Stress In Medical Students Research Articles

Evaluation of Stress, Anxiety, Depression, and Sleep Disorders in Medical Students of Hamadan University of Medical Sciences, Iran, during the COVID-19 Pandemic

Evaluation of Stress, Anxiety, Depression, and Sleep Disorders in Medical Students of Hamadan University of Medical Sciences, Iran, during the COVID-19 Pandemic

What is the association between student well-being and high-stakes examination scores?

As educators seek to improve medical student well-being, it is essential to understand the interplay between distress and important outcomes. Performance on Step 1 of the United States Medical Licensing Examination has played a significant role in selection for postgraduate residency positions in the United States and consequently has been a source of great stress for medical students. The purpose of this study was to examine whether student well-being correlates with performance on a high stakes licensing examination. Between 2014 and 2016, three sequential cohorts of medical students at the University of Michigan Medical School completed the Medical Student Well-Being Index (MSWBI) at the end of their 2nd-year curriculum, shortly before taking Step 1. Associations between well-being and Step 1 scores were investigated while adjusting for MCAT scores and cumulative second-year course scores. In total, 354 students were included in the analysis (68.1% of potential responders). On bivariate analysis, poor student well-being (0=low distress [high well-being], 7=high distress [poor well-being]) was associated with lower Step 1 examination scores (slope=-2.10, P<.01), and well-being accounted for 5% of overall Step 1 score variability (R2 =.05). However, after adjustment for MCAT scores and cumulative GPA (full model R2 =.51), the relationship between well-being and Step 1 score was no longer significant (slope=-0.70, P-value=.06). When controlling for metrics of academic performance, student well-being prior to taking Step 1 was not associated with how well students performed on Step 1 for the study sample.

Prevalence of stress, anxiety and depression in undergraduate medical students: a cross sectional study

Background: It is important to identify the prevalence and risk factors of psychological distress among medical students which not only affect their health but also the academic achievements at different points of time in their study period. In addition, the patient care is affected by psychological distress among physicians such as poor communication, diminished quality of care and medical errors have been found associated with physical stress.Methods: The present study was a descriptive type of cross-sectional study, which was conducted in a government medical college located in rural Haryana, India from June to July 2018 among 200 MBBS students after adopting inclusion and exclusion criteria. A pre-validated, pre-designed structured depression, anxiety and stress scale-21 items (DASS-21) (annexure 2) was used for obtaining information from the study subjects. The total score of the study subjects was computed and thereafter graded for levels of stress, anxiety and depression.Results: The response rate was 94.5%. The mean score for DASS 21 scale was found to be 16.13 (±11.27). Out of the total, 61.4% students are suffering from different levels of depression. About two-third of the study participants (69.8%) were suffering from different levels of anxiety. The prevalence of stress was about 46.6% in the study subjects.Conclusions: The study confirmed the general impression that there is considerable amount of stress, anxiety and depression in medical students.

The Duration of Reading the Qur'an with the Stress Levels in Medical Faculty Students in Palembang

The level of stress in each education programs differ between medical students and other scholars. Students should able to cope to normalize their stress. The study aims to determine the relationship between the duration of reading the Qur'an with the level of stress on students. The study design was a cross-sectional study, with a simple random sampling. The collecting data technique was using the Depression Anxiety Stress Scale (DASS) questionnaires and duration questionnaires followed by the chi-square analysis. The respondents are 90 medical students of Universitas Muhammadiyah Palembang. The results showed that the duration of reading the Qur'an among students is poor, and the moderate duration is correlated with a good stress level (p=0,002). Concluded that there is a relation to the duration of reading The Qur'an with the level of stress in medical students.

A comparative study of stress among medical and dental students

Background: Many researches in the past have proved that medical students experience elevated level of stress throughout their medical school life.&#x0D; Aims and Objective: The aim of the study is to study the prevalence and degree of stress among medical and dental students, find out the various stressors among them and the association of stress with various sociodemographic variables.&#x0D; Materials and Methods: A cross-sectional study was conducted among 159 medical and dental students of first and second year in Kist medical college and hospital. 81 medical and 78 dental students participated in the study. General Health Questionnaire (GHQ-12) and Medical students stress Questionnaire (MSSQ-40) was used. Statistical analysis was done by using SPSS version 25. Chisquare test was done to find the association of stress with various factors and to compare the degree of stress between medical and dental students.&#x0D; Results: Among 159 medical and dental students, 109 students (68.6%) were found to have stress. 48 out of 81 (59.3%) were medical students and 61out of 78 (78.2%) were dental students. Moderate stress was observed in 50/81(61.7%) medical students and 38/78 (48.7%) dental students. Similarly, high stress was observed in 10/81(12.3%) medical students and 11/78 (14.1%) dental students. Difference in the degree of stress between dental and medical students was not statistically significant (p value &gt;.05). Academic related stress was the major source of stress in both medical and dental students. Gender, accommodation and motivation for study were found to be significantly associated with stress.&#x0D; Conclusions: The first two years of medical and dental students is stressful with academic related stress being the most prevalent stressor. Prevalence of stress was found to be more in dental students and the difference in the degree of stress between medical and dental students was not statistically significant.

The root of the problem: identifying major sources of stress in Brazilian medical students and developing the Medical Student Stress Factor Scale.

Objectives:To investigate the most common sources of stress faced by medical students and the degree to which different stressors impact their lives. As a secondary objective, a new instrument, Medical Student Stress Factor Scale (MSSF), was developed based on these stressors.Methods:The MSSF was applied to 431 medical students. The Depression, Anxiety and Stress Scale was administered to investigate the relationship between these stressors and the students’ mental health.Results:The five greatest stressors were the extensive content, lack of time to study, sleep deprivation, excessive self-pressure for good grades, and lack of leisure time. The MSSF showed good psychometric characteristics, resulting in a 28-item scale with five subscales. The Relationships and Health subscales were associated with depressive symptoms; Relationships, Health, and Learning Environment/Academic Performance were associated with anxiety symptoms, while Health, and Learning Environment/Academic Performance were associated with stress symptoms.Conclusions:Our study presents important data about the most important stressors that affect medical students’ lives and cause mental health issues. The factors are generally related to academic performance and the learning environment and should be targeted in future interventions.

A CROSS-SECTIONAL STUDY ON ASSOCIATION OF EMOTIONAL INTELLIGENCE &amp; STRESS LEVELS IN MEDICAL STUDENTS OF TELANGANA STATE

Objective: The present study was done to assess if there is any association between Emotional intelligence (EI) &amp; stress among medical students.&#x0D; Materials &amp; Methods: In this cross-sectional observational study, information was gathered through a self-administered, semi-structured questionnaire. It consisted of Kessler Psychological Distress Scale (K10 Questionnaire) &amp; Schutte self-report EI test (SSEIT) to collect the information about stress levels and emotional intelligence respectively. Statistical test Chi-square was used and p&lt;0.05 was considered statistically significant. SPSS Version 23 was used for data analysis.&#x0D; Result: A total of 60 participants were assessed for Stress and EI. 11 (18.33%) students were found to be under severe stress. Majority (n=39, 65 %) of the students had high EI. Gender, type of stay (hostellers/day scholars) and stress levels were not found to be statistically significant with EI.&#x0D; Conclusion: Non -significant association between stress levels and EI was found hence other factors leading to stress in medical students should be investigated and studied.&#x0D; Keywords: Emotional intelligence, Medical students, Stress.

Effectiveness of a Mindfulness-Based Programme on Perceived Stress, Psychopathological Symptomatology and Burnout in Medical Students.

ObjectivesMedical students display a high prevalence of psychopathological symptomatology, stress and burnout, which may continue in their time as resident and fully qualified doctors. The aim of this study is to evaluate and compare the effects of a mindfulness-based programme on these variables in an experimental group of medical students who underwent the intervention programme compared to a control group who did not.MethodsA quasi-experimental study of two independent groups (experimental and control) with two repeated measures (pre and post) was performed. Eight sessions of 2-h duration each were held over the course of 16 weeks. A total of 143 students participated in the study, 68 in the intervention group and 75 in the control group. A sociodemographic questionnaire was administered along with the Symptom Checklist-90-R (SCL-90-R), the Perceived Stress Scale (PSS) and the Maslach Burnout Inventory-Student Survey (MBI-SS).ResultsOur study revealed a clear improvement compared to the control group in perceived stress and psychopathological symptomatology, in the Global Severity Index, Positive Symptom Total and the primary symptom dimensions of somatization, obsessive compulsive, interpersonal sensitivity and anxiety of the SCL-90-R. The improvement was significant at both intra- and intergroup level. No impact was found on the level of burnout.ConclusionsThe mindfulness-based programme that was used resulted in an improvement in psychopathological symptomatology and stress, with no effect observed on BO score. This study can contribute to the design of a training programme to promote effective self-care and stress management strategies for both medical students and doctors.

Psychometric properties of a new self-report measure of medical student stress using classic and modern test theory approaches

BackgroundMedical students face significant stressors related to the intense rigors of their training and education. Accurate measurement of their stress is important to quickly identify, characterize and ameliorate these challenges. Existing measures have limitations that modern measurement approaches, such as item response theory (IRT), are able to address. This study presents the calibration and validation of a new IRT-based measure called the Medical Student Stress Scale (MSSS).MethodsFollowing rigorous measurement development procedures described elsewhere, the authors created and tested a pool of 35 items with 348 1st – 4th year medical students along with demographic and external validity measures. Psychometric analysis included exploratory and confirmatory factor analyses, IRT modeling, and correlations with legacy measures.ResultsOf the original 35 items, 22 were retained based on their ability to discriminate, provide meaningful information, and perform well against legacy measures. The MSSS differentiated stress scores between male and female students, as well as between year in school.ConclusionDeveloped with input from medical students, the MSSS represents a student-centered measurement tool that provides precise, relevant information about stress and holds potential for screening and outcomes-related applications.

Prevalence of stress, stressors, and coping strategies among medical undergraduate students in a medical college of Mumbai.

BACKGROUND:Stress is a subjective experience which creates an obstacle in a person's path of achieving his or her goals. It creates negative outcomes among the population. Medical curriculum is very vast and stressful. As doctors are the very important part of society, medical students must be allowed to learn their trade in a stress-free environment. The present study aimed to assess the perceived stress, various sources of stress among medical undergraduate students, and the coping strategies adopted.MATERIALS AND METHODS:This was a cross-sectional study conducted among medical under-graduate students studying at a tertiary care hospital situated in Mumbai city of Maharashtra between January and June 2018. Using purposive sampling technique, a total of 450 medical students from 1st year to final year were invited to participate in the study. A self-administered questionnaire consisting of sociodemographic details and perceived stress scale questions was used. Logistic regression analysis was carried out to assess the determinants of stress. Odds ratio, 95% confidence interval was calculated. P < 0.05 was considered statistically significant.RESULTS:The overall response rate was 79.11%, with 356 out of 450 students returning the questionnaire. Among 356 participants, 324 participants (91%) were suffering from high levels of stress. Factors such as curriculum vastness, frequency of examination, competition with peer, performance in examinations, worry about future, loneliness, relation with opposite sex, and quality of food played a major role in creating additional stress.CONCLUSIONS:The perceived stress was higher among female medical students. Academic factors are greater perceived cause of stress in medical students in this study. A substantial proportion of medical undergraduate students were found to be stressed which necessitates appropriate and timely interventions. Reframing the academic curriculum along with examination and evaluation patterns, incorporating extracurricular activities, and establishment of counselling cells in the institution is the need of the hour.

Depression, Stress, Burnout and Associated Factors in Medical Students: A Cross-Sectional Study from a Turkish Medical School

Background: Mental problems are common among medical school students, and these problems affect social and academic functionality. It was aimed to determine depression, stress and burnout levels of medical school students in a university which constitutes 3.25% of the all medical students in Turkey. Methods: 1306 students studying in all classes at Gazi University Faculty of Medicine participated in this cross-sectional study. Sociodemographic data form, CES-Depression Scale (CES-D), Perceived Stress Scale (PSS), and Maslach Burnout Inventory Student Scale (MBI-SS) were applied to the participants. Results: The mean score of the MBI-SS exhaustion subscale was 15.6, cynicism was 10.4, and the efficacy subscale was 11.7. The mean score of CES- D was 21.2 and PSS was 28.3. The prevalence of depression was estimated as 64.2%. Female participants showed higher scores in PSS, but lower scores in cynicism and efficacy. For exhaustion and cynicism, 1st graders’ scores were significantly lower than all the others. For efficacy, 4th graders’ scores were significantly lower than 1st and 6th graders’. In CES-D; the 4th graders’ scores were significantly higher than the 1st and 3rd graders’. In PSS; 4th graders’ scores were significantly higher than 1sts. Conclusion: Stress, burnout, and depressive symptoms are high in medical students, especially in 4th graders and female students. It is considered to be important to raise awareness and plan preventive services on this issue.

Uticaj fizičke aktivnosti na stepen depresivnosti, anksioznosti i stresa studenata Medicinskog fakulteta Univerziteta u Beogradu

Mental health problems have become increasingly present among students. Therefore, the aim of this study was to examine the influence of physical activity (PA) on the manifestation of the symptoms of depression, anxiety and stress (DAS) in medical students. The sample of examinees included 89 students (59 female [F] and 30 male [M] students), from the first to the sixth year of studies at the Faculty of Medicine, University of Belgrade, aged 22 ± 3,3. The measuring instruments were a short version of the Depression, Anxiety and Stress Scale (DASS-21) and a short form of the International Physical Activity Questionnaire (IPAQ). The obtained results indicate that average scores fall into the category of normal degree of depression and anxiety, and a moderate degree of stress, whereby F show higher scores on the anxiety scale (x2 = 8.36, p = 0.004). Different scores were noted among students of different years of study on the depression scale (F = 2.515, p = 0.036), as well the anxiety scale (F = 3.594, p = 0.005), but not on the stress scale (F = 1.55, p = 0.183). Total PA was assessed as moderate (median [interval] = 2613 [462-11931] MET-min/week), whereby M significantly more frequently engage in high intensity activities (x2 = 7.69, p = 0.006). The research also recorded a small positive correlation between sedentary activities and stress symptoms in F (ro = 0.282, p = 0.030), while small negative correlation was noted in M between moderate PA and depression symptoms (ro = -0.279, p = 0.033). The research results indicate that total PA and the degree of DAS in examined students is at a satisfactory level.

Effects of Mentoring in First Year Medical Undergraduate Students using DASS-21

Introduction: Medical students often require high level of specialised institutional and personal support to facilitate success. Distress is commonly observed in medical undergraduate students which leads to poor academic performances. The stress though looks reasonable it needs to be addressed with right amount of counseling. A good mentoring session helps in reducing depression, stress and anxiety. Aim: To determine the effects of mentoring in first year medical students using Depression, Anxiety and Stress Scale - 21 Items (DASS 21). Materials and Methods: It was an interventional study conducted in Seth GSMC, Department of Physiology, Mumbai, Maharashtra, India, from July 2019 to February 2020. Total 120, first-year medical undergraduates were recruited in the study. At the beginning, an orientation session was conducted for the faculty. Mentoring sessions were conducted for students once in a week. Data was collected using DASS-21 in the beginning in July 2019 to February 2019. Statistical analysis was done using Wilcoxon sign rank test. Five-point Likert scale was used for qualitative analysis of the feedbacks received from mentors as well as mentees. The p-value &lt;0.05 was considered as significant. Results: Out of 15 faculty members were eight were males and seven were females with mean age of 47±8 and 46±1 years, respectively. Among mentees, 64 were males and 56 were females with mean age of 17±8 and 17±6 years. A significant decrease was obtained in the levels of depression, anxiety and stress scores of students after mentoring. Wilcoxan sign rank sum test was used. The p-value before and after mentoring session was 0.00418 for Depression, 0.00033 for anxiety and 0.00805 for stress. Conclusion: Mentoring was found to reduce stress, anxiety and depression in first-year medical undergraduate students. The mentoring program was found to be useful to students as well as faculty. It should be extended through all the years of under graduation.

Depression, anxiety, and stress among the 1st year medical students in Kanchipuram District

Background: Medical education is a full-time commitment and responsibility of students that include academic assignments, activities, social behavior, support, and patient care. The health of students around the world is becoming a major concern as they are more prone to depression, stress. Aim and Objective: This study aims to assess the severity of depression, anxiety, and stress in the Ist year medical students. Materials and Methods: The DASS 42 questionnaire was used to study stress, depression, and anxiety. The DASS is a 42-point questionnaire containing three self-report scales designed to measure the negative emotional states of depression, anxiety, and stress. Results: It was found that 16%, 25%, and 27% of medical students were affected by mild symptoms of depression, anxiety, and stress. About 11%, 12%, and 4% of medical students with moderate depression, anxiety, and stress; 12%, 4%, and 3% of medical students with severe depression, anxiety, and stress; and 3%, 4%, and 1% of medical students suffered from extremely severe depression, anxiety, and stress. Conclusion: In our study, emotional distress is common medical students and attention, support, and personalized counseling are compulsory for the students.

Perceived Stress and Sleep Quality of First Year Medical Students

Perceived Stress and Sleep Quality of First Year Medical Students

Mental health state in medical students during COVID-19 pandemic.

BACKGROUND:Before the COVID-19 pandemic, medical students had reported experiencing high rates of distress, burnout, anxiety, and depression. The psychological impact of the COVID-19 in the general population suggested that the mental health impact was increased anxiety, depression, and stress. There were no exceptions if medical students also experience the same psychological impact. The aimed to this study is analyze the mental and emotional effects of the COVID-19 pandemic among medical students.MATERIALS AND METHODS:An observational analytic study was used with a cross-sectional approach. Data were obtained with questionnaires distributed through social media platforms from July 14, 2020, to July 21, 2020. This study using the Fear of COVID-19 (FCV-19) Scale and the Depression, Anxiety, and Stress Scale-21 to assess FCV-19, anxiety, stress, and depression. statistical analysis used IBM SPSS Statistics 24 was used to analyze the two-tailed Chi-square test, the Mann–Whitney test, and the Kruskal–Wallis test, which were used with statistical significance as P < 0.05 for all tests.RESULTS:Out of 1027 samples, 44.6% had stressed, 47.8% had anxiety, and 18.6% had depression. The gender (P = 0.000), educational stage (P = 0.000), and the comorbidity factor (P = 0.001 for stress and anxiety, P = 0.036 for depression, and P = 0.000 for FCV-19) had a significant association with stress, anxiety, depression, and FCV-19 in medical students. The hometown that showed zone risk of infection only showed significant differences in FCV-19 (P = 0.026).CONCLUSIONS:Protection and psychological support for a medical student is extremely high importance given that COVID-19 is now a well-established pandemic and there will be other pandemics in the future.

Correlation between Stress and Empathy in Medical Students As Compared To General Population

Background: Medical students are exposed to numerous internal and external pressures exerted by the environment which may affect their empathy towards patients. This study was conducted to find association between perceived stress and empathy.&#x0D; Methodology: The study was conducted in Surat, Gujarat, India from August 15 2021 to September 15 2021 among 225 participants using perceived stress score and using the Toronto Empathy Questionnaire. Two groups -Undergraduate medical students and general population were compared.&#x0D; Results: Out of 160 medical undergraduates and 65 people from general population below average empathy was noted in total 51.1%. High empathic attitude was noted in general population in comparison to other medical undergraduates. 24.4% reported low stress, 64% moderate stress and 11.6% high stress and we can appreciate that low stress scores were calculated in general population in comparison to medical undergraduate students. A weak negative correlation between empathy and perceived stress was calculated in medical students whereas strong positive correlation between empathy and perceived stress was calculated in general population.&#x0D; Conclusion: A significant proportion of medical students had a comparatively higher stress scores and decreased empathy hence their stress is considered distress whereas general population’s high stress scores were corelating to high empathic attitude, therefore their stress can be considered eustress.

Suicidal ideation among medical students, burnout or depression? Maybe both.

Depression is a common mental condition worldwide and a major cause of debility, with the potential to impair the quality of life of affected people. Medical students are more likely to develop psychiatric disorders, with depression, anxiety, and burnout being the most common ones. The aim of this study was to investigate the prevalence of depressive symptoms in medical students and their association with burnout and aspects of life. This is an analytical cross-sectional study. Data collection was performed using four validated scales and a questionnaire in 511 medical students from the first to the fourth year from different universities. Depression was present in 49% of the students. A correlation was found between depression and female gender. Regarding the students' daily sleep time, 54.5% of the students slept only 3 to 6 hours per night. The use of psychoactive substances was reported by 29.9%. Regarding the emotional support offered by universities, about 92.8% of students with depressive symptoms reported not receiving adequate emotional support. As for quality of life, all domains were impaired among students with depression. According to the two-dimensional criterion, 37% of the students have burnout, with correlation between the presence of the syndrome and depressive symptoms. In addition, burnout proved to be an independent risk factor for suicidal ideation and self-mutilation. New methods that can help detect and address factors that trigger stress and depressive symptoms in medical students are needed to reduce the incidence of depression.

Assessment of Stress, Resilience, and Coping Style among Medical Students and Effectiveness of Intervention Programs on Stress Level in South India: A Non-randomized Control Trial.

Background:Uncontrolled stress can be made at ease through resilient emotions and higher coping skills. The study aimed at assessing the level of stress, resilience, and coping among medical students and to study the effect of stress intervention programs on the stress level.Materials and Methods:This was a nonrandomized control trial among 526 medical students which used medical student stress questionnaire, and perceive stress scale (PSS), resilience assessment using a 25-item resilience scale, and coping using a modified Pareekh scale. After the completion of the preintervention assessment, the students were assigned nonrandomly into two groups (intervention group n = 272 vs. nonintervention group n = 254), and the stress intervention programs were done for one group without any programs for the other group.Results:The study concluded that 246 (46.8%), 274 (52.1%), and 277 (52.7%) showed higher stress higher resilience and lower coping, respectively. The study showed that, with stress intervention programs, stress levels by PSS got significantly reduced by 2.64 scores.Conclusions:The study showed the presence of higher stress and resilience and lower coping among medical students. The inclusion of programs to reduce the stress among students showed a positive result and can be replicated.

Influence of Stress on Quality of Sleep and QT Interval Variables among Young Adult Medical Students- A Cross-sectional Study

Introduction: Stress affects different cardiovascular responses and trigger arrhythmias through Autonomic Nervous System (ANS) activation. Medical students generally tend to reduce their sleep, in order to adjust and cope with their stressful and demanding workload. Aim: To assess the correlation of QT intervals variables with quality of sleep and stress among young adult medical students. Materials and Methods: This cross-sectional study was undertaken in All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India, among 60 medical students taken as internal match for collection of data at the beginning of the academic year (unstressed) and three weeks before the term-end examination (stressed) during October 2019 to March 2020. Two validated questionnaires namely, Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality and the Medical Student Stress Questionnaire (MSSQ) to measure the stressors and the intensity of stress were used among the medical students. Short-term Electrocardiogram (ECG) recording was used to measure QT interval variables. Descriptive statistics and paired t-test were applied using Statistical Package for the Social Sciences (SPSS) version 19.0. The p≤0.05 was considered significant. Results: Academic Related Stress (ARS) showed a highly significant increase during the stressed conditions (p&lt;0.001). The mean global PSQI score of 6.03±2.76 was significantly higher (p-value &lt;0.001; PSQI &gt;5) during the stressed conditions indicating poor quality of sleep, when compared to 4.50±2.87 recorded in unstressed conditions. In stressed conditions, QT interval measures had moderate correlation with ARS. Quality of sleep had negative correlations with all QT interval measures except for corrected QT interval (QTc) and QTCmin. Conclusion: Stress affects the sleep quality and induced QT changes which reflected difference in variability between ‘stressed’ and ‘unstressed’ times. However, there is no significant impact on QT duration among the young adult medical students.