Abstract
ObjectivesTo assess the prevalence and factors associated with perceived stress among medical students. MethodsA cross-sectional study of students (n=623) selected across eight medical schools in Nigeria. A structured questionnaire obtained socio-demographic characteristics, alcohol use (Alcohol Use Disorders Identification Test), other psychoactive drug use (Drug Abuse Screening Test), anxiety/depression symptoms (Hospital Anxiety Depression Scale) and stress (Perceived Medical School Stress Scale). We performed bivariate analysis using the chi-squared test, t-test and one-way ANOVA, with multiple regression analysis for multivariate testing in analysing the data. ResultsMost students reported experiencing medical school stress. Female participants were more likely to perceive medical school as competitive (t(621)=1.17, p=0.003), less likely to see medical school as a threat (t(621)=-2.70, p=0.01) or worry about finances (t(621)=-4.80, p=0.001). Nearly a quarter; 21.3% (n=133) and 28.6% (n=178) reported depression and anxiety symptoms respectively. Approximately 4.2% (n=26) were dependent on alcohol, while 14.1% (n=88) had ‘low-risk use’ for other psychoactive substances. In the multiple regression model, lack of finance (B=2.881, p=0.001), weak adherence to religious faith (B=2.376, p=0.001), anxiety symptoms (B=-2.231, p=0.002), problematic alcohol use (B=5.196, p=0.001) and choice of study influenced by parents (B=-3.105, p=0.001) were predictors of greater perceived stress. ConclusionsMedical students in Nigeria report high levels of stress. Incorporating stress reduction strategies in the medical curriculum, and the input of students in providing feedback regarding the methods and styles of undergraduate medical education is required.
Highlights
The available body of evidence suggests that certain factors either singly or in combination contribute to the development or perpetuation of stress in undergraduate programs.[5,7,8]
We evaluated the relationship between perceived stress among medical students, their use of alcohol and other psychoactive substances, and psychiatric morbidity
Female students reported lower rates of perceived stress compared to their male counterparts, a finding inconsistent with a similar study from Pakistan.[4]
Summary
Research on stress or perceived stress among undergraduate students in general and medical students is growing.[1,2,3,4,5,6] The available body of evidence suggests that certain factors either singly or in combination contribute to the development or perpetuation of stress in undergraduate programs.[5,7,8] Factors include those unique to the individual, that either protect, predispose, or perpetuate stress, or factors considered ‘environmental’. ‘Personal’ factors include personality predisposition, coping style, psychological and physical health, psychoactive substance use and religious adherence.. Medical students consistently report higher levels of stress or perceived stress when compared to other students or the general population.[4,11] Differences in cultural and geographical setting, study design, year of study of the medical student sample, and assessment tools may explain variation in the prevalence rates
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