Perceived stress and quality of life of pharmacy students in University of Ghana

The correlation between academic stress, overactive bladder syndrome (OAB) and quality of life among healthy university students: A cross-sectional study

INTRODUCTION

This study aims to assess the presence of overactive bladder syndrome (OAB), academic stress, and their impact on quality of life (QoL) of healthy university students.

METHODS

A cross-sectional study recruited university students from different academic streams, between January 2021 to December 2021. Demographics, overactive bladder-validated 8 questionnaire (OAB-V8), International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQ-OAB) questionnaire, and Perception of Academic Stress (PAS) scale were collected. The correlation between the variables was assessed using the Social Sciences Statistical Package (SPSS) version 21.

RESULTS

Three hundred and 89 people met the inclusion criteria. There were 241 (62%) females, and 248 (63.8%) of the students were under the age of 22. Four academic streams were included: Engineering 96 (24.7%), Humanities 121 (31.1%), Medicine 85 (21.8%) and Nursing 87 (22.4%). OAB was found among 103 (26%) students. The mean OAB-V8 score was 5.8 ± 6.6. The mean PAS scale was 53.9 ± 9.4. The mean ICIQ-OAB score was 1.5 (0-9). Male gender 62 (60%), smoking 42 (40.8%), academic stream (Humanity 40 (38.8%)) and year (third and fourth-year students 34 (33%) and 33 (32%), respectively) have a statistically significant positive correlation with OAB (p < 0.001). Humanity stream (mean rank 169.2) and junior students (first and second years with mean rank of 174 and 177), respectively, had high level of academic stress and low PAS scale. There is a weak but statistically significant inverse correlation between OAB and the PAS scale (r = -0.211) (p < 0.001).

CONCLUSION

OAB is prevalent among healthy university students and is directly related to academic stress. Both OAB and academic stress have impact on quality of life. We hope this study will help to raise awareness of OAB among university students to early identify and treat such a condition, avoiding unnecessary bother among healthy university students.

Turning Lemons into Lemonade: Social Support as a Moderator of the Relationship Between Technostress and Quality of Life Among University Students

Purpose

The overuse of internet-based technologies as a means of coping with the stress they generate has resulted in an alarming level of addiction, adversely impacting the quality of life and overall health of younger individuals. This social detachment, in turn, contributes to both physical and mental health deterioration. The potential remedy for this predicament lies in the application of social support as an antidote to internet addiction. In this context, our present study employs the Stress-Strain-Outcome model to explore the indirect effects of internet addiction and the moderating role of social support in relation to the influence of technostress on the quality of life of adults.

Methods

We adopted a time-lagged design to collect data from university graduates and evaluated our study hypotheses using Mplus.

Results

Our empirical findings highlight the significant influence of technostress on internet addiction, with the latter significantly mediating the relationship between technostress and quality of life. Furthermore, our results reveal that social support effectively moderates the indirect effects of technostress on quality of life through its impact on internet addiction.

Conclusion

These findings can help researchers and educators better understand the underlying mechanisms between technostress and quality of life with social support as the silver lining. This form of social support holds the potential not only to alleviate internet addiction but also to positively enhance the quality of life and overall wellbeing of individuals facing these challenges. The implications of these findings and avenues for future research are also discussed.

Assessment of Sleeping Disorders, Characteristics, and Sleeping Medication Use Among Pharmacy Students in Saudi Arabia: A Cross-Sectional Quantitative Study

BACKGROUND Insomnia is a growing problem, especially among university students, and is associated with sleep disorders, poor academic performance, and quality of sleep. The purpose of this study was to assess the prevalence of insomnia sleeping characteristics, managing techniques, and attitudes toward sleeping pill usage among pharmacy students. MATERIAL AND METHODS A cross-sectional web-based study was conducted among pharmacy students of King Saud University, College of Pharmacy, Riyadh, Saudi Arabia between February and March 2023. SPSS version 26 was used for data analysis. A P value of <0.05 and was considered statistically significant. RESULTS In this study, 61.7% (n=108) of the students' slept an average of 6-10 h and 35.4% (n=62) slept an average of 6 h. Regarding sleeping patterns, nearly two-thirds (n=112, 64%) of the students had day and night sleeping patterns while more than one-third (n=63, 36%) had only night sleeping patterns. In this study, 2.9% (n=5) of the students had severe clinical insomnia, while 21.7% (n=38) reported moderately severe clinical insomnia, 44% (n=77) of them had subthreshold insomnia, and 31.4% (n= 55) had no clinically significant insomnia. The mean scores of the insomnia severity index were significantly related to the usage of stimulants (P=0.048), average hours of sleep (P=0.0001), and average minutes needed to fall asleep (P=0.0001). CONCLUSIONS The current findings demonstrated varying levels of insomnia among students, yet few students used sleeping pills.

Measuring and assessing well-being: A cross-sectional study of first- to third-year student pharmacists

PURPOSE

Stress may negatively influence the health and academic performance of healthcare professional students and correlates with stress and burnout as a healthcare professional. This study measured student pharmacist well-being and compared the well-being of first- through third-year student pharmacists.

METHODS

In fall 2019, the investigators administered an online survey to first- through third-year student pharmacists to assess student pharmacist well-being. Items included the World Health Organization-5 Well-being Index (WHO-5) and demographic variables. Descriptive and inferential statistical analyses were performed. Descriptive statistics were used to measure well-being, and a Kruskal-Wallis H test was used to determine whether there were differences between professional years.

RESULTS

Approximately 64.8% of student pharmacists (n = 248 of 383) completed the survey. Overall, 66.1% of respondents were female (n = 164) and 31% of respondents were Caucasian (n =77), while 31% (n =77) were African American; the majority ranged in age from 24 to 29 years. There was not a statistically significant difference in WHO-5 score between the different classes (P = 0.183), with an average WHO-5 score out of 100 of 38.2 for first-year students, 41.2 for second-year students, and 41.04 for third-year students, showing poor well-being for students in all 3 professional years.

CONCLUSION

Because of emergent evidence of increased stress and negative outcomes in university students, it is imperative that pharmacy programs expand their efforts in assessment of student pharmacist well-being. While this research manuscript revealed poor well-being in all 3 professional years, it did not identify a statistically significant difference in WHO-5 score between classes. Individualized well-being interventions in all professional years may help students improve their well-being.

Increasing occupational participation: A qualitative analysis within the “Occupational Self-Analysis” program

Introduction:

Occupational participation is a key element to increase the quality of life in the population. One of the effective interventions to increase occupational participation is the “Occupational Self-Analysis” program. The aim of this study was to analyze participant’s reported benefits about the “Occupational Self-Analysis” program.

Method:

This is a qualitative study with 26 participants (12 people with intellectual disability, 7 affected by acquired brain injury, and 7 students) who participated in weekly group sessions and one individual session. The outcomes were measured based on participant diaries and focus group transcriptions.

Results:

Two main themes emerged: (1) supports for occupational participation and (2) barriers for occupational participation. The thematic analysis of the categories was based on the Model of Human Occupation to increase applicability of the program in occupational therapy practice.

Conclusions:

The “Occupational Self-Analysis” program allowed participants to increase their knowledge of supports provided for and the barriers against occupational participation.

University Fairness Questionnaire (UFair): Development and Validation of a German Questionnaire to Assess University Justice-A Study Protocol of a Mixed Methods Study

Distress is a widespread phenomenon in the general population, but also among university students, associated with poorer learning success and negative health consequences. A source of distress might be the experience of injustice. Theoretical and empirical work in the area of perceived fairness in the workplace ("organizational justice") has shown that perceived unfairness is related to various stress indicators and health outcomes. Preliminary evidence indicates that unfairness matters not only in the work context but also in the university context. However, an adapted and validated tool to assess perceived unfairness in the university context is hitherto missing. The goal of the proposed project is therefore to adapt the construct of organizational justice to the university context and to develop a corresponding questionnaire by means of established scientific procedures. An exploratory sequential mixed-methods design is applied in which qualitative and quantitative methods are combined. A valid and practicable measurement instrument ("UFair" University Fairness Questionnaire) will be developed and tested, and the relationship with various health outcomes will be examined. The UFair questionnaire will be made available free of charge to other researchers.

Heart rate variability, perceived stress and willingness to seek counselling in undergraduate students

OBJECTIVE

The primary aim was to determine the level of stress in Czech pharmacy students using both subjective and physiological markers of stress throughout their study. The secondary aim was to investigate association of stress with sociodemographic and clinical characteristics, and to determine the predictors of the likelihood of enrolling in psychotherapy counselling.

METHODS

Design: A prospective observational study.

SETTING

Faculty of Pharmacy in Hradec Kralove, Czech Republic.

SUBJECTS

175 s-year pharmacy students in 2016, 149 students in 2017, and 51 students in 2018.

OUTCOME MEASURES

Perceived stress scale (PSS-10), heart rate variability (HRV, emWavePro), a self-administered survey (sociodemographic and clinical data, likelihood of enrolling in psychotherapy counselling).

RESULTS

The average PSS score was 18.3 ± 6.7. There were no significant changes in PSS-10 and HRV parameters between 2016 and 2018. There was a significant negative correlation between PSS-10 and LF power (p = 0.012). Female gender and poor health status were more frequently observed among the respondents with impaired HRV (p = 0.026 for female gender and p = 0.025 and p = 0.042 for poor health status). Fifty-nine percent of students would be likely to enroll in psychotherapy counselling, with men being significantly less inclined to participate compared to women (p = 0.01).

CONCLUSION

Czech pharmacy students experience moderate levels of stress throughout their studies, which correlates with physiological markers of stress as well as their overall health. Push and pull factors of using mind-body interventions to manage stress should be further examined, especially in high risk groups.

A Scoping Review of Well-being Assessment and Interventions in Student Pharmacists

Objective. To review the literature assessing student pharmacist well-being and the impact of well-being-associated interventions.Findings. Of the 15 studies included, six assessed student pharmacist well-being while nine evaluated the impact of a well-being intervention. While various approaches exist to assessing student pharmacist well-being, the body of literature suggests, overall, that student pharmacist well-being is poor. Since well-being is multifaceted and individualized, some pharmacy schools have identified various ways to incorporate tailored well-being activities, including mindfulness, into required, elective, and cocurricular experiences within the Doctor of Pharmacy program, with varying outcomes.Summary. This review highlights the limited and variable information available on the assessment of student pharmacist well-being as well as unique strategies to incorporate well-being initiatives into Doctor of Pharmacy curricula. Schools of pharmacy should identify the well-being needs of student pharmacists through a standardized well-being assessment instrument and provide meaningful well-being resources and interventions within the curriculum. There is a growing need for faculty to invest in student pharmacist mental wellness in addition to academic success. Future accreditation standards will inform the Academy on how to advance well-being initiatives.

Prevalence and determinants of depression, anxiety and stress among psychiatric nurses in Ghana: a cross-sectional study

Background

The job demand and stress associated with the nursing profession expose nurses to an increased risk of psychiatric morbidities such as anxiety and depression. This study assessed the prevalence of depression, anxiety and stress among psychiatric nurses in Ghana.

Methods

A cross-sectional survey was conducted in three psychiatric hospitals in Ghana between March 2020 and May 2021. Simple random sampling technique were used to select 311 psychiatric nurses. Beck’s Depression Inventory, Beck’s Anxiety Inventory and Perceived Stress Scale were used to assess depression, anxiety and stress, respectively. Data were analysed using SPSS version 23.0.

Results

The results showed that 19.6% of psychiatric nurses experienced mild to severe depression, 27% mild to severe anxiety and 42% mild to high stress. Regression analysis showed that participants with a diploma qualification had higher odds of having moderate depression compared to those with a master’s degree. In terms of stress, participants with a diploma qualification were 29.6% less likely to have moderate stress compared to those with a master’s degree. Those with a bachelor’s degree were 7.1% less likely to have moderate stress compared to those with a master’s degree.

Conclusion

Psychiatric nurses experience depression, anxiety and stress to varying degrees. Education level was identified as a determinant of depression, anxiety and stress. Therefore, preventive strategies should be designed to reduce the risk of these conditions.

Academic stress, COVID-19 anxiety, and quality of life among nursing students: The mediating role of resilience

AIM

This study investigated the mediating role of resilience in the relationship between academic stress, COVID-19 anxiety, and quality of life (QoL) among Filipino nursing students during the COVID-19 pandemic.

BACKGROUND

The COVID-19 pandemic has impacted the QoL of nursing students who are experiencing mental health issues. The mediating role of resilience in mitigating the effects of academic stress and COVID-19 anxiety on nursing students' QoL remains understudied.

METHODS

This study employed a correlational cross-sectional design, with a convenience sample of 611 Filipino nursing students. Data were collected using the scales Connor and Davidson Resilience, Brunnsviken Brief Quality of Life, COVID-19 Anxiety, and Perception of Academic Stress and analyzed using Pearson's r, bivariate analysis, and multistage regression analyses.

RESULTS

Academic stress and COVID-19 anxiety negatively correlated with QoL and resilience. Resilience was positively associated with QoL and reduced the effect of academic stress on QoL, indicating that resilience is a crucial mediating variable between academic stress and QoL. Finally, resilience had a significant mediating influence on QoL, as evidenced by a reduction in the effect of COVID-19 anxiety on QoL among nursing students.

CONCLUSIONS

Filipino nursing students' QoL was affected by academic stress and COVID-19-related anxiety. However, resilience mediated this impact, preserving QoL.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nursing colleges and affiliated hospitals must collaborate to monitor academic stress and pandemic-related anxiety. Nursing students should be provided with programs such as seminars and team-building activities to enhance their resilience.

Perceived Social Support and Stress: a Study of 1st Year Students in Ireland

Social support is consistently associated with positive outcomes for students, in terms of wellbeing and academic achievement. For first year students, social support offers a way to deal with stressors associated with the challenge of transitioning to university. The current research was conducted with a range of first year students (n = 315) early in their first semester in university. Both male and female students reported moderate levels of social support and perceived stress, while those with higher levels of social support reported lower levels of stress. Gender differences were apparent in both the levels and sources of social support that students perceived as available to them. Female students reported higher levels of social support and stress than males, suggesting that university initiatives for enhancing social support and dealing with stress may require a gender-specific focus. The results are discussed in terms of recommendations for developing students' social supports during first year, in order to mitigate for the experience of stress and to enhance student experience of their educational journey.

Gender Differences in Psychological Stress Factors of Physical Therapy Degree Students in the COVID-19 Pandemic: A Cross-Sectional Study

(1) Background: The aim of the study was to investigate how the COVID-19 pandemic impacted the mental health and quality of life of male and female physical therapy students at the European University of Madrid. (2) Methods: A cross-sectional online survey was conducted including a range of tests capturing different domains: 36-item Short Form Health Survey, six-item state version of the State–Trait Anxiety Inventory, Acceptance and Action Questionnaire, Three Items Loneliness Scale, four-item version of the Perceived Stress Scale, Beck Depression Inventory revised version, and Sleep Quality Numeric Rating Scale. (3) Results: A total of 151 students completed the study, consisting of 78 females and 73 males. Gender differences were observed on most of the domains evaluated. Female participants showed worse levels of general health perception, quality of life, depression symptoms, anxiety, stress, experiential avoidance and psychological inflexibility, sleep quality and loneliness compared to male physical therapy students. (4) Conclusions: The results of this study support the need of psychological interventions as preventive programs in situations such as COVID-19 pandemic. The aims of this study comprise of improving knowledge, awareness, and self-coping strategies or other psychological domains oriented to mitigate the effects of COVID-19 on mental health and health-related quality of life in university students, especially among female ones.

Nationwide Study on Stress Perception Among Surgical Residents

OBJECTIVE

Declining number of applicants and high attrition of residents are a dire reality. Surgeons in training are confronted to various stressors which interfere with their performance and may promote burnout. This study measures stress levels of Swiss surgical residents.

METHODS

Swiss surgery residents taking the Surgical Basic Exam from 2016 to 2020 completed the Perceived Stress Scale 10 (PSS). The PSS measures how unpredictable, uncontrollable, and overloaded the respondents evaluate their work life. Scores up to 13 are normal, and scores around 20 are highly pathologic. High subscores of helplessness (PH) and lower subscores of self-efficacy (PSE) indicate distress.

RESULTS

A total of 1694 questionnaires were evaluated (return rate 95.7%). Resident median (m) age was 29 years, 43.5% were female, and 72.7% of the residents were in their first 2 years of training. Residents reported a high PSS (m = 15), a high PH (m = 9), and an ordinary PSE (m = 5). Females reported worse PSS (p < 0.001), PH (p < 0.001), and PSE (p = 0.036). In multivariable analysis, male sex (p < 0.001), aiming at orthopedic (p = 0.017) or visceral surgery (p = 0.004), and French as mother tongue (p = 0.037) predicted lower stress levels, while graduating from a country not adjacent to Switzerland led to higher stress (p = 0.047).

CONCLUSION

Perceived stress levels are high in this prospective and representative cohort study of Swiss surgical residents. Females endured significantly worse stress and helplessness levels than males. These figures are worrisome as they may directly contribute to the declining attractivity of surgical residencies. Detailed sex-specific analysis and correction of stressors are urgently needed to improve residency programs.

Evaluating the effects of a mindfulness mobile application on student pharmacists' stress, burnout, and mindfulness

DISCLAIMER

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

PURPOSE

Pharmacists report high levels of burnout. Mindfulness approaches have been demonstrated to have positive results in the general population and in other healthcare professions. However, limited studies have been performed evaluating mindfulness approaches in student pharmacists. The aim of this study was to evaluate the effectiveness of daily use of a mindfulness mobile application in improving student pharmacists' perceived stress, burnout, and mindfulness.

METHODS

This study was a randomized, longitudinal, waitlist-controlled trial. The intervention group was asked to meditate using the mindfulness application Headspace daily for at least 6 weeks. The waitlist control group was asked to abstain from using the application for the entire study. Stress, burnout, and mindfulness were assessed using validated survey instruments at baseline, 6 weeks, and 10 weeks. A secondary outcome was to assess the persistence of application use after the intervention period.

RESULTS

Fifty-six participants completed the study. The intervention group reported significantly lower scores on stress and burnout at 6 weeks compared to the control group. The intervention group also reported significantly higher scores on mindfulness. The differences in stress, burnout, and mindfulness persisted at follow-up. The mean percentage of students in the intervention group who used the application each day was 90% over the intervention period and 62% over the follow-up period.

CONCLUSION

A mindfulness mobile application significantly improved student pharmacists' stress, burnout, and mindfulness with daily use. Most participants continued to use the application for 4 weeks after the end of the intervention. Positive effects on stress and mindfulness persisted even with decreased use.

General Anxiety, Academic Distress, and Family Distress Among Doctor of Pharmacy Students

Objective. To examine the prevalence of general anxiety among Doctor of Pharmacy (PharmD) students and the role of academic distress and family distress in causing general anxiety.Methods. A cross-sectional study was conducted among first, second, and third year PharmD students. All students received an online survey consisting of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62) questionnaire and sample characteristics. Variables from CCAPS-62 considered in this study included academic distress and family distress measured on a three-level scale: no, low, and high clinical level. Data on gender, race, work status, and physical activity were also collected. Descriptive and multinomial logistic regression were conducted to identify factors associated with general anxiety.Results. Of the 238 students who took the online survey (63% response rate), the majority were female (67%) and Asian (49%). Overall, 69 first year, 75 second year, and 94 third year students participated. The prevalence of general anxiety was 50%, with equal distribution (25% each) among high-clinical and low-clinical general anxiety groups. High academic distress and high family distress were associated with a greater probability of a student having high general anxiety.Conclusion. General anxiety was quite prevalent among pharmacy students. Identification and implementation of strategies to lower general anxiety as well as academic distress is of great importance. Also, understanding and enhancing the role of family members in students' lives is essential. College administrators can provide support for students as well as for family members to make improvements in these areas.

PSYCHOSOCIAL IMPACT OF COVID-19 ON STUDENTS AT INSTITUTIONS OF HIGHER LEARNING

Students at higher institutions of learning are more susceptible to psychosocial problems compared to the general public. These may further be exacerbated by the measures put in place to curb the spread of COVID-19. This mixed methods study examined the factors associated with the psychosocial impact of COVID-19 on students’ financial stability, interpersonal relationships and worries related to achieving academic milestones. Data comprised of a series of closed and open-ended questions collected via Qualtrics from students in the United States and Africa (Central and West). The quantitative data were analyzed using frequency counts, percentages and chi-square, while the qualitative data was analyzed using thematic content analysis. More than 90% of the students resided in the United States, 72.5% were females and 78.4% were undergraduates. Financial hardship was experienced by 26.4% of the students, 55.8% indicated that COVID-19 negatively affected their relationship with friends and over 40% worried over delays in achieving academic milestones. Continent of residence, employment status and financial hardship were significantly associated with the negative impact of COVID-19 on one or more of the students’ relationships and with worries about achieving academic milestones. Qualitative data support the findings that financial hardship contributed to experience of psychological distress by students. It also revealed negative (compromised relationships – broken or fractured relationships and loneliness) and positive (bonding) impact of COVID-19 on interpersonal relationships. School administrators should provide students with resources to access economic relief packages and tele-counseling services to help meet their financial and psychosocial support needs amidst COVID-19.

Measures of Burnout and Empathy in United States Doctor of Pharmacy Students: Time for a Change?

PURPOSE

To review interim data regarding longitudinal burnout and empathy levels in a single Doctor of Pharmacy class cohort.

METHODS

Students were emailed an electronic survey during their first semester and annually at the end of each academic year for a total of 3 years (2017-2020). Validated survey tools included the Jefferson Scale of Empathy (JSE) and the Maslach Burnout Inventory (MBI) student version. The JSE survey consists of 20 questions, with higher scores denoting more empathy. The MBI student version contains 3 subscales: exhaustion (higher scores are worse), cynicism (higher scores are worse) and professional efficacy (higher scores are better).

RESULTS

The median JSE score at the end of the third academic year (PY3) was 110, with females scoring significantly higher (114.5 vs. 103.5; p<0.02). A majority of the 62 students reported burn out (82.3%), scoring in the highest category for either exhaustion (76%) or cynicism (55%). A majority (66%) also reported a low or moderate professional efficacy score, a negative finding. Measures of student burnout increased after the start of the program and remained at the higher level each subsequent year (p<0.0001). In the Spring of 2020, during the COVID-19 pandemic, nearly every student had moderate or high levels of emotional exhaustion (97%) and cynicism (78%) as measured by the MBI.

CONCLUSION

This interim data suggests high degrees of pharmacy student burnout. Empathy levels remained stable throughout the duration of the study. Pharmacy schools may need to focus on reform regarding well-being and prevention of burnout.

Academic Stress and Study Habits of Health Science University Students

Introduction Academic stress and study habits are crucial indicators of academic success. At the moment, faulty study habits press on the students into academic stress. The present study was conducted to identify the academic stress and study habits of university students of health science.

Methods This cross-sectional descriptive survey was conducted among 150 undergraduate students of nursing, physiotherapy, and pharmacy (n = 50 in each group). A stratified random sampling technique was used to select the study participants. The information on academic stress and study habits was collected by using the Student Stress Inventory and Palsane and Sharma Study Habit Inventory, respectively.

Results Mean score of academic stress was found to be 75.353 ± 16.463. Pharmacy students had a higher level of stress compared to physiotherapy and nursing students (p = 0.013). Furthermore, the prevalence of unsatisfactory study habits among undergraduate students was 72%, with a mean score of 52.7 ± 9.152. Also, nursing students had a higher level of study habits compared to physiotherapy and pharmacy Students. There was no significant relationship found between study habits and academic stress (r = −0.048, p = 0.557). There was a significant association found between study habits and gender (p = 0.021), as well the association found between stress level and course type, Pre-University Course percentage, and first-year percentage (p = 0.044, 0.04, and 0.044 respectively).

Conclusion Academic stress and poor study habits are prevalent among undergraduate students. This indicates strategies need to be formed to enhance healthy study habits and alleviate the academic stress of the students, mainly in professional courses; it is an urgent need.

Association between grit and academic achievement among undergraduate pharmacy students in Malaysia

INTRODUCTION

This study evaluated the level of grit and its association with academic achievement among pharmacy undergraduate students in Malaysia.

METHODS

This was a cross-sectional study conducted at a public university in Malaysia. Data were collected using an electronic, validated, pre-tested modified version of the short Grit scale between December 2019 and January 2020. Correlation between grit and self-reported cumulative grade point average (CGPA) was examined.

RESULTS

Of 444 students invited to participate, 247 completed the questionnaire (response rate 55.6%). Mean age was 21.4 ± 1.5 years, and 70.6% were female. The mean grit score was 3.1 ± 0.4 (out of 5.0). Students had higher scores in the perseverance of effort subscale (3.3 ± 0.7) than the consistency of interest subscale (2.9 ± 0.5). Students with self-reported CGPAs ≥3.50 had higher mean grit (3.3 ± 0.4) than those with CGPAs of 3.00 to 3.49 (3.0 ± 0.4) and < 3.00 (3.1 ± 0.4) (P = .007). There was a significant correlation between self-reported CGPA with consistency of interest score (r = 0.139; P = .03) and mean grit score (r = 0.153; P = .02). There was no association between CGPA and the perseverance of effort score.

CONCLUSIONS

Pharmacy undergraduate students in Malaysia have a moderate level of grit. Academic achievement (CGPA ≥3.50) was significantly associated with consistency of interest and grit scores. Pharmacy educators should counsel students who experience academic setbacks on the importance of maintaining interest and sustaining efforts to improve their academic achievements.

Mental health resources in pharmacy schools

INTRODUCTION

This study aims to examine the availability of mental health resources available to pharmacy students. Identifying if pharmacy schools have specific resources is important given the increasing prevalence of mental health disorders among pharmacy students.

METHODS

This study has two arms: (1) survey sent to representatives of student affairs of 11 pharmacy schools, and (2) website scan performed of all pharmacy schools in the United States. The survey collected information on mental health resources available including availability, location, and future plans. The website scan examined resources at each school listed on the doctor of pharmacy school directory on the Pharmacy College Application Service website, and the difficulty of locating this information. Microsoft Excel was used to perform descriptive statistics.

RESULTS

For the survey arm (n = 9), 83% of respondents were directors of student affairs. Top services located within the university campus, but not within the pharmacy school, were wellness activities (67%) and an on-site counselor (89%). Similarly, for the website scan (n = 150), most schools had availability of an on-site counselor; however, 83% of counselors were located within the university campus, not within the pharmacy school. For 77% of pharmacy schools, no information on mental health resources was found on their websites. The information was considered "somewhat" or "extremely difficult" to find for 45% of schools.

CONCLUSION

Both arms found that the most commonly available services, including an on-site counselor, were not located at the pharmacy school but instead part of university campus services.

Exploring How Postmillennial Pharmacy Students Balance Life Priorities and Avoid Situations Known to Deplete Resilience

Objective. Students are facing increasing academic pressures that can contribute to poor wellbeing. Evidence to inform the development of better student support services is weak. This study aimed to explore Bachelor of Pharmacy students' self-reported life priorities and ways they strategize to avoid resilience-depleting events on a day-to-day basis.Methods. Postmillennial (those born after 1996) pharmacy students enrolled in their final year of pharmacy school were introduced to the coaching concepts of the Wheel of Life and anti-goals. Students' top eight life priorities were collected and categorized. Students were asked to submit one anti-goal targeting a strategy used to avoid resilience depletion. Anti-goals were coded according to student priority areas and overarching themes were interpreted.Results. The top priorities of 110 final-year pharmacy students were: family, finance, health, friends/relationships, study, career prospects, fitness, personal growth, travel, and mental health/wellbeing. Priorities were both similar and dissimilar to traditional coaching priorities. Sixty-eight anti-goals were coded. The themes "being prepared" and "being present" were used to summarize strategies that students employed to avoid resilience depletion.Conclusion. The life priorities of newer student generations may be changing to be more individualistic and include a greater focus on self-help, while maintaining the core priorities of family, health, and finance. These findings uphold the notion that student support mechanisms must be modernized to accommodate students' needs.

Socio-demographic and educational factors associated with Depression, Anxiety and Stress among Health Professions students

Depression, anxiety and stress are the most prevalent mental health problems among health professions' students. The study was aimed to explore the socio-demographic and educational factors associated with depression, anxiety and stress among health professions' students. Using non-random purposeful sampling, 366 health professions' students studied in 2018/19 were surveyed via a self-reported questionnaire that included Depression, Anxiety and Stress Scale (DASS-21) and questions on sociodemographic and educational characteristics. The majority of respondents were from the School of Medicine (59.8%), with 116 males and 250 females. Sleep duration, communication problems with teaching staff, feelings of inferiority to friends and family problems were determined to be independent predictors of depression in the current study. Communication problems with teaching staff, feelings of inferiority to friends and family problems were important predictors of anxiety. Further, we found that feelings of inferiority to friends and family problems were found to be important risk factors for stress. Our results suggest that the overall prevalence of depression, anxiety and stress among health professions' students were considerably high. All students having a severe mental health issues should be supported by the student counselling centre and expert clinicians in order to confirm the diagnosis and implement subsequent treatment strategies.

Patient-Reported Outcome Measures With Secondary Lower Limb Lymphedemas: A Systematic Review

Background

Patient-reported outcome measures are measures of patients' health-related quality of life. They should be added to other lymphedema measurements. With an improved disease-free survival of secondary lower limb lymphedema, attention must focus on such assessments.

Objective

The objectives of this study were to locate and critically appraise suitable patient-reported outcomes measures for lower limb lymphedemas and search for existing valid translations for native German speakers.

Methods

A systematic literature research was conducted. 20 semantical categories for qualitative analysis were evolved. Six questionnaires available in English and some in validated translations remained for analysis.

Results

Lower limb lymphedema patients experience poor quality of life, and one of the most critical denominators is skin quality. To establish skin care and prevent cellulitis, patients must learn about skin problems. Only two tools asked for past infections. This is considered crucial because of knowledge building and prophylactic behavior. Questions on movement restrictions were available in one questionnaire. As these have a close connection to one's ability to perform activities of daily life, they can affect quality of life. Afflicted patients have problems with the choice and availability of clothing. Only three questionnaires asked questions about clothing or shoes. Lymphedema patients are exposed to more psychological stress than healthy subjects, but only three questionnaires covered questions about this burden. There was a lack of reporting on psychometric data (Cronbach's alpha, intraclass correlation), which hinders the external validity. Analyzed questionnaires were available in English but only one in German.

Conclusions

The analyzed questionnaires were in English, and only one was adapted and tested for native German speakers. For clinical practice, Devoogdt's questionnaire is recommended despite some shortcomings. There is a need for validated lymphedema questionnaires in German.

The Effect of Occupational Stress on the Quality of Life of Pharmacists in Saudi Arabia

Purpose

The job of a pharmacist is extremely demanding, and pharmacists play a vital role in improving the success of patients’ treatment plans and disease management outcomes. The objective of this study was to evaluate the association between pharmacists’ quality of life (QOL) and occupational stress in Saudi Arabia.

Methods

This was a prospective, paper-based, cross-sectional survey. The World Health Organization Quality of Life – Brief scale (WHOQOL-BREF) was used to evaluate quality of life, and the Effort-Reward Imbalance (ERI) scale was used to assess occupational stress. The two scales were administered to licensed pharmacists working in Saudi Arabia, and demographic data were collected. Descriptive and analytical statistical tests were performed. Multiple linear regression was conducted to evaluate the association between work stress and QOL.

Results

A total of 371 questionnaires were distributed, and 284 questionnaires were returned. The average age of the participants was 33.4 ± 6.5 years. Most were male (61.2%), married (62.9%), and had children (51.1%). Multiple linear regression analysis showed significant negative relationships between stress (β = -0.454; 95% CI, −0.697 to −0.211) and QOL, and between the presence of chronic diseases (β = 3.779; 95% CI, 0.597 to 6.961) and QOL, when holding other variables constant. Also, a positive association between male sex (β = 3.779; 95% CI, 0.597 to 6.961) and QOL was reported, when other variables were kept constant.

Conclusion

Occupational stress and the presence of chronic diseases were found to have a negative influence on pharmacists’ QOL, while the male sex was associated with a better QOL. Moreover, QOL was linked to performance. Pharmacists are intensely involved in medication safety (use and administration), which might impact patients (at the micro-level) and the healthcare system (at the macro-level). Therefore, stress control is crucial to improve pharmacists’ QOL and performance in relation to patient health.

Strategies first year doctor of pharmacy students use to promote well-being

INTRODUCTION

The objective of this study is to assess strategies that first-year doctor of pharmacy (PharmD) students utilize to manage stress and promote well-being throughout the program.

METHODS

Participants included students at a university in an urban Midwestern region. Students were enrolled in the second semester of their first year of a four-year PharmD program. Students were participating in a social and administrative sciences course in which they were required to write a two-page reflection before a small group discussion and lecture on their overall well-being while in pharmacy school. Open and axial coding was conducted on these reflections using a standard content analysis approach of qualitative thematic analysis.

RESULTS

A total of 49 pharmacy students reported multiple strategies to help cope with stressors of a PharmD program and improve their well-being. Four themes emerged, including: (1) availability and accessibility of institutional resources, (2) personal time management and organizational strategies, (3) personal mental and physical health strategies, and (4) activities that maintain social relationships.

CONCLUSIONS

First-year pharmacy (P1) students are actively thinking about and participating in activities to promote personal well-being, manage extreme stress, and proactively prevent the detrimental effects of burnout. P1 students were aware of the need to incorporate specific strategies into their daily routine to aid in their overall well-being and experience during pharmacy school. Colleges and schools of pharmacy can use the findings of this study to understand strategies students currently use to identify approaches for supporting student needs and any gaps in wellness resources.

Examination of the Relationship between Health-related Quality of Life and Academic Performance Among Student Pharmacists

INTRODUCTION

First-year student pharmacists (P1s) may experience a number of stressors that may affect academic performance due to the transition into a professional program. Study objectives were to evaluate student demographic and pre-pharmacy factors associated with perceived stress among P1s, analyze relative change in perceived stress over the P1 year, and assess associations between perceived stress and academic performance.

METHODS

The Perceived Stress Scale (PSS-10) was administered three times to P1s: during orientation, midpoint of fall semester, and midpoint of spring semester. Data were also collected using school records, including demographics, P1 fall grade point average (GPA), P1 spring GPA, and P1 year GPA. Paired-sample t-tests, independent samples t-tests, Analysis of Variance, correlational analysis, and multiple linear regression were conducted.

RESULTS

Of 202 P1s, 201 (99.5%) completed the orientation survey administration and 110 (54.5%) completed all three administrations. PSS-10 score significantly increased across survey administrations. Differences in PSS-10 scores at orientation were noted based on gender and race/ethnicity (P < .05), with female and minority students experiencing greater levels of stress. PSS-10 score (spring administration) was significantly, inversely correlated to P1 fall GPA, spring GPA, and year GPA (P < .05). Undergraduate science GPA, PSS-10 score (orientation administration), and age were included in the final version of the regression model as significant predictors of P1 year GPA.

CONCLUSIONS

Perceived stress increased over the P1 year, and higher perceived stress was associated with lower P1 academic performance. Future studies should examine strategies to assist P1s in managing stress.

Perceived Stress, Depression, and Associated Factors among Undergraduate Health Science Students at Arsi University in 2019 in Oromia, Ethiopia

Background

A mental health problem is a significant cause of overall disease burden globally. Among this problem, stress and depression are the central problems observed among university students due to the transitional nature. Consequently, the problem has an adverse effect on the wellbeing and academic performance of students.

Objective

To assess perceived stress, depression, and associated factors among undergraduate health science students at Arsi University in 2019 in Oromia, Ethiopia.

Methods

An institutional-based cross-sectional study design on undergraduate health science students was employed for the study from February 25 to April 15, 2019. Data were collected by using a self-administered questionnaire of the perceived stress scale (PSS-14) item and Beck depression inventory 21 items.

Result

All of the study subjects were between ages 18 and 30 with a mean age of 20.9 ± 1.83 standard deviation years. The current prevalence of perceived stress among study subjects was 63.5%. Age category, study year, pressure to maintain a good grade, practical attachment, lack of dormitory safety, and the financial problem were identified as significantly associated factors of perceived stress. In addition to this study, results also revealed that the prevalence of depression among students was 4.4% in which thinking about career future prospects was a significantly associated factor.

Conclusion

Stress was a significant problem among study participants where a small proportion of study subjects presented with depression. Comprehensive counseling and guidance aligned with training on awareness creation were recommended.

Quality of life of pharmacy students in Northern Nigeria

Objectives

To assess the quality of life (QoL) of Nigerian pharmacy students and to investigate its predictors.

Methods

This cross-sectional descriptive study randomly sampled one pharmacy school from each of the three geopolitical zones of northern Nigeria We collected data with the WHOQOL-BREF questionnaire. Independent-samples t-test and one-way analysis of variance were used to compare groups. The predictors of QoL were identified using multiple linear regression analysis. P &lt; 0.05 was considered statistically significant.

Key findings

The overall response rate was 81.2%. The overall QoL mean score of pharmacy students in the region was 76.94 ± 17.65. There was a lower environment domain mean score (56.06 ± 14.60) compared to other domains. Multivariate analyses revealed that being a Christian, in the 5th year of study, and having a current illness/problem negatively affected overall QoL (P &lt; 0.05). Having a current illness/problem negatively affected physical health (P &lt; 0.05). Being in the 5th year of study and having a current illness/problem negatively affected psychological health, whereas schooling in the state of residence, active involvement with student organizations/clubs and having a current illness/problem negatively affected the environment domain (P &lt; 0.05).

Conclusion

This study showed that pharmacy students had a fair overall QoL and poor well-being in all four domains. Religion, state of residence, year of study, organizations/clubs and current illness/problem were the significant predictors of QoL. Therefore, these findings will be useful in reviewing the training of pharmacy students with a view to improving their well-being and quality of pharmacy education.

Getting Rigor Right

A colleague of mine once shared a story he heard of an organic chemistry teacher who would tell people he had one of the most important, lifesaving jobs in the world. Why? Because he made sure academically unprepared premed students never made it to medical school. Teachers can have many possible motivations for maintaining high academic standards in their courses. A desire to ensure future health practitioners are adequately prepared to engage in the intellectual rigor of their profession may be just one of them.

What do we need to know? Data sources to support evidence-based decisions using health technology assessment in Ghana

BACKGROUND

Evidence-based decision-making for prioritising health is assisted by health technology assessment (HTA) to integrate data on effectiveness, costs and equity to support transparent decisions. Ghana is moving towards universal health coverage, facilitated mainly by the National Health Insurance Scheme (NHIS) established in 2003. The Government of Ghana is committed to institutionalising HTA for priority-setting. We aimed to identify and describe the sources of accessible data to support HTA in Ghana.

METHODS

We identified and described data sources encompassing six main domains using an existing framework. The domains were epidemiology, clinical efficacy, costs, health service use and consumption, quality of life, and equity. We used existing knowledge, views of stakeholders, and searches of the literature and internet.

RESULTS

The data sources for each of the six domains vary in extent and quality. Ghana has several large data sources to support HTA (e.g. Demographic Health Surveys) that have rigorous quality assurance processes. Few accessible data sources were available for costs and resource utilisation. The NHIS is a potentially rich source of data on resource use and costs but there are some limits on access. There are some data on equity but data on quality of life are limited.

CONCLUSIONS

A small number of quality data sources are available in Ghana but there are some gaps with respect to HTA based on greater use of local and contextualised information. Although more data are becoming available for monitoring, challenges remain in terms of their usefulness for HTA, and some information may not be available in disaggregated form to enable specific analyses. We support recent initiatives for the routine collection of comprehensive and reliable data that is easily accessible for HTA users. A commitment to HTA will require concerted efforts to leverage existing data sources, for example, from the NHIS, and develop and maintain new data (e.g. local health utility estimates). It will be critical that an overarching strategic and mandatory approach to the collection and use of health information is developed for Ghana in parallel to, and informed by, the development of HTA approaches to support resource allocation decisions. The key to HTA is to use the best available data while being open about its limitations and the impact on uncertainty.

Independent and combined associations between screen time and physical activity and perceived stress among college students

Although both screen time (ST) and physical activity (PA) are associated with stress, independent and combined associations between ST and PA, and perceived stress among college students, have remained unclear. The present study included 1137 undergraduate medical students from a university in Shenyang, Northeast China. PA and perceived stress were measured using the International Physical Activity Questionnaire (IPAQ)-Long Form and the Chinese Perceived Stress Scale (CPSS), respectively. ST and students' characteristics were determined using a self-administered questionnaire. Data were analyzed using the independent t-test, Pearson Chi-squared test, and logistic regression. After adjusting for potential confounding factors, females reporting high ST (HST, ST > 6 h/day) were more likely to experience stress than those reporting low ST (LST, ST ≤ 6 h/day) (OR = 1.557), while those reporting light- and moderate-intensity PA (LMPA) were more likely to experience stress than those reporting vigorous-intensity PA (VIPA) (OR = 1.674). Analysis of the combined effects of PA and ST showed that, among female students, those reporting both LST and LMPA (OR = 2.174), both HST and VIPA (OR = 2.088), and both HST and LMPA (OR = 2.797) were more likely to experience stress compared to those reporting both LST and VIPA (the reference category). The present study confirmed that LST and VIPA were independently and concurrently associated with significantly lower stress among college students, suggesting that promoting PA and reducing ST might be an effective way to reduce perceived stress among college students.

Stress Associated Alterations in Dietary Behaviours of Undergraduate Students of Qassim University, Saudi Arabia

BACKGROUND:

Psychological stress associated eating habits among public health have now become a global concern.

AIM:

This study was undertaken to investigate the levels of psychological stress among undergraduate students of Qassim University and to explore the stress associated alterations in their eating habits.

METHODS:

This is a cross-sectional survey conducted on 614 undergraduate students of Qassim University, Saudi Arabia. A self-administered questionnaire was used, which included questions on socio-demography and eating habits. Level of stress was measured by a standardised questionnaire highlights the levels of non-chronic stimulation through difficulty relaxing, nervous arousal and being easily upset/agitated, irritable / over-reactive and impatient.

RESULTS:

Our results show that 28.2% of total participants suffered from some extent of stress. Among stressed participants, 17.3%, 49.1%, 24.8% and 8.7% of participants suffered from mild, moderate, severe and extremely severe stress, respectively. Stressed participants were more preferred to eat junk foods such as fast foods, snacks and beverages as compared with unstressed participants (p < 0.05) and the junk food preference was increased with the increase of stress levels. Moreover, non-stressed participants preferred more healthy foods such as vegetarian food, fresh fruits as compared with stressed participants (p < 0.05). Taste and easy to access were the main reasons for the preference of junk foods by the stressed participants.

CONCLUSIONS:

This is the first comprehensive study from Saudi Arabia to show stress associated dietary alterations in undergraduates of Qassim University. Data concluded that most of the young adults followed a healthy eating pattern, but a significant number from them were affected by stress. Therefore, specific intervention programs are strongly recommended for the reduction of stress and to improve their quality of life.

Beyond Academics: A Model for Simultaneously Advancing Campus-Based Supports for Learning Disabilities, STEM Students' Skills for Self-Regulation, and Mentors' Knowledge for Co-regulating and Guiding

Learning disabilities are highly prevalent on college campuses, yet students with learning disabilities graduate at lower rates than those without disabilities. Academic and psychosocial supports are essential for overcoming challenges and for improving postsecondary educational opportunities for students with learning disabilities. A holistic, multi-level model of campus-based supports was established to facilitate culture and practice changes at the institutional level, while concurrently bolstering mentors' abilities to provide learning disability-knowledgeable support, and simultaneously creating opportunities for students' personal and interpersonal development. Mixed methods were used to investigate implementation of coordinated personal, interpersonal, and institutional level supports for undergraduate science, technology, engineering, and math (STEM) students with learning disabilities. A one-group pre-test post-test strategy was used to examine undergraduate outcomes. Participants included 52 STEM undergraduates with learning disabilities, 57 STEM graduate student mentors, 34 STEM faculty mentors, and 34 university administrators and personnel as members of a university-wide council. Enrolled for 2 years, undergraduates were engaged in group meetings involving psychoeducation and reflective discussions, development of self-advocacy projects, and individual mentorship. Undergraduates reported improved self-efficacy (p = 0.001), campus connection (p < 0.001), professional development (p ≤ 0.002), and self-advocacy (p < 0.001) after two academic years. Graduate student mentors increased their understanding about learning disabilities and used their understanding to support both their mentees and other students they worked with. Council members identified and created opportunities for delivering learning disability-related trainings to faculty, mentors and advisors on campus, and for enhancing coordination of student services related to learning and related disorders. Disability-focused activities became integrated in broader campus activities regarding diversity. This research explicates a role that college campuses can play in fostering the wellbeing and the academic and career development of its students with developmental learning and related disorders. It offers an empirically tested campus-based model that is multilevel, holistic, and strengths-based for supporting positive outcomes of young people with learning disabilities in STEM. Moreover, findings advance the knowledge of supports and skills that are important for self-regulating and navigating complex and multi-faceted disability-related challenges within both the postsecondary educational environment and the young adults' sociocultural context.

The Association Between Perceived Stress and Quality of Life in University Students: The Parallel Mediating Role of Depressive Symptoms and Health-Promoting Behaviors

PURPOSE

This study examined whether depressive symptoms and health-promoting lifestyle behaviors mediate the association between perceived stress and quality of life (QoL) in university students.

METHODS

Using a cross-sectional survey, Korean university students (N = 187, M_age = 23.97 years; 54.0% Woman) completed structured questionnaires with psychometric adequacy. A parallel multiple mediation model was used to test the mediating effect of depressive symptoms and health-promoting lifestyle behaviors on the relationship between perceived stress and QoL.

RESULTS

Total effect of perceived stress, depressive symptoms, and health-promoting lifestyle behaviors on QoL was -.55. Of these, total indirect mediating effect was -.50, whereas direct effect was only -.05 in the parallel mediation model. In particular, depressive symptoms (indirect effect = -.32) and health-promoting lifestyle behaviors (indirect effect = -.18) completely mediated the relationship between perceived stress and QoL.

CONCLUSION

The results suggest that effective strategies primarily focusing on improving depressive symptoms along with health behaviors are needed to decrease the negative effect of perceived stress on QoL.

A Questionnaire Study to Investigate Stress among Future Pharmacists by Gender and Year Group

BACKGROUND

This work aimed to ascertain future pharmacists' stressors and stress-coping practices.

METHODS

Queens' University Belfast Year 2 and 4 pharmacy students were invited to participate in an ethically approved, pre-piloted questionnaire study. Section A was the 10-item Perceived Stress Scale, Sections B and C related to stressors and stress-coping mechanisms, and Section D gathered non-identifiable demographic information. Data analysis largely took the form of descriptive statistics.

RESULTS

A response rate of 94.2% (213/226) was obtained. The mean Perceived Stress Scale score was 19.94 [standard deviation (SD) 6.37], with females having a higher mean score than males (20.55 SD 5.67 versus 18.16 SD 7.42). Common general stressors were career choice, employment opportunities, and finance. Common degree-specific stressors were particular assessments (objective structured clinical examinations and one-off written examinations) and the amount of course material. Popular stress-coping practices included getting emotional support from friends and family and using self-distractions.

CONCLUSION

Stress appears to be an issue among these future pharmacists, and potentially more so for females. While the main stressors are unsurprising, this UK data enables comparisons to be made and helps inform support mechanisms within the university.

Evaluation of the relationships among happiness, stress, anxiety, and depression in pharmacy students

INTRODUCTION

To present the results of a survey on stress, anxiety, depression, subjective happiness, and academic satisfaction among pharmacy students.

METHODS

A total of 410 pharmacy students, were included. Sociodemographic characteristics, stress, anxiety and depressive symptoms, and happiness were evaluated using the Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale (HADS), and Subjective Happiness Scale (SHS), in May 2015.

RESULTS

First and second year student's (n = 200) presented higher levels of academic satisfaction (p = 0.003) and lower levels of stress (p < 0.001), anxiety (p = 0.011) and depression (p = 0.010) than third and fourth year students (n = 210). Academic satisfaction, HADS, and the PSS explained 36.7% of the students' happiness.

CONCLUSIONS

The student's psychological distress, academic satisfaction, and happiness varies through the school years. Monitoring a probable cumulative effect during pharmacy school may contribute to identify students at risk.

Perceived Stress among French Dental Students and Their Opinion about Education Curriculum and Pedagogy

Objectives:

The purpose of this study was to identify the major sources of perceived stress and their relation to a student satisfaction questionnaire about the curriculum and the pedagogy among French dental students.

Materials and Methods:

All dental students (n = 178) from years 4 to 6 at the University of Montpellier (France) participated in this exploratory survey. In spring 2016, a 3-part questionnaire was distributed during clinical sessions: the first part asked about sociodemographic and living conditions, the second part aimed to assess the students' perceived stress (Dental Environmental Stress questionnaire), and the third part was a satisfaction questionnaire exploring the clinical organization and the teaching methodologies (Student Course Experience Questionnaire). A Spearman's correlation test and a principal component analysis were used to assess the relation between the variables of the questionnaire.

Results:

The response rate was 99.4%. The most stressful items were “the number of tasks to be performed during clinical practice,” “the waiting time before opinion from teachers,” and “the administrative part and computer problems.” Fifty-four percent of the students claimed to be satisfied with their studies, showing a score of seven or higher. There was a negative correlation between the level of student satisfaction and the level of perceived stress.

Conclusion:

Although most of the students were globally satisfied with their curriculum, this study highlighted dysfunctions in the clinical education with a level of stress correlated with the student's dissatisfaction. Most of all, students found that examinations were too stressful and that the clinical requested task quotas were overestimated.