1
|
Palička M, Rybář M, Mechúrová B, Paličková N, Sobelová T, Pokorná K, Cvek J. The influence of excessive stress on medical students in the Czech Republic - national sample. BMC MEDICAL EDUCATION 2023; 23:168. [PMID: 36932431 PMCID: PMC10021045 DOI: 10.1186/s12909-023-04157-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE The Czech Republic has been dealing with a long-term shortage of doctors, which, according to demographic forecasts, will continue to worsen due to the retirement of stronger generations of doctors in contrast to the gradual aging of the population, which will require more health care over time. The country´s political set is trying to respond to this shortage and demographic forecasts by gradually increasing financial funding of medical faculties with the aim of increasing the number of graduates of the program in the field of general medicine. METHODS Anonymous questionnaire survey was conducted among students and graduates of general medicine at all eight Czech medical faculties. A total of 3183 respondents participated in the survey. There were 2843 medical students, which represents approximately 28% of all medical students in the Czech Republic. The distribution of respondents within the study years was approximately even and approximately corresponded to the real distribution of students between individual faculties in country, which makes survey a national sample. The statistical processing was performed in the statistical software R. Apart from the basic comparison using percentage relative frequencies and Pearson´s chi-squared test, in this study we used Odds ratios (OR) with CI 0,95 from logistic regression model for a better interpretation of some outputs. RESULTS The results show that the vast majority of Czech medical students experience excessive stress during their studies, which increases the risk of students´ somatic problems (OR = 4.89, CI 0.95 = (4.11;5.83), p < 0.001)., targeted alcohol use (OR = 2.29, CI 0.95 = (1.73;3.04), p < 0,001) and the use of anxiolytic or antidepressant medication to reduce it (OR = 2.99, CI 0.95 = (2.24;4.01), p < 0.001). Students experiencing higher levels of excessive stress are more likely to leave their studies based on their own decision (4.20 (CI 0.95 (3.39;5.19), p < 0.001) and not to enter clinical practice after graduation (OR = 2.62, CI 0.95 = (2.06;3.33), p < 0.001). CONCLUSIONS The survey shows the need for an open discussion at the highest level about the possibilities of reasonable reduction of unnecessary stress during medical studies. Medical students in the Czech Republic are exposed to excessive stress with all the consequences described above. All that remains is to state the existence of unnecessary components of stress, which represent an opportunity to reduce it, thereby achieving better conditions for studying, improvement in the staff situation in the Czech healthcare system and a reduction in inefficiently spent financial resources for the education of young doctors. TRIAL REGISTRATION No registration.
Collapse
Affiliation(s)
- M Palička
- University Hospital Ostrava, Ostrava, Czech Republic.
| | - M Rybář
- Czech Technical University, Prague, Czech Republic
| | | | - N Paličková
- University Hospital Ostrava, Ostrava, Czech Republic
| | - T Sobelová
- University of Ostrava, Ostrava, Czech Republic
| | - K Pokorná
- University of Ostrava, Ostrava, Czech Republic
| | - J Cvek
- University Hospital Ostrava, Ostrava, Czech Republic
| |
Collapse
|
2
|
Karabacak M, Hakkoymaz M, Ukus B, Ozturk E, Kaya B, Ozcan Z, Ozkara BB. Final-year medical student mental wellness during preparation for the examination for specialty in Turkey: a cross-sectional survey study. BMC MEDICAL EDUCATION 2023; 23:79. [PMID: 36726114 PMCID: PMC9891750 DOI: 10.1186/s12909-023-04063-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In Turkey, most final-year medical students prepare for the Examination for Specialty in Medicine in a high-stress environment. To the best of our knowledge, this is the first study on final-year medical student general psychological distress during preparation for the Examination for Specialty in Turkey. We aim to evaluate psychological distress and understand the variables associated with depression, anxiety, and stress levels among final-year medical students preparing for the Examination for Specialty. METHODS A self-reporting, anonymous, cross-sectional survey with 21 items consisting of demographic variables, custom variables directed for this study, and the DASS-21 was utilized. Survey results were expounded based on univariate analysis and multivariate linear regression analysis. RESULTS Our study revealed four variables associated with impaired mental wellness among final-year medical students during preparation for the examination for Specialty: attendance to preparatory courses, duration of preparation, consideration of quitting studying, and psychiatric drug usage/ongoing psychotherapy. DISCUSSION Considering that physician mental wellness is one of the most crucial determinants of healthcare quality, impaired mental wellness among future physicians is an obstacle to a well-functioning healthcare system. Our study targets researchers and authorities, who should focus on medical student mental wellness, and medical students themselves.
Collapse
Affiliation(s)
- Mert Karabacak
- Department of Neurosurgery, Mount Sinai Health System, 1468 Madison Ave, New York, NY, 10029, USA
| | - Muberra Hakkoymaz
- Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Cerrahpasa, Istanbul, 34098, Turkey
| | - Berke Ukus
- Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Cerrahpasa, Istanbul, 34098, Turkey
| | - Ece Ozturk
- Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Cerrahpasa, Istanbul, 34098, Turkey
| | - Busra Kaya
- Faculty of Medicine, Altinbas University, Mahmutbey, Istanbul, 34217, Turkey
| | - Zeynep Ozcan
- Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Cerrahpasa, Istanbul, 34098, Turkey
| | - Burak Berksu Ozkara
- Department of Neuroradiology, MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA.
| |
Collapse
|
3
|
Willms J, McCauley B, Kerr L, Presto P, Arun A, Shah N, Irby K, Strawn M, Kopel J. Case report: Medical student types journals during ketamine infusions for suicidal ideation, treatment-resistant depression, post-traumatic stress disorder, and generalized anxiety disorder. Front Psychiatry 2022; 13:1020214. [PMID: 36620675 PMCID: PMC9811588 DOI: 10.3389/fpsyt.2022.1020214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
Suicide is the most common cause of death in male resident physicians and the second most common cause of death in resident physicians overall. Physicians also experience high rates of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and burnout. These conditions frequently develop during medical school, and threaten not only physicians but the patients they care for. A 30-year-old medical student presented to our clinic with a history of treatment-resistant depression (TRD), generalized anxiety disorder (GAD), PTSD, and 5 years of daily suicidal ideation. Previous treatments included therapy, lifestyle modifications, and various combinations of six antidepressants. These interventions had little effect on the patient's mental health. The patient was treated at our clinic with an 8-month regimen of IV ketamine infusions and ketamine-assisted psychotherapy (KAP). The patient achieved remission from suicidality and PTSD within 1 month; and TRD and GAD within 7 months. The patient's Patient Health Questionnaire (PHQ-9) score decreased from 25 (severe depression) to 1 (not depressed). These findings suggest that ketamine and KAP may represent effective interventions for mental health applications in healthcare professionals. The patient made the unique decision to attempt to type narrative journals during four of his ketamine infusions (doses ranged from 1.8 to 2.1 mg/kg/h IV). The patient successfully typed detailed journals throughout each 1-h ketamine infusion. To our knowledge, these journals represent the first independently typed, first-person, real-time narratives of ketamine-induced non ordinary states of consciousness. The transcripts of these journals may provide useful insights for clinicians, particularly in the context of KAP.
Collapse
Affiliation(s)
- Joshua Willms
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, United States
- Denovo Therapy, Lubbock, TX, United States
- Researchers for Change, Lubbock, TX, United States
| | | | | | - Peyton Presto
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Ankith Arun
- Researchers for Change, Lubbock, TX, United States
| | - Nazeen Shah
- Researchers for Change, Lubbock, TX, United States
| | - Kierra Irby
- Researchers for Change, Lubbock, TX, United States
| | - Megan Strawn
- Researchers for Change, Lubbock, TX, United States
| | - Jonathan Kopel
- Department of Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| |
Collapse
|
4
|
Verma H, Verma G, Kumar P. Depression, Anxiety, and Stress During Times of COVID-19: An Analysis of Youngsters Studying in Higher Education in India. THE REVIEW OF SOCIONETWORK STRATEGIES 2021; 15:471-488. [PMID: 35506052 PMCID: PMC8475890 DOI: 10.1007/s12626-021-00089-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/08/2021] [Indexed: 11/28/2022]
Abstract
This study addressed the critical problems of depression, anxiety, and stress, which are prevalent among students pursuing higher education. Specifically, this article aimed to study the level of psychological distress due to the COVID-19 pandemic experienced by young people studying in higher education institutions in India. The study also attempted to identify various coping strategies students adopted to overcome this difficult time. Following a descriptive research design, this study used surveys to collect primary data from 235 students in graduate and undergraduate programs in India. The DASS-21 scale was used to check the levels of depression, anxiety, and stress students experienced. Furthermore, a four-point COPE scale was used to identify coping strategies students adopted. The results showed that students experienced high levels of stress and anxiety during the ongoing COVID-19 pandemic. Although depression levels were not alarming, most students were worried about several aspects of their lives and careers. However, because the data were collected from a relatively small sample, the study is likely not generalisable. Furthermore, most of the data were collected online, which has its limitations. This research likely has significant implications for various stakeholders, such as students, parents, institutions, counsellors, and government and non-government bodies, because it may help them take appropriate actions. These research contributions are original and novel, because the COVID-19 pandemic has posed unprecedented challenges and inspired new solutions to the problems of students and society.
Collapse
Affiliation(s)
| | - Garima Verma
- School of Computing, DIT University, Dehradun, India
| | | |
Collapse
|
5
|
Anton NE, Rendina MA, Hennings JM, Stambro R, Stanton-Maxey KJ, Stefanidis D. Association of Medical Students' Stress and Coping Skills With Simulation Performance. Simul Healthc 2021; 16:327-333. [PMID: 33086369 DOI: 10.1097/sih.0000000000000511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Medical students are vulnerable to experience stress, as they are routinely confronted with stressors. Acute stress can reduce students' performance on examinations, and chronic stress can contribute to cognitive disorders. Conversely, stress coping skills can reduce trainees' anxiety. Thus, stress coping skills may help students manage stress effectively and better maintain clinical performance. The goal of this study was to assess the relationship between medical students' stress, workload, stress coping skills, performance-enhancing mental skills, and clinical performance during a simulated clinical scenario. METHODS During their surgery clerkship rotation, third-year medical students participated in a simulated scenario designed to assess their ability to care for an acutely ill surgical patient. Participants' physiological stress was assessed using heart rate (HR) monitors during the simulation, their perceived stress using the State-Trait Anxiety Inventory, and workload using the NASA-Task Load Index immediately after. Clinical performance was assessed using a global rating scale. Stress coping skills were also assessed. The relationship between performance, stress level, workload, and coping skills was examined. RESULTS Forty-one third-year medical students voluntarily participated in the study. Participants' clinical performance was negatively correlated with perceived stress and workload during the scenario (P < 0.05). A stepwise linear regression model revealed that higher HR was the main predictor of poorer clinical performance (P < 0.05). CONCLUSIONS In this study, medical students' HR was associated with poorer performance during a simulated clinical scenario. Adaptive stress coping skills may allow medical students to manage stressful situations and better maintain performance.
Collapse
Affiliation(s)
- Nicholas E Anton
- From the Department of Surgery (N.E.A., M.A.R., J.M.H., K.J.S.-M., D.S.), Indiana University School of Medicine; and Simulation Center at Fairbanks Hall (R.S.), Indiana University Health, Indianapolis, IN
| | | | | | | | | | | |
Collapse
|
6
|
Yusoff MSB. Comparison between Personality, Emotional, and Educational Outcomes of Multiple Mini Interviews and Personal Interview. Oman Med J 2020; 35:e199. [PMID: 33214913 PMCID: PMC7667524 DOI: 10.5001/omj.2020.90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 05/07/2020] [Indexed: 12/30/2022] Open
Abstract
Objectives This study investigated the outcomes of multiple mini interviews and personal interview on personality traits, emotional intelligence, perceived educational environment, and stressors. Methods This is a comparative cross-sectional study on two cohorts of pre-clinical medical students who were selected by multiple mini interviews and personal interview, respectively. Their personality traits, emotional intelligence, perceived educational environment, and perceived stressors were measured using different measurement tools. Results Multiple mini interviews and personal interview demonstrated a similar ability to recruit medical students with a high level of emotional intelligence. The main advantage of personal interviews over multiple mini interviews in terms of personality traits is that it recruited candidates who had a higher level of conscientiousness trait. The main advantage of multiple mini interviews over personal interview on the educational environment is that medical students chosen by multiple mini interviews had a higher level of satisfaction with social aspects of medical training. Regardless of admission processes, the medical students were equally vulnerable to psychological distress due to various stressful events throughout medical training particularly related to academic loads. Conclusions This study provided evidence to support the outcomes that multiple mini interviews and personal interview have on medical students’ emotional intelligence, personality traits, perceived educational environment, and perceived stressors during the pre-clinical medical training. Interestingly, personal interview had a better outcome on conscientiousness while multiple mini interviews had a better outcome on the social aspect.
Collapse
|
7
|
Johnson AK, Blackstone SR, Skelly A, Simmons W. The Relationship Between Depression, Anxiety, and Burnout Among Physician Assistant Students: A Multi-Institutional Study. HEALTH PROFESSIONS EDUCATION 2020. [DOI: 10.1016/j.hpe.2020.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
8
|
Abstract
In the last decade, mental health issues have come to the foreground in academia. Literature surrounding student mental health continues to grow as universities try to implement wellness services and study the mental health of their students. Studies vary greatly in terms of measurement tools, timeframe, sample demographics, as well as the chosen threshold of symptom severity for diagnosis. This review attempts to summarize, contextualize and synthesize papers that pertain to the challenges faced by academic trainees at the undergraduate, graduate and post-graduate level. The evidence for, and against, the common claim of increasing prevalence of mental health issues among students in recent years is discussed. While some studies support this claim, it is difficult to reach a definitive conclusion due to numerous confounding factors such as increased help-seeking behaviour, greater awareness of mental health issues and weak methodology. The prevalence of depression, anxiety, suicidal and self-injurious behaviour, distress and general mental illness diagnoses are discussed. Other issues known to influence mental health, such as sexual assault and bullying, are briefly addressed. Finally, select studies on a few wellness strategies that may improve mental health of trainees, such as mindfulness, are summarised, along with diverse recommendations for individual students, universities, and academia as a whole.
Collapse
Affiliation(s)
- Renee Eleftheriades
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Clare Fiala
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Maria D. Pasic
- Laboratory Medicine and Pathobiology, St. Joseph’s Health Centre, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
9
|
Esan O, Esan A, Folasire A, Oluwajulugbe P. Mental health and wellbeing of medical students in Nigeria: a systematic review. Int Rev Psychiatry 2019; 31:661-672. [PMID: 31646912 DOI: 10.1080/09540261.2019.1677220] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
Abstract
In addition to the stresses common to medical school training, medical students in Nigeria face additional peculiar contemporary social problems due to income inequality, poverty, insecurity and political instability. These have a direct impact on their mental health and wellbeing. The aim of this study was to systematically review articles reporting on the epidemiology of psychiatric disorders among medical students in Nigeria. Studies were identified using MEDLINE, HINARI, African Journal Online (AJOL) and Google Scholar databases using search terms encompassing psychiatric morbidity amongst medical students. No date restrictions were applied to the search. The pooled prevalence estimate was calculated for each disorder. Psychological distress was present in 25.2% of the students, perceived stress in 60.5%, depression in 33.5% and anxiety in 28.8%. The current use of at least one psychoactive substance was present in up to 44.2%, while 35.5% of all the respondents had experienced one or more forms of abuse during their training as medical students. The prevalence of psychiatric disorders among medical students in Nigeria is high. Positive coping mechanisms such as religiosity, positive reframing and resilience which were identified in this review should be optimized to reduce the burden.
Collapse
Affiliation(s)
- Oluyomi Esan
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Arinola Esan
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Ayorinde Folasire
- Department of Radiation Oncology, University of Ibadan, Ibadan, Nigeria
| | | |
Collapse
|
10
|
Yusoff MS. The outcomes that an interview-based medical school admission process has on academic performance, psychological health, personality traits, and emotional intelligence. J Taibah Univ Med Sci 2019; 13:503-511. [PMID: 31435370 PMCID: PMC6694888 DOI: 10.1016/j.jtumed.2018.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/11/2018] [Accepted: 09/17/2018] [Indexed: 12/30/2022] Open
Abstract
Objectives This study investigated the outcomes that an interview-based medical school admission process has on academic performance, psychological health, personality traits, and emotional intelligence. Methods A comparative cross-sectional study was conducted on the interviewed and non-interviewed cohorts. Their examination marks were obtained from the academic office, psychological health was measured by DASS-21, personality traits were measured by USMaP-15, and emotional intelligence was measured by USMEQ-17. Results The interviewed cohort performed significantly better in the clinical examination than the non-interviewed cohort. Conversely, the non-interviewed cohort performed significantly better in the theoretical examination. Depression, anxiety, and stress level between the two cohorts showed no difference. The interviewed cohort demonstrated more desirable personality traits, higher emotional intelligence, and social competence than the non-interviewed cohort. Discussion This study provides evidence to support the claim that the interview-based admission process has favourable outcomes on clinical performance, emotional intelligence, and personality traits. Several insights gained as a result of this study are discussed.
Collapse
Affiliation(s)
- Muhamad S.B. Yusoff
- Corresponding address: Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia.
| |
Collapse
|
11
|
Malpass A, Binnie K, Robson L. Medical Students' Experience of Mindfulness Training in the UK: Well-Being, Coping Reserve, and Professional Development. EDUCATION RESEARCH INTERNATIONAL 2019; 2019:10.1155/2019/4021729. [PMID: 31168420 PMCID: PMC6546595 DOI: 10.1155/2019/4021729] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Medical school can be a stressful experience for students, resulting in stress-related mental health problems. Policy recommendations from the General Medical Council (GMC), the body responsible for improving medical education in the UK, recommend the use of mindfulness training to increase well-being and resilience to stress. Students participating in an eight-week mindfulness training between Autumn 2011 and Spring 2015 were invited to complete a free text survey at the end of their mindfulness course. In addition, six qualitative interviews were conducted lasting between 60 and 90 minutes. Interviews used a topic guide and were recorded and transcribed verbatim. We used the framework approach to analyse the data. Students reported a new relationship to their thoughts and feelings which gave a greater sense of control and resiliency, an ability to manage their workload better, and more acceptance of their limitations as learners. The small group context was important. Students described improved empathy and communication skills through building inner awareness of thoughts and feelings, noticing judgments, and developing attentive observation. The findings show how resiliency and coping reserve can be developed within medical education and the role of mindfulness in this process. We present a conceptual model of a learnt cycle of specific vulnerability and describe how MBCT intercepts at various junctures in this self-reinforcing cycle through the development of new coping strategies that embrace an "allowed vulnerability."
Collapse
Affiliation(s)
- Alice Malpass
- Centre for Academic Primary Care (CAPC), Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall 39 Whatley Road, Bristol BS8 2PS, UK
| | - Kate Binnie
- Centre for Academic Primary Care (CAPC), Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall 39 Whatley Road, Bristol BS8 2PS, UK
| | | |
Collapse
|
12
|
Dyrbye LN, Wittlin NM, Hardeman RR, Yeazel M, Herrin J, Dovidio JF, Burke SE, Cunningham B, Phelan SM, Shanafelt TD, van Ryn M. A Prognostic Index to Identify the Risk of Developing Depression Symptoms Among U.S. Medical Students Derived From a National, Four-Year Longitudinal Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:217-226. [PMID: 30188367 DOI: 10.1097/acm.0000000000002437] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE To determine baseline individual and school-related factors associated with increased risk of developing depression symptoms by year four (Y4) of medical school, and to develop a prognostic index that stratifies risk of developing depression symptoms (Depression-PI) among medical students. METHOD The authors analyzed data from 3,743 students (79% of 4,732) attending 49 U.S. medical schools who completed baseline (2010) and Y4 (2014) surveys. Surveys included validated scales measuring depression, stress, coping, and social support. The authors collected demographics and school characteristics and conducted multivariate analysis to identify baseline factors independently associated with Y4 depression symptoms. They used these factors to create a prognostic index for developing depression. They randomly divided the data into discovery (n = 2,455) and replication (n = 1,288) datasets and calculated c statistics (c). RESULTS The authors identified eight independent prognostic factors for experiencing depression symptoms during training within the discovery dataset: age; race; ethnicity; tuition; and baseline depression symptoms, stress, coping behaviors, and social support. The Depression-PI stratified four risk groups. Compared with the low risk group, those in the intermediate, high, and very high risk groups had an odds ratio of developing depression of, respectively, 1.75, 3.98, and 9.19 (c = 0.71). The replication dataset confirmed the risk groups. CONCLUSIONS Demographics; tuition; and baseline depression symptoms, stress, coping behaviors, and social support are independently associated with risk of developing depression during training among U.S. medical students. By stratifying students into four risk groups, the Depression-PI may allow for a tiered primary prevention approach.
Collapse
Affiliation(s)
- Liselotte N Dyrbye
- L.N. Dyrbye is professor of medicine and medical education, Program on Physician Well-Being, Department of Medicine, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0002-7820-704X. N.M. Wittlin is PhD student, Department of Psychology, Yale University, New Haven, Connecticut; ORCID: https://orcid.org/0000-0002-0858-3576. R.R. Hardeman is assistant professor, Division of Health Policy and Management, University of Minnesota, School of Public Health, Minneapolis, Minnesota; ORCID: https://orcid.org/0000-0003-3913-5933. M. Yeazel is associate professor, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota. J. Herrin is assistant professor of medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut; ORCID: https://orcid.org/0000-0002-3671-3622. J.F. Dovidio is Carl Iver Hovland Professor of Psychology and professor of public health, Department of Psychology, Yale University, New Haven, Connecticut; ORCID: https://orcid.org/0000-0002-6110-8344. S.E. Burke is assistant professor, Department of Psychology, Syracuse University, Syracuse, New York; ORCID: https://orcid.org/0000-0002-6952-924X. B. Cunningham is assistant professor of health disparities, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota; ORCID: https://orcid.org/0000-0002-3205-5538. S.M. Phelan is associate professor of health services research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-2091-6297. T.D. Shanafelt is Jeanie and Stewart Ritchie Professor of Medicine and associate dean, Stanford School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0002-7106-5202. M. van Ryn is Grace Phelps Distinguished Professor, Oregon Health & Science University School of Nursing, Portland, Oregon; ORCID: https://orcid.org/0000-0002-4258-7319
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Ayala EE, Winseman JS, Johnsen RD, Mason HRC. U.S. medical students who engage in self-care report less stress and higher quality of life. BMC MEDICAL EDUCATION 2018; 18:189. [PMID: 30081886 PMCID: PMC6080382 DOI: 10.1186/s12909-018-1296-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 07/25/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Research on student wellness has highlighted the importance of self-care for medical students; however, scholars have yet to identify the extent to which self-reported engagement in self-care behaviors is associated with attenuation of the negative relationship between stress and quality of life during the initial years of medical education. METHODS Using a self-report survey designed to measure self-care, perceived stress, and quality of life, we hypothesized that self-care would moderate the relationship between stress and psychological quality of life in medical students, as well as stress and physical quality of life. An online questionnaire was completed by 871 medical students representing 49 allopathic medical colleges throughout the U.S. between December 2015 and March 2016. The survey assessed perceived stress, self-care, quality of life and a variety of demographic variables. Regression analyses were used to assess interaction effects of self-care on the relationships between stress and quality of life. RESULTS Self-reported engagement in self-care appeared to moderate the relationships between perceived stress and both physical (p < .001) and psychological (p = .002) quality of life. As the level of reported engagement in self-care increased, the strength of the inverse relationship between perceived stress and both physical and psychological quality of life appeared to weaken. CONCLUSIONS Our findings suggest that self-reported engagement in self-care activities is associated with a decrease in the strength of the relationship between perceived stress and quality of life in medical students. Students who disclose utilizing a multitude of self-care practices throughout their training may also sustain greater resiliency and lower risk for higher levels of distress during medical education.
Collapse
Affiliation(s)
- Erin E. Ayala
- Department of Counseling Psychology, Saint Mary’s University of Minnesota, 2500 Park Avenue, Minneapolis, MN 55404 USA
| | - Jeffrey S. Winseman
- Department of Psychiatry, Albany Medical College, 25 Hackett Blvd, Albany, NY 12208 USA
| | - Ryan D. Johnsen
- Department of Emergency Medicine, HealthPartners Institute Regions Hospital, 640 Jackson Avenue, Saint Paul, MN 55101 USA
| | - Hyacinth R. C. Mason
- Departments of Medical Education and Family and Community Medicine, Albany Medical College, 47 New Scotland Avenue, 12208 Albany, NY, USA
| |
Collapse
|
14
|
Alveano-Hernández J, Carrillo-Santoyo L, Cortés-Fernández AA. [Morbility in applicants to the career of medicine according to sex]. SALUD PUBLICA DE MEXICO 2018; 59:603-604. [PMID: 29451624 DOI: 10.21149/8546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Señor editor: Con la presente enviamos algunos resultados de un censo sobre prevalencia de causas de enfermedad, realizado en la totalidad de aspirantes a la carrera de medicina de una universidad del interior de México. Las causas fueron detectadas mediante examen médico, antropometría e inventario multifásico de Minnessota (MMPI, por sus siglas en inglés), tras un proceso de selección llevado a cabo en junio de 2016...
Collapse
|
15
|
Kang Y, Kim C, Lee S, Youn S. Insomnia and Parental Overprotection are Associated with Academic Stress among Medical Students. SLEEP MEDICINE RESEARCH 2017. [DOI: 10.17241/smr.2017.00066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
16
|
Silva V, Costa P, Pereira I, Faria R, Salgueira AP, Costa MJ, Sousa N, Cerqueira JJ, Morgado P. Depression in medical students: insights from a longitudinal study. BMC MEDICAL EDUCATION 2017; 17:184. [PMID: 29017594 PMCID: PMC5633876 DOI: 10.1186/s12909-017-1006-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 09/05/2017] [Indexed: 05/24/2023]
Abstract
BACKGROUND Factors associated with depression of medical students are poorly understood. The purpose of this study is to determine the prevalence of depression in medical students, its change during the course, if depression persists for affected students, what are the factors associated with depression and how these factors change over time. METHODS A prospective, longitudinal observational study was conducted at the Medical School of the University of Minho, Portugal, between academic years 2009-2010 to 2012-2013. We included students who maintained their participation by annually completing a questionnaire including Beck Depression Inventory (BDI). Anxiety and burnout were assessed using the State Trait Anxiety Inventory and Maslach Burnout Inventory. Surveys on socio-demographic variables were applied to evaluate potential predictors, personal and academic characteristics and perceived difficulties. ANOVA with multiple comparisons were used to compare means of BDI score. The medical students were organized into subgroups by K-means cluster analyses. ANOVA mixed-design repeated measurement was performed to assess a possible interaction between variables associated with depression. RESULTS The response rate was 84, 92, 88 and 81% for academic years 2009-2010, 2010-2011,2011-2012 and 2012/2013, respectively. Two hundred thirty-eight medical students were evaluated longitudinally. For depression the prevalence ranged from 21.5 to 12.7% (academic years 2009/2010 and 2012/2013). BDI scores decreased during medical school. 19.7% of students recorded sustained high BDI over time. These students had high levels of trait-anxiety and choose medicine for anticipated income and prestige, reported more relationship issues, cynicism, and decreased satisfaction with social activities. Students with high BDI scores at initial evaluation with low levels of trait-anxiety and a primary interest in medicine as a career tended to improve their mood and reported reduced burnout, low perceived learning problems and increased satisfaction with social activities at last evaluation. No difference was detected between men and women in the median BDI score over time. CONCLUSIONS Our findings suggest that personal factors (anxiety traits, medicine choice factors, relationship patterns and academic burnout) are relevant for persistence of high levels of BDI during medical training. Medical schools need to identity students who experience depression and support then, as early as possible, particularly when depression has been present over time.
Collapse
Affiliation(s)
- Vanessa Silva
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Inês Pereira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Ricardo Faria
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Ana P. Salgueira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Manuel J. Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - João J. Cerqueira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| |
Collapse
|
17
|
Basudan S, Binanzan N, Alhassan A. Depression, anxiety and stress in dental students. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2017; 8:179-186. [PMID: 28553831 PMCID: PMC5457790 DOI: 10.5116/ijme.5910.b961] [Citation(s) in RCA: 139] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 05/08/2017] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To measure the occurrence and levels of depression, anxiety and stress in undergraduate dental students using the Depression, Anxiety and Stress Scale (DASS-21). METHODS This cross-sectional study was conducted in November and December of 2014. A total of 289 dental students were invited to participate, and 277 responded, resulting in a response rate of 96%. The final sample included 247 participants. Eligible participants were surveyed via a self-reported questionnaire that included the validated DASS-21 scale as the assessment tool and questions about demographic characteristics and methods for managing stress. RESULTS Abnormal levels of depression, anxiety and stress were identified in 55.9%, 66.8% and 54.7% of the study participants, respectively. A multiple linear regression analysis revealed multiple predictors: gender (for anxiety b=-3.589, p=.016 and stress b=-4.099, p=.008), satisfaction with faculty relationships (for depression b=-2.318, p=.007; anxiety b=-2.213, p=.004; and stress b=-2.854, p<.001), satisfaction with peer relationships (for depression b=-3.527, p<.001; anxiety b=-2.213, p=.004; and stress b=-2.854, p<.001), and dentistry as the first choice for field of study (for stress b=-2.648, p=.045). The standardized coefficients demonstrated the relationship and strength of the predictors for each subscale. To cope with stress, students engaged in various activities such as reading, watching television and seeking emotional support from others. CONCLUSIONS The high occurrence of depression, anxiety and stress among dental students highlights the importance of providing support programs and implementing preventive measures to help students, particularly those who are most susceptible to higher levels of these psychological conditions.
Collapse
Affiliation(s)
- Sumaya Basudan
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Saudi Arabia
| | - Najla Binanzan
- Endodontic Postgraduate Program at the College of Dentistry, King Saud University, Saudi Arabia
| | | |
Collapse
|
18
|
Killinger SL, Flanagan S, Castine E, Howard KAS. Stress and Depression among Veterinary Medical Students. JOURNAL OF VETERINARY MEDICAL EDUCATION 2017; 44:3-8. [PMID: 28206849 DOI: 10.3138/jvme.0116-018r1] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
While existing literature suggests that professional students (e.g., medical, dental, law, nursing, etc.) experience high levels of stress and depression, the experiences of veterinary medical students have been less well examined. The purpose of this study was to explore the levels of stress and depression among veterinary medical students and to examine the relationship between these variables. Study participants were 1,245 veterinary medical students from North America. The findings provide support for the assertion that veterinary medical students experience high levels of stress and depression. Results also indicated that there is a correlation between stress and depression for veterinary medical students and that female students experience higher levels of stress and depression than their male counterparts.
Collapse
|
19
|
Brenneisen Mayer F, Souza Santos I, Silveira PSP, Itaqui Lopes MH, de Souza ARND, Campos EP, de Abreu BAL, Hoffman II I, Magalhães CR, Lima MCP, Almeida R, Spinardi M, Tempski P. Factors associated to depression and anxiety in medical students: a multicenter study. BMC MEDICAL EDUCATION 2016; 16:282. [PMID: 27784316 PMCID: PMC5080800 DOI: 10.1186/s12909-016-0791-1] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 10/06/2016] [Indexed: 05/04/2023]
Abstract
BACKGROUND To evaluate personal and institutional factors related to depression and anxiety prevalence of students from 22 Brazilian medical schools. METHODS The authors performed a multicenter study (August 2011 to August 2012), examining personal factors (age, sex, housing, tuition scholarship) and institutional factors (year of the medical training, school legal status, location and support service) in association with scores of Beck Depression Inventory (BDI) and State Trait Anxiety Inventory (STAI). RESULTS Of 1,650 randomly selected students, 1,350 (81.8 %) completed the study. The depressive symptoms prevalence was 41 % (BDI > 9), state-anxiety 81.7 % and trait-anxiety in 85.6 % (STAI > 33). There was a positive relationship between levels of state (r = 0,591, p < 0.001) and trait (r = 0,718, p < 0.001) anxiety and depression scores. All three symptoms were positively associated with female sex and students from medical schools located in capital cities of both sexes. Tuition scholarship students had higher state-anxiety but not trait-anxiety or depression scores. Medical students with higher levels of depression and anxiety symptoms disagree more than their peers with the statements "I have adequate access to psychological support" and "There is a good support system for students who get stressed". CONCLUSIONS The factors associated with the increase of medical students' depression and anxiety symptoms were female sex, school location and tuition scholarship. It is interesting that tuition scholarship students showed state-anxiety, but not depression and trait-anxiety symptoms.
Collapse
Affiliation(s)
- Fernanda Brenneisen Mayer
- Center of Development of Medical Education, School of Medicine of Univrsity of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
| | - Itamar Souza Santos
- Center of Development of Medical Education, School of Medicine of Univrsity of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
| | - Paulo S. P. Silveira
- Department of Pathology, School of Medicine of University of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
| | - Maria Helena Itaqui Lopes
- University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130, 95070-560 Caxias do Sul, Rio Grande do Sul Brazil
| | - Alicia Regina Navarro Dias de Souza
- Psychiatry and Legal Medicine Department, School of Medicine of the Federal University of Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco 255, 9° andar, sala 9E28, Rio de Janeiro, 21941-590 RJ Brazil
| | - Eugenio Paes Campos
- University Center of Serra dos Órgãos, Av. Alberto Torres, 111, 25964-000 Rio de Janeiro, RJ Brazil
| | | | - Itágores Hoffman II
- School of Medicine of Tocatins, Avenida NS 15, 109, sala 18, 77020-210 Palmas, TO Brazil
| | - Cleidilene Ramos Magalhães
- Department of Education and Humanities, Federal University of Health Sciences of Porto Alegre , Rua Sarmento Leite, 245, sala 412, 90050-170 Porto Alegre, RS Brazil
| | - Maria Cristina P. Lima
- Neurology and Psychiatry Department, School of Medicine of São Paulo State University, Rua Rubião Júnior, caixa-postal: 540, 18618-000 Botucatu, SP Brazil
| | - Raitany Almeida
- School of Medicine of Federal University of Rondônia , BR 364 km 9,5, 78900-000 Porto Velho, RO Brazil
| | - Mateus Spinardi
- Marília Medical School, Av. Monte Carmelo, 800, sala 17, 17519-030 São Paulo, Brazil
| | - Patricia Tempski
- Center of Development of Medical Education, School of Medicine of Univrsity of São Paulo, Av. Dr. Arnaldo, 455, Sala 2349, 01246-903 São Paulo, SP Brazil
- Center of Development of Medical Education, Avenida Dr Arnaldo, 455, 1 andar, sala 1210, 01246903 São Paulo, Brazil
| |
Collapse
|
20
|
Tartas M, Walkiewicz M, Budziński W, Majkowicz M, Wójcikiewicz K, Zdun-Ryżewska A. The coping strategies during medical education predict style of success in medical career: a 10-year longitudinal study. BMC MEDICAL EDUCATION 2016; 16:186. [PMID: 27444777 PMCID: PMC4957329 DOI: 10.1186/s12909-016-0706-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 07/08/2016] [Indexed: 05/26/2023]
Abstract
BACKGROUND The stress associated with the physician's work is generally acknowledged and is related to well-being and life satisfaction. The presented study was designed to extract the role of coping strategies in identifying differentiated styles of success in a medical career during medical education. METHODS The participants were examined when they applied to medical school and each subsequent academic year. The final study took place four years after graduation. The baseline questionnaire measured coping strategies. The follow-up questionnaire consisted of measures of: quality of life, work stress and burnout, satisfaction with medicine as a career, and professional competency. RESULTS Based on coping strategies assessed during admission and preclinical years of medical study, some aspects of success in the participants' future medical career can be predicted. Students who take action and deal directly with a problem, neither accept resignation, nor reduce tension by expressing feelings would most probably resist future burnout. However, despite the fact that they obtain the highest quality of life or earn the highest income they would be, at the same time, the least satisfied with chosen career, as well as being more likely to be characterised by a low level of competence. CONCLUSIONS Assessment of coping strategies at the beginning of medical education could be taken into consideration as an instrument to diagnose a specific trend in physicians' career development.
Collapse
Affiliation(s)
- Małgorzata Tartas
- />Faculty of Psychology, Medical University of Gdańsk, Tuwima 15 Street, 80-210 Gdańsk, Poland
| | - Maciej Walkiewicz
- />Faculty of Psychology, Medical University of Gdańsk, Tuwima 15 Street, 80-210 Gdańsk, Poland
| | - Waldemar Budziński
- />Faculty of Psychology, Medical University of Gdańsk, Tuwima 15 Street, 80-210 Gdańsk, Poland
| | - Mikołaj Majkowicz
- />Faculty of Psychology, Medical University of Gdańsk, Tuwima 15 Street, 80-210 Gdańsk, Poland
| | | | - Agata Zdun-Ryżewska
- />Faculty of Psychology, Medical University of Gdańsk, Tuwima 15 Street, 80-210 Gdańsk, Poland
| |
Collapse
|
21
|
Ptacek JT, Smith RE, Dodge KL. Gender Differences in Coping with Stress: When Stressor and Appraisals Do Not Differ. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2016. [DOI: 10.1177/0146167294204009] [Citation(s) in RCA: 275] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In an attempt to control for the effects of event type on sex differences in coping, men and women responded to an identical achievement-related stressor under controlled laboratory conditions. Although men and women were similar in their cognitive appraisal of the situation, they nonetheless reported differences in preparatory coping. Women reported seeking social support and using emotion-focused coping to a greater extent than men, whereas men reported using relatively more problem-focused coping than women. The masculinity and femininity of respondents failed to moderate the relation between sex and coping. These results are inconsistent with a purely situational explanation of sex differences in coping but are consistent with the notion that men and women are socialized to cope with stress in different ways.
Collapse
|
22
|
Kressin NR. The Effect of Medical Socialization on Medical Students' Need for Power. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2016. [DOI: 10.1177/0146167296221009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although power-seeking and controlling behaviors on the part of physicians have been well documented, the source of these behaviors on the individual psychological level has not yet been identified. This study examined whether the individual personality characteristic of power motivation, one indicator of desires for power and control, increases during medical school and whether this process varies by race or sex. Transcripts of interviews with a diverse group of medical students at two time points were coded for power motivation. The results showed that White students' power motivation decreased, whereas minority students' levels remained the same, suggesting race-linked differences in the medical socialization experience.
Collapse
|
23
|
Ptacek JT, Dodge KL. Coping Strategies and Relationship Satisfaction in Couples. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2016. [DOI: 10.1177/0146167295211008] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The present study examined the association between relationship satisfaction and dispositional coping in 70 dating and married couples. Couple members completed Spanier's Dyadic Adjustment Scale and provided information about their own coping as well as their perceptions of their partners' coping. Three important findings emerged from the correlational analyses. First, relationship satisfaction related to both self-reported coping and report-of-other coping (reports made by one member about the other member's coping). Regarding the latter, the strongest associations were between married females' report-of-other and their partners' satisfaction with the relationship. Second, there was limited support for the notion that the more similarly couple members cope the more satisfied they will be with the relationship. Third, the more similarly couple members believed they coped, the more satisfied each member was with the relationship, regardless of whether the coping dimension was adaptive or not.
Collapse
|
24
|
Moir F, Henning M, Hassed C, Moyes SA, Elley CR. A Peer-Support and Mindfulness Program to Improve the Mental Health of Medical Students. TEACHING AND LEARNING IN MEDICINE 2016; 28:293-302. [PMID: 27092397 DOI: 10.1080/10401334.2016.1153475] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
PROBLEM There is evidence that peer-support programs can improve mental health indices and help-seeking behavior among students in some secondary school and university settings and that mindfulness can improve mental health in medical students. Peer-led programs have not been formally assessed in a medical student population, where psychological issues exist and where it has been shown that students approach peers for help in preference to staff members or professional services. INTERVENTION Medical students elected peer leaders who underwent training and then provided the intervention. The peer leaders provided support to students in the intervention group, as well as offering teaching in mindfulness meditation. CONTEXT An exploratory study was conducted with 2nd- and 3rd-year medical students at 1 medical school in New Zealand randomized into 2 groups. In addition to existing mental health resources, intervention participants received a program including peer support and peer-taught mindfulness practice. Study participants not offered the intervention participants could use existing mental health resources. Primary measures included depression (PHQ-9) and anxiety (GAD-7) scores. Secondary measures were quality of life, resilience (15-item resilience scale), academic self-concept, and motivation to learn, assessed at baseline and 6 months. OUTCOME Of the 402 students eligible, 275 (68%) participated and 232 (58%) completed the study. At baseline, 53% were female and mean age was 21 years (SD = 3)-PHQ-9 score (M = 5.2, SD = 3.7) and GAD-7 score (M = 4.5, SD = 3.4). Twelve peer leaders were elected. There was good participation in the intervention. One fourth of intervention students used the face-to-face peer support and more than 50% attended a peer social event and/or participated in the mindfulness program. Although improvements in mental health were seen in the intervention group, the difference between the intervention and nonintervention groups did not reach statistical significance. LESSONS LEARNED Although evidence exists for effectiveness of peer support and mindfulness in other contexts, this exploratory study was not able to show a statistically significant effect. Future studies could consider using a longer training period for the peer leaders, as well as targeting the study population to those most likely to benefit such as those with poorer mental health, or using a more intensive intervention or larger sample size. A cluster randomized study design would also reduce the risk of contamination.
Collapse
Affiliation(s)
- Fiona Moir
- a Department of General Practice and Primary Health Care , University of Auckland , Auckland , New Zealand
| | - Marcus Henning
- b Centre for Medical and Health Sciences Education , University of Auckland , Auckland , New Zealand
| | - Craig Hassed
- c Department of General Practice , Monash University , Melbourne , Australia
| | - Simon A Moyes
- a Department of General Practice and Primary Health Care , University of Auckland , Auckland , New Zealand
| | - C Raina Elley
- a Department of General Practice and Primary Health Care , University of Auckland , Auckland , New Zealand
| |
Collapse
|
25
|
|
26
|
Zhang N, Rabatsky A. Effects of test stress during an objective structured clinical examination. THE JOURNAL OF CHIROPRACTIC EDUCATION 2015; 29:139-144. [PMID: 25806413 PMCID: PMC4582612 DOI: 10.7899/jce-14-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 11/05/2014] [Accepted: 01/25/2015] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The existence of test stress has been widely reported among professional students. To our knowledge, no studies exist that explore student stress response to objective structured clinical examinations. The aim of this study was to evaluate possible correlations between stress and objective structured clinical examination performance in a sample of chiropractic students. METHODS A total of 116 students completed a 2-part questionnaire to assess test stress and the physiological symptoms and signs of stress. Heart rate, systolic blood pressure, and diastolic were measured during the physical examination laboratory class within the first 3 weeks and then again just prior to their objective structured clinical examination in week 5. Statistical tests were then performed for questionnaire data, heart rate and blood pressure differences, and correlation between the objective structured clinical examination grade and symptoms and signs. RESULTS Questionnaire results showed that 5.1%-22.4% of students sometimes or often felt a certain degree of stress. More than 50% had 1 or more physiological symptoms and signs of stress. The objective structured clinical examination heart rate (75.23 ± 11.20 vs 68.16 ± 8.82, p < .001), systolic blood pressure (120.43 ± 9.59 vs 114.97 ± 11.83, p < .001), and diastolic blood pressure (73.00 ± 7.93 vs 69.32 ± 7.76, p < .001) were significantly higher than baseline. There were also negative linear correlations between objective structured clinical examination grades and physiological symptoms and signs and between objective structured clinical examination grades and feeling statement score. CONCLUSION The results support our hypothesis that chiropractic students experience stress when performing the objective structured clinical examination and that high levels of stress had a negative impact on performance.
Collapse
|
27
|
Slade AN, Kies SM. The relationship between academic performance and recreation use among first-year medical students. MEDICAL EDUCATION ONLINE 2015; 20:25105. [PMID: 25819693 PMCID: PMC4376935 DOI: 10.3402/meo.v20.25105] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 01/28/2015] [Accepted: 01/30/2015] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Self-care activities, including exercise, may be neglected by medical students in response to increasing academic demands. Low levels of exercise among medical students may have ripple effects on patient care and counseling. This study investigates the reciprocal role of recreation use and academic performance among first-year medical students. METHODS We combined retrospective administrative data from four cohorts of first-year medical students at the University of Illinois at Urbana-Champaign from 2006 to 2010 (n=408). We estimated regression models to clarify the role of changes in recreation use before examinations on changes in academic performance, and vice versa. RESULTS The use of recreation facilities by first-year medical students was highly skewed. We found that changes in recreation use before an exam were positively associated with changes in exam performance, and vice versa. Students who make large decreases in their recreation use are likely to decrease their exam scores, rather than increase them. DISCUSSION Students who make decreases in their recreation, on average, are likely to decrease their exam scores. These findings suggest that medical students may be able to boost their achievement through wellness interventions, even if they are struggling with exams. We find no evidence that decreasing wellness activities will help improve exam performance.
Collapse
Affiliation(s)
- Alexander N Slade
- Department of Pathology, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA;
| | - Susan M Kies
- Department of Pathology, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| |
Collapse
|
28
|
Slavin SJ, Schindler DL, Chibnall JT. Medical student mental health 3.0: improving student wellness through curricular changes. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2014; 89:573-7. [PMID: 24556765 PMCID: PMC4885556 DOI: 10.1097/acm.0000000000000166] [Citation(s) in RCA: 237] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Medical education can have significant negative effects on the well-being of medical students. To date, efforts to improve student mental health have focused largely on improving access to mental health providers, reducing the stigma and other barriers to mental health treatment, and implementing ancillary wellness programs. Still, new and innovative models that build on these efforts by directly addressing the root causes of stress that lie within the curriculum itself are needed to properly promote student wellness. In this article, the authors present a new paradigm for improving medical student mental health, by describing an integrated, multifaceted, preclinical curricular change program implemented through the Office of Curricular Affairs at the Saint Louis University School of Medicine starting in the 2009-2010 academic year. The authors found that significant but efficient changes to course content, contact hours, scheduling, grading, electives, learning communities, and required resilience/mindfulness experiences were associated with significantly lower levels of depression symptoms, anxiety symptoms, and stress, and significantly higher levels of community cohesion, in medical students who participated in the expanded wellness program compared with those who preceded its implementation. The authors discuss the utility and relevance of such curricular changes as an overlooked component of change models for improving medical student mental health.
Collapse
Affiliation(s)
- Stuart J Slavin
- Dr. Slavin is associate dean for curriculum, Office of Curricular Affairs, and professor, Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri. Dr. Schindler is senior education specialist, Office of Curricular Affairs, Saint Louis University School of Medicine, St. Louis, Missouri. Dr. Chibnall is professor, Department of Neurology and Psychiatry, Saint Louis University School of Medicine, St. Louis, Missouri
| | | | | |
Collapse
|
29
|
Soliman M. Perception of stress and coping strategies by medical students at King Saud University, Riyadh, Saudi Arabia. J Taibah Univ Med Sci 2014. [DOI: 10.1016/j.jtumed.2013.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
30
|
Jamali A, Tofangchiha S, Jamali R, Nedjat S, Jan D, Narimani A, Montazeri A. Medical students' health-related quality of life: roles of social and behavioural factors. MEDICAL EDUCATION 2013; 47:1001-1012. [PMID: 24016170 DOI: 10.1111/medu.12247] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 10/19/2013] [Accepted: 03/28/2013] [Indexed: 05/28/2023]
Abstract
OBJECTIVES The long and demanding course of medical education may be accompanied by distress with serious consequences. This study was conducted to assess the multidimensional health-related quality of life (HR-QoL) in medical students in different stages of medical education and its associations with behavioural and social factors. METHODS A cross-sectional study was conducted in medical students at three medical schools at, respectively, Tehran University of Medical Sciences, Aja University of Medical Sciences and Baghiyatalah Medical School, in November and December 2011 using stratified sampling. Data were obtained on participants' characteristics, including gender, current education stage, living situation, smoking status, physical activity, and membership of associations or teams. Health-related QoL was measured using the Persian version of the 36-item Short Form Health Survey (SF-36), which generates a physical component score (PCS) and a mental component score (MCS). Logistic regression was applied to measure the adjusted associations between variables. RESULTS Of the 1350 students invited, 1086 individuals completed the survey to give a response rate of 80.4%. Logistic regression showed male gender (odds ratio [OR] = 2.88, p < 0.001), living with family versus in a dormitory (OR = 2.72, p < 0.001) and participation in daily physical activity (OR = 16.96, p < 0.001) to be significantly associated with a higher PCS. Being in an internship versus in the basic sciences stage of medical education showed a significant association with a lower PCS (OR = 0.12, p < 0.001). Similarly, male gender (OR = 1.67, p < 0.05), living with family rather than in a dormitory (OR = 16.91, p < 0.001), daily physical activity (OR = 25.36, p < 0.001), and membership of associations or teams (OR = 3.67, p < 0.001) were associated with a higher MCS. Likewise, studying in internship rather than in the basic sciences stage was accompanied by a lower MCS (OR = 0.12, p < 0.001). CONCLUSIONS This large, multi-institution study, despite its limitations, indicates that medical students in internships show lower scores in all domains of QoL. Social engagement is an important associate of higher HR-QoL. Further studies should address the efficacy of interventions, such as self-awareness programmes and initiatives to encourage students to be more physically and socially active, in improving students' health.
Collapse
Affiliation(s)
- Arsia Jamali
- Students' Scientific Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | | | | | | | | | | |
Collapse
|
31
|
Miller GD, Kemmelmeier M, Dupey P. Gender differences in worry during medical school. MEDICAL EDUCATION 2013; 47:932-41. [PMID: 23931542 DOI: 10.1111/medu.12236] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 03/22/2013] [Indexed: 05/24/2023]
Abstract
OBJECTIVES This research examined worry in medical students at various stages of training with reference to worries related to academic and clinical training, finances and relationships with peers. The study focused on gender differences in worries, testing the notion that being married or being in a long-term or cohabitating relationship with a partner would be linked to increased worry among women, but decreased worry among men. Additional goals included examining the relationship between worry and the seeking of counselling, and investigating the disadvantage for medical students associated with living with parents. METHODS Data collected serially on class cohorts at one western US medical school yielded 868 responses from medical students, which were analysed using general linear models, generalised linear models and generalised estimation equations. RESULTS Among four types of worry, academic and financial worries were similarly dominant (p < 0.001); financial worries were found to increase over the course of medical training (p < 0.001). Men reported more worry than women (p < 0.001). Gender differences were qualified by marital status (p = 0.007). Being married was linked to higher levels of academic and financial worry among women, whereas for men marriage was linked to lower academic, but higher financial worry (p < 0.001). Living with parents was always associated with a higher level of worry (p < 0.0001). Married male students were more likely to seek counselling than unmarried male students, whereas this pattern was reversed for female students (p = 0.002). CONCLUSIONS This study confirms that both academic and financial stress represent the greatest sources of worry in medical students. It also represents the first research to demonstrate higher levels of worry in male than female medical students, which may be evidence of women's increased representation in the medical school population. These data also support the persistence of traditional gender roles in the marriages of medical students; marriage is related to an increased psychological burden in women in comparison with men.
Collapse
Affiliation(s)
- Grant D Miller
- Department of Psychiatry and Behavioural Sciences, University of Nevada School of Medicine, Reno, Nevada 89503, USA.
| | | | | |
Collapse
|
32
|
Mental health of medical students before and during medical education: A prospective study. J Taibah Univ Med Sci 2013. [DOI: 10.1016/j.jtumed.2013.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
33
|
Prevalence and associated factors of stress, anxiety and depression among prospective medical students. Asian J Psychiatr 2013; 6:128-33. [PMID: 23466109 DOI: 10.1016/j.ajp.2012.09.012] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 09/11/2012] [Accepted: 09/15/2012] [Indexed: 11/21/2022]
Abstract
Many studies have reported that the prevalence of psychological distress among medical students during medical training was high. However, there are very few studies exploring on the psychological health of prospective medical students. This study aimed to determine the prevalence and associated factors for stress, anxiety and depression symptoms among the prospective medical students. A cross-sectional study was done on two cohorts of applicants to a public medical school. A total of 839 applicants were invited to participate in the study. The 21-item Depression Anxiety Stress Scale was administered to the applicants after they completed interviews. A total of 743 (92.2%) applicants took part in the study. The prevalence of moderate to extremely severe level of stress, anxiety and depression were 3.6%, 54.5% and 1.9%, respectively. Stress was significantly associated with extra-curricular activity (p<0.001) and race (p<0.001). Anxiety was associated with extra-curricular activity (p<0.001), race (p<0.001), mother education level (p=0.002) and CGPA group (p=0.034). Depression was associated with academic performance in class (p<0.001) and race (p=0.004). Prevalence of stress and depression among entering medical students was low; however prevalence of anxiety was high which could be due to worry about the interviews to enter medical course. The associated factors of psychological distress among prospective medical students were related to academic, non-academic, parent education and cultural backgrounds.
Collapse
|
34
|
Yusoff MSB. Associations of pass-fail outcomes with psychological health of first-year medical students in a malaysian medical school. Sultan Qaboos Univ Med J 2013; 13:107-14. [PMID: 23573390 DOI: 10.12816/0003203] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 09/12/2012] [Accepted: 10/18/2012] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The demanding and intense environment of medical training can create excessive pressures on medical students that eventually lead to unfavorable consequences, either at a personal or professional level. These consequences can include poor academic performance and impaired cognitive ability. This study was designed to explore associations between pass-fail outcome and psychological health parameters (i.e. stress, anxiety, and depression symptoms). METHODS A cross-sectional study was conducted on a cohort of first-year medical students in a Malaysian medical school. The depression anxiety stress scale 21-item assessment (DASS-21) was administered to them right after the final paper of the first-year final examination. Their final examination outcomes (i.e. pass or fail) were traced by using their student identity code (ID) through the Universiti Sains Malaysia academic office. RESULTS A total of 194 (98.0%) of medical students responded to the DASS-21. An independent t-test showed that students who passed had significantly lower stress, anxiety, and depression symptoms than those who failed the first-year final examination (P <0.05). Those who experienced moderate to high stress were at 2.43 times higher risk for failing the examination than those who experienced normal to mild stress. CONCLUSION Medical students who failed in the final examination had higher psychological distress than those who passed the examination. Those who experienced high stress levels were more likely to fail than those who did not. Reducing the psychological distress of medical students prior to examination may help them to perform better in the examination.
Collapse
|
35
|
Yusoff MSB, Abdul Rahim AF, Baba AA, Ismail SB, Mat Pa MN, Esa AR. The impact of medical education on psychological health of students: a cohort study. PSYCHOL HEALTH MED 2012; 18:420-30. [PMID: 23140393 DOI: 10.1080/13548506.2012.740162] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Many studies have shown that the prevalence of psychological distress among medical students during medical training is higher than that in general population. A few studies have shown that the prevalence of psychological distress among medical students before the onset of medical training was similar to general population. This study aimed to investigate psychological health of medical students before and during medical training. A one-year prospective study was done on successful applicants who undergo the first year of medical training for 2010/2011 academic session. The stress, anxiety and depression were measured by the DASS-21 at five intervals; during interview (Time 0), two months (Time 1), four months (Time 2), six months (Time 3) and final examination (Time 4) of the first year medical training. The prevalence of unfavourable stress, anxiety and depression before the onset of medical training was 4.1%, 55.6% and 1.8%, respectively. The prevalence of unfavourable stress during medical training ranged between 11.8% and 19.9%. The prevalence of anxiety during medical training ranged between 41.1% and 56.7%. The prevalence of depression during medical training ranged between 12% and 30%. Mean scores of stress and depression before (Time 0) and during medical training (Time 1-4) were significantly different (p < 0.001). The prevalence and level of unfavourable stress and depression during medical training were significantly higher than before the onset medical training. This study supports views that medical training is not an optimal environment to psychological health of medical students.
Collapse
|
36
|
Wolf TM, Scurria PL, Webster MG. A Four-year Study of Anxiety, Depression, Loneliness, Social Support, and Perceived Mistreatment in Medical Students. J Health Psychol 2012; 3:125-36. [PMID: 22021348 DOI: 10.1177/135910539800300110] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The goal of this study was to examine anxiety, depression, loneliness, social support, and perceived mistreatment at 4 time points over the course of the 4 years of undergraduate medical education, beginning in 1991. Representative samples of medical students completed a battery of questionnaires at freshman orientation (111 of 189 students = 59 percent), end of the first year (114 of 182 students = 63 percent), end of the second year (96 of 189 students = 51 percent), and end of the fourth year (85 of 192 students = 44 percent). Depression and anxiety were highest at the end of the first year and lowest at the end of the fourth year. Perceived mistreatment, particularly of a psychological nature, was pervasive over the course of 4 years of medical education. Perceived mistreatment was significantly positively correlated with depression and anxiety at freshman orientation and at the end of the first year. The implications of these findings are discussed with a view to making reforms in medical education designed to enhance the professional and personal development of each student.
Collapse
Affiliation(s)
- T M Wolf
- Louisiana State University School of Medicine, USA
| | | | | |
Collapse
|
37
|
Fan APC, Kosik RO, Mandell GA, Tran DTP, Cheng HM, Chen CH, Su TP, Chiu AWH. Suicidal Ideation in Medical Students: Who Is at Risk? ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2012. [DOI: 10.47102/annals-acadmedsg.v41n9p377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Suicide is one of the most tragic problems medical schools are facing today. It is an issue that has not escaped medical schools in either developing or developed nations. To combat this trend, medical educators require efficient and effective strategies for the immediate identification of students who are at an elevated risk of harming themselves. Materials and Methods: National Yang Ming University medical students were surveyed on various demographic, academic, personal, and extracurricular subjects as well as assessed for suicidal ideation. In addition, students completed the Chinese Health Questionnaire (CHQ, a translated and modified version of the General Health Questionnaire, GHQ), and the Taiwanese Depression Questionnaire (TDQ, a translated and modified version of the Center for Epidemiologic Studies’ Depression Scale, CES-D). Results: The rate of suicidal ideation was significantly higher in second year students as opposed to first year students (P <0.01). Students of lower socioeconomic status (P = 0.04), with non-inflammatory joint pain (P = 0.02), with headache (P = 0.047), with sleep disorders (P = 0.04), who scored as depressed on the TDQ (P <0.01), and/or who scored abnormally on the CHQ (P <0.01) were all significantly more likely to have experienced suicidal ideation. Conclusion: A number of groups at high risk for suicidal ideation, and thus in greater need of support, were identified. Suicide intervention programmes and depression counselling should target older students and students of lower socioeconomic status. Students presenting to university clinics with non-inflammatory joint pain, headache, and/or sleep disorders should be evaluated for suicidal tendencies. The TDQ and CHQ are potentially valuable screening tests for early detection of potential suicidal students.
Key words: CHQ, Depression, Socioeconomic status, Stress, TDQ
Collapse
Affiliation(s)
- Angela PC Fan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | | | - Greg A Mandell
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | | | - Hao-Min Cheng
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chen Huan Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Pying Su
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Allen WH Chiu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
38
|
Sun L, Sun LN, Sun YH, Yang LS, Wu HY, Zhang DD, Cao HY, Sun Y. Correlations between psychological symptoms and social relationships among medical undergraduates in Anhui Province of China. Int J Psychiatry Med 2012; 42:29-47. [PMID: 22372023 DOI: 10.2190/pm.42.1.c] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To assess the prevalence of psychological symptoms (depression, anxiety) among Chinese medical students and to find the possible relationships between psychological symptoms and social relationships. METHODS A sample of 10,140 medical students was investigated with a structured questionnaire, that included the Beck Depression Inventory, Beck Anxiety Inventory, Social Support Rating Scale, and Family APGAR Index (adaptability, partnership, growth, affection, resolve). RESULTS The present study revealed that 16.8% of the medical students suffered from depressive symptoms and 14.1% from anxiety symptoms. Female students were more likely to have anxiety, the second-year students had higher levels of psychological symptoms than the first-year students. Likewise, significant differences were found among college, satisfaction of specialty, and economic condition of the family in anxiety and depression symptoms. Social support, family function, and all dimensions were significantly negatively associated with depression and anxiety symptoms. Multivariable ordinal logistic regression showed that less social support, poor family function, the second-year students, and unsatisfactory specialty were associated with more psychological symptoms, after adjusting the effects of sex, age, and college. CONCLUSIONS Medical students have a relatively high level of depression and anxiety symptoms. These findings support the hypothesis that if medical students are better supported and cared for, negative psychosocial consequences might be prevented or at least reduced.
Collapse
Affiliation(s)
- Liang Sun
- Anhui Medical University, Hefei, China.
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Voltmer E, Kötter T, Spahn C. Perceived medical school stress and the development of behavior and experience patterns in German medical students. MEDICAL TEACHER 2012; 34:840-7. [PMID: 22917267 DOI: 10.3109/0142159x.2012.706339] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Longitudinal data about the development of health risks and resources in relation to the performance of medical students are limited. AIMS To evaluate the development of study-related experience and the correlation to performance. METHOD Medical students in the first (2006), second (2008), and fifth years (2011) of their studies were surveyed with standard instruments for quality of life, study-related behavior and experience, perceived medical school stress, anxiety and depression, and grades in their first major exam. RESULTS The proportion of students with a healthy behavior and experience pattern decreased from 47.3% in the first year to 36.9% in the second year and 17.6% in the fifth year. This corresponded to an increase in the proportion of students at risk for burnout (7.1% first, 20% second, 19% fifth year). Students with a healthy behavior and experience pattern scored higher in self-perceived performance (p < 0.05) and objective grades. Stress and risk for burnout were important predictors for anxiety and depression. CONCLUSIONS The decrease in health and the increase in risk patterns indicate a need for prevention and health promotion that should not only focus on individual behavior but also address the contextual factor of study organization within medical school.
Collapse
Affiliation(s)
- E Voltmer
- Department of Health and Behavioral Sciences, Friedensau Adventist University, Germany.
| | | | | |
Collapse
|
40
|
|
41
|
Alimoglu MK, Gurpinar E, Mamakli S, Aktekin M. Ways of coping as predictors of satisfaction with curriculum and academic success in medical school. ADVANCES IN PHYSIOLOGY EDUCATION 2011; 35:33-8. [PMID: 21385999 DOI: 10.1152/advan.00100.2010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The purpose of the present study was to determine the coping strategies of medical students and to investigate the effects of coping strategies on student satisfaction and academic achievement with different instruction methods. A total of 152 medical students was followed throughout the first 2 yr of medical education between 2008 and 2010. Students completed a sociodemographic questionnaire and revised form of the Ways of Coping questionnaire both at the beginning of the first year and at the end of the second year. These forms provided data about the characteristics and main coping strategies (problem focused or emotion focused) of the students and revealed the change over time. At the end of the second year, participants also completed a satisfaction questionnaire asking their satisfaction with lectures, problem-based learning, and practicals. The authors used block, problem-based learning, and practical exam scores of the students attained in the past 2 yr as academic achievement indicators. No sociodemographic variable was related to coping strategy. The majority of students (80.9%) adopted problem-focused coping. A shift occurred in the main coping strategies of some students in both sides. Problem-focused coping scores decreased over time. Problem-focused coping positively correlated with satisfaction with practicals and practical exam scores, whereas emotion-focused coping showed the same correlation negatively. The main coping strategy also predicted satisfaction and exam success in practicals. In conclusion, a main coping strategy may be helpful to predict student satisfaction and academic achievement with some student-centered instruction methods. Determining undesired coping strategies may provide an opportunity for intervention to prevent relevant dissatisfaction and failure.
Collapse
Affiliation(s)
- Mustafa Kemal Alimoglu
- Department of Medical Education, School of Medicine, Akdeniz University, Antalya, Turkey.
| | | | | | | |
Collapse
|
42
|
Roh MS, Jeon HJ, Kim H, Han SK, Hahm BJ. The prevalence and impact of depression among medical students: a nationwide cross-sectional study in South Korea. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:1384-90. [PMID: 20453812 DOI: 10.1097/acm.0b013e3181df5e43] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE This nationwide cross-sectional study assessed the prevalence, possible risk factors, and impact of depression among Korean medical students. METHOD Of all medical students (14,095) registered in 41 medical schools in 2006 in South Korea, 7,357 (52.2%) completed the survey. Depression was measured using the patient-rated version of the Mini International Neuropsychiatric Interview (MINI-PR). Data on academic functioning, and sociodemographic characteristics were also obtained. RESULTS Current, one-year, and lifetime prevalence of major depressive disorder (MDD) were 2.9%, 6.5%, and 10.3%, respectively. Possible risk factors for one-year MDD were female gender, lower class years, admission track with exemption from entrance exam, living alone at a lodging house or a rented room, and financial difficulty (P < .05). The grade point averages (GPAs) of students with MDD were significantly lower than those of nondepressed students for both semesters (t = 3.8, P < .001; t = 4.8, P < .001). The odds ratio of students with MDD of receiving a GPA below 2.0 was 1.8 (CI 1.4-2.4) as compared with nondepressed students. CONCLUSIONS This study demonstrated that Korean medical students experience depression frequently. It also highlighted the possible risk factors of MDD among medical students and pervasive association of depression with poor functioning.
Collapse
Affiliation(s)
- Myoung-Sun Roh
- Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
| | | | | | | | | |
Collapse
|
43
|
Alexandrino-Silva C, Pereira MLG, Bustamante C, Ferraz ACDT, Baldassin S, Andrade AGD, Alves TCDTF. Suicidal ideation among students enrolled in healthcare training programs: a cross-sectional study. ACTA ACUST UNITED AC 2009; 31:338-44. [PMID: 19838592 DOI: 10.1590/s1516-44462009005000006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Accepted: 06/26/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We aimed to assess the presence of suicidal ideation, depressive symptoms and symptoms of hopelessness in three healthcare training programs. METHOD The study's population comprised all students enrolled at the Medical School of the Fundação do ABC, Brazil, from 2006 to 2007 compared to students enrolled in nursing and pharmacy programs. We applied the Beck Scale for Suicidal Ideation, the Beck Depression Inventory and the Beck Hopeless Scale to assess psychiatric symptomatology. The general response rates of the medical, nursing, and pharmacy students were 56%, 56% and 61%, respectively. RESULTS There was no difference regarding the presence of suicidal ideation among medical, nursing and pharmacy students. There was also no difference regarding the presence of either depression or hopelessness in medical students in comparison to nursing and pharmacy students. In comparison to nursing and pharmacy students, significantly higher severity rates in terms of hopelessness were observed only among medical students. CONCLUSION Although we did not observe significant differences regarding suicidal ideation and depression among the three healthcare programs, our findings suggest that the presence of suicidal ideation is indeed a source of concern. Early identification of these symptoms is crucial in order to offer appropriate support and treatment and prevent deaths by suicide.
Collapse
|
44
|
Verger P, Combes JB, Kovess-Masfety V, Choquet M, Guagliardo V, Rouillon F, Peretti-Wattel P. Psychological distress in first year university students: socioeconomic and academic stressors, mastery and social support in young men and women. Soc Psychiatry Psychiatr Epidemiol 2009; 44:643-50. [PMID: 19096741 DOI: 10.1007/s00127-008-0486-y] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Revised: 11/21/2008] [Indexed: 11/28/2022]
Abstract
PURPOSE Little is known about the role of stressors associated with university life on psychological distress (PD). The aims of this article are to: (1) assess the prevalence of PD among students during their first year of university; (2) study its associations with stressors (socioeconomic and university-related) and protective factors (mastery, social support); and (3) to compare these factors according to gender. METHODS Cross-sectional study of a random sample of students aged 18-24 years, in their first year of university in 2005-2006, enrolled in the 6 universities of southeastern France. Standardised questionnaire, by self-administration or telephone interview. Overall, 1,743 students agreed to participate (71.0%). RESULTS PD prevalence was estimated at 15.7% (95% CI: 12.9-18.5) among the young men and 33.0% (95% CI: 30.2-35.9) among the young women. Multiple logistic regressions adjusted for social and demographic variables, mode of questionnaire administration, psychiatric history, and recent adverse life events, showed that among men PD was associated with lack of adjustment to the university academic environment (OR = 1.08; 95% CI: 1.00-1.17, P = 0.04), and mastery (OR = 0.73; 95% CI: 0.68-0.79). Among women, the prevalence of PD was associated with medical studies (OR = 2.46; 95% CI: 1.50-4.05), lack of adjustment to the university academic environment (OR = 1.07; 95% CI: 1.03-1.12), mastery (OR = 0.78; 95% CI: 0.75-0.82), and social support (OR = 0.68; 95% CI: 0.54-0.85), with a strong negative statistical interaction between mastery and lack of adjustment. CONCLUSIONS This study shows an intermediate prevalence of PD among French first-year university students compared with those observed in university students in other countries. It suggests that PD is related to university-related stressors but failed to find a relation to socioeconomic factors. Risk and protective factors for PD in first-year university students differed somewhat according to gender. However, mastery appeared to have a protective role in both genders. Further research is necessary to confirm these results in other universities and years.
Collapse
Affiliation(s)
- Pierre Verger
- Observatoire régional de la santé PACA (Southeastern Regional Health Observatory), 13006 Marseille, France.
| | | | | | | | | | | | | |
Collapse
|
45
|
Lau KS, Siong KH, Tang HY, Cheng PW, Cheung KS, Chan SW, Lee PWH, Wong JGWS. An innovative web-based peer support system for medical students in Hong Kong. MEDICAL TEACHER 2007; 29:984-986. [PMID: 18158678 DOI: 10.1080/01421590701551748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Psychological morbidity is commonly found in medical students. AIMS The Mental Health Support Group (MSG), a student-initiated and student-run web-based peer support service aims to provide mental health information, e mail counseling and an online forum for medical students. METHODS The development process of MSG is described in the paper with presentation of preliminary evaluation results. RESULTS Preliminary evaluation shows promising results. Student members of MSG acquired valuable skills in counseling, communication, webpage design and maintenance of an online forum. CONCLUSIONS Future challenges include succession issues, strategies to keep up the momentum, enhancement of publicity and further diversification of service to meet the needs of our students.
Collapse
Affiliation(s)
- K S Lau
- University of Hong Kong, Hong Kong
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Mehanna Z, Richa S. [Prevalence of anxiety and depressive disorders in medical students. Transversal study in medical students in the Saint-Joseph University of Beirut]. Encephale 2007; 32:976-82. [PMID: 17372542 DOI: 10.1016/s0013-7006(06)76276-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Evaluate the emotional state of medical students and compare them to a control population (chemistry students), in order to assess the bad effect of academic studies on the mood of medical students. METHODS Beginning of September 2003, a questionnaire composed of three parts was distributed to all students in medicine and chemistry at the Saint-Joseph University (USJ), either at the start or at the end of their cours, to be filled-in anonymously. The first part was composed of demographic data; the second and the third parts were, respectively, the Beck questionnaire for depression and Hamilton's questionnaire for anxiety. RESULTS There was no statistically significant difference between the two populations studied concerning the scores of Beck and Hamilton, neither depending on the classes nor on the depression or anxiety threshold. The prevalence found in the USJ medical students for depression (27.63%) and for anxiety (69%) was far greater than that found in the literature (23% for depression among American students and 41% for anxiety), but lower than that found in the university of Hong-Kong (48% of students having a Beck13 score>8). The forth year was the one that presented the most anxiety and depressive disorders in the seven years of medicine (44.32% of depression and 79.24% of anxiety). The psychiatric antecedents are the strongest predictors of anxiety and depressive disorders. CONCLUSION The prevalence of anxiety and depressive disorders is not greater in medical students than in chemistry students.
Collapse
|
47
|
Finkelstein C, Brownstein A, Scott C, Lan YL. Anxiety and stress reduction in medical education: an intervention. MEDICAL EDUCATION 2007; 41:258-64. [PMID: 17316210 DOI: 10.1111/j.1365-2929.2007.02685.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVES To assess the effectiveness of a stress reduction elective on Year 2 medical students and to assess the sustainability of any noted improvement. METHODS A new elective entitled 'Mind-Body Medicine: an Experiential Elective' was offered to Year 2 medical students. It was based on a course developed by the Center for Mind-Body Medicine. Enrolled students were surveyed on the first (time 1) and last (time 2) days of the elective and again 3 months later (time 3). Four validated self-report instruments were used to examine effects on anxiety, stress, mood states and depression. A comparison group of non-enrolled classmates completed the same instruments during the same timeframes. The study began in autumn 2004 and ended in June 2005. RESULTS Participating students had higher initial anxiety scores than students in the comparison group. Anxiety in the study group declined significantly during the course, with enrolled students becoming indistinguishable from non-enrolled counterparts. These decreased anxiety levels were sustained for 3 months following the conclusion of the course. CONCLUSIONS This elective was successful in attracting students who were more anxious than their peers. Enrolees had higher baseline anxiety levels than their peers. The course decreased anxiety levels. The significant drop in anxiety scores of the study group suggests that this mind-body elective was an effective way to decrease anxiety in these pre-clinical medical students. Decreases in anxiety were sustained 3 months after the course ended, indicating that the benefits of the course may be longlasting.
Collapse
|
48
|
Reisbig AMJ, Hafen M, White MB, Rush BR. Improving response rates: introducing an anonymous longitudinal survey research protocol for veterinary medical students. JOURNAL OF VETERINARY MEDICAL EDUCATION 2007; 34:194-201. [PMID: 17446648 DOI: 10.3138/jvme.34.2.194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
With the Journal of Veterinary Medical Education's recent summer 2005 theme issue on stress, the mental-health concerns of veterinary medical students has been brought to the forefront of the field. Since it is anticipated that research on this topic will continue and that educational institutions may implement changes based upon these results, it is of the utmost importance that this research be of the highest quality. Of particular concern with human-subject inquiries are response rates and confidentiality. In order to accommodate these concerns, an example of a survey research protocol that promotes high response rates and minimizes threats to internal validity influenced by student mistrust in assurances of confidentiality is presented. Specifically, the protocol is designed to ensure anonymity and to preserve the ability to track students longitudinally through the use of anonymous longitudinal identifiers. This protocol was tested with the first-year class of veterinary medical students at Kansas State University in October 2004 and March 2005. The two data collection periods yielded 90% and 76% response rates, respectively. The matching rate of participants, according to the anonymous longitudinal identifiers from Time 1 to Time 2, was 88%.
Collapse
Affiliation(s)
- Allison M J Reisbig
- Department of Family and Consumer Sciences, University of Nebraska-Lincoln, 133 Mabel Lee Hall, Lincoln, NE 68588 USA.
| | | | | | | |
Collapse
|
49
|
Park CL, Fenster JR, Suresh DP, Bliss DE. Social support, appraisals, and coping as predictors of depression in congestive heart failure patients. Psychol Health 2006. [DOI: 10.1080/14768320600682368] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
50
|
Kjeldstadli K, Tyssen R, Finset A, Hem E, Gude T, Gronvold NT, Ekeberg O, Vaglum P. Life satisfaction and resilience in medical school--a six-year longitudinal, nationwide and comparative study. BMC MEDICAL EDUCATION 2006; 6:48. [PMID: 16984638 PMCID: PMC1592096 DOI: 10.1186/1472-6920-6-48] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2006] [Accepted: 09/19/2006] [Indexed: 05/06/2023]
Abstract
BACKGROUND This study examined the relationship between life satisfaction among medical students and a basic model of personality, stress and coping. Previous studies have shown relatively high levels of distress, such as symptoms of depression and suicidal thoughts in medical undergraduates. However despite the increased focus on positive psychological health and well-being during the past decades, only a few studies have focused on life satisfaction and coping in medical students. This is the first longitudinal study which has identified predictors of sustained high levels of life satisfaction among medical students. METHODS This longitudinal, nationwide questionnaire study examined the course of life satisfaction during medical school, compared the level of satisfaction of medical students with that of other university students, and identified resilience factors. T-tests were used to compare means of life satisfaction between and within the population groups. K-means cluster analyses were applied to identify subgroups among the medical students. Analysis of Variance (ANOVA) and logistic regression analyses were used to compare the subgroups. RESULTS Life satisfaction decreased during medical school. Medical students were as satisfied as other students in the first year of study, but reported less satisfaction in their graduation year. Medical students who sustained high levels of life satisfaction perceived medical school as interfering less with their social and personal life, and were less likely to use emotion focused coping, such as wishful thinking, than their peers. CONCLUSION Medical schools should encourage students to spend adequate time on their social and personal lives and emphasise the importance of health-promoting coping strategies.
Collapse
Affiliation(s)
- Kari Kjeldstadli
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Reidar Tyssen
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Arnstein Finset
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Erlend Hem
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Tore Gude
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Nina T Gronvold
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Oivind Ekeberg
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Per Vaglum
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| |
Collapse
|