Medicine-Cleveland, 4180 Warrensville Center Road, Warrensville Heights, OH, 44122, USA
| | - Alyssa Gerth
- Ohio University Heritage College of Osteopathic Medicine-Cleveland, 4180 Warrensville Center Road, Warrensville Heights, OH, 44122, USA
| | - Christina Randolph
- Ohio University Heritage College of Osteopathic Medicine-Cleveland, 4180 Warrensville Center Road, Warrensville Heights, OH, 44122, USA
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Fletcher I, Castle M, Scarpa A, Myers O, Lawrence E. An exploration of medical student attitudes towards disclosure of mental illness. MEDICAL EDUCATION ONLINE 2020; 25:1727713. [PMID: 32054420 PMCID: PMC7034470 DOI: 10.1080/10872981.2020.1727713] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Background: Medical students are reluctant to access mental health services, despite having high rates of anxiety and depression. This reluctance persists through residency and into practice. Physicians and trainees who are unwell deliver lower quality patient care, behave less professionally, communicate less effectively and are at an increased risk for burnout and suicide. Little is known about whether students would disclose a mental health diagnosis on a state board medical license application.Objectives: The objectives of this study were to determine whether University of New Mexico School of Medicine (UNM SOM) students would be willing to disclose a mental health diagnosis on a medical licensing application if prompted to do so, and, if not, to identify the reasons for their unwillingness to do so.Design: We electronically invited all UNM SOM students enrolled in the Classes of 2019, 2020, 2021, and 2022 to participate in a confidential RedCap survey about mental health diagnoses and treatment. Four e-mail invitations and reminders were sent to students over a one-month period.Results: Response rate was 50.1%. Thirty-six percent of all respondents considered themselves to have had a mental health condition prior to medical school, and 47% of all respondents perceived a decline in mental health during medical school. The majority of respondents who perceived they had a mental health diagnosis (51%) stated they would not disclose this information on a New Mexico Medical Board (NMMB) license application. Fear of stigmatization, fear of repercussions, and a belief that such disclosure was irrelevant were the top reasons for non-disclosure.Conclusion: Students who perceive themselves to have mental health diagnoses are unlikely to disclose their mental health status on state medical board licensing applications when asked to do so. Addressing barriers to disclosure of mental health diagnoses is necessary for building a healthier physician workforce.
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Affiliation(s)
- Ian Fletcher
- School of Medicine, University of New Mexico, Albuquerque, USA
| | - Michael Castle
- School of Medicine, University of New Mexico, Albuquerque, USA
| | - Aaron Scarpa
- School of Medicine, University of New Mexico, Albuquerque, USA
| | - Orrin Myers
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Elizabeth Lawrence
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
- CONTACT Elizabeth Lawrence Department of Internal Medicine, University of New Mexico School of Medicine, Fitz Hall, Room 107 MSC08 47001, Albuquerque, NM87131, USA
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Guang SA, Eltorai AEM, Durand WM, Daniels AH. Medical student burnout: Impact of the gap year in burnout prevention. Work 2020; 66:611-616. [DOI: 10.3233/wor-203203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | - Wesley M. Durand
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Alan H. Daniels
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Pokhrel NB, Khadayat R, Tulachan P. Depression, anxiety, and burnout among medical students and residents of a medical school in Nepal: a cross-sectional study. BMC Psychiatry 2020; 20:298. [PMID: 32539732 PMCID: PMC7294639 DOI: 10.1186/s12888-020-02645-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 05/01/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Medical students and residents were found to have suffered from depression, anxiety, and burnout in various studies. However, these entities have not been adequately explored in the context of Nepal. We proposed to determine the prevalence of depression, anxiety, burnout, their associated factors, and identify their predictors in a sample of medical students and residents in a Nepalese medical school. METHODS It was a cross-sectional study with 651 medical students and residents chosen at random between December 2018 and February 2019. The validated Nepali version of Hospital Anxiety and Depression Scale, the Copenhagen Burnout Inventory, and Medical Students' Stressor Questionnaire were used to assess depression, anxiety, burnout, and stressors respectively. We used univariate and multivariable logistic regression analyses to identify the correlation of predictor variables with depression, anxiety, and burnout. RESULTS The overall prevalence of burnout (48.8%; 95% CI 44.9-52.7) and anxiety (45.3%; 95% CI 41.4-49.2) was more than that of depression (31%; 95% CI 27.5-34.7). Burnout and depression were more prevalent in residents than in medical students (burnout: 64.5% vs 37.6%, P-value < 0.0001; depression: 33.7% vs 29.1%, P-value 0.21). Whereas, medical students were found more anxious than residents (46.3% versus 43.96%, P-value 0.55). Academic related stressors caused high-grade stress to participants. Multivariable model for depression significantly showed anxiety, personal burnout, and work-related burnout as risk enhancing correlates; satisfaction with academic performance as a protective correlate. Similarly, the multivariate model for anxiety significantly identified female gender, depression, personal burnout, teaching and learning related stressors, and past history of mental illness as risk enhancing correlates; being satisfied with academic performance, getting adequate sleep, and being a second-year resident as protective correlates. The logistic model for burnout significantly showed being a first-year resident, depression, anxiety, and drive and desire related stressors as positive predictors. None of the variables were identified as significant negative predictors of burnout. CONCLUSIONS A high prevalence of depression, anxiety, and burnout was seen among medical students and residents. Most of them were stressed with academic-related factors. A strong correlation between teaching and learning-related stressors with depression and anxiety may be a call for an efficient and more student-friendly curriculum.
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Affiliation(s)
| | - Ramesh Khadayat
- grid.80817.360000 0001 2114 6728Tribhuvan University Institute of Medicine, Kathmandu, Nepal
| | - Pratikchya Tulachan
- grid.80817.360000 0001 2114 6728Department of Psychiatry and Mental Health, Tribhuvan University Institute of Medicine, Kathmandu, Nepal
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Howarth SD, Johnson J, Millott HE, O’Hara JK. The early experiences of Physician Associate students in the UK: A regional cross-sectional study investigating factors associated with engagement. PLoS One 2020; 15:e0232515. [PMID: 32396539 PMCID: PMC7217467 DOI: 10.1371/journal.pone.0232515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 04/16/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The number of physician associates (PAs) training and working in the UK has increased over the last few years following the proliferation of postgraduate courses. Understanding early experiences and what impacts on engagement is important if we are to appropriately support this relatively new professional group. METHODS This paper reports on a cross-sectional analysis of the first year of data from a prospective 10-year longitudinal cohort study. First year PA students (n = 89) were enrolled from five universities in one UK region where the training programmes were less than 2 years old. Data collected were: demographic information, wellbeing, burnout and engagement, expectations, placement experience, performance and caring responsibilities. Pearson's correlations were used to examine relationships between variables and to select variables for a hierarchical regression analysis to understand which factors were associated with engagement. Descriptive statistics were calculated for questions relating to experience. RESULTS The experiences of PA students during their first 3-6 months were mixed. For example, 78.7% of students felt that there were staff on placement they could go to for support, however, 44.8% reported that staff did not know about the role and 61.3% reported that staff did not know what clinical work they should undertake. Regression analysis found that their level of engagement was associated with their perceived career satisfaction, overall well-being, and caring responsibilities. CONCLUSIONS The support systems required for PAs may need to be examined as results showed that the PA student demographic is different to that of medical students and caring responsibilities are highly associated with engagement. A lack of understanding around the PA role in clinical settings may also need to be addressed in order to better support and develop this workforce.
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Affiliation(s)
- Sarah D. Howarth
- Leeds Institute of Medical Education, University of Leeds, Leeds, United Kingdom
| | - Judith Johnson
- School of Psychology, University of Leeds, Leeds, United Kingdom
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Helen E. Millott
- Leeds Institute of Medical Education, University of Leeds, Leeds, United Kingdom
| | - Jane K. O’Hara
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
- School of Healthcare, University of Leeds, Leeds, United Kingdom
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Bashir MBA, Mohamed SOA, Nkfusai CN, Bede F, Oladimeji O, Tsoka-Gwegweni JM, Cumber SN. Assessment of minor psychiatric morbidity, stressors, and barriers of seeking help among medical students at the University of Khartoum, Khartoum, Sudan. Pan Afr Med J 2020; 35:87. [PMID: 32537090 PMCID: PMC7250227 DOI: 10.11604/pamj.2020.35.87.17512] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 03/15/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Medical education can be stressful and a source of psychiatric morbidity for medical students with the potential of causing serious professional and personal negative consequences. With the limited studies investigating this issue in Sudan, this study aimed at assessing psychiatric morbidity, determine stressors, evaluate mental health care seeking behavior and barriers to seeking help among medical students in Khartoum, Sudan. Methods This was a cross-sectional study with data collection for a period of one month, during the survey. Following ethical clearance and administrative approval, 644 students who gave consent were selected randomly from the university of Khartoum’s faculty of medicine. The “12-General Health Questionnaire (GHQ12)” was used as a tool to assess prevalence of psychiatric morbidity, determine stressors and evaluate barriers to seeking mental health care among students for a period of a month. Results The overall prevalence of psychiatric morbidity was 56% (n = 356). The mean score of the GHQ12 was 6.7. There was a statistically significant association between GHQ12-score and level of study (in medical school), age, student’s income (student financial allowance). Stressors mostly experienced by students were fear of academic failure, dissatisfaction with academic performance and examination stress. The most frequent barriers to seeking mental health care elicited by participants were fear of stigmatization 63% (n = 401), preference for dealing with the problem alone 60% (n = 379), fear of the unknown 59% (n = 365) and failure to recognize symptoms 58% (n = 366). Conclusion Psychiatric morbidity is commonly experienced by students in medical school as can be seen from the high prevalence (56%). The reported high figures of psychiatric morbidity among medical school students points to the urgency for interventions to address this problem with potential for negative sequelae (personal and professional). Our findings suggest that interventions to improve the social and economic conditions of students in medical school as well as addressing stigma related to mental health and educating students to recognize signs and symptoms of psychiatric morbidity while making help accessible might go a long way to address this challenge.
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Affiliation(s)
| | | | | | - Fala Bede
- Goergetown University's Center for Global Health Practice and Impact (CGHPI), TIDE-Cameroon Program, Bertoua, Cameroon
| | - Olanrewaju Oladimeji
- Center for Community Healthcare, Research and Development, Abuja, Nigeria.,Department of Public Health, Walter Sisulu University, Eastern Cape, South Africa.,Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | | | - Samuel Nambile Cumber
- Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.,Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, South Africa.,School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Zhang N, Henderson CNR. Predicting stress and test anxiety among 1st-year chiropractic students. THE JOURNAL OF CHIROPRACTIC EDUCATION 2019; 33:133-139. [PMID: 30830795 PMCID: PMC6759007 DOI: 10.7899/jce-18-11] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE We evaluated perceived stress in 1st-year chiropractic students and the relationship between perceived stress and test anxiety. Moreover, we sought student-identified stressors that complicate chiropractic education. METHODS We tested 3 hypotheses in a longitudinal descriptive study: (1) student-perceived stress would increase over 6 months of chiropractic training, (2) depression level and grade-point average (GPA) at matriculation would predict student-perceived stress 6 months into the program, and (3) perceived stress would correlate with cognitive and emotional test anxiety levels. Assessments used were prematriculation GPA, perceived chiropractic college stress (PCCS), the Center for Epidemiologic Studies Depression Scale, and the Test Anxiety Inventory. RESULTS Four hundred and seven students participated during 2014 and 2015. PCCS increased 18% after 6 months (t(406) = 6.32, p < .001, d = .33). Prematriculation GPA was not a significant predictor of PCCS at 6 months, p = .082. By contrast, the Center for Epidemiologic Studies Depression Scale at the beginning of the chiropractic training program was a significant predictor p < .001, multiple R2 = 7.1%. PCCS correlated with test anxiety worry and emotionality (r = .37, p < .001 and r = .35, p < .001, respectively). The top 4 stressors identified by students were (by priority) finances, time for a life outside school, personal competence/endurance, and curriculum/environment. CONCLUSION Our findings are consistent with perceived stress increases during medical school. Surprisingly, prematriculation GPA, a widely used academic performance predictor, was a poor predictor of PCCS, while depression level at matriculation was a moderate predictor. PCCS correlated with test anxiety worry and emotionality, known academic performance impediments.
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Robertson JJ, Long B. Medicine's Shame Problem. J Emerg Med 2019; 57:329-338. [PMID: 31431319 DOI: 10.1016/j.jemermed.2019.06.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 06/18/2019] [Accepted: 06/22/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Physician mental health is an increasingly discussed topic. Despite the progress made regarding the discussion of physician mental health, these issues remain concerning. In particular, the discussion as to why these issues are so problematic remains limited. Contributors can include bullying, the "hidden curriculum" of medicine, how the medical culture handles errors, and importantly, shame. OBJECTIVE This narrative review evaluates the literature on bullying and abuse in medicine, how abuse can exacerbate shame, how the handling of medical errors can exacerbate shame, how shame can negatively affect mental health, and how the medical community and leaders can mitigate these issues. DISCUSSION Physician mental health remains an important issue. Job-related stressors, bullying, medicine's hidden curriculum, medical error, traumatic patient encounters, and perfectionism can contribute to physician depression and burnout. Shame may underlie these factors. Shame is a universal emotion that leads to poor self-esteem, depression, eating disorders, abuse, and addiction. However, shame can be addressed and overcome, especially via acknowledgment, vulnerability, and empathy. The medical community can provide some of these techniques by encouraging environments of kindness and respect, giving constructive rather than destructive feedback, providing empathy and support after a medical error, and encouraging mutual learning environments where questions are asked with respect in order to enhance learning. This is opposed to hierarchies and "pimping," where questions are asked with intimidation and disrespect. CONCLUSIONS Shame is likely a contributor to physician mental health issues. For shame resilience to occur, it must not be kept secret and mutual support should be provided. By addressing the possible causes behind physician mental health concerns, including shame, more solutions can be proposed.
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Affiliation(s)
| | - Brit Long
- Brooke Army Medical Center, Fort Sam Houston, Texas
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The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152735. [PMID: 31370266 PMCID: PMC6696211 DOI: 10.3390/ijerph16152735] [Citation(s) in RCA: 304] [Impact Index Per Article: 60.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 12/11/2022]
Abstract
Anxiety, although as common and arguably as debilitating as depression, has garnered less attention, and is often undetected and undertreated in the general population. Similarly, anxiety among medical students warrants greater attention due to its significant implications. We aimed to study the global prevalence of anxiety among medical students and the associated factors predisposing medical students to anxiety. In February 2019, we carried out a systematic search for cross-sectional studies that examined the prevalence of anxiety among medical students. We computed the aggregate prevalence and pooled odds ratio (OR) using the random-effects model and used meta-regression analyses to explore the sources of heterogeneity. We pooled and analyzed data from sixty-nine studies comprising 40,348 medical students. The global prevalence rate of anxiety among medical students was 33.8% (95% Confidence Interval: 29.2–38.7%). Anxiety was most prevalent among medical students from the Middle East and Asia. Subgroup analyses by gender and year of study found no statistically significant differences in the prevalence of anxiety. About one in three medical students globally have anxiety—a prevalence rate which is substantially higher than the general population. Administrators and leaders of medical schools should take the lead in destigmatizing mental illnesses and promoting help-seeking behaviors when students are stressed and anxious. Further research is needed to identify risk factors of anxiety unique to medical students.
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Zhong X, Liu Y, Pu J, Tian L, Gui S, Song X, Xu S, Zhou X, Wang H, Zhou W, Chen J, Qi X, Xie P. Depressive symptoms and quality of life among Chinese medical postgraduates: a national cross-sectional study. PSYCHOL HEALTH MED 2019; 24:1015-1027. [PMID: 31179736 DOI: 10.1080/13548506.2019.1626453] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
High workloads and heavy academic pressure can have significant implications for the risk for depression and poor quality of life (QoL). This study aimed to investigate QoL and depressive symptoms in medical students undergoing postgraduate neurology specialty training in China. The survey covered demographic characteristics, the 8-itemMedical Outcomes Study Short-Formquestionnaire (SF-8), and the 2-itemPrimary Care Evaluation of Mental Disorders depression screening tool. Logistic regression analysis was used to investigate the determinants of QoL and depressive symptoms. Participants were 1,814 postgraduates from 249 hospitals in 27 Chinese provinces. The mean SF-8 physical and mental component summary scores were 78.17 (standard deviation [SD] 15.20) and 68.33 (SD 17.15), respectively. One-third of respondents had depressive symptoms, and those without depressive symptoms had significantly higher QoL scores. The multivariate regression analysis showed that factors independently associated with depressive symptoms were being in the second year of study, a lower household income, and less sleep time. Although QoL among our sample of Chinese medical students undergoing postgraduate neurology specialty training was favorable relative to other comparable populations, one-third of respondents had depressive symptoms. Accurate measures should be taken to change this situation.
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Affiliation(s)
- Xiaogang Zhong
- a School of Public Health and Management , Chongqing Medical University , Chongqing , China.,b Institute of Neuroscience , Chongqing Medical University , Chongqing , China
| | - Yiyun Liu
- b Institute of Neuroscience , Chongqing Medical University , Chongqing , China.,c Department of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Juncai Pu
- b Institute of Neuroscience , Chongqing Medical University , Chongqing , China.,c Department of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Lu Tian
- a School of Public Health and Management , Chongqing Medical University , Chongqing , China.,b Institute of Neuroscience , Chongqing Medical University , Chongqing , China
| | - Siwen Gui
- b Institute of Neuroscience , Chongqing Medical University , Chongqing , China.,d College of Biomedical Engineering , Chongqing Medical University , Chongqing , China
| | - Xuemian Song
- b Institute of Neuroscience , Chongqing Medical University , Chongqing , China.,d College of Biomedical Engineering , Chongqing Medical University , Chongqing , China
| | - Shaohua Xu
- b Institute of Neuroscience , Chongqing Medical University , Chongqing , China.,c Department of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Xinyu Zhou
- b Institute of Neuroscience , Chongqing Medical University , Chongqing , China.,c Department of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Haiyang Wang
- b Institute of Neuroscience , Chongqing Medical University , Chongqing , China.,d College of Biomedical Engineering , Chongqing Medical University , Chongqing , China
| | - Wei Zhou
- a School of Public Health and Management , Chongqing Medical University , Chongqing , China.,b Institute of Neuroscience , Chongqing Medical University , Chongqing , China
| | - Jianjun Chen
- b Institute of Neuroscience , Chongqing Medical University , Chongqing , China.,c Department of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Xunzhong Qi
- b Institute of Neuroscience , Chongqing Medical University , Chongqing , China.,c Department of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Peng Xie
- a School of Public Health and Management , Chongqing Medical University , Chongqing , China.,b Institute of Neuroscience , Chongqing Medical University , Chongqing , China.,c Department of Neurology , The First Affiliated Hospital of Chongqing Medical University , Chongqing , China.,e China Neurologist Association, Chinese Medical Doctor Association , Beijing , China
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Wardley CS, Applegate EB, Almaleki AD, Van Rhee JA. Is Student Stress Related to Personality or Learning Environment in a Physician Assistant Program? J Physician Assist Educ 2019; 30:9-19. [PMID: 30801554 DOI: 10.1097/jpa.0000000000000241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE The purpose of this research was to study the impact of students' personalities and 2 different learning environments-lecture-based learning (LBL) and problem-based learning (PBL)-on the stress perceived by 5 cohorts of physician assistant (PA) students. METHODS Students rated their stress related to family obligations, financial concerns, schoolwork, relocation, and overall stress on 6 occasions over the course of the 2-year program. Personalities of students were assessed using the California Psychological Inventory 7 months into the program. Students' expectations and observations of their learning environments were measured using the PA School Learning Environment Survey at the beginning and end of the didactic year. RESULTS Personalities of LBL and PBL students were very similar, but LBL students who scored higher on the Independence concept were less stressed about their schoolwork. The LBL students, in general, were more discontented with their learning environment, but this finding was not related to higher schoolwork-related stress. In contrast, PBL students' personalities were not related to stress, and PBL students also rated some dimensions of their learning environment higher than they had expected. However, those PBL students who rated the PBL environment less favorably also reported higher schoolwork-related stress. CONCLUSIONS High stress perceived by LBL students was related to some personality concepts but not to the students' learning environment, despite their overall disappointment with that environment. The PBL students were more stressed by schoolwork, although their stress was not related to personality. Problem-based learning students, except for those most highly stressed, tended to rate their learning environment more favorably.
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Affiliation(s)
- C Sonia Wardley
- C. Sonia Wardley, MA, is an adjunct associate professor in the Physician Assistant Department at Western Michigan University, Kalamazoo, Michigan. E. Brooks Applegate, PhD, is a professor in the Department of Education Leadership, Research, and Technology at Western Michigan University, Kalamazoo, Michigan. A. Deyab Almaleki, PhD, is an assistant professor of Evaluation Measurement and Research at Umm-Al Qura University, Mecca, Saudi Arabia. James A. Van Rhee, MS, PA-C, is the director and an associate professor for the Physician Assistant Online Program at the Yale University School of Medicine, New Haven, Connecticut
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Kam J, Khadra S, Tran QH, Ainsworth H, Louie-Johnsun M, Winter M. Portable Video Media Versus Standard Verbal Communication in Surgical Teaching: A Prospective, Multicenter, and Randomized Controlled Crossover Trial. JOURNAL OF SURGICAL EDUCATION 2019; 76:440-445. [PMID: 30253985 DOI: 10.1016/j.jsurg.2018.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/02/2018] [Accepted: 08/15/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE This study aims to evaluate the effectiveness of portable video media (PVM) compared to standard verbal communication (SVC) as a novel adjunct for surgical education of junior medical officers and medical students, in terms of knowledge acquisition and participant satisfaction. BACKGROUND The effective, continued education of final year medical students and junior doctors is the foundation of quality healthcare. The development of new media technologies and rapid internet streaming has resulted in an opportunity for the integration of PVM into medical education. PVM is an educational platform with the advantage of being standardized, efficient, and readily available. DESIGN This is a multicenter, prospective, and randomized controlled crossover study. Participants completed a preintervention knowledge test and were then randomized in an allocation ratio of 1:1 to receive surgical education regarding cystoscopy and ureteric stenting for acute renal colic via either PVM or SVC. A 32-point knowledge test and a modified Client Satisfaction Questionnaire-8 were then administered and the participants were then crossed over to the other educational method. The knowledge and satisfaction tests were then readministered. RESULTS Fifty-four participants were recruited for this study with 27 participants in each group. Both groups had a 18% to 20% increase in knowledge scores following the first intervention p < 0.001 and on crossover there was a further 4% increase in knowledge scores, p < 0.01. There was no significant difference between the groups in knowledge scores before intervention, p = 0.23 after first intervention p = 0.74 or following crossover p = 0.09. After first intervention, participants in the group receiving PVM education first had a significant 8% higher satisfaction score compared to the SVC group, p = 0.023. CONCLUSIONS Our study has shown that PVM shows similar efficacy in information uptake to traditional forms of education. Furthermore, PVM was shown to have higher satisfaction scores compared to SVC. Further studies will need to evaluate the use of PVM for education in other surgical and medical domains and assess the long-term knowledge retention.
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Affiliation(s)
- Jonathan Kam
- Nepean Urology Research Group (NURG), Kingswood, NSW, Australia; Faculty of Medicine, University of Newcastle, Callaghan, NSW, Australia.
| | - Sam Khadra
- Nepean Urology Research Group (NURG), Kingswood, NSW, Australia.
| | - Quoc Hoai Tran
- Nepean Urology Research Group (NURG), Kingswood, NSW, Australia.
| | | | - Mark Louie-Johnsun
- Faculty of Medicine, University of Newcastle, Callaghan, NSW, Australia; Gosford District Hospital, Gosford, NSW, Australia.
| | - Matthew Winter
- Nepean Urology Research Group (NURG), Kingswood, NSW, Australia.
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Romo-Nava F, Bobadilla-Espinosa RI, Tafoya SA, Guízar-Sánchez DP, Gutiérrez JR, Carriedo P, Heinze G. Major depressive disorder in Mexican medical students and associated factors: A focus on current and past abuse experiences. J Affect Disord 2019; 245:834-840. [PMID: 30699867 DOI: 10.1016/j.jad.2018.11.083] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/18/2018] [Accepted: 11/11/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is highly prevalent among medical students (MS). Abuse experiences, as well as stress, are among the factors associated with MDD. However, their association with MDD in MS has been scarcely addressed. METHODS A cross-sectional study design was used to evaluate the association between MDD and possible risk factors, focusing on current and past abuse experiences inside and outside the academic setting in a large representative MS sample (n = 1,068) using self-report instruments to assess MDD (PHQ-9) and perceived academic stress levels during exam season. RESULTS Depressive symptom severity directly correlates with levels of perceived academic stress. The prevalence of MDD was 16.2%. A history of emotional abuse during childhood or adolescence, as well as most types of current abuse were associated with MDD. Multiple logistic regression analysis showed that current emotional abuse outside school had the strongest association with MDD in MS, followed by a personal history of depression and suicide attempt, a family history of depression, and perceived academic stress levels. LIMITATIONS Cross-sectional design, participants represent a specific population, and other variables that could be associated with MDD: comorbid psychiatric disorders, current antidepressant treatment and protective factors (resilience and health-promoting coping strategies) were not evaluated. CONCLUSIONS MDD is strongly associated with several risk factors that include most types of current and past abuse experiences. Timely identification of individuals at-risk will be critical to establish preventive strategies to limit the impact of MDD in MS and offer prompt therapeutic alternatives when needed.
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Affiliation(s)
- Francisco Romo-Nava
- Lindner Center of HOPE Research Institute, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, OH, USA; Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, México
| | - Rosa I Bobadilla-Espinosa
- Departamento de Salud Pública de la Universidad Nacional Autónoma de México (UNAM), Unidad de Medicina Familiar No. 1, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Silvia A Tafoya
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, México
| | - Diana P Guízar-Sánchez
- Unidad de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, México
| | - Joaquín R Gutiérrez
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, México
| | - Pilar Carriedo
- Servicios Clínicos, Instituto Nacional de Psiquiatría ``Ramón de la Fuente Muñiz", Ciudad de México, México
| | - Gerhard Heinze
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, México; Unidad de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, México.
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Balaji NK, Murthy PS, Kumar DN, Chaudhury S. Perceived stress, anxiety, and coping states in medical and engineering students during examinations. Ind Psychiatry J 2019; 28:86-97. [PMID: 31879453 PMCID: PMC6929237 DOI: 10.4103/ipj.ipj_70_18] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/12/2019] [Accepted: 07/11/2019] [Indexed: 11/04/2022] Open
Abstract
AIM This study aims to study the factors associated with stress, anxiety, and coping states in students of 1st and 2nd year in medical and engineering colleges during examinations. MATERIALS AND METHODS This prospective, longitudinal study was conducted on 200 undergraduate medical and engineering students from 1st to 2nd year (50 in each year), after obtaining ethical approval from the institutional ethics committee. All the participants gave written informed consent. All students filled a questionnaire which consisted of a general information sheet, perceived stress scale, Hamilton Anxiety Rating Scale, brief COPE inventory, and sources of stress questionnaire 1 month before and 1 month after their university examinations. Data were analyzed using t-test, Mann-Whitney U-test, Kruskal-Wallis test, and Chi-square test as appropriate. RESULTS In medical students, perceived stress was significantly higher in those in the management quota (both years), living in shared accommodation and from nuclear family (1st year) and male (2nd year). Only accommodation had a statistically significant relationship with perceived stress in 2nd year engineering students. A statistically significant association of perceived stress and anxiety with academic performance was observed. Anxiety in students was significantly more before the examination compared to after the examination. The association of all the coping strategies used, with the academic performance, was statistically significant. CONCLUSIONS In both medical and engineering students, there was a significant association of perceived stress and anxiety with academic performance. Both medical and engineering students used active coping a little more than avoidant coping strategies during the examination time. The association of all the coping strategies used, with the academic performance, was statistically significant, thereby proving the importance of coping states in academic performance.
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Affiliation(s)
- Nihal K Balaji
- Department of Psychiatry, Santhiram Medical College and General Hospital, Kurnool, Andhra Pradesh, India
| | - P S Murthy
- Department of Psychiatry, Santhiram Medical College and General Hospital, Kurnool, Andhra Pradesh, India
| | - D Naveen Kumar
- Department of Psychiatry, Santhiram Medical College and General Hospital, Kurnool, Andhra Pradesh, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
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Fujita Y, Maki K. Associations of smoking behavior with lifestyle and mental health among Japanese dental students. BMC MEDICAL EDUCATION 2018; 18:264. [PMID: 30445940 PMCID: PMC6472720 DOI: 10.1186/s12909-018-1365-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 10/31/2018] [Indexed: 05/05/2023]
Abstract
BACKGROUND Smoking is a major risk factor for cancer and cardiovascular disease. However, mental stress leads to smoking in dental students. We believe that dentists, as health professionals, should set an example for the public. Therefore, this study determined the prevalence of and factors associated with regular smoking among Japanese dental students. We also surveyed their attitudes regarding smoking cessation and how to counsel smokers about quitting. METHODS We collected demographic and behavioral data from 453 students at Kyushu Dental University, and evaluated their mental health with the 12-item General Health Questionnaire (GHQ 12). We also asked them nine questions related to their intentions to counsel smokers about quitting. A multivariate binary logistic regression analysis was used to identify factors associated with smoking. RESULTS Fifty-two (11.5%) of the dental students smoked. Univariate analyses indicated that male gender, higher academic year, greater number of times eating out per day, alcohol consumption, prevalence of skipping breakfast, poor health, and poor sleep habits were significantly associated with regular smoking. Regular smokers were less likely to have GHQ 12 scores ≥4. On multivariate analysis, male gender (OR = 5.449, 95% CI = 1.851-16.040), sixth year students (OR = 21.971, 95% CI = 1.686-286.290), eating out two or more times a day (OR = 2.492, 95% CI = 1.165-5.331), drinking alcohol three or more times per week (OR = 9.484, 95% CI = 3.335-26.970), and GHQ 12 score ≥ 4 (OR = 0.339, 95% CI = 0.136-0.845) were significantly associated with regular smoking. Overall, 50.1% of the non-smokers and 71.2% of the regular smokers responded that patients' chances of quitting smoking are not increased when a dentist advises them to quit. CONCLUSIONS Regular smoking was strongly associated with male gender, higher academic year, alcohol consumption, and higher frequency of eating out per day. Mental health status among regular smokers was better than that among non-current smokers. Furthermore, we found that more than half of dental students have inadequate attitudes to advise their patients to quit smoking. It is necessary to develop educational programs regarding smoking for dental students.
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Affiliation(s)
- Yuko Fujita
- All in the Division of Developmental Stomatognathic Function Science, Department of Health Promotion, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, 803-8580 Japan
| | - Kenshi Maki
- All in the Division of Developmental Stomatognathic Function Science, Department of Health Promotion, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, 803-8580 Japan
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Barbosa J, Silva Á, Ferreira MA, Severo M. Do reciprocal relationships between academic workload and self-regulated learning predict medical freshmen's achievement? A longitudinal study on the educational transition from secondary school to medical school. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2018; 23:733-748. [PMID: 29663182 DOI: 10.1007/s10459-018-9825-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 04/05/2018] [Indexed: 06/08/2023]
Abstract
One of the most important factors that makes the transition from secondary school to medical school challenging is the inability to put in the study time that a medical school curriculum demands. The implementation of regulated learning is essential for students to cope with medical course environment and succeed. This study aimed to investigate the reciprocal relationships between self-regulated learning skills (SRLS) and academic workload (AW) across secondary school to medical school transition. Freshmen enrolled in medical school (N = 102) completed questionnaires at the beginning and at the end of their academic year, assessing AW (measured as study time hours and perceived workload), SRLS (planning and strategies for learning assessment, motivation and action to learning and self-directedness) and academic achievement. An exploratory factor analysis (EFA) and a longitudinal path analysis were performed. According to the EFA, study time and perceived workload revealed two factors of AW: students who had a high perceived workload also demonstrated increased study time (tandem AW); and those who had a low perceived workload also demonstrated increased study time (inverse AW). Only a longitudinal relationship between SRLS and AW was found in the path analysis: prior self-directedness was related to later tandem AW. Moreover, success during the first year of medical school is dependent on exposure to motivation, self-directedness and high study time without overload during secondary school and medical school, and prior academic achievement. By better understanding these relationships, teachers can create conditions that support academic success during the first year medical school.
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Affiliation(s)
- Joselina Barbosa
- Faculty of Medicine, University of Porto, Porto, Portugal.
- Cardiovascular Research and Development Center, University of Porto, Porto, Portugal.
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
| | - Álvaro Silva
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Maria Amélia Ferreira
- Faculty of Medicine, University of Porto, Porto, Portugal
- Cardiovascular Research and Development Center, University of Porto, Porto, Portugal
| | - Milton Severo
- Faculty of Medicine, University of Porto, Porto, Portugal
- Institute of Public Health, University of Porto, Porto, Portugal
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Bin Saif GA, Alotaibi HM, Alzolibani AA, Almodihesh NA, Albraidi HF, Alotaibi NM, Yosipovitch G. Association of psychological stress with skin symptoms among medical students. Saudi Med J 2018; 39:59-66. [PMID: 29332110 PMCID: PMC5885122 DOI: 10.15537/smj.2018.1.21231] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To evaluate the association between psychological stress and skin symptoms among medical students. Methods: A cross-sectional study was carried out between January and June 2015. Electronic survey consists of Perceived Stress Questionnaire (PSQ) and Self-Reported Skin Complaints Questionnaire were distributed to all 1435 undergraduate students at College of Medicine, King Saud University (KSU), Riyadh, Saudi Arabia. Results: Final analysis was performed on data from 529 (36.9%) students. Students were divided into three groups: least stressed students, n=135, PSQ index <0.39; highly stressed students, n=136, PSQ index >0.61; and moderately stressed students, n=258. Older age, female gender, during exam weeks, and fourth and fifth years of medical school (all p<0.01) were associated with the highest perceived stress levels. When compared to least stressed students, highly stressed students suffered from more oily, waxy patches or flakes on scalp (p≤0.0001), dry/sore rash (p≤0.0001), warts (p≤0.0001), pimples (p≤0.0001), itchy skin (p≤0.0001), hands itchy rash (p≤0.0001), hair loss (p≤0.0001), pull-out own hair (p=0.008), scaly skin (p=0.012), troublesome sweating (p=0.016), nails biting (p=0.028), and other rashes on face (p=0.028). Conclusion: Various common skin conditions could appear in context of psychological stress among medical students.
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Affiliation(s)
- Ghada A Bin Saif
- Department of Dermatology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Ayala EE, Winseman JS, Johnsen RD, Mason HRC. U.S. medical students who engage in self-care report less stress and higher quality of life. BMC MEDICAL EDUCATION 2018; 18:189. [PMID: 30081886 PMCID: PMC6080382 DOI: 10.1186/s12909-018-1296-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 07/25/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Research on student wellness has highlighted the importance of self-care for medical students; however, scholars have yet to identify the extent to which self-reported engagement in self-care behaviors is associated with attenuation of the negative relationship between stress and quality of life during the initial years of medical education. METHODS Using a self-report survey designed to measure self-care, perceived stress, and quality of life, we hypothesized that self-care would moderate the relationship between stress and psychological quality of life in medical students, as well as stress and physical quality of life. An online questionnaire was completed by 871 medical students representing 49 allopathic medical colleges throughout the U.S. between December 2015 and March 2016. The survey assessed perceived stress, self-care, quality of life and a variety of demographic variables. Regression analyses were used to assess interaction effects of self-care on the relationships between stress and quality of life. RESULTS Self-reported engagement in self-care appeared to moderate the relationships between perceived stress and both physical (p < .001) and psychological (p = .002) quality of life. As the level of reported engagement in self-care increased, the strength of the inverse relationship between perceived stress and both physical and psychological quality of life appeared to weaken. CONCLUSIONS Our findings suggest that self-reported engagement in self-care activities is associated with a decrease in the strength of the relationship between perceived stress and quality of life in medical students. Students who disclose utilizing a multitude of self-care practices throughout their training may also sustain greater resiliency and lower risk for higher levels of distress during medical education.
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Affiliation(s)
- Erin E. Ayala
- Department of Counseling Psychology, Saint Mary’s University of Minnesota, 2500 Park Avenue, Minneapolis, MN 55404 USA
| | - Jeffrey S. Winseman
- Department of Psychiatry, Albany Medical College, 25 Hackett Blvd, Albany, NY 12208 USA
| | - Ryan D. Johnsen
- Department of Emergency Medicine, HealthPartners Institute Regions Hospital, 640 Jackson Avenue, Saint Paul, MN 55101 USA
| | - Hyacinth R. C. Mason
- Departments of Medical Education and Family and Community Medicine, Albany Medical College, 47 New Scotland Avenue, 12208 Albany, NY, USA
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Nguyen TTT, Nguyen NTM, Pham MV, Pham HV, Nakamura H. The four-domain structure model of a depression scale for medical students: A cross-sectional study in Haiphong, Vietnam. PLoS One 2018; 13:e0194550. [PMID: 29566050 PMCID: PMC5864022 DOI: 10.1371/journal.pone.0194550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 03/06/2018] [Indexed: 11/19/2022] Open
Abstract
Depression is a common mental health problem with a higher prevalence in medical students than in the general population. This study aims to investigate the association between depressive symptoms, particularly those in each domain of the Center for Epidemiological Studies Depression (CES-D) Scale, and related factors. A cross-sectional study was conducted with a random sample of 1319 medical students at Haiphong University of Medicine and Pharmacy in 2016. The CES-D scale and a self-reported questionnaire were used to identify the prevalence of depressive symptoms and related risk factors. Univariate and multivariate logistic regression were performed to assess the risk factors associated with depressive symptoms and the score for each structure factor. Depressive symptoms were observed in 514 (39%) students, including more males than females (44.2% vs 36.9%, p = 0.015). Students whose mothers' highest education level was primary school had a higher prevalence of depressive symptoms than students whose mothers had higher education levels (p = 0.038). There was a significant relationship between depressive symptoms and stressful life events, especially a decline in personal health. A higher correlation was found between the somatic complaints and depressive affect domains. The impacts of risk factors differed for each domain of the depression scale. Only the factor of achieving excellence showed no statistically significant associations with depressive symptoms and the scores on the four domains considered in this study. The high prevalence of depressive symptoms among medical students with risk factors and the impact of these risk factors on each domain of depression scale need further clarification to alleviate depression in students during their medical training.
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Affiliation(s)
- Thao Thi Thu Nguyen
- Department of Environmental and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa City, Ishikawa Prefecture, Japan
- * E-mail:
| | - Ngoc Thi Minh Nguyen
- Department of Environmental Health, Public Health Faculty, Haiphong University of Medicine and Pharmacy, Haiphong City, Vietnam
| | - Manh Van Pham
- Department of Psychiatry, Haiphong University of Medicine and Pharmacy, Haiphong City, Vietnam
| | - Han Van Pham
- Department of Environmental Health, Public Health Faculty, Haiphong University of Medicine and Pharmacy, Haiphong City, Vietnam
| | - Hiroyuki Nakamura
- Department of Environmental and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa City, Ishikawa Prefecture, Japan
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Yang E, Schamber E, Meyer RML, Gold JI. Happier Healers: Randomized Controlled Trial of Mobile Mindfulness for Stress Management. J Altern Complement Med 2018; 24:505-513. [PMID: 29420050 DOI: 10.1089/acm.2015.0301] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Medical students have higher rates of depression and psychologic distress than the general population, which may negatively impact academic performance and professional conduct. This study assessed whether 10-20 min of daily mindfulness meditation for 30 days, using a mobile phone application, could decrease perceived stress and improve well-being for medical students. METHODS Eighty-eight medical students were stratified by class year and randomized to either intervention or control groups to use the mobile application Headspace, an audio-guided mindfulness meditation program, for 30 days. All participants completed the Perceived Stress Scale (PSS), Five-Facet Mindfulness Questionnaire (FFMQ), and General Well-Being Schedule (GWBS) at baseline (T1), 30 days (T2), and 60 days (T3). Repeated measures analysis of variance (rANOVA) was conducted for intervention versus control groups across T1, T2, and T3 to examine differences in stress, mindfulness, and well-being. RESULTS There was a significant interaction between time and treatment group for perceived stress and well-being. Perceived stress significantly decreased for the intervention group from T1 to T3 (F[2,142] = 3.98, p < 0.05). General well-being significantly increased for the intervention group compared to the control group from T1 to T2, and the increase was sustained through T3 (F[2,144] = 3.36, p < 0.05). CONCLUSIONS These results highlight that a mobile audio-guided mindfulness meditation program is an effective means to decrease perceived stress in medical students, which may have implications on patient care. Integrating mindfulness training into medical school curricula for management of school- and work-related stress may lead to fewer negative physician outcomes (e.g., burnout, anxiety, and depression) and improved physician and patient outcomes. This has implications for a broad group of therapists and healthcare providers, ultimately improving quality of healing and patient care.
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Affiliation(s)
- Elaine Yang
- 1 Department of Emergency Medicine, Highland Hospital-Alameda Health System , Oakland, CA
| | | | - Rika M L Meyer
- 3 Psychology Department, Bellevue College , Bellevue, WA
| | - Jeffrey I Gold
- 4 Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles , Los Angeles, CA.,5 Department of Anesthesiology, Pediatrics, and Psychiatry & Behavioral Sciences, Keck School of Medicine, University of Southern California , Los Angeles, CA
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Differential determination of perceived stress in medical students and high-school graduates due to private and training-related stressors. PLoS One 2018; 13:e0191831. [PMID: 29385180 PMCID: PMC5792003 DOI: 10.1371/journal.pone.0191831] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/11/2018] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Numerous studies from diverse contexts have confirmed high stress levels and stress-associated health impairment in medical students. This study aimed to explore the differential association of perceived stress with private and training-related stressors in medical students according to their stage of medical education. METHODS Participants were high-school graduates who plan to study medicine and students in their first, third, sixth, or ninth semester of medical school or in practical medical training. The self-administered questionnaire included items addressing demographic information, the Perceived Stress Questionnaire, and items addressing potential private and training-related stressors. RESULTS Results confirmed a substantial burden of perceived stress in students at different stages of their medical education. In particular, 10-28% of students in their third or ninth semesters of medical school showed the highest values for perceived stress. Training-related stressors were most strongly associated with perceived stress, although specific stressors that determined perceived stress varied across different stages of students' medical education. High-school graduates highly interested in pursuing medical education showed specific stressors similar to those of medical students in their third, sixth, or ninth semesters of medical school, as well as stress structures with heights of general stress rates similar to those of medical students at the beginning of practical medical training. CONCLUSIONS High-school graduates offer new, interesting information about students' fears and needs before they begin medical school. Medical students and high-school graduates need open, comprehensive information about possible stressors at the outset of and during medical education. Programmes geared toward improving resilience behaviour and teaching new, functional coping strategies are recommended.
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Grendar J, Beran T, Oddone-Paolucci E. Experiences of pressure to conform in postgraduate medical education. BMC MEDICAL EDUCATION 2018; 18:4. [PMID: 29298717 PMCID: PMC5751422 DOI: 10.1186/s12909-017-1108-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 12/14/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Perception of pressure to conform prevents learners from actively participating in educational encounters. We expected that residents would report experiencing different amounts of pressure to conform in a variety of educational settings. METHODS A total of 166 residents completed questionnaires about the frequency of conformity pressure they experience across 14 teaching and clinical settings. We examined many individual characteristics such as their age, sex, international student status, level of education, and tolerance of ambiguity; and situational characteristics such as residency program, type of learning session, status of group members, and type of rotation to determine when conformity pressure is most likely to occur. RESULTS The majority of participants (89.8%) reported pressure to conform at least sometimes in at least one educational or clinical setting. Residents reported higher rates of conformity during informal, rather than formal, teaching sessions, p < .001. Also, pressure was greater when residents interacted with higher status group members, but not with the same or lower level status members, p < .001. Effect sizes were in the moderate range. CONCLUSIONS The findings suggest that most residents do report feeling pressure to conform in their residency settings. This result is consistent with observations of medical students, nursing students, and clerks conforming in response to inaccurate information within experimental studies. Perception of pressure is associated with the setting rather than the trainee personal characteristics.
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Affiliation(s)
- Jan Grendar
- Department of Postgraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Tanya Beran
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, NW, Calgary, AB T2N 4Z6 Canada
| | - Elizabeth Oddone-Paolucci
- Departments of Community Health Sciences and Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Abstract
This paper will focus primarily on the most recent research studies involving doctors in the UK. We will not discuss the treatment of doctors who are psychiatrically unwell as this is covered in other papers elsewhere in this issue. Before reviewing specific studies, we will consider the measurement of psychiatric disorder, stress and burn-out.
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Kang Y, Kim C, Lee S, Youn S. Insomnia and Parental Overprotection are Associated with Academic Stress among Medical Students. SLEEP MEDICINE RESEARCH 2017. [DOI: 10.17241/smr.2017.00066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rezayat AA, Niroumand S, Shiehzadeh E, Saghebi A, Oskooie RR, Dadgarmoghaddam M. Assessment of life skills of medical students in Mashhad, Iran, in 2015. Electron Physician 2017; 9:5536-5540. [PMID: 29238495 PMCID: PMC5718859 DOI: 10.19082/5536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 08/10/2017] [Indexed: 11/25/2022] Open
Abstract
Background Developing social skills and mental health is a crucial part of the psychosocial health status of medical students. Objective The aim of this study was to assess the life skills of medical students in Mashhad University of Medical Sciences (MUMS). Methods This cross-sectional study was performed in Mashhad University of Medical Sciences, Iran in 2015. By census method, 146 interns were entered into the study. The life skill questionnaire, consisting of 144 questions, was used as the measurement tool. Over 3 months, all the medical students in internship period were asked to complete the questionnaire. Data were analyzed by independent-samples t-test, one-way ANOVA, and Mann-Whitney with SPSS version 11.5 software. Results Women were shown to have higher decision-making ability than men (p=0.046). It was also shown in the study that social behavior (p=0.018), participation in activities that improve benefits (p=0.006), critical thinking (p=0.007), observing and using safety points (p=0.005), and mental health status (p=0.034) were significantly lower in men than in women. The data also suggests that men (13.97±4.7249) are more likely to become global citizens than women (12.15±3.6298) (p=0.010). Furthermore, there was a significant difference when comparing smoking and non-smoking in freedom and justice (p=0.003) and becoming a global citizen (p=0.012). Conclusion Our study provides helpful information about medical students’ life skills for policy makers and university authorities. We suggest that gender differences should be considered during life skill training.
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Affiliation(s)
- Arash Akhavan Rezayat
- Medical Student, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shabnam Niroumand
- M.D, Community Medicine Specialist, Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Shiehzadeh
- M.D., School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Saghebi
- M.D., Psychiatry, Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Rahimzadeh Oskooie
- Medical Student, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maliheh Dadgarmoghaddam
- M.D, Community Medicine Specialist, Assistant Professor of Community Medicine, Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Adhikari A, Dutta A, Sapkota S, Chapagain A, Aryal A, Pradhan A. Prevalence of poor mental health among medical students in Nepal: a cross-sectional study. BMC MEDICAL EDUCATION 2017; 17:232. [PMID: 29183315 PMCID: PMC5704530 DOI: 10.1186/s12909-017-1083-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 11/21/2017] [Indexed: 05/15/2023]
Abstract
BACKGROUND Poor mental health among medical students is widely acknowledged. Studies on mental health among medical students of Nepal are lacking. Therefore, we conducted a study to determine the prevalence of mental disorders. METHODS A cross-sectional study was conducted among medical students at KIST Medical College and Teaching Hospital, Nepal from December 2016 to February 2017. Our survey instrument consisted of the Patient Health Questionnaire (PHQ) and questions about socio-demographic factors, smoking, marijuana use, suicidal ideation and thoughts of dropping out of medical school. RESULTS The prevalence rates were 29.2% (95% CI, 24.4% - 34.3%) depression, 22.4% (95% CI, 18.0% - 26.9%) medium to highly severe somatic symptoms, 4.1% (95% CI, 2.0% - 6.2%) panic syndrome, 5.8% (95% CI, 3.4% - 8.3%) other anxiety syndrome, 5% (95% CI, 2.7% - 7.3%) binge eating disorder and 1.2% (95% CI, 0.0% - 2.3%) bulimia nervosa. Sixteen students [4.7% (95% CI, 2.4% - 6.9%)] seriously considered committing suicide while in medical school. Thirty-four students [9.9% (95% CI, 6.8% - 13.1%)] considered dropping out of medical school within the past month. About 15% (95% CI, 11.1% - 18.6%) of the students reported use of marijuana during medical school. CONCLUSIONS We found high prevalence of poor mental health among medical students of Nepal. Future studies are required to identify the factors associated with poor mental health.
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Affiliation(s)
- Arjab Adhikari
- KIST Medical College and Teaching Hospital, Lalitpur, Nepal
| | - Aman Dutta
- KIST Medical College and Teaching Hospital, Lalitpur, Nepal
| | | | | | - Anurag Aryal
- Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Amita Pradhan
- KIST Medical College and Teaching Hospital, Lalitpur, Nepal
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Al Saadi T, Zaher Addeen S, Turk T, Abbas F, Alkhatib M. Psychological distress among medical students in conflicts: a cross-sectional study from Syria. BMC MEDICAL EDUCATION 2017; 17:173. [PMID: 28931387 PMCID: PMC5607487 DOI: 10.1186/s12909-017-1012-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 09/14/2017] [Indexed: 05/23/2023]
Abstract
BACKGROUND Medical education can be a time of great psychological distress for students. The ongoing Syrian conflict represents an additional factor potentially contributing to poor mental health among medical students. Studies revealed high levels of psychological distress among Syrians. We aimed to investigate the prevalence and risk factors of depression, anxiety and stress among medical students at Damascus University during this period of war. METHODS A cross-sectional study was conducted using the Depression, Anxiety and Stress Scale (DASS-21) in addition to questions about demographic and financial characteristics, and questions about the effects of the ongoing war on the participants' lives. RESULTS 350 students were included. Prevalence of depression, anxiety and stress was 60.6%, 35.1%, and 52.6%, respectively. Depression was more likely in females and those with "intermediate" or "insufficient" personal income. Anxiety was more likely in females and those with "insufficient" personal income while less likely in fifth- and sixth-year compared to second-year students. Stress was lower in fifth-year compared to second-year students and higher in "insufficient" personal income compared to "sufficient" personal income. CONCLUSIONS We concluded that Syrian medical students suffer from high rates of psychological distress. Females, second-year students, and those with "insufficient" personal income were the most affected. Students' perception of their own financial status, rather than the financial status per se was related to psychological distress. There was no evidence of a direct relationship between the ongoing conflict and psychological distress. Further investigations of causes and consequences of poor mental health in Syrian medical students are essential.
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Affiliation(s)
- Tareq Al Saadi
- Faculty of Medicine, University of Damascus, Damascus, Syrian Arab Republic
| | - Sarah Zaher Addeen
- Faculty of Medicine, University of Damascus, Damascus, Syrian Arab Republic
| | - Tarek Turk
- Faculty of Medicine, University of Damascus, Damascus, Syrian Arab Republic
| | - Fatima Abbas
- Faculty of Medicine, University of Damascus, Damascus, Syrian Arab Republic
| | - Mahmoud Alkhatib
- Faculty of Medicine, University of Damascus, Damascus, Syrian Arab Republic
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