A longitudinal study of psychological stress among undergraduate dental students at the University of Jordan

A Qualitative Analysis of Students' Perceptions and Experiences of Stressors and Well-Being in Dentistry

INTRODUCTION

Well-being is increasingly regarded as an integral component of a graduating dentist's professional responsibility, yet studies demonstrate significant levels of stress and poor mental health in the dental student population. The aim of this qualitative study was to explore final-year dental students' perceptions of stressors in dentistry and their experiences of managing their individual well-being and supporting the well-being of their colleagues and patients.

METHODS

A literature search was performed to guide the development of an interview framework which included questions centred around three higher domains based on self, peers and patients. Participants were randomly sampled and the interviews audio recorded and transcribed verbatim. An inductive-deductive approach was adopted for thematic analysis of the results.

RESULTS

Fourteen interviews were conducted, revealing four themes and 15 subthemes. Students were acutely aware of poor well-being symptoms amongst themselves and their peers. Treating dental patients with mental illness was common but some students expressed uncertainties in managing these patients. The key stressors were assessments and clinical stress. Students frequently sought support from peers and half had received professional help. Barriers to approaching faculty staff were identified. The role of stigma in preventing students from openly sharing their well-being experiences was discussed.

CONCLUSION

A range of curricular and clinical stressors, and potential sources of support to manage these stressors, have been explored from the perspectives of final-year dental students. From these experiences, action points have been proposed to address knowledge gaps and enhance faculty-level wellness support for dental students.

Stress levels amongst Turkish dental students, general dentists and paediatric dentists during performing paediatric dentistry: a questionnaire-based cross-sectional study

PURPOSE

This study aimed to evaluate stress levels and stressors amongst dental students, general dentists and paediatric dentists treating paediatric patients.

METHODS

This study was conducted on 664 dentistry students, general dentists and paediatric dentists in Turkey. Data were collected through an online questionnaire consisting of demographic characteristics and the Pedodontic Practice Stress Scale (PPSS). Stressors when treating paediatric patients were compared between the groups. The scores obtained from the questionnaire were analysed. Compliance with normal distribution was analysed according to Kurtosis-Skewness values. One-way analysis was used to compare the scale scores (p < 0.050).

RESULTS

Of the participants, 74.54% were female and 25.46% were male. The females showed a significantly higher level of stress, compared to the males (p = 0.001).When compared according to the level of education, the mean total stress scores did not differ (p = 0.211), but the mean complication score was found to be statistically significantly higher in paediatric dentists (p = 0.001). In addition, the lowest mean stress score was found in dental students. Statistically significant differences were found in all sections of the PPSS scale in terms of the ability to manage a paediatric patient as an adult patient and the importance of knowing child psychology theories.

CONCLUSION

Factors, such as the educational status, the number of patients treated, the behaviour of the patient's relatives and the potential to communicate with them, cause variable stress in dental students and general and specialist dentists working with children.

Predicting oral hygiene practices through health behavior, perceived stress and self-efficacy in undergraduate dental students of Pakistan: a national survey

BACKGROUND

Dental students face the rigorous demands of coursework, which can lead to feelings of inadequacy and stress. These pressures can negatively influence self-efficacy and cause neglect in practicing healthy behaviors that encompass oral health. Identifying the associations of these variables with oral hygiene practices can help in the formulation of interventions tailored toward supporting young students. Therefore, this study aimed to investigate the impact of health behaviors, perceived stress and self-efficacy on oral hygiene practices among undergraduate dental students in Pakistan.

METHODS

A national online survey was carried out among 904 students across the dental colleges of Pakistan. The survey assessed general health behaviors such as tobacco use, sleep, and exercise, among other demographic variables. Perceived stress was evaluated via the Perceived Stress Scale (PSS-10), and self-efficacy was evaluated via the General Self-Efficacy Scale (GSES). Twice daily brushing, brushing for 2 min, and changing toothbrushes after 3 months informed oral hygiene practice of the participants.

RESULTS

The students experienced moderate perceived stress (20.82 ± 5.92) and high self-efficacy (29.19 ± 5.43). The majority of participants were in their third year (31.9%), were female (65.9%), and resided in home during their studies (64.4%). Perceived stress was observed to have no significant effect on the oral practice of participants. Female gender, non tobacco user, regular exercise, frequent dental visits and higher self-efficacy were associated with good oral hygiene practices.

CONCLUSIONS

The results highlight the importance of addressing stress, enhancing self-efficacy and encouraging healthy behaviors among dental students to improve their oral health, which could be reflected in their professional practice and personal well-being. This study contributes to the understanding of behavioral determinants and emphasizes the need for supportive measures to foster better health behaviors in future dental professionals.

The impact of the Khartoum war on dental education

The relentless conflict in Khartoum has severely crippled higher education, especially in specialized fields like dental education. The war has wreaked havoc on academic schedules, severely damaging infrastructure, and creating an atmosphere of pervasive uncertainty and stress for students and faculty alike. Academic continuity has been shattered, with courses and training programs facing frequent disruptions, leaving students struggling to complete their studies and gain essential practical experience. Faculty members, too, are under immense pressure, dealing with the dual burdens of maintaining educational standards and ensuring personal safety. This commentary delves into the devastating and far-reaching consequences of the ongoing conflict on dental education in Khartoum, highlighting the urgent need for comprehensive recovery and support strategies to restore this critical field.

Determinants of dietary behaviors among dental professionals: insights across educational levels

BACKGROUND

Healthy dietary behaviors are fundamental for maintaining optimal health. Understanding the dietary behaviors of dentists is vital for designing effective interventions to foster healthier behaviors. However, investigations into dietary behaviors and their associations among dental professionals have been limited.

OBJECTIVE

To investigate the dietary behaviors of dental professionals, along with the associated factors influencing their dietary options.

MATERIALS AND METHODS

A self-administered online questionnaire was constructed to collect data from three groups of dental professionals: undergraduates (UG), postgraduates (PG), and practicing dentists (DT). The questionnaire encompassed inquiries regarding demographic characteristics, knowledge assessment, evaluation of attitudes, and examination of dietary behaviors. Data analysis procedures included descriptive statistics, Spearman's rank correlation, and multiple linear regression.

RESULTS

A total of 842 individuals participated in the study (UG: 264, PG: 247, DT: 331). Attitude emerged as the strongest association of healthy dietary behaviors across all groups (UG: ß=0.370, PG: ß=0.512, DT: ß=0.642; P < 0.001), while alcohol consumption showed a negative correlation with healthy dietary behaviors (UG: ß=-0.135, PG: ß=-0.220, DT: ß=-0.216; P < 0.001).

CONCLUSION

Significant variations in dietary behaviors across diverse educational levels of dental professionals were observed. Attitude emerged as the predominant factor influencing dietary behaviors, while knowledge was found to have a weak association. Tailored interventions addressing individual challenges at different career stages should be considered to enhance dietary behaviors and overall well-being in dental practice settings.

Dental and endodontic-related stress amongst undergraduate students before and during the COVID-19 pandemic: A mixed-methods study

AIM

To determine and explain the principal sources of stress among preclinical and clinical dental undergraduate students with a particular focus on the stressors linked to endodontics.

METHODOLOGY

A mixed-methods study, with an explanatory sequential design, was employed. Volunteer students of second, third and fourth years were asked to complete both the Dental Environment Stress (DES) questionnaire and a bespoke questionnaire for endodontic-related stress assessment, which had 21 questions in common with the DES. The results were analysed by Kruskal-Wallis and Marginal Homogeneity tests. In the second part of the study, a qualitative phase was conducted through focus group interviews of students from each academic year included in the study. Interviews were analysed by inductive content analysis.

RESULTS

The DES questionnaire determined that for all years the most stressful domains were 'performance pressure', 'workload' and 'clinical training'. According to the endodontic stress questionnaire, the most stressful domains were 'self-efficacy beliefs', 'endodontic clinical training' and 'faculty and administration' in early years, while they were 'endodontic patient treatment', 'performance pressure in endodontics' and 'clinical training' in later years. Comparing questions common to both questionnaires revealed that the stress score was lower for the endodontic stress questionnaire than in the DES questionnaire for 17 questions, being significantly lower for 13 questions (p < 0.05) and significantly higher for no question. The qualitative study showed that students' dental and endodontic-related stress was linked to different domains: patient, clinical procedure, organization, staff, academic education, evaluation and COVID-19-related issues. Qualitative aspects highlighted the important role that patients and COVID-19 have played in student stress. However, they suggested a possible explanation for the lower endodontic stress observed in this dental university hospital, which was based on: the nature of the teaching in endodontics, the consensus between endodontic supervisors, the use of a logical, progressive procedure and the considerable experience that students gain over the years.

CONCLUSION

Students considered endodontics stressful; however, education can play a central role in reducing stress, particularly during the early parts of the undergraduate course.

Stress experienced by dental students performing clinical training in different dental disciplines: a cross-sectional study

OBJECTIVES

To assess the stress level, the impact of stress factors, and discrepancies between fourth- and fifth-year undergraduate clinical students at the University of Jordan.

METHODS

A cross-sectional study was conducted in the academic year 2022/2023. The study group included fourth- and fifth-year dental students at the University of Jordan (n = 382) who were asked to voluntarily fill in an online dental environment stress (DES) questionnaire. Analysis was conducted using Mann-Whitney U test, independent t-test, χ2 test, and Spearman ρ rank correlations. Statistical significance was inferred when P < .05.

RESULTS

Fourth-year students reported higher levels of nervousness before treating patients for the first time. Fifth-year students faced more difficulty, higher stress, and/or fear regarding the amount of assigned work, provided treatment, completed requirements, failing the course, time to finish assignments, patient comprehensive care, and financial expenses of the course. Comparison between groups revealed that the fifth-year students scored higher levels of stress on the total DES score and all partial DES scores. Furthermore, the total DES questionnaire scores were significantly correlated with grade point average (GPA) among the total study sample and the prosthodontics clinical course marks among the fourth-year students' group.

CONCLUSIONS

The stress level among students in clinical courses was influenced by their academic performance, gender, year level, and the type and time needed for the provided treatment. Completing course requirements was among the most commonly faced stressors. Future research endeavors might be considered to study each clinical factor, its impact on students' stress level, and how to manage and positively improve these factors.

Lifestyle factors associated with poor sleep quality among undergraduate dental students at a Malaysian private university

OBJECTIVE

The purpose of this study was to look into the associations between lifestyle factors, gender, clinical level, and sleep quality among undergraduate dental students at a private university in Malaysia.

MATERIAL AND METHODS

A self-administered Pittsburg sleep quality index (PSQI) scale and the lifestyle and habits questionnaire-brief (LHQ-B) were used in this cross-sectional study. A global PSQI score of greater than 5 indicates poor sleep quality. All university dental students were invited to take part. Descriptive statistics and logistic regression analyses were used to analyze the data.

RESULTS

A total of 338 students took part in the study, with a response rate of 90.4%. The proportion of females was higher (68.3 %) and more than half of the respondents (56.7 %) were in their clinical years. The prevalence of poor sleep quality was 36.7%. At multivariable level, poor sleep quality was associated with being male (OR=1.72 [95% confidence interval (1.05, 2.83)] and engaging in an unhealthy lifestyle for psychological health (OR=2.64 [95% confidence interval (1.34, 5.21)] and nutrition (OR=2.48 [95% confidence interval (1.028, 4.82)].

CONCLUSION

The prevalence of poor sleep quality among undergraduate dental students in our study was comparable to that found in other studies. Male students were more likely to have poor sleep quality than female students. Our findings indicate that poor sleep quality (PSQI score >5) may be linked to unhealthy lifestyle habits related to psychological health and nutrition. Health education that emphasizes these domains is essential for improving their lifestyle habits and sleep quality.

Stress amongst paediatric dental postgraduate students in India: A mixed-method approach

INTRODUCTION

Dental profession is one of the most stressful healthcare occupations. Paediatric dental postgraduates face multifaceted challenges in their everyday practice. This study aimed to determine the sources of stress amongst paediatric dental postgraduate students in India using a mixed-method approach.

MATERIALS AND METHODS

A sequential mixed-methods approach was employed. In the quantitative phase, a cross-sectional web-based questionnaire survey was conducted amongst paediatric dental postgraduates in India using the "Google Forms application" link. Based on the Dental Environment Stress (DES) questionnaire, the stress PACT questionnaire which includes 35 items was framed and validated. This validated questionnaire was used in the survey. In the qualitative phase, one-on-one, semi-structured telephone interviews were conducted amongst 12 postgraduates.

RESULTS

A total of 422 participants took part in the quantitative survey. Academic and specialty-related domains were found to be the significant causes of stress amongst the five domains (p < .001). The top three stressful factors were as follows: getting an ideal case for clinical exams (68.2%), financial resources for conferences, dissertation, short studies and publications (53.2%) and fear of unemployment after graduation (52.3%). Based on qualitative interviews, four themes were derived, namely choice of paediatric dentistry, postgraduate life experience, stress management and expected changes in postgraduate life.

CONCLUSION

Psychological well-being of the student is an important factor that influences the overall performance of students. Identifying the stress factors and using appropriate coping strategies can help postgraduates achieve personal, academic and professional success.

Stress amongst dental students in the transition from preclinical training to clinical training: A qualitative study

OBJECTIVES

The present study sought to qualitatively evaluate third-year undergraduate dental students' perceptions of sources of stress during the transition from preclinical to clinical training.

METHODS

This was an observational, cross-sectional, and qualitative study with a nonprobabilistic sampling design. The sample consisted of students in the third year of the five-year undergraduate degree program in dentistry offered by the São Paulo State University (UNESP), School of Dentistry, Araraquara, São Paulo State, Brazil (n = 37). Data were collected using open-ended, semistructured, and individual interviews that were recorded on a digital voice recorder. The students were interviewed on campus at a previously scheduled time. Efforts were made to provide a secure and welcoming environment for the interview. The interview questions addressed students' adaptation to clinical training and their perceptions of stress resulting from this transition. Data analysis was based on the qualitative and quantitative Discourse of the Collective Subject (DCS) technique performed with the aid of Qualiquantisoft®.

RESULTS

Most of the students evaluated (75.7%) reported difficulty in the transition from the preclinical to the clinical phase of their program and that this difficulty increased their stress levels during this transition (81.1%). The most frequently cited reason for the increase in stress was the responsibility and demands associated with caring for real patients (54.1%). Almost half of the students (48.6%) reported feeling physical symptoms of stress such as tachycardia, dizziness, headache, and muscle tension during this period. Most of the students (81.1%) required up to one semester to feel that they had adapted to the clinic. Many students used stress reduction strategies such as simply trying to calm down, studying before their clinical work, improving organisation, and asking professors for help. Adaptation to ergonomics and biosafety in the clinic was the most frequently cited impediment (45.9%) to the adaptation process. The students' main suggestions for reducing stress in this transition phase were additional preclinical training in a clinical setting, a more gradual transition, and greater professor receptiveness.

CONCLUSION

The dental students interviewed herein perceived high levels of stress during the transition from preclinical to clinical training.

Burnout assessment among academic dental staff during COVID-19: Data from Arab countries

Purpose/objective

This study aimed to identify factors that were associated with high burnout and investigate the prevalence of burnout among academic dental staff during the COVID‐19 pandemic.

Method

A cross‐sectional online survey was carried out among academic dentists who are working in multiple dental schools in Arab countries. The Copenhagen Burnout Inventory was used to assess participants’ work‐related burnout. Logistic regression was used to assess the factors that increase the risk of burnout among academic dentists.

Results

Of the 254 participants who took part in the study, 141 were males (55.5%). The average age of the participants in the study was 42.1 years (standard deviation = 10.0). The prevalence of burnout among participants was 44.9% (n = 114). Using a fully adjusted logistic regression model, age (odds ratio [OR] = 1.05, 95% confidence interval [CI]: 1.01–1.09, p = 0.008) and gender (OR = 0.54, 95% CI: 0.31–0.94, p = 0.03) were significant variables associated with high overall burnout. Female individuals had a substantially reduced risk of experiencing high personal burnout than male participants (OR = 0.56, 95% CI: 0.32–0.98, p = 0.043) in the personal burnout subdomain. While in the patient's burnout subdomain, age (OR = 1.04, 95% CI: 1.00–1.08, p = 0.048), type of speciality (OR = 2.44, 95% CI: 1.02–5.83, p = 0.044), and teaching place (OR = 2.49, 95% CI: 1.21–5.11, p = 0.013) were associated with higher burnout.

Conclusion

This study concluded that gender and age are characteristics that increase the risk of higher burnout among academic dentists during the COVID‐19 pandemic.

An analysis of business students’ stressors and their coping strategies in the post-pandemic era

The COVID-19 pandemic has brought a dramatic change in teaching–learning practices in higher education across the world. The post-pandemic era with a new shift of teaching–learning phase raises the concern of students' psychological well-being, especially the novice, i.e., first-year undergraduate students, as first-year students often struggle to adjust to the new environment of higher institutions, thereby depressive symptoms are more prevalent among them. In this regard, a qualitative study was conducted followed by a dyadic approach to explore the symptoms of students’ psychological stressors, their causes, and provide essential remedies for coping with such behaviors in the post-pandemic era. The findings show that students’ stressors were commonly reported due to the academic workload, institutional regulations, lack of resources, and financial constraints. Regarding indications, unusual behavior, lack of confidence, improper sleep, and lack of motivation were identified as the primary symptoms of students’ stress. However, participants reported a lack of understanding regarding stress-related matters. Yet, students and faculty members try to adopt several strategies for reducing such stressors. By examining the perceived psychological stress, indications, and coping behaviors, this study enriches the literature by bridging pragmatic and theoretical gaps regarding students’ stressors of business management. Furthermore, the study mainly suggests that adequate institutional support should be provided to deal with students’ problems that cause stress. Also, universities should organize workshops or seminars to cultivate psychological health awareness among students and faculty members.

The association of smartphone addiction, sleep quality and perceived stress amongst Jordanian dental students

INTRODUCTION

Smartphone addiction has been associated with sleeping problems and psychological anxiety. However, little is known about the association of smartphone addiction, sleep quality and perceived stress amongst university students particularly in dentistry. This study investigated the association of these variables amongst dental students in a Jordanian dental faculty.

MATERIALS AND METHODS

A sample of 420 undergraduate dental students enrolled for academic year 2017/2018 at the Jordan University of Science and Technology participated in this study. They were given a set of self-administered questionnaires which consisted of questions regarding demographic information, characteristics of smartphone use, assessment of smartphone addiction, sleep quality as well as perceived stress.

RESULTS

The mean Smartphone Addiction Scale (SAS) score amongst Jordanian dental students was high (109.9 ± 23.8). The correlation between SAS and Global Pittsburg Sleep Quality Index (PSQI) score was significant (r = 0.137, P =0.005) indicating that the higher the smartphone addiction level, the poorer the quality of sleep. Similarly, a significant correlation was found between Perceived Stress Scale-10 (PSS-10) score and Global PSQI score (r = 0.348, P < 0.001) which implied that students who have higher perceived stress experienced poorer sleep quality. Year 3 students (clinical year), smartphone addiction and perceived stress were determinants of sleep quality.

CONCLUSIONS

Dental students who have high levels of smartphone addiction or high perceived stress levels experienced poor sleep quality. Identifying smartphone addicts amongst students as well as stressors are imperative measures to allow timely assistance and support in the form of educational campaigns, counselling, psychotherapy and stress management.

Effect of Dental Environment Stressors and Coping Mechanisms on Perceived Stress in Postgraduate Dental Students

Aim and objective

To investigate the effect of dental environment stressors and coping mechanisms on perceived stress in postgraduate dental students.

Materials and methods

This cross-sectional study enrolled 250 postgraduate students from four dental colleges. Modified dental environment stress (DES) questionnaire was used to study the dental environment-related stressors, perceived stress score (PSS) to measure the extent of stress perception, and brief COPE (BC) scale to measure the use of various coping strategies deployed to combat stress. An independent T-test was used to determine the associations of these measures with gender and marital status and one-way ANOVA for associations with year of study. Hierarchical regression was used to determine the effect of demographic factors, career-related psychological background, health-related habits, DES, and BC score on PSS.

Results

“Synopsis, thesis, library dissertation” and “lack of adequate infrastructure” were reported as the highest stressors by the postgraduate students. Only 4.8% of respondents perceived low stress, while 65.2% perceived high stress. A high correlation between the DES score and PSS was observed. Active coping, acceptance, and positive reframing were the most commonly utilized coping strategies. Planning and use of emotional support were the only coping strategies that were significant negative predictors of PSS. Problem-focused coping strategies had a positive, but non-significant correlation with PSS, while emotion-focused coping strategies had a significant negative correlation with PSS.

Conclusion

Postgraduate dental environment causes a high-stress perception in students and reactive coping strategies have only a limited role in reducing stress perception.

How to cite this article

Sikka N, Juneja R, Kumar V, et al. Effect of Dental Environment Stressors and Coping Mechanisms on Perceived Stress in Postgraduate Dental Students. Int J Clin Pediatr Dent 2021;14(5):681–688.

Extreme Situation Experienced by Dental Students of the Medical University of Silesia Due to the SARS-CoV-2 Epidemic during the First Lockdown

The pandemic declared in many countries in 2020 due to COVID-19 led to the freezing of economies and the introduction of distance learning in both schools and universities. This unusual situation has affected the mental state of citizens, which has the potential to lead to the development of post-traumatic stress and depression. This study aimed to assess the level of stress in dental students in the context of the outbreak of the SARS-CoV-2 virus pandemic. A survey on the PSS-10 scale was prepared to measure the level of perceived stress. The study included 164 dental students at the Faculty of Medical Sciences of the Medical University of Silesia in Katowice, Poland. The results showed the impact of COVID-19 on the stress of students, with 67.7% reporting high levels of stress. The study also revealed that stress was higher among older female students. This paper recommends that the university provide more intensive psychological care as psychological first aid strategies in epidemics or natural disasters and to consider telemedicine in order to deliver services due to the limitations of the pandemic.

Sleep Deprivation and Its Associated Factors Among Undergraduate Students in Malaysia

This cross-sectional study examines the prevalence of sleep deprivation and its associated factors among 1017 undergraduate students in Malaysia. Sociodemographic and lifestyle factors such as smoking, alcohol, dietary habits, Internet/smartphone use, physical activity, and sedentary behavior were assessed. Sleep deprivation was defined as sleeping less than 7 hours in a day. There were almost equal proportions of females (51.0%) and males (49.0%), and the average age was 20.71 ± 1.47 years. Prevalence of sleep deprivation was 58.1% and its associated factors were students in Year 3 (adjusted odds ratio [AOR] = 0.52, 95% confidence interval [CI] = 0.35-0.77) and Year 4 (AOR = 0.65, 95% CI = 0.45-0.95), Chinese ethnicity (AOR = 0.44, 95% CI = 0.34-0.59), Indian ethnicity (AOR = 0.49, 95% CI = 0.25-0.96), and consuming fast food more than once a week (AOR = 0.69, 95% CI = 0.51-0.93). Understanding the associated lifestyle factors with sleep deprivation among young generation will be beneficial to develop public health policies and programs to tackle the issue.

Poor sleep quality among young adults: The role of anxiety, depression, musculoskeletal pain, and low dietary calcium intake

PURPOSE

This study examined the relationships between sleep quality, anxiety, depression, musculoskeletal pain (MSP), and calcium intake.

DESIGN AND METHODS

In this cross-sectional study (N = 1422), sleep was assessed using the Pittsburgh Sleep Quality Index, anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, and calcium intake and MSP were assessed by self-reporting.

FINDINGS

Poor sleep quality was reported by 62.66% of the participants. The participants with poor sleep quality reported lower calcium intake, higher anxiety and depression levels, more severe MSP, and multisite pain. Anxiety, depression, low calcium intake, and multisite pain were significant predictors of poor sleep quality. Anxiety was predicted by poor sleep quality, depression, multisite pain, and sex (ie, female). Depression was predicted by anxiety, poor sleep quality, and low calcium intake.

PRACTICAL IMPLICATIONS

The findings underscore the role of low calcium intake in the development of sleep problems, anxiety, depression, and MSP. Individuals with these conditions should be advised to increase their calcium intake.

Stress and its association with academic performance among dental undergraduate students in Fujian, China: a cross-sectional online questionnaire survey

BACKGROUND

The aim of this study was to investigate the amount and sources of stress in dental undergraduate students in Fujian, China, and the factors associated with stress.

METHODS

This cross-sectional study was conducted during the second semester of the 2017-2018 academic year at the School of Stomatology, Fujian Medical University, China. A total of 396 students were surveyed with the Dental Environment Stress Questionnaire (DES) and the Perceived Stress Scale (PSS) using an online survey system. The participants' demographic information, including sex, age, year of study, and grade point average (GPA) was also collected. One-way analysis of variance (ANOVA) was performed to compare the stress scores. Pearson correlation and multiple linear regression analyses were conducted to explore the associated factors of stress and academic performance. All statistical analyses were performed at a significance level of 5%.

RESULTS

A total of 347 undergraduate students participated in the present study, for a response rate of 87.6%. There were no significant differences in the DES and PSS total scores among students of different grades and sexes. Significant differences were found in the DES "workload" and "self-efficacy beliefs" scores among students from different study years (all P < 0.05). The Multiple linear regression showed that DES and PSS scores were negatively correlated with GPA, while sex was positively correlated with GPA (all P < 0.05). Female students had significantly higher GPAs than male students.

CONCLUSIONS

Dental undergraduates in Fujian, China experienced moderate levels of stress. While the amount of stress did not differ by year of study, the sources of stress did differ. Stress scores and sex were negatively correlated with academic performance.

Evaluating the stress-response of dental students to the dental school environment

Introduction and Objective

Dentists experience high amounts of professional stress beginning with their student years in dental school. This stress, given its early onset, may negatively impact the personal and professional lives of these individuals, as well as the quality of their clinical work. We sought to create an objective scale to evaluate the levels of stress in students at different stages of their education, as well as in practicing physicians.

Materials and Methods

Thirty dental students participated in this study, with 10 students each selected from junior, mid-senior, and senior classes. They were randomly divided into two groups in which one group was subjected to stressors while the other group was not. JINS MEME ES_R (JINS) smart glasses and Garmin Vivoactive 3 smartwatches were used to obtain data, including electrooculography (EOG), heart rate (HR), and accelerometer (ACC) and gyroscope (GYRO) feedback, while the subjects performed a dental exercise on a phantom tooth.

Results

The heart rates of more experienced students were lower than those of the junior students. The EOG, ACC, and GYRO signals showed multiple differences in the measurement of amplitudes and frequency of episodes.

Conclusion

Our pilot results show that electronic tools, like smart glasses with software and sensors, are useful for monitoring the stress levels of dental students in preclinical operating conditions. We would like to further assess the stress levels in students performing dental procedures on phantom teeth and in later clinical interactions with patients.

Emotional exhaustion, burnout, and perceived stress in dental students

Objective

As in other health sciences, a career in dentistry is associated with numerous stressors in practitioners. The main objective of this research was to examine the prevalence of emotional exhaustion, burnout, and perceived stress among dental students in Mexico.

Methods

A cross-sectional study was conducted among 73 dental students attending a private university in Northern Mexico. Three scales were administered to students to identify emotional exhaustion, burnout, and perceived stress, and parametric data analysis was performed.

Results

Among participants (mean age 19.7 years), the proportion with emotional exhaustion, perceived high stress, and burnout was 52.0%, 42.3%, and 17.8%, respectively. All students with perceived stress also had burnout.

Conclusions

We found that emotional exhaustion and perceived stress are experienced by a large proportion of dentistry students enrolled in the third semester at this private university in Northern Mexico. The proportions were independent of age and sex.

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

BACKGROUND:

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

AIM:

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

METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

Short-Term Effects of a Multidimensional Stress Prevention Program on Quality of Life, Well-Being and Psychological Resources. A Randomized Controlled Trial

It is well-documented that university students have an increased risk in developing psychological problems because they face multiple stressors. Cognitive, behavioral, and mindfulness-based stress prevention programs were shown to reduce symptoms of anxiety, depression, and perceived stress in university students. However, little is known of their effect on resource activation. Additionally, most validated interventions are unidimensional, i.e., including one stress-coping approach. In this study, we investigated the short-term effects of a multidimensional stress prevention program on students' quality of life, psychological symptoms and resources, and resilience factors against stress. Using an experimental design, 64 healthy undergraduate students (56 women), between 18 and 34 years old (M = 21.34, SD = 2.53), from the University of Fribourg, Switzerland, were randomly allocated either to the intervention or the wait-list control group. The intervention group participated in a multidimensional stress prevention program, integrating mindfulness-based activities, cognitive and behavioral strategies, social skills, and emotional regulation exercises. The program consisted of eight 2-h weekly sessions. Before and after the intervention, participants completed self-reported questionnaires evaluating quality of life; psychological symptoms such as depression, anxiety, social anxiety, and interpersonal problems; as well as psychological resources like self-efficacy, sense of coherence, self-compassion, and social support, presented online. A standardized clinical interview was performed at pre- and post-measurement times. To analyze the sort-term effects of the program, we used mixed, two-factorial ANOVAs (per-protocol analyses). In accordance with our hypotheses, our results showed significant reduction of psychological symptoms, including anxiety, interpersonal problems, and symptoms of pain; a significant increase in quality of life, sense of coherence, and self-compassion in students who participated in the intervention program compared to the control group, (all p < 0.05). No significant results were found for symptoms of depression, social anxiety, self-efficacy, and social support. These preliminary findings indicate specific short-term effects of our multidimensional stress prevention program on psychological symptoms and on quality of life as well as promising effects on psychological resources and factors associated with resilience against stress. Future studies should investigate the long-term effects of the intervention as well as the effects in clinical samples.

Perceived sources of stress amongst dental students: A multicountry study

AIMS

The aim of this study was to explore the perceived sources of stress reported by dental students from fourteen different countries.

METHODS

A total of 3568 dental students were recruited from 14 different dental schools. The dental environmental stress (DES) questionnaire was used including 7 domains. Responses to the DES were scored in 4-point Likert scale. Comparison between students was performed according to the study variables. The top 5 stress-provoking questions were identified amongst dental schools. Data were analysed using SPSS software program. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Logistic regression analysis was also conducted to determine the effect of the studied variables on the stress domains. The level of statistical significance was set at <.05.

RESULTS

Internal consistency of the scale was excellent (0.927). Female students formed the majority of the total student population. The percentage of married students was 4.8%. Numbers of students in pre-clinical and clinical stages were close together. The most stress-provoking domain was "workload" with a score of 2.05 ± 0.56. Female students scored higher stress than male students did in most of the domains. Significant differences were found between participating countries in all stress-provoking domains. Dental students from Egypt scored the highest level of stress whilst dental students from Jordan scored the lowest level of stress.

CONCLUSION

The self-reported stress in the dental environment is still high and the stressors seem to be comparable amongst the participating countries. Effective management programmes are needed to minimise dental environment stress.

Can we learn to manage stress? A randomized controlled trial carried out on university students

In our research, we examined the efficacy of an Internet-based stress management program. Our interest in evaluating this type of intervention is based on the increasing accessibility of the Internet today, the growth of Internet-based interventions for various psychopathological problems, and the observation that despite the prevalence of stress among university students, only a fraction of students ever seek professional help. Methodology: “I’m managing my stress” (“Je gère mon stresse”), an Internet-based self-help program composed of four sessions, was examined in this study. The aforementioned program is based on cognitive-behavioral therapy and was inspired by the “Funambule” program in Quebec. Four questionnaires (Perceived Stress Scale, Rosenberg Self-Esteem Scale, Scale of Satisfaction in Studies, and General Health Questionnaire) uploaded online were answered thrice: during “preintervention”, “postintervention”, and “follow-up” stages, the latter of which occurred three months after the intervention. The sample comprised 128 university students, with the majority being women (81.25%). The subjects were divided randomly into two groups (an experimental group and a control group that did not follow the program). Results: The self-esteem scores of the control group were significantly higher than those of the experimental group at the preintervention stage, but this difference disappeared at the postintervention and follow-up stages. There were also significantly lower scores on the General Health Questionnaire subfactors of somatic symptoms and anxiety/insomnia in the experimental group than in the control group during the postintervention stage, though no differences were observed before the intervention. These differences no longer remained after three months. ANOVA revealed significant effects of the intervention over time in the experimental group. Effects were observed at both the postintervention and follow-up stages for self-esteem, perceived stress, satisfaction in studies, and in the somatic symptoms, anxiety and insomnia and severe depression aspects of the General Health Questionnaire (Cohen’s d = 0.38 to 4.58). In contrast, no effects were observed in the control group. Conclusion: This type of Internet-based program has the ability to reach a large number of students due to its rather short format and accessibility. It has already shown improvements in terms of the levels of perceived stress, psychological distress and satisfaction with studies. The option of online interventions could appeal specifically to students who do not seek professional help. However, even though these results are promising at the postintervention stage, they are limited, as indicated by the lack of significant differences between the two groups after the initial three months of follow-up. We still, specifically, need to improve this intervention program and, generally, need more research to address the methodological problems raised by this type of intervention.

Trial registration: ISRCTN registry, ISRCTN13709272

Evaluation of the Knowledge and Attitudes of Dental Students toward Occupational Blood Exposure Accidents at the End of the Dental Training Program

Aims and Objectives:

This study was conducted to assess knowledge, attitudes, and behavior regarding occupational blood exposure accidents (OBEA) among dental students at the end of the whole dental education program.

Materials and Methods:

The survey was performed using a student self-administered questionnaire during July 2015 in the dental teaching hospital in Rabat. It was conducted on 117 dental students registered in the 5^th year. The results were analyzed by SPSS Software, Version 13.0. Univariate analysis was performed by descriptive statistics, and bivariate analysis was used to identify correlations between different variables.

Results:

Eighty-three students answered the questionnaire (participation rate: 70%). Most participants had incomplete knowledge about the management and the risks of OBEA. Thirty-five participants (42%) experienced at least one occupational exposure to patients' blood. Needle recapping has been the main cause of such injuries (41%). Most accidents occurred, respectively, in the oral surgery (51%) and the restorative dentistry (17%) departments. According to many participants, they had received insufficient education concerning this topic.

Conclusions:

More effective education on prevention and management of OBEA is highly recommended to reduce the prevalence of such injuries. Dental schools should set up a local management unit for following and supporting the exposed students.

A longitudinal study on stress sources perceived by Chilean dental students

Introducción. La percepción de los estudiantes universitarios sobre el estrés académico es fundamental, ya que proporciona información valiosa sobre la eficiencia y aceptabilidad de los métodos educativos.Objetivo. Evaluar las diferencias en los factores de estrés percibidos por los estudiantes de primer año de odontología durante el primer y segundo semestre según género.Materiales y método. Estudio descriptivo exploratorio, longitudinal y no experimental. En mayo y octubre de 2016 se aplicó la versión en español del Dental Environment Stressors (DES), adaptado y validado para estudiantes de odontología en la Universidad San Sebastián (Concepción, Chile). La muestra consistió en 83 estudiantes de primer año. La comparación de las variables en estudio (stress y sus dimensiones) entre los dos períodos comparados, en general y considerando los géneros, se realizaron mediante la prueba t-Student, previa estimación de existencia o no de igualdad de varianzas entre los grupos mediante la prueba F de Fisher.Resultados. En la segunda medición, la dimensión “Formación clínica” en mujeres fue el único componente que mostró diferencias significativas con valores superiores de la media.Conclusión. Existe una percepción de estrés para todos los ítems del cuestionario DES; las mujeres tuvieron una mayor puntuación en la dimensión “Formación clínica”.

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

Objectives:

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

Materials and Methods:

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

Results:

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

Conclusion:

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