Assessment of academic stress and its coping mechanisms among medical undergraduate students in a large Midwestern university

The perception and association between depression and academic stress among female undergraduate nursing students: a cross-sectional study

Introduction

Academic demands and stressors put nursing students at increasing risk of depression. The aims of the study examine the perceived level of depression and academic stress and investigate the association between these variables among nursing students in Saudi Arabia.

Methods

A cross-sectional design was used in this study. Data was collected using depression subscale from DASS-21 scale and the Academic Stress Inventory scale.

Results

A total of 237 students participated in the study. Nursing students perceived normal to mild levels of depression. Students perceived moderate levels of academic stress in all subscales, except for time management and test stress which were high. All academic stress subscales had a positive statistically significant correlation with depression. The regression model explains 49.0% of the variance in the depression scale and indicated that the main significant predictor of depression is studying in group stress, followed by self-inflected stress, study year, and sleep problem. The mean score of depression for first year students was significantly different than students in other study years.

Discussion

Nurse educators should facilitate group formation and teach students about time-management, problem-solving, negotiation, and coping strategies to deal with academic expectations and demanding situations. Understanding the causes, limiting the exposure to negative influences, and seeking support as needed are important. To enhance the quality of sleep, students should maintain a consistent sleep schedule, while avoiding stimulating activities before bedtime. Future research should focus on a longitudinal study and other variables such as quality of life, satisfaction with the quality of teaching, and support from others.

The interplay between self-regulation, learning flow, academic stress and learning engagement as predictors for academic performance in a blended learning environment: A cross-sectional survey

Aim

To examine the correlations between self-regulation, learning flow, academic stress and learning engagement as predicting variables for academic achievement in a blended learning environment in Namibia.

Design

Cross-sectional survey.

Methods

Data were collected from 166 randomly selected undergraduate nursing students through an online survey between January and February 2023, and were analysed using IBM SPSS AMOS version 28.0. The data were explored through factor, parallel and confirmatory factor analyses. The relationship between the study factors and the total score of the scale was analysed using the Pearson correlation coefficient.

Results

The results indicate that the two factors identified in the factor analysis are consistent with the theoretical proposition in this research. Factor 1 comprises items C1 to C24, which pertain to self-regulation (SR), while factor 2 consists of items D1 to D9, which relate to learning flow (LR). The findings demonstrate that self-regulation significantly predicts both flow and stress, as well as learning engagement. Additionally, there is a significant relationship between stress and self-regulated learning, as well as between stress and learning flow (r = 0.23-0.26; p= < .05). However, none of the study constructs were found to predict academic achievement.

Conclusion

Although self-regulation significantly predicted flow, stress and learning engagement, a non-significant association exists between all the study constructs and academic achievement. The results of this study have significant implications for improving the development of a positive learning environment that fosters active student engagement. Future studies should investigate correlation by conducting large-scale studies.

Impact

This study makes a valuable contribution to the current body of literature concerning academic achievement within the context of undergraduate nursing education. The insignificant relationship between the study variables and academic achievement indicate that these elements are not of considerable significance in enhancing educational achievements in blended learning surroundings in Namibia.

Patient or public contribution

One hundred and sixty-six undergraduate nursing students participated in the survey. The data collected were analysed and interpreted by a skilled statistician.

Online Learning Stress and Chinese College Students' Academic Coping during COVID-19: The Role of Academic Hope and Academic Self-Efficacy

Colleges around the world have adopted emergency online learning to continue with teaching and learning activities during COVID-19. Existing research has indicated that this teaching mode is perceived negatively by many college students. The difficulty students encounter in emergency online learning can adversely affect their mental health and academic performance. To shed further light on how emergency online learning may have impeded college students' academic functioning and adjustment, this study examined the association between online learning stress and academic coping and the mediating roles of academic self-efficacy and academic hope. It was conducted in early 2021, a year after the outbreak of the pandemic. Ninety-nine Chinese college students in Hong Kong were recruited and they completed an online questionnaire for this study. Results showed that online learning stress was negatively associated with approach academic coping and social support seeking, and the associations were mediated by academic hope. On the other hand, online learning stress was positively associated with avoidance academic coping, which was not mediated by academic hope. The mediation effects of academic self-efficacy were all non-significant. In sum, college students used more passive and maladaptive coping to handle academic problems when they experienced more online learning stress, and this was partly explained by lower levels of academic hope.

Coping strategies adopted by medical residents in dealing with work-related stress: a mixed-methods study

BACKGROUND

This study was carried out to identify and explore the difference in coping strategies for dealing with stress; adopted by medical residents in surgical and nonsurgical specialties.

METHODS

A mixed methods approach, was chosen for this study. In phase one (quantitative); data were collected by a web-based survey, using a structured questionnaire. This survey was carried out in five major teaching hospitals of Rawalpindi & Muzaffarabad in 2020. Purposive sampling was done and data were analysed using SPSS, recording frequencies and major trends. In phase two (qualitative); six focus group discussions were carried out with 24 participants, using semi-structured questions and prompts. Convenient sampling was done from the cohort of phase 1. These focus group discussions, explored the various coping strategies adopted by medical residents. Later, the data were analysed manually for development of codes, sub-themes and themes.

RESULTS

Out of 250 (100%) participants, 146 (58%) participants responded to the online survey. Surgical residents had a higher response rate (60%, n = 87) than nonsurgical residents. Moreover, female participation (54%, n = 79) was greater than male participation (46%, n = 67). The Mann-Whitney U test was statistically significant only for seeking medical advice to cope with stress (P = .029). There was no statistically significant difference found between the coping strategies, employed by medical residents. In focus group discussions, female involvement was more (58% n = 14) than their counterparts. Four main themes were developed after data analysis: self-regulation, tailor-made strategies, educational focus and support system. Finally, minor differences were obtained qualitatively; like, socializing is preferred by surgical residents whereas, spiritualism is chosen by nonsurgical residents.

CONCLUSION

Quantitatively, no significant differences were found between the coping strategies of medical residents, against work-related stress. However, minor differences were obtained qualitatively due to difference in job demands and level of burnout between these two specialities.

Coping styles to vitiate the risk of psychological morbidities among pre/para-clinical and clinical undergraduate medical students: a comparative cross-sectional study in India

Background

Psychological morbidities are high among undergraduate medical students. They experience the transition between pre/para-clinical and clinical training as a stressful period and cope differently. Research from India in this regard are lacking. The aim of this study is to assess and compare the prevalence of psychological morbidities, associated factors and coping styles between pre/para-clinical and clinical undergraduate medical students. This institution-based cross-sectional observational design study was conducted among pre/para-clinical and clinical group of undergraduate medical students (a total of 382) by using a questionnaire in the period between April and June 2021. Stratified random sampling technique was used to select the study participants. The survey included standard self-administered questionnaires like GHQ-28 and Lin-Chen’s coping inventory to assess psychological morbidities and coping styles, respectively. Associated factors for psychological morbidities, and coping styles between two groups, were compared using chi-square test, independent t-test and binary logistic regression analysis.

Results

Out of the 382 responders, psychological morbidities (GHQ-28 score > 23) were found in 61% participants. Both groups reported high level, a slightly higher preponderance in clinical (61.5%) than pre/para-clinical students (60.6%) and with nonsignificant difference of psychological morbidities. Compared to pre/para-clinical group, clinical group was found to have more substance consumption behavior (p < 0.001), dissatisfaction with academic performance (p < 0.001), sought psychiatric consultation (p < 0.004) and currently on psychiatric treatment (p < 0.04). Overall, coping was found to be average and good among the participants. Active problem coping behavior was more significantly used by pre/para-clinical group, while passive problem coping and passive emotional coping behaviors were positively significantly correlated with psychological morbidities in clinical group.

Conclusions

This study established a significant correlation between psychological morbidities and passive coping styles in clinical group. These students need interventions to encourage the use of more active coping styles during the training to provide advances in future career. A strong correlation with dissatisfied academic performance may be a call for an efficient and more student-friendly curriculum.

Psychological Morbidities and Coping Styles: A Rural Institution-Based Cross-Sectional Comparative Study between Undergraduate Medical Students Undergoing Different Phases of Training

Background Psychological morbidities are high among undergraduate medical students. They experience the transition between pre-/para-clinical and clinical training as a stressful period, and cope differently. Research studies from India in this regard are lacking.

Aims The aim of this study is to assess and compare the prevalence of psychological morbidities and their respective associated factors and coping styles between pre-/para-clinical and clinical undergraduate medical students.

Materials and Methods This institution-based cross-sectional observational design study was conducted among undergraduate medical students (a total of 382) in pre-/para-clinical and clinical years by using a questionnaire in the period between April and June 2019. A stratified random sampling technique was used to select the study participants. The survey included standard self-administered questionnaires like General Health Questionnaire-28 (GHQ-28) and Lin–Chen's coping inventory to assess psychological morbidities and coping styles, respectively. Associated factors for psychological morbidities and coping styles between two groups were compared using the Chi-square test, independent t-test, and binary logistic regression analysis.

Results Out of the 382 responders, psychological morbidities (GHQ-28 score > 23) were found in 61% participants. Both groups reported high levels of psychological morbidities; a slightly higher preponderance in clinical (61.5%) than in pre-/para-clinical students (60.6%) with a nonsignificant difference. Compared with the pre-/para-clinical group, the clinical group was found to have more substance consumption behavior (p < 0.001), dissatisfaction with academic performance (p < 0.001), sought psychiatric consultation (p < 0.004), and at that time on psychiatric treatment (p < 0.04). Active problem coping behavior was more significantly used by the pre-/para-clinical group, while passive problem coping and passive emotional coping behaviors were positively significantly correlated with psychological morbidities in the clinical group.

Conclusion This study suggests a significant correlation between psychological morbidities and passive coping styles in the clinical group. These students need interventions to encourage the use of more active coping styles during training to provide advances in future career. A strong correlation between psychological morbidities and dissatisfied academic performance may be a call for an efficient and more student-friendly curriculum.

Correlation between Positive Orientation and Control of Anger, Anxiety and Depression in Nursing Students in Poland, Spain and Slovakia during the COVID-19 Pandemic

(1) This study analysed the relationship between positive orientation and subjective control of anger, anxiety and depression in nursing students in Poland, Spain and Slovakia during the pandemic. (2) The survey was carried out by the diagnostic survey method in a group of 756 nursing students in Poland, Spain and Slovakia. The empirical data were gathered using an original survey questionnaire, the Positive Orientation Scale and the Courtauld Emotional Control Scale. (3) It was shown that the positive orientation level in Polish students was significantly lower than in students in Spain (p < 0.0001) and Slovakia (p < 0.0001). Low results for positive orientation were obtained in nearly half (47.18%) of the respondents in the Polish sample, whereas it was 34.18% and 31.18% in the Spanish and Slovak samples, respectively (p < 0.0001). A positive orientation was the most important predictor of emotional control among the nursing students at all the sites (p < 0.0001). (4) Positive orientation has been shown to have a significant impact on emotional control in nursing students during the pandemic. Therefore, it is important to carefully monitor students' mental health during the pandemic to determine the demand for psychological and emotional support.

Health Behaviours and the Sense of Optimism in Nursing Students in Poland, Spain and Slovakia during the COVID-19 Pandemic

(1) The COVID-19 outbreak brought about several socio-economic changes and has had a negative impact on the mental health of people around the world. The aim of this study was to examine the correlation between health behaviours and dispositional optimism among nursing students in Poland, Spain and Slovakia during the COVID-19 pandemic. (2) The study was carried out in spring 2021 on a group of 756 nursing students in Poland (n = 390), Spain (n = 196) and Slovakia (n = 170). The diagnostic survey method was applied with the questionnaire technique, and the following standardised research tools were used: Life Orientation Test—Revised (LOT-R) and the Health Behaviour Inventory (IZZ). The survey was conducted in a mixed arrangement: in direct contact with the respondents in Poland and in Spain and online in Slovakia. (3) Significant differences were demonstrated in health behaviour preferences in students in Poland, Spain and Slovakia (F = 6.22; p < 0.002). The highest IZZ index was found in Spanish students (82.60 ± 13.65), while lower values were observed in Slovak (80.38 ± 13.74) and Polish (78.44 ± 13.47) students. The correlation between dispositional optimism and a positive attitude was the strongest in the Polish sample (r = 0.56; p < 0.001), at a high level in the Spanish sample (r = 0.53; p < 0.001) and at an average level in the Slovak sample (r = 0.48; p < 0.001). (4) 1. The study showed a moderating effect of the country of origin on the students’ health behaviours. 2. Dispositional optimism is an important predictor of the students’ health behaviours, regardless of the country of origin.

The Prevalence of Stress Among Medical Students Studying an Integrative Curriculum During the COVID-19 Pandemic

PURPOSE

Stress is a psychological shift that negatively affects student achievement. We sought to investigate the extent of stress in the medical students at our university.

PATIENTS AND METHODS

A total of 337 medical students representing three program phases were represented. Stress was measured using a questionnaire divided into three main parts: 10-question Kessler instruments, 10-questions specific to identifying the causes of stress, and a qualitative component to report additional information. For the Kessler questionnaire, a score of less than 20 was considered negative for stress of any level (alert) and scores of 20-24 were considered mild stress (resistance phase), 25-29 moderate stress (near exhaustion), and 30-50 severe stress (exhaustion). Descriptive studies in the form of mean, standard deviation, and confidence interval (CI) were used in addition to the chi-squared test for estimate significant differences between variables. A P-value of <0.05 was considered significant.

RESULTS

The prevalence of stress was 85.5%, with a slight male predominance. The prevalence of stress was seen among the male students during Phase I (88.25%), followed by male students during Phase III (87.7%), female students during phase II (86.5%), male students during phase II (84.5%), female students during phase I (83.3%) and female students during phase III (80.4%). Stress was uniformly high during phase I (86.2%) followed by phase II (85.4%) and phase III (85.1%), and 85% of stress was obtained from the number and content of assessments.

CONCLUSION

There is a high level of stress throughout the curriculum. The number of assessments and the number of modules and their content are the primary sources of stress. Student mentorship, including academic, psychic, and social counseling, may help predict and manage stress and improve student performance. Detection of stress among the students is a major issue for program monitoring and development.

Psychological distress among the people during COVID-19 pandemic: a cross-sectional study (Preprint).. [DOI: 10.2196/preprints.35616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

BACKGROUND

The COVID-19 epidemic has had a major impact on mental health in the general population. As a result, during a pandemic, monitoring and oversight of the population's mental health is a top responsibility.

OBJECTIVE

The aim of this study is to examines the anxiety level of the people during initial period of COVID-19.

METHODS

The cross sectional online survey was done using the zung self-rating anxiety scale (SAS) and zung self-rating depression scale. Out of 250 responders, 19.2%, 6.4%, and 0.8% experienced mild, moderate, marked to severe levels of anxiety

RESULTS

According to analysis, female (OR=1.3,95% CI=0.55 – 3.3,P=0.524), above the age of 59 years(OR=1.6,CI=(0.33 – 7.72),P=0.555), were experiencing moderate level of anxiety when compared with others. Related to depression, 36.4%,16.4% and 5.2% experienced mild, moderate ,marked to severe levels of depression. The findings show that female (OR=0.79,95%,CI=0.36–1.7,P=0.of0.845),above the age of 59 years(OR=4.4,CI=0.75 – 25.8,P=0.101)were experiencing marked level of depression than others.

CONCLUSIONS

The main causes for anxiety and depression among the people is due to financial constraints, dual role of women, work from home, fear of infection, unemployment and online education.

Psycho-social components determining the strategies of coping with stress in undergraduate Polish nursing students

BACKGROUND

In order for the nursing students to fully benefit from the clinical experience, it is necessary for them to be able to handle education-related stress. It is important to establish the importance of personal resources and social determinants, that influence coping strategies in stressful situations.

METHODS

The cross-sectional study was conducted among 307 nursing students. The study research tools: Perceived Stress Scale (PSS-10), Life Orientation Test - Revised (LOT-R), Generalized Self-Efficacy Scale (GSES), Satisfaction With Life Scale (SWLS), Clinical Learning Environment Inventory (CLEI - 19), Brief COPE and the original questionnaire were used.

RESULTS

Active strategies of coping with stress were used significantly more often by the respondents with a greater sense of self-efficacy, a greater sense of life satisfaction and disposable optimism. Avoidance strategies of coping with stress were used significantly more often by the respondents with low self-efficacy, low level of disposable optimism, low sense of life satisfaction, and not a lot of teacher support. The higher was the intensity of stress experienced by students, the more often they coped by avoidance behaviour or showing helplessness.

CONCLUSIONS

All the variables had a significant impact on coping with stress: the level of perceived stress, disposable optimism, sense of self-efficacy, sense of life satisfaction, as well as satisfaction with the stay in a hospital ward, support received from the teacher and the year of the study. The results of the research have allowed the identification of the needs in the field of strengthening the personal resources of nursing students. In the future, they may be useful for the development of educational programs.

Fear, Stress, Resilience and Coping Strategies during COVID-19 in Spanish University Students

COVID-19 (2019 coronavirus pandemic) and the resulting confinement has had an impact on mental health and the educational environment, affecting the stress, concerns, fear, and life quality of the university population. This study aimed to examine the correlation between fear of COVID-19, stress with COVID-19, and technological stress in university students, and their resilience, self-esteem, and coping strategies. The final sample comprised 180 Spanish university students, with an average age of 20.76 years (SD = 4.59). The above-mentioned effects were administered a series of self-report scales. We found statistically significant associations between fear of COVID-19 and stress with COVID-19, technological stress (total score), overload, and complexity (subdimensions of technological stress). Likewise, we found inverse relationships between the students’ fear of COVID-19 and the use of the coping strategy, cognitive restructuring. Ascertaining the factors that influence the coping strategies of undergraduate university students and their fears, psychological stress, and resilience provides valuable information for the development of educational interventions. This research has relevant implications for the diagnosis, orientation, and design of psycho-educational and clinical interventions that can improve students’ well-being and training for effective coping strategies for daily stress and this pandemic situation.