Is There an Association between Increased Stress and Smartphone Addiction? Insights from a Study on Medical Students from Saudi Arabia during the COVID-19 Pandemic

Purpose: Smartphone addiction is prevalent among medical students, and there is a concern that the coronavirus disease 2019 (COVID-19) pandemic fueled a rise in smartphone addiction. Earlier studies suggest a link between excessive smartphone usage and negative outcomes such as depression, stress, and reduced academic achievement. However, there is a dearth of both local studies in Saudi Arabia and studies conducted during the COVID-19 pandemic exploring the prevalence of smartphone addiction and its association with academic performance, depression, and perceived stress, which is the purpose of the current study. Methods: In 2021, a cross-sectional research project took place among medical students at King Saud University and the Vision Colleges located in Riyadh, Saudi Arabia. An online self-administered questionnaire consisting of demographic variables, grade point average (GPA), the Patient Health Questionnaire-9 (PHQ-9), the Perceived Stress Scale-4 (PSS-4), and the Smartphone Addiction Scale-Short Version (SAS-SV) was deployed. Results: Three hundred and fifteen students participated. Around 47.9% of students reported smartphone addiction, and the mean SAS-SV score was 32.31 ± 12.01 points. Both PHQ-9 and PSS-4 scores showed a significant positive correlation with the SAS-SV score (r = 0.216, p < 0.001 and r = 247, p < 0.001, respectively), while GPA did not (r = -0.027, p = 0.639). An adjusted analysis showed that the PSS-4 score was positively associated with the SAS-SV score (odds ratio (OR) = 1.206, p < 0.001), while the PHQ-9 score was not (OR = 102, p = 0.285). Conclusions: Smartphone addiction is prevalent among medical students and associated with perceived stress. Additional research is required to gain a deeper comprehension of this issue and to assess the success of intervention initiatives aimed at encouraging healthy smartphone usage, particularly in times of crisis like the COVID-19 pandemic.

Empathy among Saudi Residents at a Tertiary Academic Center during the COVID-19 Pandemic and Its Association with Perceived Stress

Background and Objectives: Empathy is an important attribute of a healthy doctor−patient relationship. Although multiple studies have assessed empathy in different countries, little is known about its levels among Saudi residents and its association with perceived stress. Objectives: To assess the levels of empathy and to identify if there is an association with stress in general and across the demographic and training characteristics of residents. Materials and Methods: A cross-sectional questionnaire-based study was carried out from December 2020 to March 2021 among residents training at a tertiary academic center in Riyadh, Saudi Arabia. Empathy and perceived stress were measured using the Jefferson Scale of Empathy (JSE) and the Perceived Stress Scale (PSS). Results: A total of 229 residents participated. The mean JSE score was 105.25 ± 15.35. The mean JSE scores were significantly higher among residents training in pediatrics (mean difference (MD) = 17.35, p < 0.001), family medicine (MD = 12.24, p = 0.007), and medical specialties (MD = 11.11, p = 0.012) when compared with surgical specialties and anesthesia. In addition, residents who worked 1−4 on-calls per month had a higher mean JSE score (MD = 11.23, p = 0.028) compared with those who worked 7 or more on-calls. Lastly, no correlation between empathy and perceived stress was detected in the whole sample (r = −0.007, p = 0.913); however, there was a correlation among residents training in medical specialties (r = −0.245, p = 0.025). Conclusion: Residents in our study had empathy levels comparable with Asian but lower than Western residents. We recommend qualitative studies that explore potential factors that might affect empathy among residents and studying the association between empathy and perceived stress among medical residents. Postgraduate curricula should incorporate interventions that foster a more empathetic doctor−patient relationship.

The Diagnostic Yield of Abdominal Ultrasounds Requested by Family Physicians at an Academic Hospital in Riyadh, Saudi Arabia

Background: Abdominal ultrasound is a non-invasive, relatively inexpensive, and widely available diagnostic modality in family medicine settings.

Objectives: Our study aimed to identify the most common indications for requesting abdominal ultrasounds by family physicians, determine the frequency of abdominal ultrasound with abnormal findings, identify the most common findings, and determine patients’ characteristics associated with abnormal findings.

Methods: This retrospective chart-based study was conducted from January 2020 to June 2020 to analyze patients’ abdominal ultrasounds reports requested by family physicians in 2019 at King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia.

Results: We assessed abdominal ultrasound reports of 1,113 patients. There were 620 (55.7%) female patients. The mean age and body mass index (BMI) were 46.35 years ± 15.04 and 29.33 kg/m² ± 7.06, respectively. The most common indications were abdominal pain (43.2%), suspicion of gallbladder and biliary system diseases (18.5%), and abnormal liver function tests (14.6%). The frequency of abnormal findings was 793 (71.2%), and the most common findings were fatty liver infiltration (49.7%), liver enlargement (20.1%), and gallstones (13.3%). Females had a lower likelihood to have abnormal findings compared to males (odds ratio (OR)=0.688, p=0.009). Lastly, the likelihood of abnormal findings increased with age and was highest among patients aged 71 years or more (OR=25.9, p< 0.001).

Conclusion: Abnormal findings were more prevalent in our study compared with other studies. Abnormal findings were more common among males and older age groups. We recommend future studies on patients from community-based family medicine settings, and to examine the association of abnormal findings with patient-centered endpoints. Finally, disseminating the results of this study will inform family physicians with the most common abnormal abdominal ultrasound findings, and will enhance the discussion with patients undergoing an abdominal ultrasound examination.

Which Volunteering Settings Do Medical Students Prefer During a Novel Respiratory Virus Pandemic? A Cross-Sectional Study of Multiple Colleges in Central Saudi Arabia During the COVID-19 Pandemic

Purpose

Novel respiratory virus outbreaks are a recurring public health concern. Volunteering medical students can be a valuable asset during such times. This study investigated the willingness of medical students to volunteer during the coronavirus disease of 2019 (COVID-19) pandemic and the barriers to doing so, considering the possibility of exposure to COVID-19 and mode of contact.

Patients and methods

This cross-sectional study was conducted using a self-administered online questionnaire adapted from the literature. The questionnaire comprised four parts: demographic variables, COVID-19-related variables, willingness scale, and barrier scale. The target population was medical students at four different colleges in Riyadh, Saudi Arabia.

Results

A total of 802 students participated in the study. A small proportion of students (10.6%) were willing to participate in volunteering activities that could involve contact with patients with COVID-19 as compared to other settings (39.4-43.4%). More than one-quarter of students (26.8%) had risk factors for severe COVID-19. The main barrier to volunteering was the concern of transmitting the infection to family members (76.8%). Registration to receive the COVID-19 vaccine was positively associated with more willingness to volunteer (β=0.17, p <0.001), whereas residing in a household with an elderly person was negatively associated (β=-0.13, p <0.001). Female sex was positively associated with higher barrier score (β=0.12, p <0.001).

Conclusion

Medical students were more willing to volunteer in activities that did not involve direct contact with patients with COVID-19. A considerable proportion of participants had risk factors for severe illness. Sharing a household with an elderly person or child was associated with lower willingness to volunteer. Organizers of volunteering activities should offer various volunteering options considering the risk of infection; and be mindful of barriers to volunteering, especially risk factors for severe illness and eldercare and childcare responsibilities.

Nondisclosure of Medical Related Information by Persons with Type 1 and Type 2 Diabetes Mellitus to Their Healthcare Providers: Do Different Patterns Exist?

PURPOSE

The doctor-patient relationship is often challenged by complex communication issues and nondisclosure of important related medical information, especially in diabetes management. Very little information is known about diabetic patient nondisclosure to their doctors. The present study evaluated the prevalence of nondisclosure of information by persons with type 1 and type 2 diabetes mellitus to healthcare providers and its associated factors among the Saudi population, as well as the differences between persons with type 1 and type 2 diabetes mellitus.

METHODS

A cross-sectional study targeting persons with type 1 and type 2 diabetes mellitus was conducted at King Saud University Medical City, Saudi Arabia, Riyadh. An online self-administered questionnaire was used to collect data.

RESULTS

A total of 285 participants were included in the study (155 [54.4%] and 130 [45.6%] type 1 and 2 diabetic patients, respectively). Having an unhealthy diet (25.3%, n = 72), not regularly exercising (23.5%, n = 67), hiding some glucose readings (23.2%, n = 65), and not following instructions for weight loss (22.8%, n = 44) were the most common types of nondisclosed information among diabetic patients. The nondisclosure of information was significantly higher among type 2 patients (29.2%) than type 1 diabetic patients (18.7%) in terms of not participating in regular exercise (p = 0.018). Similarly, the nondisclosure of information was significantly higher among persons with type 1 diabetes compared to persons with type 2 diabetes in terms of hiding some glucose readings (p < 0.001) and not disclosing hyperglycemia (p = 0.011).

CONCLUSION

Nondisclosure of important related medical information among diabetic patients to their healthcare providers is prevalent among the Saudi population. Furthermore, the types and causes of nondisclosed information differ among persons with type 1 and type 2 diabetes mellitus.

Willingness and Self-Perceived Competence of Final-Year Medical Students to Work as Part of the Healthcare Workforce During the COVID-19 Pandemic

Purpose

The coronavirus disease 2019 (COVID-19) pandemic may increase demand for healthcare professionals (HCPs), either because of a HCP shortage due to illness or because of the need to increase surge capacity. Final-year medical students are one of the resources potentially available to expand the workforce. There is a need to explore the willingness of final-year medical students to meet this demand, examine their perceived competence, and determine how their overall perceived competence correlates with their willingness.

Methods

A cross-sectional study using a self-administered electronic questionnaire was used. The questionnaire included demographic data, students’ self-perceived competence derived from the patient care theme of the Saudi Medical Education Directives (SaudiMED) framework, and their willingness to be measured on a 5-point Likert scale. The study targeted final-year medical students at King Saud University, Riyadh, Saudi Arabia.

Results

The number of participants was 134 (56.1% response rate), of whom 47 students (34.3%) were willing to work, while 31 (23.1%) were somewhat willing. The mean total self-perceived-competence score was 58.36/88 (66.3%). Demonstration of essential clinical skills had the highest mean score 11.48/16 (71.8%) among learning outcomes. There was a positive moderate correlation between willingness and mean perceived-competence score (Spearman correlation coefficient=0.45, p<0.001).

Conclusion

Fifty-seven percent of medical students were willing to work as part of the healthcare workforce during the COVID-19 pandemic. Better overall self-perceived competence appeared to correlate with more willingness. Students perceive themselves to be more competent in essential clinical skills. Appropriate training and supervision are suggested in all tasks assigned to them, with additional care required in areas with a lower perceived competence, such as prescription writing and essential clinical procedures.

Prevalence of and risk factors for poor sleep quality among residents in training in KSA

Objectives

This study aimed to identify the prevalence of and risk factors for poor sleep quality among medical residents in KSA.

Methods

A cross-sectional study was conducted on residents in programmes supervised by the Saudi Commission for Health Specialties. An anonymous, self-administered, web-based survey using the Pittsburgh Sleep Quality Index (PSQI) was done. The study received ethical approval from the institutional review board of the King Saud University College of Medicine, Riyadh, KSA.

Results

A total of 1205 residents responded to the survey. A high prevalence of 86.3% of poor sleep quality was recorded. When grouped by specialty, anaesthesia residents had the highest prevalence of poor sleep quality (96%), whereas pathology residents had the lowest prevalence (68.7%). Increased sleep latency was the most common contributor to poor sleep quality, observed in 68.4% of residents at least once a week. Poor sleep quality was further stratified based on median PSQI scores into stages 1 (46.9%) and 2 (39.4%). Using multivariate logistic regression, the age group of those between 27 and 29 years (p = 0.012) covering on-call cases (p ≤ 0.01) or working shifts (p < 0.001) was significantly associated with stage 2 poor sleep quality.

Conclusion

Poor sleep quality is highly prevalent among medical residents in KSA. Increased sleep latency and short sleep duration were the most reported sleep distractors. On-call scheduling and shift work were major risk factors for poor sleep quality. Training programmes should abide by the 80-hour weekly limit and integrate wellness programmes into the curriculum.