Hipohondrijski strahovi i uverenja studenata medicine

Background/Aim. The mental health of medical students worsens during their studies, and research shows that medical students are at high risk of depression. The aim of this study was to evaluate the prevalence of depressive symptoms and to examine the association between various risk factors and depressive symptoms in a sample of first- and sixth-year medical students at the University of Novi Sad. Methods. A cross-sectional study was conducted at the Faculty of Medicine of the University of Novi Sad. The sample consisted of 308 students divided into two groups ? 213 students in the first year and 9 5 students in the final (sixth) year of medical studies. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depressive symptoms. Within this instrument, item 9 was used to identify suicidal ideation. Self-esteem was evaluated with the Rosenberg Self-Esteem Scale (RSES). Additional questions were focused on self-assessed material status, lifestyle factors, and mental healthcare-seeking. Univariate and multivariate logistic regression analyses were applied. Results. The prevalence of depressive episodes among medical students was 16.6%. Almost 9% had thoughts of committing suicide. First-year students with low self-esteem were almost seven times more likely to suffer from moderate to severe depressive symptoms than those with high self-esteem. Students who had used sleeping pills or sedatives without a prescription were nearly five times more likely to have a PHQ-9 score ? 10 than those who had not [odds ratio (OR) = 4.97, 95% confidence interval (CI): 1.83?13.52)]. Sixth-year students with poor or average self-assessed social relation-ships and low self-esteem had a stronger association with a PHQ-9 score ? 1 0. Conclusion. There is a high prevalence of depressive episodes among first and sixth-year medical students, and it is associated with low self-esteem in both groups, use of sleeping or sedative pills without a prescription among first-year students, and poor social health in sixth-year students. We recommend routine screening for depression in medical students and establishing prevention and intervention programs.

We aimed to determine the influence of a medical school program on altering the opinion of medical students on disaster myths. This cross-sectional survey study was conducted in October 2005 in Hacettepe University Faculty of Medicine, Turkey, with the participation of 191 (83.0%) first-year and 232 (80.8%) sixth-year medical students. The opinions of the students with regard to 22 disaster myths and the influence of the medical school program on these opinions were evaluated. Chi-square test was used in the statistical analysis. One hundred and fifty-nine first-year (83.2%) and 178 (76.7%) sixth-year students had knowledge about disasters (chi2=2.75, P=0.972). Television was cited as the leading source of knowledge among both first-year (63.9%, 122) and sixth-year (62.1%, 144) students. The medical school was the last resource for knowledge as reported by first-year students (0.5%, one student), and ranked fourth as a knowledge resource according to sixth-year students (47.0%, 109 students). Statistically significant differences were determined in opinions between the two groups of students, with sixth-year students having a higher rate of correct answers in only seven myths. In 17 myths, the number of correct responses for both groups was below 60%. If the myths and realities in disaster situations are valid, we demonstrated that the medical education curriculum at one of the leading medical faculties in Turkey failed to correct the misconceptions of the medical students. As the opinions of students regarding disaster myths may reflect those of their trainers, similar surveys conducted among the faculty would be informative.

Introduction: The prevalence of smoking among medical students indicates that studying medicine is an insufficient protection from tobacco use. The aim of the study was an analysis of medical students’ attitudes towards smoking at the first and sixth year of their studies. Material and methods: A questionnaire on tobacco smoking was distributed among medical students of the study year 2002–2008 at the first and sixth year of their studies. The questionnaire used on the sixth year students included additional questions designed to assess changes in their attitudes towards smoking during their studies, to ask their opinion of the teaching of diagnostics and treatment of tobacco dependence (TD), and to discover how they evaluated their knowledge of the issue. The numbers of students who participated at the two points of the study were 287 and 175 respectively. Results: Students in their sixth year significantly less frequently smoked cigarettes regularly than those starting their medical education (13% v. 21%; p = 0.022). However, 20% of smokers started smoking during their studies. The proportion of smokers saying they were not embarrassed by their smoking habit was significantly lower among sixth-year students compared to first-year students (31% v. 70%; p = 0.0006), as were the numbers who said they wanted to quit smoking (91% v. 61%). Those who wished to undergo treatment for TD (54% v. 22%) were significantly higher among sixth year students group (p = 0.013 and p = 0.001, respectively). More than half (57%) the sixth-year students claimed that they had no knowledge of the diagnostics and treatment of TD, or that their knowledge on this issue was poor or very poor. In the opinion of 43% of students, the medical curriculum was not a good source of knowledge on TD. Conclusions: Medical studies induce positively students’ attitudes towards smoking. However, a proportion of individuals start smoking during studies, which may suggest dominance of genetic influences on smoking initiation in this period of life. In sixth-year students’ opinion, medical studies are not a sufficient source of knowledge on TD.

The organization of medical curricula with a clear distinction between basic and clinical subjects makes it difficult for teachers to collaborate and teach students in an integrated way. We designed a new subject, Integrated Medicine, to overcome such limitations. Here, we describe the evaluation of the first three years of running the experience, as well as the opinion of the first group of students in their sixth year. Three cohorts of first-year medical students (n=158) and eight teachers, as well as a group of students of sixth year (n=41), participated in the experiment. Students worked following the problem-based learning approach. Their satisfaction, their subjective improvement of content knowledge in basic and clinical fields, and their belief about the accomplishment of educational objectives were evaluated. The results showed a high level of satisfaction, increased content knowledge, and improvement in solving problems, searching for relevant information, team working, and oral and written communication skills. Students of sixth year agreed that the subject helped them to better understand the clinical manifestations of disease, the diagnosis process, and therapeutic approaches. In conclusion, experiences such as Integrated Medicine may enhance the integration of knowledge by the joint work of basic and clinical teachers.

Background and aim: Outbreak of the COVID-19 pandemic has had big impact on higher education system. To prevent spreading of the disease, distance learning was organised. The aim of this research was to assess medical students’ perception of quality of educational process during the COVID-19 pandemic.Respondents and methods: Online research was conducted during May 2021 on 142 students of fourth, fifth and sixth year of School of Medicine University of Zagreb. This research was conducted using Questionnaire for Assessing Quality of Distance Learning in Biomedicine Studies. It consists of 28 items which are rated using 7-point Likert scale and are distributed in six subscales. All statistical analyses were conducted using IBM® SPSS® Statistics for Windows (Version 25.0).Results: Statistically significant difference was found in Perception of Teachers’ Work between fourth and sixth year (p = 0.012), as well as Perception of Educational Environment and Personal Academic Achievements between fourth and fifth, and fourth and sixth year of study (p < 0.001). The lowest mean for all subscales was found in fourth year, except subscales Perception of Personal Academic Activity (3.51 ± 1.32) and Perception of Equipment Quality (6.22 ± 1.04). The highest mean was found in sixth year for subscales Perception of Distance Learning Organization (3.47 ± 1.04), Perception of Cooperation (4.39 ± 1.04) and Perception of Teachers’ Work (4.73 ± 0.96). For subscales Perception of Educational Environment and Personal Academic Achievements and Perception of Equipment Quality, the highest mean was found in the fifth year (5.42 ± 1.14 and 6.28 ± 1.01, respectively). Majority of students were satisfied with equipment quality and Internet connection they used, however most of them (N = 68, 47.9 %) thought that teachers were not qualified enough to use tools for online teaching.Conclusion: The highest quality of educational process was perceived by sixth-year (64.9 % of the total score), and the lowest by fourth-year medical students (58.7 % of the total score). Teachers should continue with their education in order to maximize the use of digital technology in achieving educational outcomes, especially in biomedical area.

BackgroundResearch on health anxiety has bloomed in recent years, but summaries of the literature are complicated by the use of dissimilar self-report questionnaires. Furthermore, these instruments have rarely been administered in parallel, and especially not in clinical samples. In this study, we aimed to investigate the relationship between five widespread health anxiety measures, and to draft guidelines for the conversion of different sum scores.MethodsClinical trial participants with principal pathological health anxiety (n = 335) and a sample of healthy volunteers (n = 88) completed the 14-item Whiteley Index (WI-14), the Illness Attitude Scale (IAS), and the 14-, 18-, and 64-item Health Anxiety Inventory (the HAI-64, HAI-18, and HAI-14). Cross-sectional data from all participants were pooled (N = 423) and we conducted a joint factor analysis and approximate equipercentile linking of the WI-14, IAS, HAI-64, HAI-18, and HAI-14.ResultsInter-scale correlations were high (rs ≥ 0.90 and ≥ 0.88 in adjusted analyses), and the scree plot of the joint factor analysis spoke for a unifactorial solution where 89/105 items (85%) had loadings ≥ 0.40. Most items at the core of this broad trait health anxiety factor pertained to the worry about health, the fear of having or developing a serious disease, and to some extent bodily preoccupation. We present a cross-walk table of observed equipercentile linked sum scores.ConclusionsThis study speaks clearly in favor of the WI-14, IAS, HAI-64, HAI-18, and HAI-14 all tapping into the same trait health anxiety construct, the core of which appears to concern the worry about health, the fear of having or developing a serious disease, and to some extent bodily preoccupation. Based on recently reported cut-offs for the HAI-14, a reasonable cutoff for pathological health anxiety in a psychiatric setting probably lies around 7–8 on the WI-14, 52–53 on the IAS, 82–83 on the HAI-64, and 26–27 on the HAI-18.Trial registrationClinicalTrials.gov NCT01966705, NCT02314065.

Background It has been reported that doctors have poor attitudes towards collaboration with health professionals, and that female medical students have more collaborative attitudes than male students. The aim of this study was to reveal medical trainees’ attitudes toward team collaboration and clarify an effective educational intervention. Summary of Work This was a cross-sectional study targeting medical students in seven Japanese medical schools, residents in four university hospitals, and doctors in one university hospital. A survey was conducted from 2016 to 2017 using the Japanese version of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC-J), which evaluated “working relationship” and “accountability”. To clarify the related factors and educational intervention associated with the JeffSATIC-J score, analysis of variance and Spearman’s rank correlation coefficient for the length of teamwork or clinical courses were analyzed. Summary of Results A total of 2409 (response rate 79.8%) responses were analyzed. The average scores of first-, fourth- and sixth-year medical students, residents, and doctors were 110.3, 105.9, 105.6, 101.4, and 107.2, respectively. Learning year, institution, and gender were significant variables of students’ “working relationship” and “accountability” scores. First-year students’ scores were the highest, and female scores were significantly higher than those of males. As for educational intervention, scores of sixth-year students, who finished all clinical courses, were significantly correlated with the length of clinical clerkship, except females’ “working relationship” scores. For residents’ score, institution and gender were not significant variables for “working relationship” scores. Female “accountability” scores were significantly higher than those of males. Gender was not a significant variable for doctors’ scores. Discussion and Conclusion Japanese medical students had lower attitudes towards collaboration than previously reported for medical students in the United States. Sixth-year students’ scores were lower than those of first-year students and equivalent to those of residents. Clinical practice with multiple professions in long-term clinical clerkship, which was classified as transprofessional education, might be the most effective intervention for improving students’ attitudes towards collaboration. The study has been published in the International Journal of Medical Education (2022; 13:274-286). Take Home Messages Long-term clinical clerkship in the community at higher grades is important in improving medical students' attitudes toward team collaboration.

The DSM-IV definition of hypochondriasis is contrasted with hypochondriacal dimensions as provided by the Whiteley Index (WI) and Illness Attitude Scales (IAS). Exploratory factor analysis was conducted on self-report data from 570 patients with mental and psychophysiological disorders. Of these, 319 were additionally diagnosed according to DSM-IV by structured interviews. The three 'classic' factors of the WI labelled disease phobia, somatic symptoms and disease conviction were confirmed. The IAS consisted of two dimensions indicating health anxiety and illness behaviour. The overall scores of both instruments were highly correlated (0.80). Optimal cut-off points for case identification yielded sensitivity/specificity rates of 71/80% (WI) and 72/79% (IAS). The IAS was superior to the WI when patients with hypochondriacal disorder were to be discriminated from non-hypochondriacal somatizers. Largest group differences were found for scales related to affective components (health anxieties), smallest for illness behaviours. Affective components of hypochondriasis explained more variance of diagnostic group membership than somatization symptoms. The subscales of disease phobia (WI) and health anxiety (IAS) were most sensitive to treatment-related changes. The self-rating scales are valid for screening, case definition and dimensional assessment of hypochondriacal disorder, including the differentiation between hypochondriasis and somatization. The existence of distinguishable affective and cognitive components was confirmed.

Background Medical training is a stressing situation, making medical students vulnerable to psychiatric disorders, such as depression and anxiety. Objective The study aimed to assess the prevalence of stress and coping in students of a public medical school in Brazil, comparing the groups from the first and sixth years of training. Methods Through a cross-sectional, observational study, a sample of 232 first and sixth-year regularly registered medical students has been evaluated. Students filled a socio-demographic questionnaire, the Lipp Inventory of Stress Symptoms (ISSL), and the Coping Strategies Inventory (CSI). Results From the total sample of 232 students, 110 were first-year students and 122 sixth-year students. Stress symptoms were significantly higher in first-year students (49.1%) than in the sixth-year group (33.6%; p = 0.018). Variables significantly associated with stress were: year of the training (1st year > 6th year), income (lower > higher income), satisfaction with the training (dissatisfied > satisfied) and the use of escape/avoidance copying strategy (positive association). Discussion Considering the higher stress symptoms among first-year medical students and the positive association of the escape/avoidance copying strategy with stress, strategies must be developed to enable students starting medical school to be better at coping with this stressful situations.

Purpose: Sexual violence encompasses a range of coercive behaviors, from verbal harassment to forced penetration, and includes from social pressure and intimidation to the application of physical force. Sexual violence has numerous mental and physical health consequences on the individual. Although physicians recognize their crucial role in caring for sexual violence victims, various attitudes and behaviors hinder their fulfillment of these roles. In our study, the aim was to determine the attitudes of first and sixth-year medical faculty students towards sexual assault victims and the socio-demographic factors influencing these attitudes. Materials and methods: A total of 370 voluntary first- and sixth-year students enrolled in the 2021-2022 academic year at Manisa Celal Bayar University Faculty of Medicine were administered a questionnaire comprising socio-demographic characteristics, the "Social Attitudes Scale Towards Sexual Assault Victims," and questions assessing their knowledge of forensic medicine regarding sexual assault. Results: Our study found that 55.9% of the medical faculty students who participated were female, with an average age of 20.83±2.85 years. 56.5% were first-year students. 18.9% reported that they or someone close to them had been subjected to behavior considered as sexual assault. The average score of the participants in the Social Attitudes Scale towards Sexual Assault Victims was determined to be 95.29. It was statistically significant that women aged between 17-22 and those with a high monthly family income had higher average scores on the scale. It was found that 17.3% of the participants answered all six forensic medical questions correctly. The total scores of female students on the Social Attitudes Scale Towards Sexual Assault Victims and the scores of the behavior and thought sub-dimensions were found to be statistically significantly higher than those of male students. Conclusion: It was determined that participants generally held a positive attitude towards sexual assault victims. Factors contributing to this positive attitude included higher parental education levels, the influence of education received during medical school and preceding periods, and social environments.

BackgroundThe weight of social inequalities during education is a reality. Students of lower socioeconomic status may have less chance of success in higher education, particularly in medical studies. However, the role of students’ socioeconomic factors, such as their parents’ profession, in their success in the national ranking exam (NRE) has not been studied.Our aim was to investigate the association between socioeconomic factors and success in the national ranking exam among sixth year medical students at the Paris-Sud Faculty of Medicine.MethodsThis was a prospective survey of all sixth-year medical students at the Paris-Sud Faculty of Medicine, using a questionnaire on socioeconomic factors, which were compared according to NRE rank.ResultsOf 172 sixth year medical students, 110 completed the questionnaire. Their ranking ranged from 20 to 7695, with a median of 2815 (interquartile range: 1029–4581). The factors associated with the NRE rank were a high school diploma (baccalauréat) A or B grade, success at the first attempt in the first-year medical examination, and enrollment in the NRE preparatory lectures during the sixth year of medical training (linear regression, p < 0.001). The educational status and socio-professional category of the parents were not associated with the NRE rank (linear regression, p = 0.92).ConclusionAt the Paris-Sud Faculty of Medicine, there was no association between parental socioeconomic status and sixth year students’ success in the NRE.

Medical training is considered a significant stress factor. We sought to assess the prevalence and intensity of anxiety and depressive symptoms in medical students and compare samples of first-year and sixth-year students. This was a cross-sectional study of first- and sixth-year medical students who attended classes regularly. The study instruments were a sociodemographic questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). A total of 232 students (110 first-year, 122 sixth-year) completed the questionnaires, for a response rate of 67.4%. Overall 50.4% of respondents were male (56.4% of first-year and 45.1% of sixth-year students). Anxiety symptoms were reported by 30.8% of first-year students and 9.4% of sixth-year students (p < 0.001). Female students were more affected by anxiety. There were no significant between-group differences in depressive symptoms. A higher prevalence of anxiety symptoms was found in first-year medical students as compared with sixth-year students. Strategies should be developed to help medical students, particularly female students, manage these symptoms at the beginning of their medical training.

BackgroundPalliative care (PC) is a relatively new field in Brazil, but this knowledge is of great importance in medical practice.ObjectiveTo evaluate the degree of confidence among medical students and first-year...

The synaptic challenge

There are serious concerns about the commercialization of healthcare and adoption of the business approach in medicine. As market dynamics endanger established professional values, healthcare workers face more complicated ethical dilemmas in their daily practice. The aim of this study was to investigate the willingness of medical students to accept the assertions of commercialized healthcare and the factors affecting their level of agreement, factors which could influence their moral stance when market demands conflict with professional values. A cross-sectional study was conducted in three medical schools in Turkey. The study population consisted of first-, third-, and sixth-year students, and 1,781 students participated in total. Students were asked to state if they agreed with the assertions of commercialized healthcare. Of all students, 87.2 per cent agreed with at least one of the assertions, and one-fifth (20.8 per cent) of them agreed with more than half of the assertions. First-year students significantly agreed more with some assertions than third- and sixth-year students. Being female, having mid-level family income, choosing medicine due to idealistic reasons, and being in the third or sixth years of medical study increased the probability of disagreement. Also, studying in a medical school that included integrated lectures on health policies, rights related to health, and health inequities, along with early field visits, increased the probability of disagreement. This study suggests that agreement with the assertions of commercialized healthcare might be prevalent among students at a considerable level. We argue that this level of agreement is not compatible with best practice in professional ethics and indicates the need for an educational intervention in order to have physicians who give priority to patients' best interests in the face of market demands.