1
|
Mohammed HE, Bady Z, Abdelhamid ZG, Elawfi B, AboElfarh HE, Elboraay T, Abdel-Salam DM. Factors influencing stress and resilience among Egyptian medical students: a multi-centric cross-sectional study. BMC Psychiatry 2024; 24:393. [PMID: 38783215 PMCID: PMC11112873 DOI: 10.1186/s12888-024-05820-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Psychological stress is a common psychological comorbidity among medical students and worsens their quality of life. Psychological resilience is thought to have a protective role against stress. However, evidence regarding the prevalence of stress and resilience alongside their associated factors is scarce, especially in the Middle East. This is the first multicenter, cross-sectional study to investigate resilience and stress among Egyptian medical students. METHODS The current cross-sectional study was conducted on 2465 university students in seven public universities in Egypt. The universities were selected using the simple randomization method. The data was collected using a self-administered questionnaire consisting of four parts: demographic data, socioeconomic tool represented in the Family Affluence Scale (FAS), the Kessler Psychological Distress Scale (K10), and the Brief Resilience Scale (BRS). Data was analyzed in SPSS version 26 software. RESULTS The majority of the students were stressed (86.5%), most of whom had severe stress (48.9%). Most of the students had low resilience (49.9%), while only 3.2% had high resilience. In the logistic regression analysis, being a female, living alone, spending long hours on social media, and thinking of suicide or leaving medicine were associated with being stressed and having low resilience. Medical students with low resilience were significantly more liable to stress [Adjusted odds ratio (AOR) = 3.667, confidence interval (CI): 2.709-4.965, P = 0.000], and vice versa [AOR = 3.709, CI: 2.746-5.009, P = 0.000]. Interestingly, high socioeconomic status showed a significant association with high resilience (P = 0.004); nonetheless, it was not associated with stress (P = 0.993). Academic grades were not associated with both the level of stress and resilience. Aging, being in clinical or academic stages, smoking, having a chronic disease, and being financially-supported are neither associated with stress nor resilience. CONCLUSIONS The present study revealed that Egyptian medical students had low resilience and high stress, with a significant relationship between both of them. Further investigations via longitudinal study design to understand the resilience-stress relationship are recommended. Developing and implementing resilience-improving strategies in medical schools is highly recommended to decrease the prevalence of stress and its subsequent burdens.
Collapse
Affiliation(s)
| | - Zeyad Bady
- Faculty of Medicine, Assiut university, Assiut, Egypt
| | - Zeinab G Abdelhamid
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Bashaer Elawfi
- Faculty of Medicine, Sana'a University, Sana'a, Yemen
- Medical research group of Egypt (MRGE), Cairo, Egypt
| | - Hadeer Elsaeed AboElfarh
- Neurology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Medical research group of Egypt (MRGE), Cairo, Egypt
| | - Toka Elboraay
- Faculty of Medicine, Zagazig University, Elsharqia, Egypt
- Medical research group of Egypt (MRGE), Cairo, Egypt
| | - Doaa Mazen Abdel-Salam
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.
| |
Collapse
|
2
|
Gabay G. The protective role of sense of coherence in resident physicians facing secondary trauma due to patient death in intensive care-A qualitative inquiry. DEATH STUDIES 2024:1-12. [PMID: 38696822 DOI: 10.1080/07481187.2024.2348058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
The salutogenic paradigm is increasingly used in research and practice but remains to be investigated in secondary trauma of health professionals. This qualitative study explored the main anchor of salutogenics, the sense-of-coherence, as a coping mechanism among resident physicians facing secondary trauma due to continuous exposure to patient suffering and deaths. Participants were sixteen resident physicians from intensive care units at emergency departments of two Israeli public tertiary hospitals. Data analysis employed reflexive thematic analysis. Findings suggest that while all residents described having comprehensibility, manageability and meaningfulness differed among residents. Some residents thrived, coped well with secondary trauma, centered on patient emotional needs, and drew meaningfulness from the challenges. Other residents suffered while providing care, reported poor well-being, were too overwhelmed to center patients, and doubted their career choices. Salutogenic-based interventions to cultivate the resilience of resident physicians experiencing secondary trauma are proposed.
Collapse
Affiliation(s)
- Gillie Gabay
- Faculty of Social Sciences, Achva Academic College, Shikmim, Israel
| |
Collapse
|
3
|
Schneider K, Breuer G, Luibl L, Paulsen F, Scholz M, Burger PHM. Vulnerable in the end - Longitudinal study among medical students on mental health and personal and work-related resources over a 5.5-year-period. Ann Anat 2023; 250:152155. [PMID: 37683899 DOI: 10.1016/j.aanat.2023.152155] [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: 05/22/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Mental health problems are common in medical professionals and their development already starts at the undergraduate level. Studies on medical students can replicate higher prevalence for depression and burnout in this group, but they normally compare semester cohorts in an anonymized, cross-sectional approach and without a preventive perspective. METHODS We surveyed medical students at the beginning and end of their medical curriculum and collected data on burnout, depressivity, work related experience and salutogenesis parameters with validated self-administered questionnaires. Most remarkably we obtained the data from the same 58 individuals after 5.5 years, representing data of the highest quality in order to compare the mental health status at the beginning and the end of our students´ medical curriculum. RESULTS Our results not only show a severe exacerbation of physical, mental and emotional burnout in the participants at the end of their studies. The students also do not seem to have sufficient personal (resilience) or social resources (e.g. experience of social support) for coping with their mental health problems around the time of their graduation. CONCLUSIONS Our participants reflect a development of mental health during their medical studies at university that is paving the way to the devastating prevalence of mental disorders and suicide in health professionals. From our results we derive an urgent need to integrate self-care and active coping in the learning goals of medical curricula.
Collapse
Affiliation(s)
- K Schneider
- Department of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - G Breuer
- REGIOMED Hospital Group, Coburg Hospital, Coburg, Germany
| | - L Luibl
- Child and Adolescent Psychiatry, University Hospital, Erlangen, Germany
| | - F Paulsen
- Triaplus Zugersee Hospital, Center of Psychiatry and Psychotherapy, Oberwil, Zug, Switzerland
| | - M Scholz
- Department of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
| | - P H M Burger
- Triaplus Zugersee Hospital, Center of Psychiatry and Psychotherapy, Oberwil, Zug, Switzerland
| |
Collapse
|
4
|
Kayi I, Uzunköprü G, Dadaczynski K, Soylar P, Otludil B, Dündar P, Bakırcı N, Okan O, Sakarya S. Gender differences in sense of coherence among university students during the COVID-19 pandemic in Turkey. Health Promot Int 2023; 38:daad048. [PMID: 37279469 PMCID: PMC10243759 DOI: 10.1093/heapro/daad048] [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] [Indexed: 06/08/2023] Open
Abstract
Non-pharmaceutical interventions (NPIs) implemented to mitigate the COVID-19 pandemic halted everyday life in higher education along with social and psychological impacts. The objective of our study was to explore the factors related to sense of coherence (SoC) from a gender perspective among university students in Turkey. This is a cross-sectional survey conducted online with a convenience sampling method as part of the international COVID-Health Literacy (COVID-HL) Consortium. SoC was measured by a nine-item questionnaire that was adapted to the Turkish language, including socio-demographic information and health status, including psychological well-being, psychosomatic complaints, and future anxiety (FA). 1595 students from four universities, of whom 72% were female, participated in the study. Cronbach's alpha for the SoC scale was 0.75. Based on the median split of the individual scores, levels of SoC showed no statistically significant difference according to gender. Logistic regression analysis indicated that higher SoC was associated with medium and high subjective social status, studying in private universities, high psychological well-being, low FA, and none/one psychosomatic complaint. While results were similar among female students, type of university and psychological well-being showed no statistically significant association with SoC among males. Our results indicate that structural (subjective social status) and contextual (type of university) factors, along with gender-based variations, are associated with SoC among university students in Turkey.
Collapse
Affiliation(s)
- Ilker Kayi
- Department of Public Health, Koç University School of Medicine, İstanbul, Turkey
| | | | - Kevin Dadaczynski
- Department of Health Science, Fulda University of Applied Sciences, Fulda, Germany
- Center for Applied Health Sciences, Leuphana University, Lueneburg, Germany
| | - Pınar Soylar
- Department of Health Sciences, Nursing School, Fırat University, Elazığ, Turkey
| | | | - Pınar Dündar
- Department of Public Health, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Nadi Bakırcı
- Acıbadem University School of Medicine, Dean, İstanbul, Turkey
| | - Orkan Okan
- Technical University Munich, TUM Department of Sports and Health Science, Munich, Germany
| | - Sibel Sakarya
- Department of Public Health, Koç University School of Medicine, İstanbul, Turkey
| |
Collapse
|
5
|
Tei S, Fujino J. The educational value of sense of coherence for grief care. Front Psychol 2022; 13:1037637. [PMID: 36420379 PMCID: PMC9676356 DOI: 10.3389/fpsyg.2022.1037637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Shisei Tei
- Department of Psychiatry, Kyoto University, Kyoto, Japan
- Institute of Applied Brain Sciences, Waseda University, Saitama, Japan
- School of Human and Social Sciences, Tokyo International University, Saitama, Japan
| | - Junya Fujino
- Department of Psychiatry, Kyoto University, Kyoto, Japan
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
6
|
Wu X, Lu Y, Zhang Q, Wang H, Sun X, Han H, Ye Z. Stress/Resource Complex, Sense of Coherence and Professional Identity Among Nursing Students: A Latent Profile and Mediation Analysis. Psychol Res Behav Manag 2022; 15:2409-2420. [PMID: 36065461 PMCID: PMC9440726 DOI: 10.2147/prbm.s378088] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/23/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose Sense of coherence is significant to mental health and professional development in nursing students. However, the association among stress/resource complex, sense of coherence, and professional identity is less explored in nursing students. This study was designed to identify latent subtypes of stress/resource complex and to evaluate the mediating role of sense of coherence between stress/resource complex types and professional identity in nursing students. Participants and Methods A total of 595 nursing students were recruited from Be Resilient to Nursing Career (BRNC) between October and December 2021 and administered with 10-item Connor-Davidson Resilience Scale, General Self-efficacy Scale, 10-item Chinese Perceived Stress Scale, 13-item Sense of Coherence Scale, and Professional Identity Questionnaire for Undergraduate Students. Latent profile analysis and mediation analysis were performed. Results Three latent subtypes of stress/resource complex were identified: Flexibility (14.8%), Ordinary (44.2%), and Maladjustment (41.0%). Nursing students with role model were prone to Ordinary (OR = 1.48, 95% CI 1.03–2.13, p = 0.035) and Flexibility (OR = 1.92, 95% CI 1.17–3.16, p = 0.011). The association between stress/resource complex types and professional identity was mediated by sense of coherence (P < 0.05). Conclusion There exists heterogeneity in nursing students’ stress/resource complex. The association between stress/resource complex subtypes and professional identity was mediated by sense of coherence.
Collapse
Affiliation(s)
- Xiaona Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Yingzi Lu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Qishan Zhang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Huiyuan Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Xiaoming Sun
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Hui Han
- School of Marine Finance and Economics, Qingdao Engineering Vocational College, Qingdao, People’s Republic of China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Correspondence: Zengjie Ye, School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, People’s Republic of China, Tel +15914411786, Email
| |
Collapse
|
7
|
Depression Among Medical Students in the United States During the COVID-19 Pandemic: The role of Communication Between Universities and Their Students. Disaster Med Public Health Prep 2022; 17:e145. [PMID: 35241197 PMCID: PMC9002152 DOI: 10.1017/dmp.2022.56] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Medical students are vulnerable to stress and depression during medical school and the COVID-19 pandemic may have exacerbated these issues. This study examined whether the risk of depression was associated with COVID-19 pandemic-related medical school communication. METHODS A 144 - item pilot cross-sectional online survey of medical students in the US, was carried out between September 1, 2020 and December 31, 2020. Items on stress, depression, and communication between students and their medical schools were included. This study examined associations of student perceptions of universities' communication efforts and pandemic response with risk of developing depression. RESULTS The sample included 212 students from 22 US states. Almost 50% (48.6%) were at risk of developing depression. Students felt medical schools transitioned well to online platforms, while the curriculum was just as rigorous as in-person courses. Students at risk of developing depression reported communication was poor more frequently compared to students at average risk. Students at risk of depression were also more than 3 times more likely to report their universities' communication about scholarships or other funding was poor in adjusted analyses. CONCLUSION Universities communicated well with medical students during the pandemic. However, this study also highlights the need for ongoing efforts to address student mental health by medical schools.
Collapse
|
8
|
Montoro-Fernández E, Cárdenas-Gutiérrez AR, Bernal-Guerrero A. Entrepreneurial Resilience: A Case Study on University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2589. [PMID: 35270281 PMCID: PMC8910058 DOI: 10.3390/ijerph19052589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 12/04/2022]
Abstract
Entrepreneurial resilience refers to the capacity to face, overcome and project oneself after suffering life events with a negative impact. Emerging adulthood and the characteristics of university life facilitate the occurrence of stressful situations that can affect well-being. The aim of this phenomenological research is to explore the strategic components of entrepreneurial resilience and how young university students have shaped their entrepreneurial resilience after experiencing negative life events. The present research is a multiple case study that was developed through a mixed methodology. The methodological sequence was quantitative and qualitative, with priority given to the qualitative phase of the research. Ten university students with high levels of resilience were interviewed. The data were analysed using thematic analysis. The results indicate that resilience is built through intrapersonal and exopersonal processes. These processes make up a set of strategic dimensions related to entrepreneurial behaviour that are used for the construction of personal projects.
Collapse
Affiliation(s)
- Elisabet Montoro-Fernández
- Department of Communication and Education, Faculty of Social and Human Sciences, University Loyola Andalucía, 41704 Seville, Spain
| | - Antonio Ramón Cárdenas-Gutiérrez
- Department of Theory and History of Education and Social Pedagogy, Faculty of Education Sciences, Seville University, 41013 Seville, Spain; (A.R.C.-G.); (A.B.-G.)
| | - Antonio Bernal-Guerrero
- Department of Theory and History of Education and Social Pedagogy, Faculty of Education Sciences, Seville University, 41013 Seville, Spain; (A.R.C.-G.); (A.B.-G.)
| |
Collapse
|
9
|
Holzer BM, Ramuz O, Minder CE, Zimmerli L. Motivation and personality factors of Generation Z high school students aspiring to study human medicine. BMC MEDICAL EDUCATION 2022; 22:31. [PMID: 35016664 PMCID: PMC8753872 DOI: 10.1186/s12909-021-03099-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 12/31/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND A new generation of medical students, Generation Z (Gen Z), is becoming the predominant population in medical schools and will join the workforce in a few years' time. Medicine has undergone serious changes in high-income countries recently. Therefore, it is unclear how attractive the medical profession still is for high school students of Gen Z. The aim of this study was to investigate what motivation leads Gen Z students in their choice to study human medicine, and how they see their professional future. Our study was guided by motivation theory and the influence of personality traits and other personal factors on students' choice of university major. METHODS In a cross-sectional online survey, we included third- and fourth-year high school students in Northern Switzerland. We examined the importance of criteria when choosing a university major: personality traits, career motivation, life goals, and other considerations influencing the choice of human medicine versus other fields of study. Results Of 1790 high school students, 456 (25.5%) participated in the survey (72.6% women, mean age 18.4 years); 32.7% of the respondents aspired to major in medicine at university. For all respondents, the foremost criterion for selecting a field of study was 'interest in the field,' followed by 'income' and 'job security.' High school students aiming to study human medicine attached high importance to 'meaningful work' as a criterion; supported by 36.2% of those students answering that helping and healing people was a core motivation to them. They also scored high on altruism (p < 0.001 against all groups compared) and intrinsic motivation (p < 0.001) and were highly performance- (p < 0.001) and career-minded (p < 0.001). In contrast, all the other groups except the law/economics group had higher scores on extraprofessional concerns. CONCLUSIONS Swiss Gen Z students aspiring to study human medicine show high intrinsic motivation, altruism, and willingness to perform, sharing many values with previous generations. Adequate work-life balance and job security are important issues for Gen Z. Regarding the current working conditions, the ongoing shortage of physicians, and recent findings on physicians' well-being, the potential for improvement and optimization is high.
Collapse
Affiliation(s)
- Barbara M Holzer
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Oriane Ramuz
- Department of Internal Medicine Cantonal Hospital Olten, Solothurner Spitäler AG, Olten, Switzerland
| | - Christoph E Minder
- Department of Internal Medicine Cantonal Hospital Olten, Solothurner Spitäler AG, Olten, Switzerland
| | - Lukas Zimmerli
- Department of Internal Medicine Cantonal Hospital Olten, Solothurner Spitäler AG, Olten, Switzerland.
| |
Collapse
|