Psychological Distress among Undergraduate Dental Students in Saudi Arabia and Its Coping Strategies-A Systematic Review

Perceived stress among dental students and the role of parental influence in career decision-making

OBJECTIVES

The current study aimed to assess perceived stress levels among dental students at Riyadh, Saudi Arabia, and to explore the influence of parental roles in their decision to pursue dentistry as a potential source of social stress.

METHODS

This cross-sectional study employed the validated Dental Environmental Stress (DES) Scale to evaluate perceived stress, and incorporated additional questions to fulfill the research aim. We approached all undergraduate dental students at King Saud University, both male and female, across all academic years, using online channels (such as emails, WhatsApp, Twitter, etc.) and hard copy distribution. Data collected were analyzed using SPSS version 20, utilizing descriptive and correlation statistics.

RESULTS

A total of 326 students participated in the study, with an even distribution of male and female students. Female students reported higher levels of stress compared to their male counterparts across most DES domains. A notable correlation emerged between mean DES scores in certain domains and influence of parents in the decision to pursue dentistry.

CONCLUSION

Our findings indicate that female dental students experience higher stress levels than males in all examined areas, barring social stressors. Furthermore, the study underscores the significant impact of parental involvement in choosing dentistry as a career on students' stress level.

Students' perception of the educational environment at King Saud bin Abdulaziz University for health sciences using DREEM tool

BACKGROUND

Students' learning results are influenced by the educational environment. The best learning environment is created when students are involved in the evaluation process of their education. The purpose of this study was to evaluate students' perceptions of their learning environment at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh using the Dundee Ready Education Environment Measure (DREEM) instrument.

METHODS

This observational cross-sectional study was conducted through an online questionnaire using the Arabic version of the DREEM tool. Students from six colleges at KSAU-HS Riyadh campus were asked to complete the questionnaire through emails. The study was carried out between November 2021 and April 2022. Descriptive statistics and inferential statistics were performed for DREEM as both a continuous (two-way ANOVA test) and categorical variable (Chi-squared and Monte-Carlo test).

RESULTS

A total of 370 students completed the questionnaire. The overall DREEM score for the study was 125.88/200, with a standard deviation of 58.79. SSP items received the highest scores, while SAP items earned the lowest scores. The college and the academic level showed statistically significant differences in the DREEM overall score and the five subscales, whereas gender showed no significant difference. The college of pharmacy scored the highest total DREEM score (140.35 ± 27.75), and scored higher among the five subscales than both colleges of dentistry (114.13 ± 29.74) and medicine (113.87 ± 33.03). Students in their third year had the greatest overall DREEM score (132.23 ± 29.76), and scored higher in SPL, SPA and SSP compared to students in their sixth year, in which the total DREEM score was (111.65 ± 27.58).

CONCLUSIONS

Students of KSAU-HS generally perceived the educational environment as having more positive than negative. The educational level and college differed significantly in the overall DREEM score and the five subscales. Junior students had better perception of the educational environment and they differed significantly in the SPL and SPA subscales. The faculty of pharmacy had higher scores in the overall DREEM and the five subsequent scales than colleges of dentistry and medicine. Further research is needed in order to optimize the educational environment by investigating different solutions.

Prevalence, Symptoms, and Triggering Factors of Panic Attacks among Dental Students in Riyadh Saudi Arabia-A Cross Sectional Survey

Panic disorder by definition is an anxiety disorder of unexpected and repeated episodes of intense fear. Panic attacks are usually diagnosed by four or more of a set of symptoms that include palpitations, sweating, trembling, shortness of breath, chest pain, nausea, dizziness, and hot flushes. They usually interfere with daily life situations and also interfere with education. Hence, the aim of this study was to assess the prevalence of panic attacks, their symptoms, and triggering factors among dental students in Riyadh, Saudi Arabia. Data were collected from 394 students using a structured and validated questionnaire. The prevalence of panic attacks among dental students in Riyadh, Saudi Arabia, was 42.9%. Most of the participants who experienced higher episodes of panic attacks were females (53.4%) when compared to males (24.5%). Third year students displayed greater (58.3%) episodes of panic attacks compared to their respective counterparts. The most reported symptom of panic attacks was rapid or pounding heartbeat followed by breathlessness, chest pain, and shaking or trembling. It was also noted that most of the participants (63.31%) encountered a panic attack for the first time after joining dental school. The situations where dental students frequently experienced panic attacks were during exams, clinic procedures, giving presentations, and especially while under a lot of stress. The high occurrence of panic attacks 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. Dental students experiencing panic attacks should be provided with necessary counseling sessions or psychiatric consultation in order to overcome such scenarios. Dental schools should consider these findings when planning the dental curriculum. Hence, the role of the faculty members is essential in these situations to provide support for the affected students.

Prevalence of burnout and practice-related risk factors among Saudi Board dental residents using the Copenhagen Burnout Inventory: A survey-based cross-sectional study

Occupational burnout is a chronic psychological problem affecting professionals. The aim of this study was to assess the types and categories of burnout among Saudi Dental board residents at different levels of residency in different provinces of Saudi Arabia, using the Copenhagen Burnout Inventory. Questionnaires were sent to 170 Saudi Dental board residents via Email and WhatsApp. at various training centers in Saudi Arabia, in May 2022. A part of the questionnaire covered the socio-demographic characteristics of the participants such as gender, training level or center, number of working sessions or hours per week and day, dental speciality, and marital status. The second part consisted of the Copenhagen Burnout Inventory survey with 21 questions. Only 110 participants returned the answered questions. The overall significant type of burnout was present in 46.3% of the respondents while 53.7%, were for free or minimal burnout. Personal, work-related, and patient-related burnout recorded 62%/38%; 40% to 60%, and 60%:40% for free or minimal to significant burnout. The overall burnout types of values were equal in both gender as well as training levels with no significant differences and P-values ≤ .05. Burnout values were close to each other among the participants in different specialties, except for orthodontics residents which were the least. Analysis of variance, followed by chi-square tests showed a significant difference among participants in different specialties in type and categories of burnout with P-values between .002 to .029. Finally, the burnout value was higher among married participants. Overall burnout types were marginally similar between genders and training levels, while the significant was slightly higher in females, married, highest training level, restorative, and prosthodontic speciality participants.

A Retrospect of the Special Issue "Second Edition of Innovative Solutions for Oral Healthcare"

Medicine and oral health are constantly progressing through a series of small advancements that, together, lead to significant discoveries and breakthroughs [...].

Psychological distress facing the COVID-19 pandemic in dental interns from the Peruvian capital: A cross-sectional study under a multivariable regression model

Aim

Psychological distress can be considered a maladaptive response to a stressful situation that occurs when external events or stressors impose demands that cannot be coped with. Therefore, the aim of the present study was to evaluate the sociodemographic factors associated with psychological distress in dental interns from the Peruvian capital facing the COVID-19 pandemic.

Materials and methods

This analytical, observational, cross-sectional study was conducted on 392 Stomatology interns from the Peruvian capital from June to July 2022. The validated COVID-19 Peritraumatic Distress Index (CPDI) scale to detect the levels of psychological distress consisted of four dimensions: negative mood, changes in behavior and cognitive skills, fatigue and hyperreactivity, and somatization. Pearson's chi-square and Fisher's exact test were used for bivariable analysis. In addition, a logit model was used to assess the influence of variables: sex (X1), age group (X2), marital status (X3), monthly economic income (X4), working area in the capital city (X5), and living with people vulnerable to COVID-19 (X6), with the psychological distress levels, considering a significance p < 0.05.

Results

The prevalence of psychological distress in dental interns was severe in 6.4% [95% confidence interval (CI): 3.9-8.8%] and mild in 37.8% (95% CI: 33.0-42.6%). According to bivariable analysis, the levels of psychological distress by COVID-19 were not significantly associated with sex (p = 0.190), age group (p = 0.418), marital status (p = 0.554), monthly economic income (p = 0.327), working area in the capital city (p = 0.993), and living with people vulnerable to COVID-19 (p = 0.134). In addition, according to the logistic regression analysis, none of the variables studied was considered an influential factor (p > 0.05) in psychological distress presented by dental interns.

Conclusion

The 44.2% of dental interns from the Peruvian capital presented psychological distress facing the COVID-19 pandemic, without any of the possible associated variables of this study significantly affecting this behavioral disorder.

Evaluation of anxiety-provoking situations related to clinical training in dental education

INTRODUCTION

The aims of this study were to evaluate the situations that cause anxiety in clinical training and to discuss the precautions that can be taken to reduce clinical anxiety in dental education.

MATERIALS AND METHODS

This multi-centred survey-based study was created through Google Docs, and 3rd, 4th and 5th grade dental students were included. The students were asked to rate their reactions on a 4-point Likert scale "not anxious" to "very anxious" for 27 questions related to academics, communication and interaction, diagnosis, dental treatments, deficiencies and mistakes in the treatments.

RESULTS

1332 students were reached, and 1320 students completed the questionnaire. Whilst extracting wrong tooth (3.53 ± 0.83), getting infected by patient (3.39 ± 0.85) and getting diagnosis wrong (3.31 ± 0.83) were identified as the 3 most anxiety-provoking situations, taking panoramic radiograph (1.48 ± 0.71) and communication with patients and dental assistants/nurses (1.76 ± 0.87; 1.64 ± 0.76) were identified as 3 situations that cause the least anxiety. Female students reported higher anxiety levels than male students in most of the questions (p < .05). A statistically significant difference was observed between the grades of the students (p < .05). 3^rd grade students showed statistically higher anxiety levels than higher grades in 16 out of 27 questions. No statistical significance was observed according to the status of the university (p > .05).

CONCLUSION

Questions related to diagnosis, delivery of the dental treatments, deficiencies and mistakes in the treatments caused higher anxiety levels amongst dentistry students. As experience and time in the clinical training increase, the anxiety level of the students decreases. Orientation programmes and establishing an effective communication between grades are recommended. Also, gender-based solutions must be taken into consideration.

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.

Burnout and Its Relation to Emotion Dysregulation and Social Cognition among Female Interns and Undergraduate Dental Students at King Khalid University

Background: Burnout is a state of vital exhaustion that has a high global prevalence among dental professionals. Yet the early diagnosis of this syndrome is challenging due to its multidimensional nature. Aim: To assess burnout and its relation to emotional dysregulation and social cognition among undergraduate dental students. Methods: We mailed 148 self-administered questionnaires to all interns and undergraduate dental students belonging to the College of Dentistry’s female campus at King Khalid University, Saudi Arabia. A questionnaire was designed comprising three measuring instruments of psychological inventories to assess work-related stress, namely, burnout (Copenhagen burnout inventory questionnaire (CBI)), emotional dysregulation (emotion regulation questionnaire (ERQ)), and social cognition (interpersonal reactivity index (IRI)). We examined the difference in burnout between two cohorts (interns and undergraduates) using Student’s ‘t’ test and the association between emotional regulation/social cognition domains using Pearson’s correlation. Results: Among the participants, around 70% obtained higher scores than the cut-off points for personal and work-related domains in both groups. There was no statistically significant difference in burnout domain between the two cohorts (p > 0.05; Cohen d < 0.3). A negative correlation existed between burnout and emotion regulation, i.e., higher burnout score is associated with lesser cognitive reappraisal and more expressive suppression (CBI—personal burnout r = −0.251; r = −0.220 respectively). Social cognitive scores had various associations among interns and undergraduates, with personal distress being significantly associated with greater burnout levels among both groups (p < 0.05). Conclusions: The present study revealed significantly elevated burnout levels among both interns and undergraduate students. Emotional dysfunction and social cognition assessment can be a valuable adjunct in identifying this erosive syndrome. Early recognition and primordial prevention targeting burnout are strongly recommended.

Academic and non-academic life stressors and their impact on psychological wellbeing of medical students

Objectives

Among medical students, depression, anxiety, and stress (DAS) are key public wellbeing challenges that require epidemiological research. We aimed to evaluate potential sources of these psychological disturbances and assess the contribution of academic and non-academic life stressors in psychological morbidity among medical students.

Methods

This exploratory questionnaire-based survey was conducted in a Saudi Arabian public sector medical college. A total of 231 medical students were enrolled and completed the depression, anxiety, and stress scale-21 (DASS-21) questionnaire.

Results

More than half of the medical students, 129 (55.8%), had depression, 106 (45.9%) students had anxiety, and 87 (37.7%) students had stress. Academic achievement was the largest explanatory factor for depression and stress, whereas bodily appearance constituted the largest explanatory factor of anxiety among the study sample. Academic and non-academic stressors score was significantly associated with depression (adjusted Odds Ratio, aOR = 1.13, 95% CI 1.07–1.19), anxiety (aOR = 1.07, 95% CI 1.03–1.12), and stress (aOR = 1.12, 95% CI 1.08–1.17).

Conclusions

Medical students have a high incidence of negative emotional states. These negative psychological states were explained by academic achievement and bodily appearance. The studied stressors influenced medical students' psychological wellbeing.