Sleep quality and its correlates among undergraduate medical students in Nepal: A cross-sectional study

Associations between Stress, Anxiety, Depression and Sleep Quality among Healthcare Students

OBJECTIVES

Stress, anxiety, and depression among students have many negative health consequences and may predispose students to poor sleep quality; therefore, this research aimed to investigate the perceived stress, anxiety, and depression and their relation to the level of sleep quality among healthcare students.

METHODS

A cross-sectional study using a validated survey was conducted among Saudi healthcare students from different regions during the period from 26 September 2022 to 30 October 2022. The Pittsburgh Sleep Quality Index (PSQI) was utilized to assess sleep quality. PSPP Statistical Analysis Software version 1.2.0 was used for all statistical analyses.

RESULTS

701 respondents participated in this research; the response rate was 73.8%. About 60% of the study sample was female, and the average age was 20.9 years. 80.3% of students have poor sleep quality; the participants' mean sleeping hours per night was 6.81 ± 1.88 h. About three-quarters of students (72.9%) perceive themselves as stressed. A significant positive correlation was observed between sleep quality and perceived stress (r-value = 0.363), anxiety (r-value = 0.387), and depression (r-value = 0.347). Poor sleep quality was more likely among those with stress than those without stress (AOR = 1.79; 95% CI 1.07, 2.99) and two times more likely among students with cases of anxiety than those without anxiety (AOR = 2.07; 95% CI 1.10, 3.94).

CONCLUSIONS

Our study highlights the high prevalence of poor sleep quality, anxiety, depression, and stress among healthcare students in Saudi Arabia. Students' reported stress, anxiety, and residence region were associated with poor sleep quality. These results imply the necessity of regular screening and appropriate intervention for sleep problems, stressors, and anxiety among healthcare students.

The prevalence of stress among medical students in Syria and its association with social support: a cross-sectional study

INTRODUCTION

Chronic stress can interrupt personal life and cause fatigue, inability to concentrate, and irritability. This study aims to determine the prevalence of stress and its associated factors among medical students in Syria and whether social support could be a protective factor against stress.

METHODS

A cross-sectional study was conducted in the faculty of medicine of five Syrian universities. The Medical Student Stressor Questionnaire (MSSQ) was used to evaluate the stress caused by the possible sources of stress. And Social Support Questionnaire - short version (SSQ - short version) was used to assess the social support that medical students received from family, friends, and their fellow medical students using six questions.

RESULTS

A total of 1472 medical students participated in the study. Among the total participants, 671 (45.6%) were males, and 801 (54.4%) were females. The majority of the participators had mild (50.6%; n = 745) and moderate (37.0%; n = 545) stress levels. Academic-related stressors were the most important cause of stress among undergraduate medical students. Social support was provided equally to both genders, and genders reported the same degree of satisfaction.

CONCLUSION

Our results emphasize the importance of improving the curricula, providing mental health consultants for students, and paying more attention to the mental health of female students. Finally, students in their clinical years should also receive mental health care, decreasing their duties and providing more self-free time.

Sleep quality among undergraduate medical students in Rwanda: a comparative study

Despite the abundance of literature highlighting poor sleep quality among medical students and its detrimental impact on their mental well-being and academic performance, no study has been conducted to investigate the sleep quality of undergraduate medical students in Rwanda to date. Therefore, this study sought to determine the magnitude of sleep quality of undergraduate medical students in Rwanda and to compare the scores of seven components of sleep quality across classes. This cross-sectional study was conducted among 290 undergraduate medical students aged 18-35 years (mean = 24, SD = 2.9) randomly recruited countrywide from 1st November 2021 to 1st March 2022. The questionnaire was self-administered with 2 sections: characteristics of medical students, and Pittsburgh Sleep Quality Index (PSQI). The Pearson Chi-square test was used to test whether the categories of seven components of sleep quality differ between classes, then ANOVA followed by the post hoc test was used to test if the seven components and global score of Pittsburgh Sleep Quality Index differ between classes. The results revealed that the global PSQI mean score was 7.73 (SD = 2.83), with fifth-year medical students reporting the highest PSQI mean score (M = 8.44, SD = 2.77), followed by first-year (M = 8.15, SD = 3.31). One-way ANOVA showed that the global PSQI score (F = 2.76, p = 0.028), subjective sleep quality (F = 3.35, p = 0.011), habitual sleep efficiency (F = 10.20, p < 0.001), and daytime dysfunction (F = 3.60, p = 0.007) were significantly different across classes. Notably, the post hoc test revealed significant scores differences in the global PSQI score between class II and V (p = 0.026), in subjective sleep quality between class I and II (p = 0.043), and between class I and IV (p = 0.016); habitual sleep efficiency between class V and all other classes (p < 0.001); and daytime dysfunction between class III and IV (p = 0.023). This paper concludes by arguing that poor sleep quality is highly prevalent among medical students in Rwanda, with final and first-year students reporting the poorest sleep quality. There were significant differences across classes in the global PSQI, subjective sleep quality, habitual sleep efficiency, and daytime dysfunction. Intervention approaches such as sleep education, behavioral changes, and relaxing techniques are recommended to address contributing factors and ultimately maximize the academic goals of Rwandan medical students.

Tobacco Use and Its Associated Factors among Undergraduate Public Health Students in Kathmandu Valley, Nepal

Background. Despite the crucial role of public health students in tobacco control, there is a paucity of information regarding tobacco use among this population in Nepal. This study aims to assess the prevalence of tobacco use among undergraduate public health students in Kathmandu valley, Nepal. Methods. A web-based survey was conducted among 386 undergraduate public health students in Kathmandu valley, Nepal, using the Global Health Professions Student Survey (GHPSS) questionnaire. Associated factors were examined using multivariate logistic regression analyses at the level of significance of 0.05. Results. A total of 16.8% of students were current cigarette smokers, 39.9% had ever smoked cigarettes, and 62.2% had smoked their first cigarettes during adolescence. Among the participants, 11.7% currently used other tobacco products. Male students (aOR: 15.4; 95% CI: 4.9–47.8), students with higher age (aOR: 2.4; 95% CI: 1.0–5.4), students belonging to non-Brahmin/Chhetri ethnic group (aOR: 2.3; 95% CI: 1.2–4.4), and those staying without family (aOR: 2.0; 95% CI: 1.1–5.0) had higher odds of being current smoker. Similarly, students with a parental history of tobacco use (aOR: 2.4; 95% CI: 1.3–5.0) and friends with smoking habits (aOR: 7.9; 95% CI: 2.3–27.0) were more likely to be a current smoker. Conclusion. There is a notable prevalence of tobacco use among public health students in Kathmandu valley, Nepal. Concerned stakeholders should work jointly to implement a cessation program to discourage tobacco use among these populations who have a potential role in educating communities about the hazards of tobacco smoking, tobacco use prevention, and control.

Behavioral and psychosocial predictors of depression in Bangladeshi medical students: a cross-sectional study

BACKGROUND

Depression, stress, and anxiety were found in a large number of medical undergraduate students, indicating a neglected aspect of their psychology that required immediate attention. The goal of this study was to find out the prevalence of depression among medical students, as well as potential psychosocial and behavioral predictors for depression.

METHODS

This cross-sectional study was conducted from July to November 2021 among 840 randomly selected medical students from four medical colleges using stratified random sampling. Data were collected using a semi-structured, self-administered questionnaire and were analyzed through the SPSS v.23 software. Multiple regression was performed to assess the effect of several behavioral and psychosocial factors on depression.

RESULTS

Among the 840 study participants, 55.7% (n= 468) were female and 44.3% (n= 372) were male. According to the data, the prevalence of depression, anxiety, perceived stress among medical students was found to be 28.8%, 65% and 85% respectively. A strong link was found between depression and anxiety, stress, poor sleep quality, poor academic performance, and a negative social and romantic relationship status.

CONCLUSIONS

A significant number of medical students are depressed. In order to prevent and treat depression, medical students should be screened for depression and its associated factors.