Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia

Hamza M Abdulghani, Abdulaziz A AlKanhal, Ebrahim S Mahmoud, Gominda G Ponnamperuma, Eiad A Alfaris, Hamza M Abdulghani, Abdulaziz A AlKanhal, Ebrahim S Mahmoud, Gominda G Ponnamperuma, Eiad A Alfaris

Abstract

Medical education is perceived as being stressful, and a high level of stress may have a negative effect on cognitive functioning and learning of students in a medical school. This cross-sectional study was conducted to determine the prevalence of stress among medical students and to observe an association between the levels of stress and their academic performance, including the sources of their stress. All the medical students from year one to year five levels from the College of Medicine, King Saud University, were enrolled in the study. The study was conducted using Kessler10 psychological distress (K10) inventory, which measures the level of stress according to none, mild, moderate, and severe categories. The prevalence of stress was measured and compared with the five study variables, such as gender, academic year, academic grades, regularity to course attendance, and perceived physical problems. The response rate among the study subjects was 87% (n=892). The total prevalence of stress was 63%, and the prevalence of severe stress was 25%. The prevalence of stress was higher (p<0.5) among females (75.7%) than among males (57%) (odds ratio=2.3, chi2=27.2, p<0.0001). The stress significantly decreased as the year of study increased, except for the final year. The study variables, including being female (p<0.0001), year of study (p<0.001), and presence of perceived physical problems (p<0.0001), were found as independent significant risk factors for the outcome variables of stress. Students' grade point average (academic score) or regularity to attend classes was not significantly associated with the stress level. The prevalence of stress was higher during the initial three years of study and among the female students. Physical problems are associated with high stress levels. Preventive mental health services, therefore, could be made an integral part of routine clinical services for medical students, especially in the initial academic years, to prevent such occurrence.

References

    1. Rosal MC, Ockene IS, Ockene JK, Barrett SV, Ma Y, Hebert JR. A longitudinal study of students' depression at one medical college. Acad Med. 1997;72:542–6.
    1. Stewart SM, Lam TH, Betson CL, Wong CM, Wong AM. A prospective analysis of stress and academic performance in the first two years of medical school. Med Educ. 1999;33:243–50.
    1. Singh G, Hankins M, Weinman JA. Does medical school cause health anxiety and worry in medical students? Med Educ. 2004;38:479–81.
    1. Wilkinsos TJ, Gill DJ, Fitzjohn J, Palmer CL, Mulder RT. The impact on students of adverse experiences during medical school. Med Teach. 2006;28:129–35.
    1. Styles WM. Stress in undergraduate medical education: ‘the mask of relaxed brilliance’. Br J Gen Pract. 1993;43:46–7.
    1. Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Med Educ. 2005;39:594–604.
    1. Ross S, Cleland J, Macleod MJ. Stress, debt and undergraduate medical performance. Med Educ. 2006;40:584–9.
    1. Roberts J. Junior doctors' years: training not education. BMJ. 1991;302:225–8.
    1. Firth-Cozen J. Emotional distress in junior hospital doctors. BMJ. 1987;295:533–6.
    1. Tyssen R, Vaglum P, Gronvold NT, Ekeberg O. The relative importance of individual and organizational factors for the prevention of job stress during internship: a nationwide and prospective study. Med Teach. 2005;27:27–31.
    1. Willcock S, Daly MG, Tennant CC, Allard BJ. Burnout and psychiatric morbidity in new medical graduates. Med J Aust. 2004;181:357–60.
    1. Firth J. Levels and sources in medical students. BMJ. 1986;292:1177–80.
    1. Sherina MS, Rampal L, Kaneson N. Psychological stress among undergraduate medical students. Med J Malaysia. 2004;59:207–11.
    1. Saipanish R. Stress among medical students in a Thai medical school. Med Teach. 2003;25:502–6.
    1. Tyseen R, Vaglum P, Gronvold NT, Ekeberg O. Factors in medical school that predict postgraduate mental health problems in need of treatment. A nationwide and longitudinal study. Med Educ. 2001;35:110–20.
    1. El-Gilany AH, Amr M, Hammad S. Perceived stress among male medical students in Egypt and Saudi Arabia: effect of sociodemographic factors. Ann Saudi Med. 2008;28:442–8.
    1. Amr M, El-Gilany A, El-Sayed M, El-Sheshtawy E. Study of stress among medical students at Manssoura University. Banha Med J. 2007;37:25–31.
    1. Aktekin M, Karaman T, Senol YY, Erdem S, Erengin H, Akaydin M. Anxiety, depression and stressful life events among medical students: a prospective study in Antalya, Turkey. Med Educ. 2001;35:12–7.
    1. Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, et al. Short screening scales to moni-tor population prevalence and trends in non-specific psychological distress. Psychol Med. 2002;32:959–76.
    1. Cairney J, Veldhuizen S, Wade TJ, Kurdyak P, Streiner DL. Evaluation of 2 measures of psychological distress as screeners for depression in the general population. Can J Psychiatry. 2007;52:111–20.
    1. Brooks RT, Beard J, Steel Z. Factor structure and interpretation of the K10. Psychol Assess. 2006;18:62–70.
    1. Forero R, Young L, Hillman KM, Bauman AE, Leraci S. Prevalence of psychological stress assessed in emergency departments. Emerg Med J. 2006;23:489.
    1. Kilkkinen A, Kao-Philpot A, O'Neil A, Philpot B, Reddy P, Bunker S, et al. Prevalence of psychological distress, anxiety and depression in rural communities in Australia. Aust J Rural Health. 2007;15:114–9.
    1. Niemi PM, Vainiomaki PT. Medical students' distress—quality, continuity and gender differences during a six-year medical programme. Med Teach. 2006;28:136–41.
    1. Dyrbye L, Thomas MR, Shanafelt TD. Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proc. 2005;80:1613–22.
    1. Helmers KF, Danoff D, Steinert Y, Leyton M, Young SN. Stress and depressed mood in medical students, law students, and graduate students at McGill University. Acad Med. 1997;72:708–14.
    1. Guthire E, Black D, Bagalkote H, Shaw C, Campbell M, Creed F. Psychological stress burnout in medical students: a five-year prospective longitudinal study. J R Soc Med. 1998;91:237–43.
    1. Gushae J. Financial worries part of education for Memorial's medical students. Can Med Assoc J. 1997;157:559–62.
    1. Salmons PH. Psychiatric illness in medical students. Br J Psychiatry. 1983;143:505–8.
    1. Abramovitch H, Schreier A, Koren N. American medical students in Israel: stress and coping—a follow-up study. Med Educ. 2000;34:890–6.
    1. Lee J, Graham A. Students' perception of medical school stress and their evaluation of a wellness elective. Med Educ. 2001;35:652–9.
    1. Wolf TM, Randall HM, Faucett JM. A survey of health promotion programs in U.S. and Canadian medical schools. Am J Health Promot. 1988;3:33–6.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj