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Gaume J, Carrard V, Berney S, Bourquin C, Berney A. Substance use and its association with mental health among Swiss medical students: A cross-sectional study. Int J Soc Psychiatry 2024; 70:808-817. [PMID: 38420921 PMCID: PMC11144353 DOI: 10.1177/00207640241232321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND Studies on mental health and substance use among medical students indicated worrying prevalence but have been mainly descriptive. AIM To evaluate the prevalence of substance use in a sample of medical students and investigate whether mental health variables have an influence on substance use. METHODS The data were collected as part of the first wave of the ETMED-L, an ongoing longitudinal open cohort study surveying medical students at the University of Lausanne (Switzerland). N = 886 students were included and completed an online survey including measures of mental health (depression, suicidal ideation, anxiety, stress, and burnout) and use of and risk related with several substances (tobacco, alcohol, cannabis, cocaine, stimulants, sedatives, hallucinogens, opioids, nonmedical prescription drugs, and neuroenhancement drugs). We evaluated the prevalence of use of each substance and then tested the association between mental health and substance use in an Exploratory Structural Equation Modeling framework. RESULTS Statistical indices indicated a four-factor solution for mental health and a three-factor solution for substance use. A factor comprising risk level for alcohol, tobacco, and cannabis use - which were the most prevalent substances - was significantly associated with a burnout factor and a factor related to financial situation and side job stress. There was a significant association between a factor comprising depression, anxiety, and suicidal ideation and a factor related to the use of sedatives, nonmedical prescription drugs and neuroenhancement drugs. Although their use was less prevalent, a factor comprising the risk level of stimulants and cocaine use was significantly but more mildly related to the burnout factor. A factor comprising stress related to studies and work/life balance as well as emotional exhaustion was not related to substance use factors. CONCLUSION In this sample of medical students, the prevalence of substance use was substantial and poorer mental health status was related with higher substance use risk levels.
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Affiliation(s)
- Jacques Gaume
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Valérie Carrard
- Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sylvie Berney
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Céline Bourquin
- Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alexandre Berney
- Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Mazzoleni A, Garg S, Bhatia S, Kumar NS. Medical students' attitudes towards well-being and welfare: a systematic review protocol. BMJ Open 2024; 14:e080977. [PMID: 38777594 PMCID: PMC11116847 DOI: 10.1136/bmjopen-2023-080977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Medical education poses serious stressors on medical students, as they report overall higher rates of psychiatric comorbidities compared with students enrolled in other university-level courses. The high rates of poor well-being reported should be considered a concern, as students represent the future workforce of healthcare professionals. Although there has been an increased interest towards well-being and burn-out in medical students, there is still much to be elucidated. Indeed, there is an overall lack of understanding of which attitudes medical students have towards well-being and welfare, something that could be used to develop targeted practice to improve medics' quality of life and reduce overall burn-out.This review will aim at evaluating and reporting the current research available on medical students' attitudes towards well-being and welfare. We will take into account which countries have published data on the topic, and we will analyse papers written during the COVID-19 period separately, giving this particular time frame a separate outlook. METHODS AND ANALYSIS This systematic review protocol has been developed following Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. A systematic search including "medical students" AND "wellbeing" AND "perceptions" was carried out on MEDLINE, Embase and Scopus databases. The Mixed Method Appraisal Tool will be used to assess the quality of the available studies and risk of bias. Studies will be screened using predetermined inclusion and exclusion criteria. Data will be summarised narratively and in tabular forms. A narrative subgroup analysis of the COVID-19 period will be carried out, and a country-wise approach will be used to describe which areas have published relevant studies. ETHICS AND DISSEMINATION This will be the first systematic review looking at the reported attitudes that medical students have towards well-being and welfare. This will provide an account of the available data on the topic, and a starting point to understand where further research is needed in the future. PROSPERO REGISTRATION NUMBER CRD42023471022.
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Affiliation(s)
- Adele Mazzoleni
- Barts and The London School of Medicine and Dentistry, London, UK
- National Medical Research Association, London, UK
| | - Sakshi Garg
- National Medical Research Association, London, UK
- University of Nottingham School of Medical and Surgical Sciences, Nottingham, UK
| | - Shreya Bhatia
- National Medical Research Association, London, UK
- School of Medicine, Dentistry and Biomedical Sciences, Queen University Belfast, Belfast, UK
| | - Niraj S Kumar
- National Medical Research Association, London, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
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Eley DS, Slavin SJ. Medical student mental health - the intransigent global dilemma: Contributors and potential solutions. MEDICAL TEACHER 2024; 46:156-161. [PMID: 37976369 DOI: 10.1080/0142159x.2023.2279909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- Diann S Eley
- Medical School, University of Queensland, Queensland, Australia
| | - Stuart J Slavin
- Accreditation Council for Graduate Medical Education, Chicago, IL, USA
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Milić J, Skitarelić N, Majstorović D, Zoranić S, Čivljak M, Ivanišević K, Marendić M, Mesarić J, Puharić Z, Neuberg M, Čukljek S, Racz A, Puljak L. Levels of depression, anxiety and subjective happiness among health sciences students in Croatia: a multi-centric cross-sectional study. BMC Psychiatry 2024; 24:50. [PMID: 38218757 PMCID: PMC10787412 DOI: 10.1186/s12888-024-05498-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024] Open
Abstract
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.
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Affiliation(s)
- Jakov Milić
- Croatian Carmelite Province of St. Joseph, Zagreb, Croatia
- Catholic Faculty of Theology, University of Zagreb, Zagreb, Croatia
| | | | | | - Sanja Zoranić
- Department of Nursing, University of Dubrovnik, Dubrovnik, Croatia
| | - Marta Čivljak
- Centre for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Ilica 242, 10000, Zagreb, Croatia
| | - Kata Ivanišević
- Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
| | - Mario Marendić
- University Department of Health Studies, University of Split, Split, Croatia
| | | | - Zrinka Puharić
- Department of Nursing, Bjelovar University of Applied Sciences, Bjelovar, Croatia
- Faculty of Dental Medicine and Health, Osijek, Croatia
| | | | - Snježana Čukljek
- Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
- University of Applied Health Sciences, Zagreb, Croatia
| | - Aleksandar Racz
- Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
- University of Applied Health Sciences, Zagreb, Croatia
| | - Livia Puljak
- Centre for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Ilica 242, 10000, Zagreb, Croatia.
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Alencar MS, Kubrusly M, Aquino BOAD, Viana IN, Morais PI, Rocha HAL. Depression among Brazilian medical students exposed to remote learning and the role of scopophobia. MEDICAL TEACHER 2024; 46:102-109. [PMID: 37485691 DOI: 10.1080/0142159x.2023.2236779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Medical education was greatly affected by the COVID-19 pandemic, and remote teaching through lectures and classes through videoconferencing was heavily used. However, the need to use cameras led to scopophobia, which is the fear of being watched, which can lead to psychological symptoms. Despite the relevance and prevalence of depression and the increase in the use of cameras for learning, research evaluating the impact of scopophobia on students' mental health is surprisingly scarce. Hence, to fill up this gap, a cross-sectional study was carried out in medical schools in Brazil. To assess the presence of depressed mood, the Patient Health Questionnaire-9 (PHQ-9) was applied. We used logistic regression models to verify the associations. The overall prevalence of positive PHQ9 found in our study was 62%. By studying the factors associated with a high risk of scopophobia, we could identify that the PHQ was statistically associated with scopophobia (odds ratio 2.43 (confidence interval 1.11-5.26), adjusted p value = .0269). Also, a lower family income, a higher number of household inhabitants, and female gender were associated. These results suggest that scopophobia is associated with depression, leading us to believe that interventions to mitigate this risk in students are opportune, especially if targeted at lower-income students.
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Affiliation(s)
| | - Marcos Kubrusly
- Medical Education Department, Unichristus University Center, Fortaleza, Brazil
| | | | - Isadora Néri Viana
- Medical Education Department, Unichristus University Center, Fortaleza, Brazil
| | | | - Hermano Alexandre Lima Rocha
- Medical Education Department, Unichristus University Center, Fortaleza, Brazil
- Community Health Department, Federal University of Ceará, Fortaleza, Brazil
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Kanneganti A, Tan BYQ, Nik Ab Rahman NH, Leow AST, Denning M, Goh ET, Lim LJH, Sia CH, Chua YX, Kinross J, Tan M, Tan LF, Wan YM, Sharma A, Danuaji R, Komal Kumar RN, Sheng CK, Kheng CP, Abdul Karim SS, Abdul Ghani MN, Mahmud S, Chan YH, Sharma VK, Sim K, Ooi SBS. Safety attitudes, burnout and well-being among healthcare workers during the COVID-19 pandemic: an Indo-Pacific regional cross-sectional study. Singapore Med J 2023; 64:667-676. [PMID: 35139631 PMCID: PMC10754367 DOI: 10.11622/smedj.2022014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022]
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact in Asia and has placed significant burden on already stretched healthcare systems. We examined the impact of COVID-19 on the safety attitudes among healthcare workers (HCWs), as well as their associated demographic and occupational factors, and measures of burnout, depression and anxiety. Methods A cross-sectional survey study utilising snowball sampling was performed involving doctors, nurses and allied health professions from 23 hospitals in Singapore, Malaysia, India and Indonesia between 29 May 2020 and 13 July 2020. This survey collated demographic data and workplace conditions and included three validated questionnaires: the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory and Hospital Anxiety and Depression Scale. We performed multivariate mixed-model regression to assess independent associations with the SAQ total percentage agree rate (PAR). Results We obtained 3,163 responses. The SAQ total PARs were found to be 35.7%, 15.0%, 51.0% and 3.3% among the respondents from Singapore, Malaysia, India and Indonesia, respectively. Burnout scores were highest among respondents from Indonesia and lowest among respondents from India (70.9%-85.4% vs. 56.3%-63.6%, respectively). Multivariate analyses revealed that meeting burnout and depression thresholds and shifts lasting ≥12 h were significantly associated with lower SAQ total PAR. Conclusion Addressing the factors contributing to high burnout and depression and placing strict limits on work hours per shift may contribute significantly towards improving safety culture among HCWs and should remain priorities during the pandemic.
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Affiliation(s)
- Abhiram Kanneganti
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Benjamin Yong Qiang Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nik Hisamuddin Nik Ab Rahman
- Department of Emergency & Trauma, Hospital Universiti Sains Malaysia, Malaysia
- Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Ma laysia, Kota Bharu, Malaysia
| | - Aloysius Sheng-Ting Leow
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Max Denning
- Department of Surgery and Cancer, Imperial College London, UK
| | - Ee Teng Goh
- Department of Surgery and Cancer, Imperial College London, UK
| | - Lucas Jun Hao Lim
- Early Psychosis Intervention Program, Institute of Mental Health, Singapore
| | - Ching-Hui Sia
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | - Ying Xian Chua
- National University Polyclinics – Pioneer, National University Health System, Singapore
| | - James Kinross
- Department of Surgery and Cancer, Imperial College London, UK
| | - Melanie Tan
- Department of Geriatric Medicine, Ng Teng Fong General Hospital, Singapore
| | - Li Feng Tan
- Division of Healthy Ageing, Alexandra Hospital, Singapore
| | - Yi Min Wan
- Department of Psychiatry, Ng Teng Fong General Hospital, Singapore
| | - Arvind Sharma
- Department of Neurology, Zydus Hospitals and BJ Medical College, Ahmedabad, Gujarat, India
| | - Rivan Danuaji
- Department of Neurology, Dr Moewardi Hospital, Kota Surakarta, Jawa Tengah, Indonesia
| | - RN Komal Kumar
- Cerebrovascular Unit, Yashoda Institute of Neuroscience, Secunderabad, Telangana, India
| | - Chew Keng Sheng
- Department of Surgery, Faculty of Medicine & Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - Cheah Phee Kheng
- Emergency and Trauma Department, Sabah Women and Children’s Hospital, Kota Kinabalu, Sabah, Malaysia
| | | | - Mohd Najib Abdul Ghani
- Emergency and Trauma Department, Hospital Raja Perempuan Zainab (II), Bandar Kota Bharu, Kelantan, Malaysia
| | - Suhaimi Mahmud
- Emergency and Trauma Department, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Vijay Kumar Sharma
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shirley Beng Suat Ooi
- Emergency Medicine Department, National University Hospital, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University Singapore, Singapore
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AlHarthi AS, AlZaabi A, Al Harthi MS, Al Ghafri TS. Depression, Anxiety, and Stress Among Medical Students During COVID-19 at Sultan Qaboos University in Oman. Cureus 2023; 15:e46211. [PMID: 37908948 PMCID: PMC10613834 DOI: 10.7759/cureus.46211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction With the spread of COVID-19 around the world, several interventions have been reported to be useful to control disease transmission. However, the impact of the pandemic on the mental health of medical students is underreported in the Arab world. This study aimed to explore the rates of depression, anxiety, and stress among medical students at Sultan Qaboos University (SQU) and to identify the factors associated with a higher risk of these mental disruptions. Method This was a cross-sectional study where medical students were approached to answer an online questionnaire via emails from the administrative affairs in the College of Medicine in SQU from 16/01/2021 to 18/05/2021. A 21-item depression, anxiety, and stress (DASS-21) scale was used as a self-reporting tool to measure the negative feelings of depression, anxiety, and stress. Results Out of 700 students, 184 (26.3%) students responded fully to the study questionnaire. More than half of the participants were females (58.7%, n=108), and the mean (SD) age was 20.31 (1.642). Most students were Omani (93.5%, n=172), and 34.2% (n=63) lived in Muscat. More than half of the students (51.6%) were in phase 2 of the academic years, in which the majority were considered within the cohort ≥2017 (81%, n=149), with a mean (SD) GPA of 2.9 (1.5). Scores from the DASS-21 scale showed that 29.4% vs 27.2% vs 14.7% had extremely severe depression vs anxiety and vs stress. The proportion of students who reported lower GPAs was significantly associated with higher scores of severe-to-extremely-severe depression (P=0.001), anxiety (P=<0.001), and stress (P=0.001). Living in Muscat vs other regions was associated with severe anxiety and stress (P=0.038 and P=0.007, respectively). Conclusion Similar to a few studies in Oman, this study confirms the high rates of depression, anxiety, and stress among medical students during the COVID-19 pandemic. Results may be utilized to alert decision-makers, student academic council, and academic authority to the need to adopt a preventive mental health policy and design guidelines with resilience measures for college students, including prolonged cognitive-behavioral interventions and recovery programs.
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Affiliation(s)
| | - Adhari AlZaabi
- Human and Clinical Anatomy, Sultan Qaboos University, Muscat, OMN
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Feher A, Fejes E, Kapus K, Jancsak C, Nagy GD, Horvath L, Tibold A, Feher G. The association of problematic usage of the internet with burnout, depression, insomnia, and quality of life among Hungarian high school students. Front Public Health 2023; 11:1167308. [PMID: 37559742 PMCID: PMC10407570 DOI: 10.3389/fpubh.2023.1167308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023] Open
Abstract
Introduction The extensive availability of the internet has led to the recognition of problematic usage of the internet (PUI) or so called internet addiction (IA), probably mostly involving adolescents. Aim Here we present a study focusing on the incidence and consequences (including burnout, which is relatively rarely studied) of internet addiction among high school students using a questionnaire-based non-random sampling cross-sectional survey. Included questionnaires were the Problematic Internet Use Questionnaire, the Maslach Burnout Inventory General Survey for Students MBI-GS (S), the 9-item short version of Beck Depression Inventory (BDI-SF), the Athens Insomnia Questionnaire and the EQ-5D (quality of life) questionnaire. Data were evaluated the exertion of Student's t-test, chi square test and Pearson's rank-order correlation. Logistic regression analysis was used to determine the significance of the different parameters as independently associated with PUI. Results Overall 3,000 paper-based questionnaires were successfully delivered and 2,540 responses received (response rate of 84.6%). 1,309 males (mean age 17.6 ± 1.43 years) (51.5%) and 1,231 females (mean age 17.5 ± 1.4 years) (48.5%) took part in our study. Problematic usage of the internet was detected in 486 (19.1%) students (232 males, mean age 17.6 ± 1.35 years and 254 females, mean age 17.34 ± 1.37 years). In a logistic regression analysis sleep disturbance (OR: 1.84, 95% CI: 1.83-2.03), depression (OR: 1.97, 95% CI: 1.77-2.02) and burnout (OR: 1.8, 95% CI: 1.16-1.94) were significantly associated with PUI. Conclusion Nearly one fifth of our study population suffered from PUI, which was strongly associated with school burnout, insomnia and depression, which underlines the importance of this phenomenon.
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Affiliation(s)
- Andrea Feher
- Centre for Occupational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Szent Rafael Hospital, Zalaegerszeg, Hungary
| | | | - Krisztian Kapus
- Centre of Excellence for Interdisciplinary R&D and Innovation of the University of Szeged, Social Responsibility Competence Centre, Interdisciplinary Family R&D Centre Research Group, Szeged, Hungary
| | - Csaba Jancsak
- Centre of Excellence for Interdisciplinary R&D and Innovation of the University of Szeged, Social Responsibility Competence Centre, Interdisciplinary Family R&D Centre Research Group, Szeged, Hungary
| | - Gabor Daniel Nagy
- Centre of Excellence for Interdisciplinary R&D and Innovation of the University of Szeged, Social Responsibility Competence Centre, Interdisciplinary Family R&D Centre Research Group, Szeged, Hungary
| | - Lilla Horvath
- Centre for Occupational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Antal Tibold
- Centre for Occupational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Gergely Feher
- Centre for Occupational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Department of Primary Health Care, Medical School, University of Pécs, Pécs, Hungary
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New LL. How Workplace Challenges Affect the Risk of Substance Use Disorders in a Health Care Environment. Nurs Clin North Am 2023; 58:183-195. [PMID: 37105653 DOI: 10.1016/j.cnur.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Health care environments have historically faced stressful situations that place those working in those environments at risk for substance use disorders. Over the past several years, the rates of burnout, workplace violence, diverse population stigmatization, and mental health concerns (including suicide) during the Covid-19 pandemic have increased, further challenging and contributing to development of negative coping skills, including use of substances to reduce the side effects and emotions from work. This article introduces the problem of substance use disorders, pathophysiology, and how the challenges contribute to the development of turning to substances to cope.
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Affiliation(s)
- Luci L New
- Wake Forest School of Medicine Department of Academic Nursing, 525 Vine Street, Suite 230, Winston-Salem, NC 27101, USA.
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Redelinghuys K, Morgan B. Psychometric properties of the Burnout Assessment Tool across four countries. BMC Public Health 2023; 23:824. [PMID: 37143022 PMCID: PMC10161461 DOI: 10.1186/s12889-023-15604-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 04/04/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The Burnout Assessment Tool (BAT) is a new burnout measure developed to replace the Maslach Burnout Inventory (MBI). Studies have supported the psychometric properties and cross-cultural measurement invariance of the BAT. However, some unresolved questions remain. These questions are the appropriate level of score interpretation, convergent validity with the MBI, and measurement invariance using sample groups from countries outside of Europe. METHODS We used a cross-sectional survey approach to obtain 794 participants from Australia (n = 200), the Netherlands (n = 199), South Africa (n = 197), and the United States (n = 198). In brief, we used bifactor modelling to investigate the appropriate score interpretation and convergent validity with the MBI. Hereafter, we used the Rasch model and ordinal logistic regression to investigate differential item functioning. RESULTS The bifactor model showed a large general factor and four small group factors, which suggests calculating and interpreting a general burnout score. This model further shows that the BAT and MBI measure the same burnout construct but that the BAT is a more comprehensive burnout measure. Most items fit the Rasch model, and few showed non-negligible differential item functioning. CONCLUSIONS Our results support the psychometric properties and cross-cultural measurement invariance of the BAT in Australia, the Netherlands, South Africa, and the United States. Furthermore, we provide some clarity on the three previously mentioned unresolved questions.
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Affiliation(s)
- Kleinjan Redelinghuys
- Department of Industrial Psychology and People Management, University of Johannesburg, Johannesburg, South Africa
| | - Brandon Morgan
- Department of Industrial Psychology and People Management, University of Johannesburg, Johannesburg, South Africa
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Watanabe T, Akechi T. The mediating role of psychological flexibility in the association of autistic-like traits with burnout and depression in medical students during clinical clerkships in Japan: a university-based cross-sectional study. BMC Psychiatry 2023; 23:302. [PMID: 37127557 PMCID: PMC10150344 DOI: 10.1186/s12888-023-04811-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 04/21/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Burnout and depression among medical students is linked to serious problems that require appropriate solutions. Subthreshold autism traits or autistic-like traits (ALTs) may be possible factors associated with burnout and depression. The effectiveness of acceptance and commitment therapy (ACT) for burnout and depression has been widely reported. The treatment aims to improve psychological flexibility, a concept indicating engagement in personal value-based behaviors without avoiding uncomfortable private experiences. This study examined whether ALTs were associated with burnout or depression among medical students during clinical clerkships in Japan, and then investigated what psychological flexibility processes might mediate these associations. METHODS A cross-sectional survey was administered to 284 medical students at Nagoya City University School of Medical Sciences who had been in clinical clerkships for 10 months or longer. Linear multiple regressions were performed with each burnout factor or depression as the outcome variable using validated tools measuring burnout (Maslach Burnout Inventory), anxiety and depression (Hospital Anxiety and Depression Scale), ALT (Autism-Spectrum Quotient Japanese version-21), and psychological flexibility processes (Cognitive Fusion Questionnaire-7 and Valuing Questionnaire). Additionally, a mediation analysis was conducted using structural equation modeling. RESULTS A linear multiple regression analysis that controlled for age and gender found that ALTs were significantly associated with lower personal accomplishment, a factor of burnout, and depression. Lower personal accomplishment was also associated with males and lower progress toward values of the psychological flexibility process. Depression was also associated with males and higher cognitive fusion, lower progress towards values, and higher obstruction to values of the psychological flexibility process. Surprisingly, emotional exhaustion and depersonalization were not significantly associated with ALTs. The mediation analysis revealed that the relationship between ALTs and personal accomplishment was partially mediated by a process of progress toward values, while the relationship between ALTs and depression was partially mediated by both processes of progress toward values and cognitive fusion. CONCLUSIONS ALTs were significantly associated with lower personal accomplishment of burnout and depression among medical students in clinical clerkships. Consideration should be given to the psychological flexibility processes that focus on interventions targeting psychological flexibility for medical students with ALTs to reduce burnout and depression.
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Affiliation(s)
- Takafumi Watanabe
- Department of Psychiatry and Coginitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan.
| | - Tatsuo Akechi
- Department of Psychiatry and Coginitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
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12
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Estephan L, Pu C, Bermudez S, Waits A. Burnout, mental health, physical symptoms, and coping behaviors in healthcare workers in Belize amidst COVID-19 pandemic: A nationwide cross-sectional study. Int J Soc Psychiatry 2023:207640231152209. [PMID: 36748178 PMCID: PMC9908523 DOI: 10.1177/00207640231152209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Healthcare workers are vulnerable to burnout, especially during the COVID-19 pandemic in the low resource settings. Belize is a small Central American developing country known for its chronic healthcare worker shortage and this is the first study to assess burnout prevalence and its associated factors among healthcare workers in Belize. AIM To evaluate the prevalence of burnout and its associated factors in HCWs in Belize covering multiple domains (mental health, physical symptoms, and coping behaviors) during the COVID-19 pandemic. METHODS A cross-sectional survey that was developed and validated by a panel of experts was delivered online to all the healthcare workers in Belize from September to November 2021. Burnout was assessed using Copenhagen Burnout Inventory. Depression and anxiety screening was carried out using the Patient Health Questionnaire - 2 (PHQ-2) and Generalized Anxiety Disorder 2-item (GAD-2). Burnout associated factors were estimated using logistic regression models. FINDINGS Of the total of 263 participants, 27.76% had overall burnout: 56.65% had personal, 54.37% had work-related, and 19.39% had patient-related burnout. Burnout was positively associated with anxiety (OR: 3.14 [1.67, 5.92]), depression (OR: 4.45 [2.30, 8.61]), intentions of quitting their jobs (OR: 2.59 [1.49, 4.51]), health status worsening (OR: 2.21 [1.26, 3.87]), multiple physical symptom presentation (OR: 1.19, [1.10, 1.29]), and use of multiple maladaptive coping behaviors (OR: 1.66, [1.30, 2.12]). INTERPRETATION Healthcare workers in Belize showed substantial levels of burnout which were significantly associated with using maladaptive coping behaviors, presenting multiple physical symptoms, quitting their jobs, health status worsening, and other mental health issues. These findings should be used to develop and implement programs such as regular health check-ups, health promotion awareness campaigns, and worker recruitment strategies which would improve the working conditions, quality of life, and psychological well-being of our healthcare workers.
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Affiliation(s)
- Lila Estephan
- International Health Program, National Yang Ming Chiao Tung University, Taipei
| | - Christy Pu
- International Health Program, National Yang Ming Chiao Tung University, Taipei.,Institute of Public Health, National Yang Ming Chiao Tung University, Taipei
| | - Selma Bermudez
- Epidemiology Unit, Karl Heusner Memorial Hospital Authority, Belize City, Belize
| | - Alexander Waits
- International Health Program, National Yang Ming Chiao Tung University, Taipei.,Institute of Public Health, National Yang Ming Chiao Tung University, Taipei
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13
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Lee BE, Zlotshewer BA, Mayeda RC, Kaplan LI. Impact of Online-Only Instruction on Preclinical Medical Education in the Setting of COVID-19: Comparative Analysis of Online-Only Vs. Hybrid Instructions on Academic Performance and Mental Wellbeing. MEDICAL SCIENCE EDUCATOR 2022; 32:1367-1374. [PMID: 36245945 PMCID: PMC9540297 DOI: 10.1007/s40670-022-01650-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 05/19/2023]
Abstract
INTRODUCTION With the onset of the COVID-19 pandemic, many medical schools were forced to adopt a virtual learning environment. The purpose of this study is to investigate the impact of online-only instruction compared to online and in-person (hybrid) instruction on educational performance, wellbeing, and course satisfaction. METHODS We performed a descriptive cross-sectional survey of second-year medical students following a transition to online-only and hybrid instruction. Of the 198 total students, we collected 61 responses (42.6% [N = 26] male, 55.7% [N = 34] female, 1.6% [N = 1] preferred not to specify). 49.2% of the participants were in the online-only group. 50.8% of the participants were in the hybrid group. RESULTS There was a significantly lower mean final grade in the online-only group compared to the hybrid group (p = 0.04293). In contrast, there was no significant difference in measures of wellbeing (p = 0.6858) or course satisfaction (p = 0.9332). CONCLUSION Our study suggests that hybrid instructional delivery may be more effective than online-only instructional delivery for academic performance. However, there was no significant difference in mental wellbeing between either form of teaching. Students report that mental wellbeing was considerably impacted by factors related to the home environment as well as by unique concerns associated with the COVID-19 pandemic. While the online-only model may have been the safest-and only-option for many medical schools during the COVID-19 pandemic, we advise caution in transitioning to a complete online format without carefully designing the online curriculum to account for the negative impact it may have on student education. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-022-01650-6.
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Affiliation(s)
- Briana E. Lee
- Lewis Katz School of Medicine, 3500 N Broad St, Philadelphia, PA 19140 USA
| | | | - Rebecca C. Mayeda
- Lewis Katz School of Medicine, 3500 N Broad St, Philadelphia, PA 19140 USA
| | - Lawrence I. Kaplan
- Section of General Internal Medicine, Lewis Katz School of Medicine, Philadelphia, PA USA
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14
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Moir F, Patten B, Yielder J, Sohn CS, Maser B, Frank E. Trends in medical students' health over 5 years: Does a wellbeing curriculum make a difference? Int J Soc Psychiatry 2022; 69:675-688. [PMID: 36453078 PMCID: PMC10149885 DOI: 10.1177/00207640221133944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Trends in New Zealand (NZ) medical students' health and the influence of a wellbeing curricula are unknown. METHODS The author's collected self-report data from NZ medical students on 'Graduation Day' from 2014 to 2018, using a serial cross-sectional survey design with validated scales assessing psychological health, stigma, coping, and lifestyle. Comparisons were made with NZ general population same-age peers. Analyses examined trends, differences between 'cohorts' of students receiving different exposures to a wellbeing curriculum, and correlations between students' own lifestyle practices and their frequency of talking with patients about those topics. RESULTS Of 1,062 students, 886 participated. The authors found statistically significant self-reported increases from 2014 to 2018 for negative psychological indices, including scores for distress and burnout, suicidal thoughts in the preceding year, and the likelihood of being diagnosed with an anxiety disorder. There was a significant increase in numbers of students reporting having their own doctor as well as increased healthy coping strategies and a significant decrease in stigma scores. Academic cohorts of students who had completed a wellbeing curriculum were more likely to report high distress levels, having been diagnosed with a mood disorder, and being non-drinkers than students without wellbeing training. When compared to NZ peers, medical students smoked less, exercised more, and were less likely to have diagnosed mood and anxiety disorders, but reported more distress. The authors found a significant correlation between the amount of exercise students undertook and their likelihood to discuss exercise with patients. CONCLUSIONS NZ medical students have better physical health than general population peers and are more likely to discuss exercise with patients if exercising themselves. However, cohorts of graduating students report increasing distress despite the implementation of a wellbeing curriculum. Research is needed into mechanisms between students' self-awareness, willingness to report distress, stigma, mind-set, coping, and psychological outcomes, to inform curriculum developers.
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Affiliation(s)
- Fiona Moir
- Medical Programme Directorate, University of Auckland, New Zealand
| | - Bradley Patten
- Medical Programme Directorate, University of Auckland, New Zealand
| | - Jill Yielder
- Medical Programme Directorate, University of Auckland, New Zealand
| | | | - Brandon Maser
- Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - Erica Frank
- Faculty of Medicine, University of British Columbia, Vancouver, Canada.,Annenberg Physician Training Program in Addiction Medicine, Bethel, MI, USA
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15
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Ceyhun HA. Psychiatric symptoms, current use of tobacco, alcohol, illicit drug, and poly-substance among medical students in Eastern Turkey. J Ethn Subst Abuse 2022; 21:1-28. [PMID: 36271892 DOI: 10.1080/15332640.2022.2135656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The study aims to investigate the prevalence and patterns of substance use among medical students and to examine associated psychiatric symptoms. It has been observed that depression and psychoticism scores have a significant effect on smoking, and interpersonal sensitivity-hostility-paranoid ideation scores have a significant effect on drinking. It has been shown that interpersonal sensitivity and depression scores are more predictive of mono-and poly-substance use. Revealing the relationship between tobacco, alcohol, poly-substance use, and psychiatric symptoms in the medical school sample shows the importance of practices aimed at increasing students' awareness of their psychiatric symptoms and providing access to psychiatric services.
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16
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Chumakov E, Petrova N, Mamatkhodjaeva T, Ventriglio A, Bhugra D. The impact of covid-19: Anxiety, depression, and wellbeing among medical students. Int J Soc Psychiatry 2022; 68:1270-1276. [PMID: 36062424 DOI: 10.1177/00207640221121717] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Medical students have been considered as a vulnerable group at higher risk of mental health issues during the COVID-19 outbreak. AIMS We set out to detect symptoms of depression and anxiety in medical students in St. Petersburg (Russia) during the first wave of COVID-19 outbreak and explore the associations between psychosocial factors related to the pandemic and students' psychological well-being. METHOD An anonymous online survey of medical students was conducted in May-June 2020. The Hospital Anxiety and Depression Scale (HADS) was used for screening anxiety and depression symptoms. The final sample consisted of 144 students (78.5% females). RESULTS About 69.4% of respondents reported that COVID-19 pandemic and social restrictions were a new source of stress in their lives. More than one-third (38.9%) of respondents reported a need for psychological (emotional) support due to a change in their daily life during the COVID-19 pandemic, with the vast majority (83.9%) of these respondents indicated an increased need for support in this specific period. Symptoms of anxiety were reported by 55.8% of females (HADS score: 9.05 ± 4.69) and 48.4% of males (8.09 ± 5.0), and symptoms of depression were found in 38.9% of females (6.40 ± 3.57) and 41.9% of males (6.16 ± 3.21). CONCLUSIONS These findings indicate that it is necessary to develop additional measures for the prevention and early diagnosis of mental disorders along with right levels of support for wellbeing and mental health of medical students in this ongoing pandemic.
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Affiliation(s)
- Egor Chumakov
- St. Petersburg State University, Saint Petersburg, Russian Federation
| | - Nataliia Petrova
- St. Petersburg State University, Saint Petersburg, Russian Federation
| | | | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Dinesh Bhugra
- Institute of Psychiatry, King's College London, London, UK
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17
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Cipta DA, Wijovi F, Melisa L, Lili R, Marcella E, Tancherla A, Siswanto FG, Adiya DAKL, Chen S, Dermawan GJCI, Louis MI, Citraningtyas T, Molodynski A. Burnout prevalence and degree among undergraduate medical students in Indonesia during 1 month of the COVID-19 pandemic: A cross-sectional descriptive survey. Int J Soc Psychiatry 2022; 68:1232-1237. [PMID: 36047053 DOI: 10.1177/00207640221116812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Medical students are under high pressure to perform academically and also face the impact of the COVID-19 pandemic, putting them at risk of developing burnout. AIMS This study aims to evaluate the prevalence and degree of burnout among medical students in Indonesia during 1 month of the COVID-19 pandemic. METHODS From April to May 2021, we conducted an online survey of Indonesian medical students to assess burnout (using Maslach Burnout Inventory-Student Survey, MBI-SS). RESULTS A total of 1,947 students from 27 universities participated in the study. About 35.5% had burnout, 41.7% with a moderate to high level of emotional exhaustion, 45% had moderate to high level of depersonalization and 66.7% had a low level of personal accomplishment. CONCLUSION A total of 35.5% of medical students in our sample experienced burnout. We suggest further research to explore and identify factors related to these findings and the need for potential interventions at global and national level to enhance the well-being of medical students.
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Affiliation(s)
- Darien Alfa Cipta
- Department of Psychiatry, Pelita Harapan University, Tangerang, Indonesia
| | - Felix Wijovi
- Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
| | - Leslie Melisa
- Department of Psychiatry, Universitas Indonesia, Jakarta, Indonesia
| | - Rossalina Lili
- Personality and Human Relations Indonesia, Jakarta, Indonesia
| | | | | | | | | | - Sharon Chen
- Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
| | | | | | - Theresia Citraningtyas
- Personality and Human Relations Indonesia, Jakarta, Indonesia.,Department of Psychiatry, Krida Wacana University, Jakarta, Indonesia
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18
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Kjær JN, Molodynski A, Bhugra D, Lewis T. Wellbeing, psychiatric morbidity and psychological distress amongst medical students in Denmark. Int J Soc Psychiatry 2022; 68:1289-1294. [PMID: 35100882 DOI: 10.1177/00207640221074916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Medical students in Denmark undertake a demanding 6-year course which is generally during a critical age for the development of psychiatric disorder and harmful substance or alcohol use behaviours. Previous literature has highlighted significant rates of distress in Danish students. AIMS We surveyed medical students in Denmark to better understand wellbeing, psychiatric morbidity, sources of stress, substance and alcohol use, psychological distress and burnout. METHODS Medical students were invited to participate in a single survey via email and social media which was completed through an online form, available for a 6-month period. The survey used a mixture of pre-defined answer options alongside free-text responses. Embedded within the survey were standardised and reliable specific instruments related to alcohol use (the CAGE questionnaire), overall psychological wellbeing and burnout. RESULTS There were 647 respondents, with a quite even year-group distribution, representing just over 16% of total number of students attending medical school in Denmark. Prior to medical school 35% had visited a professional regarding their mental health. While at medical school 16% reported a diagnosis of a mental health condition. 83% reported significant stress from study. Around 7 in 10 met case criteria using instruments designed to test for minor psychiatric morbidity and burnout. 13% tested CAGE positive, whilst 4% reported concerns from themselves or others about their substance use. CONCLUSIONS Our study demonstrates high levels of psychiatric morbidity and worrying levels of burnout in this population. The striking 13% CAGE positive rate suggests this demographic is at risk of harm from alcohol. Our results suggest a high level of need to support this population - with further study required to demonstrate which interventions would be of most benefit for this population in light of our findings.
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Affiliation(s)
- Jesper Nørgaard Kjær
- Psychosis Research Unit, Department of Psychosis, Aarhus University Hospital, Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Affective Disorders, Aarhus University Hospital, Psychiatry, Aarhus, Denmark
| | - Andrew Molodynski
- Oxford Health NHS Foundation Trust and Oxford University, Oxford, UK
| | | | - Thomas Lewis
- Tees, Esk and Wear Valleys NHS Foundation Trust, Darlington, UK
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19
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Lili R, Molodynski A, Farrell SM, Citraningtyas T, Kloping NA. Wellbeing and mental health among medical students in Indonesia: A descriptive study. Int J Soc Psychiatry 2022; 68:1277-1282. [PMID: 34823405 DOI: 10.1177/00207640211057709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Medical students face high pressures to perform academically, which may lead to poor psychological well-being, burnout, and even mental illness. AIMS This study aims to evaluate the mental health, degree of burnout and substance misuse among medical students in Indonesia in order to to build a system that supports the prosperity of future doctors. METHODS In February to March 2020, we conducted an online survey of Indonesian medical students to assess burnout (using Oldenburg Burnout Inventory, OLBI), minor psychiatric illness (General Health Questionnaire 12, GHQ12), and alcohol abuse (CAGE questionnaire). RESULTS/CONCLUSION A total of 1,729 students from 29 universities participated in the study; 93% felt disengaged, 95% felt exhausted, and 74% were identified to have mild psychiatric illness. We discuss potential factors that need to be explored in further research, including further concerns related to developments since the pandemic, and the need for potential interventions at both local and national levels to enhance the wellbeing of medical students.
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Affiliation(s)
- Rossalina Lili
- Community Mental Health Section, Indonesian Psychiatry Association, Kecamatan Senen, Indonesia
| | - Andrew Molodynski
- Oxford Health NHS Foundation Trust, UK.,Department of Psychiatry, Oxford University, UK
| | - Sarah Marie Farrell
- Oxford University Clinical Academic Graduate School (OUCAGs), University of Oxford, UK
| | - Theresia Citraningtyas
- Community Mental Health Section, Indonesian Psychiatry Association, Kecamatan Senen, Indonesia.,Faculty of Medicine, Krida Wacana Christian University, Jakarta, Indonesia
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20
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Kadhum M, Ayinde OO, Wilkes C, Chumakov E, Dahanayake D, Ashrafi A, Kafle B, Lili R, Farrell S, Bhugra D, Molodysnki A. Wellbeing, burnout and substance use amongst medical students: A summary of results from nine countries. Int J Soc Psychiatry 2022; 68:1218-1222. [PMID: 35549470 DOI: 10.1177/00207640221094955] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE There has been increasing interest in the physical health, mental wellbeing and burnout afflicting medical students over recent years. This paper describes the overall results from phase two of an international study including a further nine countries across the world. METHODS We sampled large groups of medical students in nine countries at the same time and with exactly the same method in order to aid direct comparison of demographics, burnout and mental wellbeing through validated instruments. RESULTS A total of 4,942 medical students from these countries participated in this study. Around 68% of respondents screened positive for mild psychiatric illness using the General Health Questionnaire-12. Around 81% and 78% of respondents were found to be disengaged or exhausted respectively using the Oldenburg Burnout Inventory. Around 10% were found to be CAGE positive and 14% reported cannabis use. The main source of stress reported by medical students was their academic studies, followed by relationships, financial difficulties and housing issues. CONCLUSION Cultural, religious and socioeconomic factors within each country are important and understanding their effects is fundamental in developing successful local, regional and national initiatives. Further quantitative and qualitative research is required to confirm our results, clarify their causes and to develop appropriate preventative strategies.
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Affiliation(s)
| | - Olatunde O Ayinde
- Department of Psychiatry, University of Ibadan and University College Hospital, Nigeria
| | - Chris Wilkes
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Egor Chumakov
- Department of Psychiatry and Addiction, Saint Petersburg State University, Russia
| | - Dulangi Dahanayake
- Department of Psychiatry, Faculty of Medicine, University of Colombo, Sri Lanka
| | - Agaah Ashrafi
- Students' Guidance and Counselling Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bikram Kafle
- Department of Psychiatry, Devdaha Medical College, Kathmandu University, Nepal
| | - Rossalina Lili
- Community Mental Health Section, Indonesian Psychiatric Association, Jakarta Pusat, Indonesia
| | - Sarah Farrell
- Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, UK
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21
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Wilkes TC, Lewis T, Paget M, Holm J, Brager N, Bulloch A, Macmaster F, Molodynski A, Bhugra D. Wellbeing and mental health amongst medical students in Canada. Int J Soc Psychiatry 2022; 68:1283-1288. [PMID: 34791951 PMCID: PMC9465500 DOI: 10.1177/00207640211057724] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
RESEARCH There is abundant data revealing that there is significant rate of rates of Psychiatric morbidity, psychological stress, and burnout in the medical student population. A core study group in the UK collaborated with 12 countries around the world to review medical student wellness. In this context we surveyed 101 medical students at the Cummings medical school, Calgary, Canada during the height of the COVID pandemic regarding their wellbeing and mental health. RESULTS/MAIN FINDINGS Prior to medical school 27% reported a diagnosis with a mental disorder. Whilst at medical school 21% reported a mental health condition, most commonly an anxiety disorder and or depressive disorder. The most commonly reported source of stress was study at 81%, the second being relationships at 62%, money stress was a significant source of stress for 35%, and finally 10% reported accommodation or housing as stressful. Interestingly only 14% tested CAGE positive but 20% of students reported having taken a non-prescription substance to feel better or regulate their mood. Seventy-five percent of medical students met specific case criteria for exhaustion on the Oldenburg Burnout inventory 74% met criteria for the GHQ questionnaire. CONCLUSIONS These findings confirm that medical students are facing significant stressors during their training. These stressors include, in order of frequency, study, relational, financial, and accommodation issues. Nonprescription Substance use was a common finding as well as exhaustion and psychiatric morbidity. Future interventions pursued will have to address cultural issues as well as the organizational and individual determinates of stress.
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Affiliation(s)
| | - Thomas Lewis
- Tees Esk and Wear Valleys NHS Foundation Trust, Darlington, UK
| | - Mike Paget
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Johanna Holm
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nancy Brager
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andy Bulloch
- The Mathison Centre for Health Research and Education, Calgary, AB, Canada
| | - Frank Macmaster
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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22
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Kloping NA, Citraningtyas T, Lili R, Farrell SM, Molodynski A. Mental health and wellbeing of Indonesian medical students: A regional comparison study. Int J Soc Psychiatry 2022; 68:1295-1299. [PMID: 34791935 DOI: 10.1177/00207640211057732] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Our previous research found very high levels of burnout and mental health problems among medical students across Indonesia, in line with rates in many other countries. This study further analyses the data by comparing six different regions of Indonesia to determine any differences between them on such measures and to look for possible explanations. RESULTS Our sample of 1,729 students reported high levels of burnout and 'mild' psychiatric illness across all six regions. There were however significant differences between some regions. Sumatran students reported the lowest scores for both the Oldenburg Burnout Inventory (OLBI) and General Health Questionnaire 12 (GHQ12) scales. Sources of stress also varied among regions, with relationships and study the most reported. Further exploration of possible cultural differences is needed as well as prompt mental health support for medical students.
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Affiliation(s)
| | - Theresia Citraningtyas
- Faculty of Medicine, Krida Wacana Christian University, Jakarta, Indonesia.,Community Mental Health Division, Indonesian Psychiatry Association, Kecamatan Senen, Indonesia
| | - Rossalina Lili
- Faculty of Medicine, Krida Wacana Christian University, Jakarta, Indonesia.,Community Mental Health Division, Indonesian Psychiatry Association, Kecamatan Senen, Indonesia
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23
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Atienza-Carbonell B, Guillén V, Irigoyen-Otiñano M, Balanzá-Martínez V. Screening of substance use and mental health problems among Spanish medical students: A multicenter study. J Affect Disord 2022; 311:391-398. [PMID: 35609765 DOI: 10.1016/j.jad.2022.05.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to determine the prevalence of substance consumption and mental health problems among Spanish medical students, and their association with sociodemographic factors. METHODS A multicentre cross-sectional study was conducted. Self-reported data on sociodemographic and clinical characteristics were collected, including BDI-II, PHQ-9, brief STAI, and single-item academic burnout (IUBA). RESULTS Overall, 1265 students (74.2% female) completed the survey. Of them, 37.4% scored positive for depressive symptoms, as measured by the BDI-II, and more than half (53%) by the PHQ-9. Suicidal ideation was reported by about 12% whilst high levels of state and trait anxiety were informed by 28.8% and 29.4% of the students. The prevalence of burnout was 40.2%. Female and pre-clinical students reported significantly (p < 0.01) higher rates of depressive, anxiety, and burnout symptoms. Alcohol, energy drinks, and tobacco were the most frequently used substances. Total scores of self-reported mental health problems negatively correlated (p < 0.001) with objective academic results and positively correlated (p < 0.02) with the number of substances consumed in the last 30 days. LIMITATIONS Research-based on self-reported data could favour information bias due to the social desirability effect and memory error. CONCLUSIONS A high prevalence of substance consumption and several mental health problems was found among medical students, especially females. The relevant influence of academic-related factors on students' well-being may be a call for medical schools to implement initiatives aimed to improve students' ability to detect, address, and seek help for their mental health issues.
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Affiliation(s)
- B Atienza-Carbonell
- Department of Medicine, University of Valencia, Valencia, Spain; Faculty of Health Sciences, Valencian International University, Valencia, Spain
| | - V Guillén
- Department of Neurosciences, School of Medicine and Nursing. University of the Basque Country, UPV/EHU, Spain.
| | - M Irigoyen-Otiñano
- Department of Psychiatry. Santa Maria University Hospital. Lleida, Spain
| | - V Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
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24
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Nayak B S, Ria D, Narissa D, Kalere E, Gabrielle E, Richeaé F, Lissette F, Amanda F, Nathanael F. An investigation into the impact of the COVID-19 pandemic on the mental health and the study habits of medical students of the University of the West Indies. PSYCHOL HEALTH MED 2022:1-10. [PMID: 35686310 DOI: 10.1080/13548506.2022.2085878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The COVID-19 pandemic has caused increased anxiety among medical students due to the uncertainty of the long-term effects on the future of medical education. There are currently insufficient studies aimed at investigating the changes in the mental health and studying habits of medical students during public health emergencies such as this pandemic, as well as methods that can be incorporated to appropriately manage anxiety effectively. To investigate the psychological impact and associated factors on medical students during the pandemic. This retrospective, cross-sectional study consisted of 291 medical students of the faculty of medical sciences at the university of the West Indies, St. Augustine campus, Trinidad and Tobago. The mental health and study habits of said students were assessed with the use of questionnaires via an online survey platform. Data of our study showed that 56% of the students were experiencing increased stress and anxiety. Students of 82.8% experienced irregular sleeping habits and 76.3% of participants experienced a change in eating habits brought on by the pandemic. Participants of 67.4% studied less than 4 hrs. a day, 61.5% were less productive, 62.2% showed an inability to focus and avoid distractions in their study environment during the COVID-19 pandemic. There is a need for proper supportive strategies to assist students in effectively managing anxiety and depression during public health emergencies such as COVID-19. It is suggested that all universities, colleges and education bodies alike implement a pandemic preparedness course as well as an accessible online support forum.
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Affiliation(s)
- Shivananda Nayak B
- Faculty of Medical Sciences, University of the West Indies, Saint Augustine, Trinidad
| | - Duncan Ria
- Faculty of Medical Sciences, University of the West Indies, Saint Augustine, Trinidad
| | - Dookieram Narissa
- Faculty of Medical Sciences, University of the West Indies, Saint Augustine, Trinidad
| | - Edgecombe Kalere
- Faculty of Medical Sciences, University of the West Indies, Saint Augustine, Trinidad
| | - Edwards Gabrielle
- Faculty of Medical Sciences, University of the West Indies, Saint Augustine, Trinidad
| | - Ferguson Richeaé
- Faculty of Medical Sciences, University of the West Indies, Saint Augustine, Trinidad
| | - Fernander Lissette
- Faculty of Medical Sciences, University of the West Indies, Saint Augustine, Trinidad
| | - Fernandez Amanda
- Faculty of Medical Sciences, University of the West Indies, Saint Augustine, Trinidad
| | - Ferret Nathanael
- Faculty of Medical Sciences, University of the West Indies, Saint Augustine, Trinidad
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Psychometric validation and cultural adaptation of the Italian medical student stressor questionnaire. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00922-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AbstractMedical students encounter specific stressors that can lead to higher levels of psychological distress compared to their similar aged counterparts who study other subjects. The Medical Student Stressor Questionnaire (MSSQ) was developed to specifically identify stressors among medical students as well as measure the intensity of stress caused by the stressors. However, no Italian version has been validated to date. The aim of this study was to develop an Italian version of the MSSQ (MSSQ-I) and to assess its psychometric properties. The MSSQ has been translated and culturally validated into Italian. All medical students from the University of Brescia were asked to participate in a web-survey in which they were asked to complete the MSSQ-I. For the analysis of the stability over time, participating students were asked to complete again the MSSQ-I after about one month. Among 1754 medical students, 964 completed the MSSQ-I for the validation analyses. A first Confirmatory Factor Analysis and a subsequent Explanatory Factor Analysis outlined a slightly modified factor structure of the scale with five factors instead of six as in the original scale. The internal consistency on the overall scale was high (α = 0.94), as well as the internal consistency of each of the new factors: (α > 0.83 for the first four factors and α = 0.67 for the fifth). External validity analysis confirmed moderate/high concurrent validity. These results suggest that the MSSQ-I can be used as a tool to identify stressors among Italian medical students, although further research is needed to confirm its individual test-retest reliability.
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El-Gabry DA, Okasha T, Shaker N, Elserafy D, Yehia M, Aziz KA, Bhugra D, Molodynski A, Elkhatib H. Mental health and wellbeing among Egyptian medical students: a cross-sectional study. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00193-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
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.
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Duarte I, Alves A, Coelho A, Ferreira A, Cabral B, Silva B, Peralta J, Silva J, Domingues P, Nunes P, Serrão C, Santos C. The Mediating Role of Resilience and Life Satisfaction in the Relationship between Stress and Burnout in Medical Students during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052822. [PMID: 35270518 PMCID: PMC8910345 DOI: 10.3390/ijerph19052822] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 01/07/2023]
Abstract
Following the WHO's declaration of a public health emergency due to the COVID-19 outbreak, the subsequent quarantine and confinement measures that were adopted, including distance learning measures, were shown to have caused a significant deterioration in the mental health of medical students. The goal of this study was to explore the mediating role of resilience and life satisfaction in the relationship between perceived stress and burnout among medical students in the context of COVID-19. A transversal assessment was performed using an online questionnaire, to which 462 students responded. The instruments applied were the Perceived Stress Scale-10, the Resilience Scale-25 items, the Satisfaction with Life Scale (SWLS), and the Burnout Scale (Oldenburg Inventory). A regression model was estimated for each dimension of burnout. The results revealed that resilience and life satisfaction play a mediating role in the association between stress and the dimensions of burnout. This suggests that measures of promoting mental health based on resilience and improving perceptions of life should be implemented.
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Affiliation(s)
- Ivone Duarte
- Department of Community Medicine, Information and Decision in Health (MEDCIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal;
- CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
- Correspondence: ; Tel.: +351-220-426-840
| | - Ana Alves
- Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.A.); (A.C.); (A.F.); (B.C.); (B.S.); (J.P.); (J.S.); (P.D.); (P.N.)
| | - Ana Coelho
- Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.A.); (A.C.); (A.F.); (B.C.); (B.S.); (J.P.); (J.S.); (P.D.); (P.N.)
| | - Ana Ferreira
- Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.A.); (A.C.); (A.F.); (B.C.); (B.S.); (J.P.); (J.S.); (P.D.); (P.N.)
| | - Beatriz Cabral
- Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.A.); (A.C.); (A.F.); (B.C.); (B.S.); (J.P.); (J.S.); (P.D.); (P.N.)
| | - Bebiana Silva
- Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.A.); (A.C.); (A.F.); (B.C.); (B.S.); (J.P.); (J.S.); (P.D.); (P.N.)
| | - João Peralta
- Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.A.); (A.C.); (A.F.); (B.C.); (B.S.); (J.P.); (J.S.); (P.D.); (P.N.)
| | - Juliana Silva
- Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.A.); (A.C.); (A.F.); (B.C.); (B.S.); (J.P.); (J.S.); (P.D.); (P.N.)
| | - Pedro Domingues
- Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.A.); (A.C.); (A.F.); (B.C.); (B.S.); (J.P.); (J.S.); (P.D.); (P.N.)
| | - Pedro Nunes
- Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (A.A.); (A.C.); (A.F.); (B.C.); (B.S.); (J.P.); (J.S.); (P.D.); (P.N.)
| | - Carla Serrão
- School of Education, Polytechnic of Porto, 4200-465 Porto, Portugal;
- INED-Centre for Research and Innovation in Education, School of Education, Polytechnic of Porto, 4200-465 Porto, Portugal
| | - Cristina Santos
- Department of Community Medicine, Information and Decision in Health (MEDCIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal;
- CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
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The COVID-19 Pandemic Increased Burnout and Bullying among Newly Graduated Nurses but Did Not Impact the Relationship between Burnout and Bullying and Self-Labelled Subjective Feeling of Being Bullied: A Cross-Sectional, Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031730. [PMID: 35162753 PMCID: PMC8835049 DOI: 10.3390/ijerph19031730] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 01/18/2023]
Abstract
(1) Background: The COVID-19 pandemic posed a great challenge to health care systems worldwide. Health care personnel, including nurses, work under high pressure and are overworked and overwhelmed, which results in a higher prevalence of burnout and workplace bullying, which further increases the intention to leave the nursing profession. (2) Methods: A comparative correlational and cross-sectional study design was adopted, and an online questionnaire was used to collect data between October 2019 and October 2021. Two hundred and fifty-seven newly graduated nurses participated in this study. The studied variable was measured using the Oldenburg Burnout Inventory, the Negative Acts Questionnaire, and metrics developed by the authors. (3) Results: The prevalence of bullying and burnout is significantly higher among nurses who worked during the COVID-19 pandemic than among those who worked before the pandemic, but the pandemic has not had an impact on the level of the subjective assessment of bullying. Working as a newly graduated nurse before or during the COVID-19 pandemic is a moderator between person-related bullying and its dimensions and disengagement. (4) Conclusions: Pandemics increase bullying and burnout among newly graduated nurses; however, the current challenges have caused some of this to remain unrevealed, the repercussions of which will appear with double strength later.
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Muldoon KM. IMPROVing communication about diversity, equity, and inclusion in health professions education. Anat Rec (Hoboken) 2022; 305:1000-1018. [PMID: 35103421 DOI: 10.1002/ar.24864] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/26/2021] [Accepted: 12/21/2021] [Indexed: 12/22/2022]
Abstract
There has never been a stronger call for authenticity in health professions education than this moment in time. The health inequities laid bare by the COVID-19 syndemic (a concept that describes the clustering of SARS-CoV-2 infection and disease by political, social, and economic factors) compels health professions educators to learn how to best engage in, sustain, and deepen conversations on diversity, equity, and inclusion (DEI) within our learning environments. Health professions curricula should address such concerns through explicit faculty training programs in dialogue models of communication. In this commentary, I propose that medical improv can help refocus health professions training to the humanistic values of empathy for others and respect for multiple viewpoints. Medical improv refers to teaching methods that adapt improvisation principles and exercises to enhance professional competencies in the health professions, such as communication. I describe a training series implemented at one institution to prepare faculty facilitators to engage in conversations about DEI in a discussion-based core course on the social determinants of health for first year medical students called "Humanity in Medicine." Key elements of dialogue training, including examinations of identity and positionality, caretaking and team-making, and conversations with a skeptic, are viewed through the lens of improv exercises as a pedagogy in communication. I report on facilitator and medical students' positive response to facilitator training and the Humanity in Medicine course. Potential next steps towards a formal evaluation of the method, and outcomes assessments of the use of improv in health professions training are discussed.
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Affiliation(s)
- Kathleen M Muldoon
- Department of Anatomy, College of Graduate Studies and Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA
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Alswayed K, Alshuaibi S, Alsayegh H, Bin Shulhub A, Alsultan R, AlKhudhair M, Haddad B. Medical and nonmedical use of psychiatric medications among medical students in Riyadh, Saudi Arabia. J Family Med Prim Care 2022; 11:1455-1461. [PMID: 35516669 PMCID: PMC9067198 DOI: 10.4103/jfmpc.jfmpc_1720_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/12/2021] [Accepted: 12/16/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction: Psychiatric medication use has increased recently among college students. This includes antidepressants, opioids, stimulants, analgesics, sedatives, and anxiolytics, which could be self-administered without medical supervision. Objectives: To determine the prevalence of medical and nonmedical use of psychiatric prescription medications and its correlation with academic performance, demographic data as well as the motives for the nonmedical use. Methods: A cross-sectional study aims to assess the psychiatric medication use with or without prescription with the motives behind it, and demographic data of the students at medical colleges in Riyadh, Saudi Arabia. Results: A total of 1268 responded to the questionnaire. 251 (20%) of the participants reported using some psychiatric medications in their lifetime, while 191 (15%) participants used some psychiatric medications in the last 12 months. Antidepressants were most used in the surveyed population 144 (57%), followed by opioids/pain relief medications 62 (24%) and anxiolytics 39 (15%). Only 44 surveyed students (3.5%) reported nonmedical use of these psychiatric medications. As for the motives of nonmedical use, the greatest portion reported to use it for “relax or relieve tension” 12 (29%), followed by “relieve pain caused by other health problems” 8 (20%), and “medication to get through the day” 6 (15%). Conclusion: Nonmedical use of psychiatric medications among medical students in Riyadh is several times lower than reports by other researchers. Future research should focus on collecting more participants who are using medications without prescription and conduct cross-cultural studies to examine factors contributing to such low rates of illicit psychiatric medication use.
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The impact of the COVID-19 pandemic on the mental health of medical students. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.1061178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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The Association of Internet Addiction with Burnout, Depression, Insomnia, and Quality of Life among Hungarian High School Teachers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010438. [PMID: 35010695 PMCID: PMC8744802 DOI: 10.3390/ijerph19010438] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/17/2021] [Accepted: 12/24/2021] [Indexed: 02/06/2023]
Abstract
The extensive availability of Internet has led to the recognition of problematic Internet use (so called Internet addiction, IA) mostly involving adolescents. There are limited data about the prevalence and consequences of IA in adults especially among high school teachers. Here, we present a cross-sectional prospective study focusing on the association of Internet addiction with burnout, depression, insomnia, and lower quality of life among high school teachers taking many co-variates into account. Overall, 623 males (34.3%) and 1194 females (65.7%) participated in our study. Internet addiction was detected in 5.2% (95/1817) based on the Problematic Internet Use Questionnaire. Internet addiction was associated with severe burnout (10.5 vs. 2.7%, p < 0.001), moderate (36.8 vs. 1.7%, p < 0.001), and severe (6.3 vs. 0.1%, p < 0.001) depression, insomnia (23.1 vs. 11.4%, p < 0.001), and severe sleep disturbance (severe insomnia, 27.4 vs. 3.8%, p < 0.001) and lower quality of life in all domains (p < 0.001). There was also a significant correlation of the severity of the above-mentioned parameters and the severity of IA (overall scores, p < 0.001 in all cases). In a multivariate analysis including demographic criteria, risk factors medical conditions and the above-mentioned parameters as co-variates internet addiction was significantly associated with depression (OR = 3.836, CI: 2.92-5.44, p = 0.03), and insomnia (OR: 3.932, CI: 3.6-5.69, p = 0.002). This is the first study from Hungary and is one of the first studies showing the association of IA with mental issues, burnout, and lower quality of life among adults. It underlines the clinical importance of problematic Internet use among adults.
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El Hachem C, Atallah E. Burnout prevalence and associated factors in a sample of Lebanese residents. Encephale 2021; 48:615-623. [PMID: 34872704 DOI: 10.1016/j.encep.2021.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/18/2021] [Accepted: 08/29/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study aims to determine the prevalence of burnout in a sample of Lebanese residents, and to identify its correlates and risk factors compared to local and international data. METHOD A cross-sectional study was conducted at the end of the academic year 2018-2019, between the months of April and July, and targeted residents enrolled at Saint Joseph University, Faculty of Medicine (USJ- FM), in Beirut, Lebanon. Data was gathered via an anonymous online survey which was sent to all the residents through the Faculty administration on their personal email addresses. The questions dealt with demographic and mental health data. The Copenhagen Burnout Inventory (CBI) was used to measure burnout. RESULTS 25.7% of the residents responded to the survey, two thirds of whom were female. 72.22% of the respondents suffered from personal burnout whereas as 77.78% suffered from work-related burnout. Only 26.39% residents were concerned with patient-related burnout. Money and professional problems were associated with burnout whereas suicidal thoughts were correlated with higher scores. Alcohol consumption was negatively correlated with CBI. CONCLUSION The surveyed residents suffered from burnout which was mainly related to personal and occupational factors. Burnout was not an isolated entity; it should be considered as a whole and described as a subjective experience that varies from one person to another and results from complex biological, psychological and social interactions. It has consequences on the victims' health and quality of life.
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Affiliation(s)
- C El Hachem
- Département de psychiatrie, Faculté de Médecine de l'Université Saint-Joseph, Beyrouth, Liban; Service de psychiatrie, Hôtel Dieu de France, Centre Hospitalier de l'Université Saint-Joseph, Beyrouth, Liban.
| | - E Atallah
- Département de psychiatrie, Faculté de Médecine de l'Université Saint-Joseph, Beyrouth, Liban
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Mohr DC, Swamy L, Wong ES, Mealer M, Moss M, Rinne ST. Critical Care Nurse Burnout in Veterans Health Administration: Relation to Clinician and Patient Outcomes. Am J Crit Care 2021; 30:435-442. [PMID: 34719713 DOI: 10.4037/ajcc2021187] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Critical care nurses have a burnout rate among the highest of any nursing field. Nurse burnout may impact care quality. Few studies have considered how temporal patterns may influence outcomes. OBJECTIVE To test a longitudinal model of burnout clusters and associations with patient and clinician outcomes. METHODS An observational study analyzed data from annual employee surveys and administrative data on patient outcomes at 111 Veterans Health Administration intensive care units from 2013 through 2017. Site-level burnout rates among critical care nurses were calculated from survey responses about emotional exhaustion and depersonalization. Latent trajectory analysis was applied to identify clusters of facilities with similar burnout patterns over 5 years. Regression analysis was used to analyze patient and employee outcomes by burnout cluster and organizational context measures. Outcomes of interest included patient outcomes (30-day standardized mortality rate and observed minus expected length of stay) for 2016 and 2017 and clinician outcomes (intention to leave and employee satisfaction) from 2013 through 2017. RESULTS Longitudinal analysis revealed 3 burnout clusters among the 111 sites: low (n = 37), medium (n = 68), and high (n = 6) burnout. Compared with sites in the low-burnout cluster, those in the high-burnout cluster had longer patient stays, higher employee turnover intention, and lower employee satisfaction in bivariate models but not in multivariate models. CONCLUSIONS In this multiyear, multisite study, critical care nurse burnout was associated with key clinician and patient outcomes. Efforts to address burnout among nurses may improve patient and employee outcomes.
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Affiliation(s)
- David C. Mohr
- David C. Mohr is an investigator, Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, Massachusetts, and a research assistant professor, Department of Health Policy and Management, Boston University School of Public Health, Boston
| | - Lakshmana Swamy
- Lakshmana Swamy was a pulmonary and critical care fellow at Boston Medical Center and VA Boston, Boston, Massachusetts; he is now an assistant professor, Population & Quantitative Health Sciences, UMass Medical School, Worcester, Massachusetts
| | - Edwin S. Wong
- Edwin S. Wong is a core investigator, Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington
| | - Meredith Mealer
- Meredith Mealer is an associate professor of medicine, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Marc Moss
- Marc Moss is a professor of medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora
| | - Seppo T. Rinne
- Seppo T. Rinne is an assistant professor, Pulmonary Center, Boston University School of Medicine, and a physician scientist, Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts
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Thye M, Tauschel D. Fostering learning capacities for meaningful, healthy and efficient studying in undergraduate medical education: evaluation of a longitudinal learning workshop. BMC Psychol 2021; 9:131. [PMID: 34474686 PMCID: PMC8414862 DOI: 10.1186/s40359-021-00631-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/16/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Academic studies place high demands on the development of learning capacities. Beyond learning techniques, knowledge about the effect of the learning environment, as well as the ability for self-regulation, self-determination and self-care play a major role in the development of learning skills. A longitudinal learning workshop was developed aiming to support academic learning life. The study at hand describes and evaluates this intervention. METHODS Students participated in a seven-week program fostering reflection and training on physical, physiological, psychological and mental dimensions of learning. Fifty evaluations of medical students reflecting the workshop underwent qualitative analysis of open-ended questions concerning changes students experienced in their learning life. In addition, general satisfaction was measured quantitatively. RESULTS Qualitative results revealed an impact on five core dimensions of students´ learning life: knowledge gained about the process of learning, enhanced awareness of intrapersonal learning processes, getting easier into action, experience of change and raised skills of regulating one´s learning behavior. Students evaluate the workshop as helpful, supportive and as a source of guidance. Quantitative results demonstrated good overall satisfaction with the intervention. CONCLUSIONS Educating knowledge about learning how to learn and providing skill training of how to regulate physiology, psychology and mentality should be taken into account in order to support the multidimensional learning life of students. Using a holistic, anthropologically grounded approach could be considered to enhance healthy, meaningful and efficient ways of learning. This learning workshop seems to be a useful and transferable tool to support students' development of learning capacities.
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Affiliation(s)
- Miriam Thye
- Faculty of Health, Department of Medicine, Integrated Curriculum for Anthroposophic Medicine (ICURAM), Witten/Herdecke University, Witten, Germany
- Faculty of Health, Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Diethard Tauschel
- Faculty of Health, Department of Medicine, Integrated Curriculum for Anthroposophic Medicine (ICURAM), Witten/Herdecke University, Witten, Germany
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Chumakov E, Petrova N, Mamatkhodjaeva T, Ventriglio A, Bhugra D, Molodynski A. Screening of minor psychiatric disorders and burnout among a sample of medical students in St. Petersburg, Russia: a descriptive study. MIDDLE EAST CURRENT PSYCHIATRY 2021. [PMCID: PMC8387095 DOI: 10.1186/s43045-021-00118-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
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.
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Molodynski A, Farrell SM, Bhugra D, Okasha T. Poor medical student welfare—a growing threat to healthcare. MIDDLE EAST CURRENT PSYCHIATRY 2021. [PMCID: PMC8377449 DOI: 10.1186/s43045-021-00135-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Žuljević MF, Jeličić K, Viđak M, Đogaš V, Buljan I. Impact of the first COVID-19 lockdown on study satisfaction and burnout in medical students in Split, Croatia: a cross-sectional presurvey and postsurvey. BMJ Open 2021; 11:e049590. [PMID: 34187830 PMCID: PMC8245286 DOI: 10.1136/bmjopen-2021-049590] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/10/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To evaluate the impact of the first COVID-19 lockdown in 2020 on the burnout and study satisfaction of medical students. DESIGN A cross-sectional study with a presurvey and postsurvey. SETTING University of Split School of Medicine (USSM), Split, Croatia. The lockdown in the COVID-19 pandemic lasted from late March to mid-May 2020. There was a full switch to e-learning at the USSM during this period, and all clinical teaching was stopped. PARTICIPANTS Students enrolled in the 2019/2020 academic year. Data were collected before lockdown in December 2019 and January 2020 and again after the end of lockdown in June 2020. PRIMARY AND SECONDARY OUTCOME MEASURES Study satisfaction was assessed using the study satisfaction survey. Burnout was assessed using two instruments: Oldenburg Burnout Inventory and Copenhagen Burnout Inventory. We used Bayesian statistics to compare before-and-after differences. RESULTS 437 independent responses (77.2% response rate) were collected before and 235 after lockdown (41.5% response rate). 160 participant responses were eligible for pairing. There was no significant difference for both paired and unpaired participants in study satisfaction before (3.38 on a 1-5 scale; 95% credible interval (95% CrI) 3.32 to 3.44) and after (3.49, 95% CrI 3.41 to 3.57) lockdown. We found no evidence (Bayes factor (BF10) >3.00 as a cut-off value) for an increase in the level of burnout before and after lockdown, both in independent and paired samples. CONCLUSIONS It seems that the first pandemic-related lockdown and a switch to e-learning did not affect burnout levels among medical students or their perception of their study programme. More insight is needed on the short-term and long-term effects of the COVID-19 pandemic on medical students and their education. Well-structured longitudinal studies on medical student burnout during the COVID-19 pandemic are needed.
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Affiliation(s)
- Marija Franka Žuljević
- Department of Medical Humanities, University of Split Faculty of Medicine, Split, Croatia
| | - Karlo Jeličić
- University Hospital for Infectious Diseases Dr Fran Mihaljević, Zagreb, Croatia
| | - Marin Viđak
- Department of Research in Biomedicine and Health, University of Split Faculty of Medicine, Split, Croatia
| | - Varja Đogaš
- Department of Psychological Medicine, University of Split Faculty of Medicine, Split, Croatia
| | - Ivan Buljan
- Department of Research in Biomedicine and Health, University of Split Faculty of Medicine, Split, Croatia
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Wang J, Liu W, Zhang Y, Xie S, Yang B. Perceived Stress Among Chinese Medical Students Engaging in Online Learning in Light of COVID-19. Psychol Res Behav Manag 2021; 14:549-562. [PMID: 34017205 PMCID: PMC8131094 DOI: 10.2147/prbm.s308497] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/14/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose After a year of the COVID-19 pandemic, countries have repeatedly imposed strict quarantine regimes as the virus mutates and becomes more contagious. Medical undergraduate education has been disrupted and transformed into prolonged home isolation and online learning. Although studies have reported that the COVID-19 pandemic tends to increase perceived stress (PS) and affect the mental health of medical students, the influencing factors are unclear. Therefore, based on the stress process model, this study will comprehensively evaluate the distribution of stressors of medical students and explore the personal and environmental predictors of PS during the epidemic. Participants and Methods An online survey was conducted among medical students (n=369) from three medical universities in western China who engaged in online learning. A stress process conceptual framework was formed to explore the influencing factors of PS. The survey items contained four sections: (a) the potential stressors derived from academic, psychosocial and health-related demands; coping resources such as (b) online learning environment support and (c) personal resilience, including online learning behavior and individual characteristics; and (d) PS, perception of imbalanced demands and coping resources. Results The mean PS score was 17.39 (SD=4.58), and over four-fifths (82.3%) of the students had moderate to high levels of stress. The average item scores of academic, psychosocial and health-related stressors were 2.72 (SD=0.55), 2.31 (SD=0.55) and 2.07 (SD=0.50), respectively. Gender, grade, psychosocial stressors, health-related stressors, specific online learning behavior (persistence, attitude and flexibility), and the online learning environment (teaching, social and cognitive presence) were predictors of PS. Conclusion Our results specify that a reduction in psychological and health-related stressor stimulation, specific online learning behavior promotion, and well-established online learning environment support could be considered essential for alleviating the negative impacts of COVID-19 on the psychosocial health of medical undergraduates.
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Affiliation(s)
- Jun Wang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Weichu Liu
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Yunmei Zhang
- School of Nursing, Chongqing Medical University, Chongqing, People's Republic of China
| | - Shiqi Xie
- School of Nursing, Chongqing Medical University, Chongqing, People's Republic of China
| | - Bing Yang
- Department of Nursing, Stomatological Hospital of Chongqing Medical University, Chongqing, China
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The Role of Burnout in the Association between Work-Related Factors and Perceived Errors in Clinical Practice among Spanish Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094931. [PMID: 34066327 PMCID: PMC8124853 DOI: 10.3390/ijerph18094931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/30/2021] [Accepted: 05/02/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to evaluate the prevalence of burnout syndrome in a sample of residents from different specialties, to determine the influence of work-related factors on the development of burnout, and to examine the mediating role of burnout in the relation between such work factors and perceived errors in clinical practice. A total of 237 Spanish residents participated (Mage = 28.87, SD = 3.84; 73.8% females). The Maslach Burnout Inventory and an ad hoc questionnaire were administered to assess burnout and work-related factors. Comparison analyses and mediational models were conducted. Half of the residents reported high levels of burnout (48.9%). Burnout was significantly associated with perceived errors in clinical practice. Significant differences were found between residents with lower and higher burnout levels, showing that those with higher burnout were less satisfied with the working conditions. Burnout mediated the associations between adjustment of responsibility, support among residents, satisfaction with teaching and rotations, general satisfaction, and perceived errors in the clinical practice. Adjusted levels of responsibility and workload, enhanced supervision, and more social support from colleagues predict lower levels of burnout, which may result in fewer errors in clinical practice. Consequently, such work-related factors should be taken into account as a preventive strategy for burnout and errors in the clinical practice so adequate patient care, good mental health of future specialists, and, therefore, higher quality of public health care can be ensured.
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Sepede JC, Petrides J, Collins PB, Jones MC, Cantor N, Boyd L. The role of extracurricular activities and lectures in mitigating medical student burnout. J Osteopath Med 2021; 121:617-623. [PMID: 33892526 DOI: 10.1515/jom-2020-0311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/09/2021] [Indexed: 02/07/2023]
Abstract
CONTEXT Strong evidence throughout the literature highlights burnout as a significant and increasing problem among medical students, impacting students' ability to effectively care for and empathize with patients. OBJECTIVES To examine how involvement in extracurricular activities and attendance at burnout lectures can impact burnout among medical students. METHODS An anonymous digital survey including the Maslach Burnout Inventory (MBI) was sent to all students (n=765) at Rowan University School of Osteopathic Medicine. The survey included questions regarding the number of burnout/wellness lectures respondents had attended, the number of clubs in which the respondents participated, the number of hours spent in these clubs, and any leadership positions held by the respondents. RESULTS Of the 765 students enrolled, 597 completed the survey. Results indicated that women participated in significantly more clubs than men (t[456]=-4.30; p<0.001). Men had higher scores on the depersonalization subscale of the MBI than women (t[463)=2.98; p<0.01]. There were no gender differences in emotional exhaustion or personal accomplishment. Linear regression analyses including gender and club participation as predictors of each of the burnout subscales indicated a significant interaction between gender and number of clubs (β=0.34; p<0.05), in that more club participation was associated with higher depersonalization scores for women, but lower depersonalization scores for men. The number of wellness/burnout prevention lectures attended was not predictive of scores on any of the burnout subscales. CONCLUSIONS Our results indicate the importance of understanding what drives burnout on the individual level and adapting interventions to suit the needs of individual students, rather than the student body as a whole.
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Affiliation(s)
- Jennifer C Sepede
- Department of Family Medicine, School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
| | - Joanna Petrides
- Department of Family Medicine, School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
- Department of Psychology, Rowan University, Glassboro, NJ, USA
| | - Philip B Collins
- Department of Family Medicine, School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
| | | | - Nicole Cantor
- Department of Psychology, Rowan University, Glassboro, NJ, USA
| | - Linda Boyd
- Department of Family Medicine, School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
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Majumder MAA, Cohall D, Ojeh N, Campbell MH, Adams OP, Sa B, Khan K, Pierre R, Trotman-Edwards H. Assessing online learning readiness and perceived stress among first year medical students during COVID-19 pandemic: a multi-country study. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:e131-e133. [PMID: 33995740 PMCID: PMC8105569 DOI: 10.36834/cmej.71609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
| | - Damian Cohall
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Barbados
| | - Nkemcho Ojeh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Barbados
| | - Mike H Campbell
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Barbados
| | - Oswald Peter Adams
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill, Barbados
| | - Bidyadhar Sa
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, Trinidad and Tobago
| | - Katija Khan
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, Trinidad and Tobago
| | - Russell Pierre
- Faculty of Medical Sciences, The University of the West Indies, Mona Campus, Jamaica
| | - Helen Trotman-Edwards
- Faculty of Medical Sciences, The University of the West Indies, Mona Campus, Jamaica
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Toth G, Kapus K, Hesszenberger D, Pohl M, Kosa G, Kiss J, Pusch G, Fejes E, Tibold A, Feher G. Internet Addiction and Burnout in A Single Hospital: Is There Any Association? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020615. [PMID: 33450812 PMCID: PMC7828215 DOI: 10.3390/ijerph18020615] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 12/27/2020] [Accepted: 01/11/2021] [Indexed: 12/19/2022]
Abstract
The extensive availability of the internet has led to the recognition of problematic internet use, the so-called Internet Addiction (IA), mostly involving adolescents. Burnout can lead to substance abuse or addictive behaviour (such as internet addiction) as a coping method. There are insufficient data about internet addiction and its possible association with burnout in adults, especially among healthcare workers. The aim of our present study was to focus on prevalence and the risk factors of internet addiction and its possible association with burnout among healthcare workers in a single hospital applying a questionnaire-based survey. In total, 49 doctors (10.1%), 198 nurses (40.9%), 123 medical assistant (25.4%), 73 other healthcare workers (15.1%), and 42 (1.7%) healthcare associated workers (cleaning, laundry, etc.) have completed our survey. In a multivariate analysis, IA was associated with age between 18 and 25 (OR: 2.6, p = 0.024), surfing on the internet >5 h daily (OR 25.583, p < 0.001), being single (OR: 4.275, p = 0.006), being childless (OR: 3.81, p = 0.011), working less than five years (OR 2.135, p = 0.048) and job type (being healthcare associated worker, OR: 2.907, p = 0.009). Illicit drug intake (OR 52.494, p < 0.001), and diabetes (OR: 4.122, p = 0.043) were also significantly associated with internet addiction. No association of burnout and IA could be found. A small but significant proportion of our healthcare workers suffered from IA, which was associated with substance abuse and diabetes in multivariate analysis. Our study also draws attention to the risk factors of IA such as younger age, family status, working type and working hours internet use. The possible association of burnout and IA merits further investigation.
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Affiliation(s)
- Gabor Toth
- Centre for Occupational Medicine, Medical School, University of Pécs, 7627 Pécs, Hungary; (G.T.); (K.K.); (M.P.); (G.K.); (J.K.); (E.F.); (A.T.)
- Szent Rókus Hospital, 1085 Baja, Hungary
| | - Krisztian Kapus
- Centre for Occupational Medicine, Medical School, University of Pécs, 7627 Pécs, Hungary; (G.T.); (K.K.); (M.P.); (G.K.); (J.K.); (E.F.); (A.T.)
| | - David Hesszenberger
- Department of Laboratory Medicine, Medical School, University of Pecs, 7627 Pécs, Hungary;
| | - Marietta Pohl
- Centre for Occupational Medicine, Medical School, University of Pécs, 7627 Pécs, Hungary; (G.T.); (K.K.); (M.P.); (G.K.); (J.K.); (E.F.); (A.T.)
| | - Gabor Kosa
- Centre for Occupational Medicine, Medical School, University of Pécs, 7627 Pécs, Hungary; (G.T.); (K.K.); (M.P.); (G.K.); (J.K.); (E.F.); (A.T.)
| | - Julianna Kiss
- Centre for Occupational Medicine, Medical School, University of Pécs, 7627 Pécs, Hungary; (G.T.); (K.K.); (M.P.); (G.K.); (J.K.); (E.F.); (A.T.)
| | - Gabriella Pusch
- Department of Neurology, Medical School, University of Pecs, 7627 Pécs, Hungary;
| | - Eva Fejes
- Centre for Occupational Medicine, Medical School, University of Pécs, 7627 Pécs, Hungary; (G.T.); (K.K.); (M.P.); (G.K.); (J.K.); (E.F.); (A.T.)
- Hospital of Komlo, 7300 Komlo, Hungary
| | - Antal Tibold
- Centre for Occupational Medicine, Medical School, University of Pécs, 7627 Pécs, Hungary; (G.T.); (K.K.); (M.P.); (G.K.); (J.K.); (E.F.); (A.T.)
| | - Gergely Feher
- Centre for Occupational Medicine, Medical School, University of Pécs, 7627 Pécs, Hungary; (G.T.); (K.K.); (M.P.); (G.K.); (J.K.); (E.F.); (A.T.)
- Neurology Outpatient Clinic, EÜ-MED KFT, 7300 Komlo, Hungary
- Correspondence: ; Tel.: +36-72518-523; Fax: 36-72518-521
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Chandratre S, Knight C, Dodson L. Supporting Medical Student Mental Health during COVID-19: Strategies Implemented for an Accelerated Curriculum Medical Campus. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2021; 8:23821205211006392. [PMID: 34095501 PMCID: PMC8141979 DOI: 10.1177/23821205211006392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/02/2021] [Indexed: 06/02/2023]
Abstract
Medical student education has not been immune to life altering changes of the global Coronavirus disease 2019 (COVID-19) pandemic. Pre-pandemic anxiety and mental health concerns were already a significant problem in the world of medical student education. Educators are reformulating strategies to address the increased demand for mental health services and wellness during COVID-19. Adaptations include increased and varied internal and student focused communication, as well as new support structures built around student connection and coaching, mental illness, and general wellness. Additional alterations to student support include expanded mental health counseling and also incorporating novel wellness events in an effort to support thriving during COVID-19.
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Affiliation(s)
- Sonal Chandratre
- Ascension Medical Group-Regional Medical Director Primary Care Northern Region, Stevens Point, WI, USA
- Pediatric Endocrinology, Ascension Saint Michael’s Hospital, Stevens Point, WI, USA
| | - Christopher Knight
- Medical College of Wisconsin-Central Wisconsin Regional Campus, Wausau, WI, USA
| | - Lisa Dodson
- Medical College of Wisconsin-Central Wisconsin Regional Campus, Wausau, WI, USA
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Nagose V, Soni D, Rathod S, Yelne Y. COVID-19 impact on mental health, sleep quality and various aspects of life of medical students and interns, and nonmedical students: A comparative study in Indian scenario. ANNALS OF INDIAN PSYCHIATRY 2021. [DOI: 10.4103/aip.aip_79_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Seera G, Arya S, Sethi S, Nimmawitt N, Ratta-Apha W. Help-seeking behaviors for mental health problems in medical students: Studies in Thailand and India. Asian J Psychiatr 2020; 54:102453. [PMID: 33271732 DOI: 10.1016/j.ajp.2020.102453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/06/2020] [Accepted: 10/12/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To compare the rate of help-seeking from mental health professionals (MHPs) and other sources of help for mental health problems of medical students in Thailand and India, and explore factors associated with help-seeking from MHPs. METHODS Cross-sectional survey-based study was conducted in two medical schools in Thailand and India. Students were asked to rate their preferences for each source of help on a Likert-scale basis. Mental health status was measured by the General health questionnaire-12 (GHQ-12). Attitudes and stigma toward mental illness were collected using the Mental illness clinician's attitude scale: medical student version or MICA v2. RESULTS 593 students participated in the survey. The percentage of students who chose to seek help from any source was lower in Thailand than in India. 81 % of students in India site chose to seek help from MHPs, compared to 66 % in Thailand site. The risk factors for avoiding seeking help from MHPs in Thailand were history of alcohol use (OR = 1.88, p = .014) and total GHQ score (OR = 1.11, p = .006), whereas having GHQ score ≥ 2 was a significant risk factor in India (OR = 2.20, p = .044). Total MICA score, which reflected overall attitude toward mental illness, was not associated with seeking help from MHPs. CONCLUSIONS The rate of help-seeking behaviors for mental health problems and factors associated differed between medical students in Thailand and India. A high GHQ score was a common risk factor of not seeking help from MHPs in both countries.
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Affiliation(s)
- Genis Seera
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.
| | - Sidharth Arya
- Department of Psychiatry, Pt BDS University of Health Sciences, Rohtak, India.
| | - Sujata Sethi
- Department of Psychiatry, Pt BDS University of Health Sciences, Rohtak, India.
| | - Neshda Nimmawitt
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.
| | - Woraphat Ratta-Apha
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.
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Saraswathi I, Saikarthik J, Senthil Kumar K, Madhan Srinivasan K, Ardhanaari M, Gunapriya R. Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: a prospective longitudinal study. PeerJ 2020; 8:e10164. [PMID: 33088628 PMCID: PMC7571415 DOI: 10.7717/peerj.10164] [Citation(s) in RCA: 154] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/22/2020] [Indexed: 12/19/2022] Open
Abstract
Background The COVID-19 pandemic is found to affect the mental health of the population. Undergraduate medical students are especially prone to mental health disorders and hence could be more vulnerable to the impact of the pandemic. Methods A prospective longitudinal study was conducted on 217 undergraduate medical students in a medical college at Chennai, India. Depression, anxiety, and stress levels were recorded using Depression Anxiety Stress Scale 21 Items (DASS21) before and during the COVID-19 outbreak in India in December 2019 and June 2020, respectively. In the follow-up survey, in addition to DASS21, the Pittsburgh Sleep Quality Index to assess sleep quality and a self-administered questionnaire to assess the impact of COVID-19 related stressors were used. The self-administered questionnaire assessed the status of COVID-19 testing, interactions with COVID-19 patients, self-perceived levels of concerns and worries related to academics (COVID-19-AA (academic apprehensions)) and those pertaining to the self and family/friends (COVID-19-GA (general apprehensions)). Cross-sectional and longitudinal comparison of overall scores of depression, anxiety, and stress and scores stratified by gender, year of study, place of residence and monthly family income were performed. Predictors for depression, anxiety, and stress during COVID-19 were investigated using adjusted binary logistic regression analysis and results were expressed as adjusted odds ratio with 95% confidence interval (CI). A P value < 0.05 was considered statistically significant. Results The average scores of depression, anxiety, and stress during the baseline survey were 7.55 ± 7.86, 4.6 ± 6.19 and 7.31 ± 7.34 with the prevalence (95% Cl) of 33.2% [27-39.9%], 21.2% [16-27.2%] and 20.7% [15.5-26.7%]; in follow-up survey, the mean scores were 8.16 ± 8.9, 6.11 ± 7.13 and 9.31 ± 8.18 with the prevalence being 35.5% [29.1-42.2%], 33.2% [27-39.9%] and 24.9% [19.3-31.2%] for depression, anxiety, and stress respectively. There was a significant increase in both the prevalence and levels of anxiety and stress (P < 0.001), with depression remaining unchanged during COVID-19, irrespective of gender, year of study, place of residence and family's monthly income. Poor sleep quality, higher levels of baseline depression, anxiety, and stress, higher COVID-19-GA, COVID-19 patients in family/friends and direct interactions with COVID-19 patients were found to be significant predictors of negative mental health in undergraduate medical students. COVID-19-AA was not significantly associated with depression, anxiety, and stress. Conclusion The COVID-19 pandemic appears to negatively affect the mental health of the undergraduate medical students with the prevalence and levels of anxiety and stress being increased, and depression symptoms remaining unaltered. Addressing and mitigating the negative effect of COVID-19 on the mental health of this population is crucial.
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Affiliation(s)
- Ilango Saraswathi
- Department of Physiology, Madha Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - Jayakumar Saikarthik
- Department of Basic Medical Sciences, Majmaah University, Ar-Riyadh, Saudi Arabia
| | - K Senthil Kumar
- Department of Physiology, Madha Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - Kumar Madhan Srinivasan
- Department of General Medicine, Madha Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - M Ardhanaari
- Department of Psychiatry, Meenakshi Medical College Hospital and Research Institute, Enathur, Tamil Nadu, India
| | - Raghunath Gunapriya
- Department of Anatomy, Saveetha Medical College Hospital, Thandalam, Tamil Nadu, India
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Bhandari A, Bhatta N. Psychological Effects of COVID-19 and Its Measures in Nepalese Medical Students. JNMA J Nepal Med Assoc 2020; 58:820-822. [PMID: 34504364 PMCID: PMC7654500 DOI: 10.31729/jnma.5276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Indexed: 11/29/2022] Open
Abstract
Having to listen to the devastating daily news brought by COVID-19 since the first case was reported on 23rd January 2020 in Nepal, it has pushed the country into various crises. The issue of psychological health has been overlooked during this crisis.COVID-19 has sabotaged the psychological health of general people and more importantly medical students. It has disrupted the academics and clinical rotations of medical education. The prospect of being the future health care personnel without adequate training has destroyed the confidence and aspiration andin addition, joining the frontline against this type of deadly virus with little preparedness has instilled fear and uncertainty among them. So, concerning the context, this article focuses on the psychological effects faced by medical students and some ways to overcome this issue.
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Affiliation(s)
- Anima Bhandari
- Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Nisha Bhatta
- Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
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Tan BYQ, Kanneganti A, Lim LJH, Tan M, Chua YX, Tan L, Sia CH, Denning M, Goh ET, Purkayastha S, Kinross J, Sim K, Chan YH, Ooi SBS. Burnout and Associated Factors Among Health Care Workers in Singapore During the COVID-19 Pandemic. J Am Med Dir Assoc 2020; 21:1751-1758.e5. [PMID: 33256955 PMCID: PMC7534835 DOI: 10.1016/j.jamda.2020.09.035] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/24/2020] [Accepted: 09/26/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The strain on health care systems due to the COVID-19 pandemic has led to increased psychological distress among health care workers (HCWs). As this global crisis continues with little signs of abatement, we examine burnout and associated factors among HCWs. DESIGN Cross-sectional survey study. SETTING AND PARTICIPANTS Doctors, nurses, allied health professionals, administrative, and support staff in 4 public hospitals and 1 primary care service in Singapore 3 months after COVID-19 was declared a global pandemic. METHODS Study questionnaire captured demographic and workplace environment information and comprised 3 validated instruments, namely the Oldenburg Burnout Inventory (OLBI), Safety Attitudes Questionnaire (SAQ), and Hospital Anxiety and Depression Scale (HADS). Multivariate mixed model regression analyses were used to evaluate independent associations of mean OLBI-Disengagement and -Exhaustion scores. Further subgroup analysis was performed among redeployed HCWs. RESULTS Among 11,286 invited HCWs, 3075 valid responses were received, giving an overall response rate of 27.2%. Mean OLBI scores were 2.38 and 2.50 for Disengagement and Exhaustion, respectively. Burnout thresholds in Disengagement and Exhaustion were met by 79.7% and 75.3% of respondents, respectively. On multivariate regression analysis, Chinese or Malay ethnicity, HADS anxiety or depression scores ≥8, shifts lasting ≥8 hours, and being redeployed were significantly associated with higher OLBI mean scores, whereas high SAQ scores were significantly associated with lower scores. Among redeployed HCWs, those redeployed to high-risk areas in a different facility (offsite) had lower burnout scores than those redeployed within their own work facility (onsite). A higher proportion of HCWs redeployed offsite assessed their training to be good or better compared with those redeployed onsite. CONCLUSIONS AND IMPLICATIONS Every level of the health care workforce is susceptible to high levels of burnout during this pandemic. Modifiable workplace factors include adequate training, avoiding prolonged shifts ≥8 hours, and promoting safe working environments. Mitigating strategies should target every level of the health care workforce, including frontline and nonfrontline staff. Addressing and ameliorating burnout among HCWs should be a key priority for the sustainment of efforts to care for patients in the face of a prolonged pandemic.
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Affiliation(s)
- Benjamin Y Q Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurology, Department of Medicine, National University Hospital, Singapore.
| | - Abhiram Kanneganti
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Lucas J H Lim
- Department of Forensic Psychiatry, Institute of Mental Health, Singapore
| | - Melanie Tan
- Department of Geriatric Medicine, Ng Teng Fong General Hospital, Singapore
| | - Ying Xian Chua
- Pioneer Polyclinic, National University Polyclinics, National University Health System, Singapore
| | - Lifeng Tan
- Division of Healthy Ageing, Alexandra Hospital, Singapore
| | - Ching Hui Sia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre, Singapore
| | - Max Denning
- Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, United Kingdom
| | - Ee Teng Goh
- Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, United Kingdom
| | - Sanjay Purkayastha
- Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, United Kingdom
| | - James Kinross
- Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, United Kingdom
| | - Kang Sim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; West Region, Institute of Mental Health, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shirley B S Ooi
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Emergency Medicine Department, National University Hospital, Singapore
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Chandratre S. Medical Students and COVID-19: Challenges and Supportive Strategies. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2020; 7:2382120520935059. [PMID: 32637642 PMCID: PMC7315659 DOI: 10.1177/2382120520935059] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/26/2020] [Indexed: 05/09/2023]
Abstract
As coronavirus disease 2019 (COVID-19) pandemic continues to spread across the world, it is also adversely affecting medical student education. In addition, COVID-19 poses several challenges to medical students' physical and mental health and their professional identity formation. Medical students are experiencing increasing anxiety due to the COVID-19 disruption. Medical students show higher rates of depression, suicidal ideation, and stigmatization around depression and are less likely to seek support. It is therefore important to safeguard their mental health and implement effective strategies to support their educational, physical, mental, and professional well-being.
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Affiliation(s)
- Sonal Chandratre
- Division of Pediatric Endocrinology, Department of Pediatrics, Medical College of Wisconsin, Central Wisconsin Regional Medical Campus, Wausau, WI, USA
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