A descriptive study of mental health and wellbeing among medical students in Portugal

Levels of depression, anxiety and subjective happiness among health sciences students in Croatia: a multi-centric cross-sectional study

BACKGROUND

Previous studies have shown that symptoms of depression and anxiety were highly prevalent among health sciences students. This may lead to other professional and personal difficulties and a decrease in individuals' well-being. This study aimed to analyze levels of depression, anxiety and subjective happiness among health sciences students in Croatia.

METHODS

We conducted a cross-sectional study in 10 higher education institutions in Croatia during March 2023. Eligible participants were health sciences students. Participants filled out an online survey consisting of sociodemographic questions and validated scales for determining the levels of depression (9-question Patient Health Questionnaire, PHQ-9), anxiety (General Anxiety Disorder 7-item scale, GAD-7), and happiness (Subjective Happiness Scale, SHS).

RESULTS

Of 7460 invited students, 2137 students participated in the study (29% response rate). There were 41.4% of students that exhibited at least mild depressive symptoms, with 8% of students exhibiting moderately severe symptoms and 1.8% severe depressive symptoms. Mild anxiety was found in 36.8%, moderate anxiety in 23.9% and severe anxiety in 15.8% of students. The median SHS score was 19 (15.25-22). Women students had significantly higher levels of depression (p < 0.001) and anxiety (p < 0.001) than their men peers. Students in earlier study years showed higher levels of depression, anxiety and lower levels of subjective happiness compared to those in later study years. Students with lower self-assessed financial status had higher levels of depression (p < 0.001) and anxiety (p < 0.001). Students that failed an academic year had higher levels of depression (p < 0.001), but lower levels of anxiety (p = 0.005).

CONCLUSION

In this study, we have shown that health sciences students exhibit high levels of depression and anxiety, at rates exceeding those in the general population reported in other studies. Our results may help educational institutions to put greater effort into the battle against mental health stigma, foster acceptance of mental health issues and encourage students to seek help when needed. Adequate mental health services are needed at universities to promote timely diagnosis and treatment of mental health problems.

Avoiding Academic Burnout: Academic Factors That Enhance University Student Engagement

Burnout is one of the major problems in higher education and is linked to a decline in students' academic performance and achievement. Burnout, when prolonged over time and added to stress and high workloads, promotes the intention to drop out of studies, which translates into negative consequences for individuals and groups. Academic engagement is proposed as an effective alternative to offer solutions to improve the quality of education and counteract current negative trends. This study is based on a correlational-descriptive research design. It aimed to find out to what extent students feel engaged in their university studies and to identify and analyze possible correlations between engagement and specific classroom variables. To this end, a sample of 764 college students was studied. The result showed that students feel connected to and interested in their studies and that the area of knowledge impacts student engagement. They also indicate how learning strategies used in the classroom positively impact academic engagement.

Profiles of Military Medical Students' Well-being, Burnout, and Retention

BACKGROUND

Well-being concerns among medical students are more prevalent than their age-matched peers in the United States. It remains unknown, however, if individual differences in well-being exist among U.S. medical students serving in the military. In this study, we sought to identify profiles (i.e., subgroups) of well-being in military medical students and examine the associations between these well-being profiles and burnout, depression, and intended retention in military and medical fields.

METHODS

Using a cross-sectional research design, we surveyed military medical students and then conducted latent class analysis to explore profiles of well-being, and applied the three-step latent class analysis method to assess predictors and outcomes of well-being profiles.

RESULTS

Heterogeneity in well-being was identified among the 336 military medical students surveyed, portraying medical students' falling into three distinct subgroups: High well-being (36%), low well-being (20%), and moderate well-being (44%). Different subgroups were associated with different risks of outcomes. Students in the subgroup of low well-being were at the highest risk of burnout, depression, and leaving medicine. In contrast, students in the moderate well-being group were at the highest risk of leaving military service.

CONCLUSIONS

These subgroups may be clinically important as burnout, depression, and intention to leave medical field and/or military service occurred with varying likelihoods among medical students across the different well-being subgroups. Military medical institutions may consider improving recruitment tools to identify the best alignment between students' career goals and the military setting. Besides, it is crucial for the institution to address diversity, equity, and inclusion issues that may lead to alienation, anxiety, and a sense of wanting to leave the military community.

Psychological State and Exam Performance among Paramedics' Students in Geneva during the COVID-19 Pandemic: A Mixed Methods Study

The COVID-19 pandemic forced higher education institutions in Switzerland to move to distance learning, with certain limitations such as "Zoom fatigue" and a lack of interaction with peers and teachers. This has also impacted the development of interprofessional skills and key concepts such as professional acknowledgement, cooperation, and communication skills. This study was conducted using mixed methods, including performance assessment regarding examination notes, the 12-item General Health Questionnaire, and semi-structured interviews, to assess the impact of the pandemic on the performance of paramedic students and their psychological state. The results of the semi-structured interviews provided insight into the impact of the pandemic. The period of the COVID-19 pandemic appears to have had an impact on the psychological state of the paramedic students, most of whom were considered to be either at risk or in psychological distress. There may have been an effect on their theoretical knowledge performance, with pre-pandemic promotions performing better than pandemic promotions.

Mental health, wellbeing and burnout among medical students in the United Arab Emirates

BACKGROUND

Medical students tend to experience high levels of stress during their studies, that can result in mental health disorders and burnout, further affecting academic performance and later ability to practice.

AIMS

To investigate previous and current mental health issues, significant sources of stress, burnout, and substance use among medical students in the United Arab Emirates (UAE).

METHOD

We conducted an online survey to collect data on demographics, sources of stress, mental health problems, burnout, and substance use in 385 medical students from the UAE University. We used the Oldenburg Burnout Inventory (OLBI), the General Health Questionnaire 12 (GHQ-12), and the CAGE questionnaire.

RESULTS

Our results indicated that 5.7% of participants had been diagnosed with a mental health condition prior to joining medical school, and that 21.6% of participants were diagnosed with a mental illness while in medical school. On the OLBI, 77.4% screened positive for burnout (81.3% for disengagement and 95.1% for exhaustion), with 74.5% screening positive for mental health difficulties on the GHQ-12 and <1% screening positive on the CAGE for problem drinking. There was a statistically significant positive correlation between scores on the OLBI and the GHQ-12.

CONCLUSIONS

Our study indicated that high levels of stress, burnout and mental illness are experienced among medical students in the UAE.

A descriptive study of welfare and mental health issues among health-related sciences undergraduate students at the Medical University of Gdansk

PURPOSE AND METHODS

We surveyed a large sample of health-related sciences undergraduate students at the Medical University of Gdańsk (MUG), Poland in a pilot study to assess self-reported somatic/mental health-related issues, measure the level of burnout using Oldenburg Burnout Inventory (OLBI), the presence of depressive symptoms with Patient Health Questionnaire 9-item (PHQ-9) and assess the problematic alcohol intake (CAGE questionnaire). Additionally, stress coping mechanisms were investigated.

RESULTS

A total of 864 students participated in the survey. The mean total OLBI and PHQ-9 scores equalled 43.3 ± 2.7 and 11.3±5.8 points, respectively. The CAGE questionnaire was positive in 21.6% of students. Three most prevalent stress coping mechanisms included TV binge-watching, binge-eating and cigarette chain smoking (51.0%, 45.0% and 28.0% respectively).

CONCLUSIONS

Future studies are required to confirm the obtained results, assess, and monitor trends and set-up interventions to improve the welfare of health-related science MUG students.

Prevalence of burnout in medical students in Guatemala: Before and during Covid-19 pandemic comparison

Burnout is a syndrome consisting of physical, emotional, and mental exhaustion along with depersonalization and poor sense of personal accomplishment. Often related to work conditions. Several recent studies from around the world have shown high rates of burnout among medical students in different countries. In Guatemala City, we decided to assess levels of burnout in 2017 and then again in December 2020. In the first wave from one private medical school, we had a total of 159 respondents (response rate of 56.7%) and 132 (48.5%) in the second wave. Not surprisingly rates of burnout were higher during the pandemic even though response rate is lower. Surprisingly we found that rates of depersonalization had not increased, and levels of personal accomplishment had. These findings present a mixed picture of levels of burnout in Guatemala City. Further qualitative research is indicated to explore cultural differences in order to set up appropriate and suitable intervention strategies.

The Appraisal of Self-Care Agency Scale-Revised (ASAS-R): Reliability and Validity among Portuguese Medical Students

Self-care agency plays an important role in an individual's health. Considering the particularities of their education, it can be a protective factor for the mental health of medical students. This study aims to validate the Portuguese version of the Appraisal of Self-care Agency Scale-Revised (ASAS-R) in Portuguese medical students. A cross-sectional, quantitative, and analytical online study was conducted between 23 April 2021, and 15 July 2021. Exploratory factor analysis (EFA) was performed to test the internal structure of the ASAS-R. Correlations with the SHS (Subjective Happiness Scale), SWLS (Satisfaction with Life Scale), and MHI (Mental Health Inventory) were calculated using Pearson's coefficient so as to test convergent validity. Internal consistency was evaluated using inter-item correlation, corrected item-total correlation, and Cronbach's alpha. The total sample included 781 individuals. EFA yielded a 3-factor solution accounting for 53.9% of the explained variance. Pearson's coefficients obtained between the 3 factors of ASAS-R and the total scores of the 3 construct-related scales demonstrated adequate convergent validity. Total Cronbach's alpha value was 0.85, while the Cronbach's alpha of the three factors was 0.81, 0.55, and 0.83, respectively. This study demonstrated that ASAS-R is a valid and reliable instrument for measuring self-care agency among Portuguese medical students.

Research on the Intervention and Prevention of College Students' Mental Health Crisis From the Perspective of Ideological and Physical Education

Present study has aimed to understand the intervention and prevention of the mental health crisis of college students. For this purpose, this study has checked the effect of trust in wellbeing information on preventive behavior and mental wellbeing. The target population taken for this study is the students of colleges situated in Mainland in China. The data was collected from the 458 students of the college. Smart PLS has been employed on the data to get the results using partial least square structural equation modeling. For this purpose, the data were analyzed in two stages, i.e., measurement model stage and the structural model stage. Results of this study have revealed that trust in wellbeing information plays a significant and positive role in setting preventive behavior and the mental wellbeing of students. Further, it has also been revealed that preventive behavior also plays a significant and positive role in mental wellbeing. Additionally, preventive behavior has been found as an important mediating variable among the relationship of trust in wellbeing information and mental wellbeing. Moreover, family support is crucial by positively moderating the relationship between preventive behavior and mental wellbeing. Many practical implications have been found among which the foremost is that the education institutes must undertake those efforts that aim to ensure the fairness in the information spread regarding the mental wellbeing during seminars, workshops and administration should play a positive role responsible for strengthening the mental health of students by managing ideas, improving student education management, innovating management techniques and methods.

Well-being and burnout in medical students: challenges and solutions

Medicine (like many others) can be an extremely stressful profession. The pressures faced by clinicians are often related to 'life and death' situations that can lead to high levels of stress and distress. Students and trainees in a variety of allied health professions face similar pressures related to study or work environments. The practice of medicine continuously evolves and changes, and so too do the pressures. If the correct support is not accessible, this can result in burnout. Medical students are generally at a vulnerable stage in life (18-24 years) when they are more likely to develop mental health problems. A recent focus on the mental health and well-being of medical students has highlighted various worrying trends with a series of studies from around the world highlighting surprisingly high rates of stress and burnout among medical students, and fairly similar contributory factors. Despite the challenge of defining and measuring burnout, these studies indicate an urgent need for changes in methods of teaching, alongside rapid access to support. In this editorial, we make some proposals that could help the next generation of doctors to look after themselves and their patients. Medical schools have a moral and ethical obligation to ensure the well-being of their students in these stressful times.

Mental health and wellbeing among Egyptian medical students: a cross-sectional study

Background

Medical students are prone to experience high levels of stress during their studies, which can lead to burnout and mental health disorders such as anxiety and depression, that can affect their academic performance and ability to practice. We therefore conducted an online survey to collect data on demographics, sources of stress, mental health problems, burnout, and substance use in 547 medical students from two universities in Cairo. We used the Oldenburg Burnout Inventory (OLBI), the General Health Questionnaire 12 (GHQ-12), and the CAGE questionnaire.

Results

Our results indicated that 16% of participants were diagnosed with a mental illness while in medical school, with 88% screening positive for burnout on the OLBI, 63% reaching the threshold as cases on the GHQ-12 and 9% screening positive on the CAGE questionnaire. There was a statistically significant positive correlation between scores on the OLBI and the GHQ-12.

Conclusions

Our study indicated that there were very high levels of psychological distress (burnout, mental illness) among medical students, with high rates of disengagement and exhaustion.

Screening of minor psychiatric disorders and burnout among a sample of medical students in St. Petersburg, Russia: a descriptive study

Background

Despite the general interest of researchers around the world, there are few studies on the psychological wellbeing and burnout among medical students in Russia. The aim of this study was to perform screening for minor psychiatric disorders, burnout, problematic alcohol use, and quantify the psychological issues and stress among a sample of medical students in St. Petersburg, Russia.

Results

According to the GHQ-12, screening for minor mental disorders was positive in 140 students (85%). Screening for burnout using the OLBI showed positive results in 121 (73%) students for disengagement and 132 (80%) students for exhaustion. Screening with the CAGE tool identified a risk of alcohol consumption in 33 students (20%). Most students reported academic studies as the main source of stress in their life (n = 147; 89.1%).

Conclusions

This study identified very high levels of stress, burnout, risk of minor mental disorders, and problematic alcohol use among medical students in St. Petersburg, Russia. These findings suggest more attention is needed to the poor mental wellbeing and health in medical students in Russia.

Well-being and burnout in medical students

There is no doubt that practice of medicine is an extremely stressful profession. Not surprisingly, training and education in medicine also creates a degree of pressure. In the past 50 years, more attention is being paid to the mental health and well-being of doctors. However, recently focus has shifted to the mental health and well-being of medical students. A series of studies have shown that the rates of mental ill-health among doctors and medical students are exceptionally high and appear to be getting worse. In studies across 12 countries with over 3600 responses, it has been shown that rates of burnout among medical students vary and have been reported to be over 90% of respondents in Hong Kong. Explanations for these high rates vary according to cultural factors which include parental expectations, financial and housing problems, and relationship difficulties. It is crucial that institutions make every effort at looking after the mental health needs of medical students and their medical staff.

Stigma about mental disease in Portuguese medical students: a cross-sectional study

BACKGROUND

The stigma about mental diseases is common in the population and also in medical students, where it may condition their future practice and the way they deal with these patients.

AIM

To evaluate and characterize the stigma on mental diseases in Portuguese sixth-year medical students, based on a clinical scenario of a classmate suffering from a mental disorder.

METHODS

Observational cross-sectional study, involving sixth-year students of all Portuguese medical schools. We applied an online self-response questionnaire, using the Portuguese version of the Attribution Questionnaire AQ-9, and a vignette of a classmate colleague, presenting mental illness symptoms. Stigma scores were calculated. We used logistic regression to estimate the effect of social determinants on stigma pattern, and we analysed the correlation between 9 variables evaluated by the AQ-9 and total stigma.

RESULTS

A total of 501 participants were included for analysis (69.5% females, median age of 24 years old). Medical students were available to help in the proposed clinical scenario (6.93/9.00; 95%CI:6.77-7.10), if necessary using coercion for treatment (3.85; 95%CI:3.63-4.07), because they felt pity (6.86; 95%CI:6.67-7.06) and they perceived some kind of dangerousness (4.06; 95%CI:3.84-4.28). Stigma was lower in students having a personal history of mental illness (OR:0.498; 95%CI:0.324-0.767; p = 0.002) and in those with positive familial history (OR: 0.691; 95%CI:0.485-0.986; p = 0.041).

CONCLUSION

Our results show the importance of implementing anti-stigma education, to improve medical students' attitudes towards peers living with mental diseases.

Cultural variations in wellbeing, burnout and substance use amongst medical students in twelve countries

High levels of stress, burnout, and symptoms of poor mental health have been well known among practicing doctors for a number of years. Indeed, many health systems have formal and informal mechanisms to offer support and treatment where needed, though this varies tremendously across cultures. There is increasing evidence that current medical students, our doctors of the future, also report very high levels of distress, burnout, and substance misuse. We sampled large groups of medical students in 12 countries at the same time and with exactly the same method in order to aid direct comparison. 3766 students responded to our survey across five continents in what we believe is a global first. Our results show that students in all 12 countries report very high levels of 'caseness' on validated measures of psychiatric symptoms and burnout. Rates of substance misuse, often a cause of or coping mechanism for this distress, and identified sources of stress also varied across cultures. Variations are strongly influenced by cultural factors. Further quantitative and qualitative research is required to confirm our results and further delineate the causes for high rates of psychiatric symptoms and burnout. Studies should also focus on the implementation of strategies to safeguard and identify those most at risk.