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Azim SR, Yusoff MSB, Roslan NS. Mapping the multidimensional factors of medical student resilience development: A scoping review. BMC MEDICAL EDUCATION 2025; 25:744. [PMID: 40399860 PMCID: PMC12096491 DOI: 10.1186/s12909-025-07290-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2025] [Accepted: 05/05/2025] [Indexed: 05/23/2025]
Abstract
Resilience plays a vital role in promoting mental wellbeing by facilitating recovery from stressful experiences. Medical students face intense academic and clinical requirements throughout their rigorous training. However, existing literature has predominantly focusing on individual attributes, neglecting the significant role that educational institutions play in resilience development. This scoping review seeks to comprehensively map both individual and institutional factors that contribute to the resilience development among medical students. This scoping review adhered to the Joanna Briggs Institute (JBI) methodology and following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. To ensure a rigorous and comprehensive search, multiple databases including Google Scholar, Scopus, PsycINFO, and PubMed were searched for relevant studies published in English between 2000 and Feb 2025, focusing on the resilience or mental health of undergraduate medical students. Two reviewers independently screened the articles, and any discrepancy were resolved through a third reviewer. A descriptive analytical approach and thematic analysis were used to identify key themes in the data. Fifty-nine studies, mostly cross-sectional, were included. Identified themes were broadly categorize into individual factors (e.g., gender, personality traits, personal life events, financial constraints, health-related issues, academic performance) and institutional factors (e.g., academic workload, faculty support and peer interaction, learning environment, extracurricular activities, support systems). This review highlighted that both personal and institutional factors substantially impact medical students' resilience development. Cultivating a supportive learning environment, strengthening faculty-student relationships, and implementing targeted interventions such as resilience training, mentorship, and increased academic and financial support as well as access to mental health resources can mitigate stressors and enhance students' resilience. Addressing these multifaceted factors will empower medical students to thrive both personally and professionally, ultimately contributing to the provision of high-quality patient care.
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Affiliation(s)
- Syeda Rubaba Azim
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
- Dow University of Health Sciences, Karachi, Pakistan
| | | | - Nurhanis Syazni Roslan
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia.
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Ge D, Shah V, Kim D, Fayngersh A, Wong K, Sunderram J, Scharf M, Jagpal S, Jobanputra AM. Medical Students on Their Internal Medicine Clerkship Experience Short Sleep Duration. ATS Sch 2025. [PMID: 40179286 DOI: 10.34197/ats-scholar.2024-0116oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 01/24/2025] [Indexed: 04/05/2025] Open
Abstract
Background: Third-year medical students during their internal medicine clerkship may be predisposed to short sleep duration (<7 h of sleep per night) because of rigorous clinical schedules and academic demands. Objective: To evaluate the prevalence of short sleep duration, its impact on performance, and perceived causes among third-year medical students on their internal medicine clerkship. Methods: During the 2023-2024 academic year, third-year medical students at Rutgers Robert Wood Johnson Medical School (RWJMS) and Rutgers New Jersey Medical School completed a survey at the end of their internal medicine clerkship regarding their sleep practices. The schools differed in clerkship structure and grading system. Data were analyzed and compared between schools using the Fisher exact test. Responses for an open-ended question on sleep strategies were categorized into themes by sleep physicians. Results: Of the 314 third-year medical students invited, 222 (70.7%) completed the survey. Short sleep duration was reported by nearly two-thirds of our cohort (143, 64.4%), with a significantly higher prevalence at RWJMS. Most reported sleep-related impairment on clinical duties or educational activities for 1-3 days per week (125, 56.3%), with more reporting ⩾4 days per week at RWJMS. About one-third of our cohort reported drowsy driving either 1-3 days (82, 36.9%) or ⩾4 days (68, 30.6%) per week. Despite high rates of short sleep duration, the overwhelming majority (196, 88.3%) had never received education on sleep management. Conclusion: Short sleep duration is prevalent among third-year medical students during their internal medicine clerkship, potentially impacting their clinical performance and safety.
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Affiliation(s)
| | - Vraj Shah
- Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey
| | | | - Alla Fayngersh
- Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Kristin Wong
- Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey
| | | | - Matthew Scharf
- Department of Medicine, and
- Department of Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; and
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Samarasinghe NR, Nagpal TS, Barbeau ML, Martin CM. Getting physical with medical education: Exercise based virtual anatomy review classes for medical students. World J Methodol 2025; 15:95985. [PMID: 40115406 PMCID: PMC11525886 DOI: 10.5662/wjm.v15.i1.95985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 08/07/2024] [Accepted: 08/13/2024] [Indexed: 09/29/2024] Open
Abstract
The benefits of regular physical activity are well known. Yet, few studies have examined the effectiveness of integrating physical activity (PA) into curricula within a post-secondary setting. To investigate the incorporation of PA into medical curriculum, we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal (MSK) anatomy course material. These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor. The fitness instructor would lead students through both strength and yoga style exercises, while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered. After the sessions, participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge, PA levels, and mental wellbeing. Thirty participants completed surveys; a majority agreed that the classes increased understanding of MSK concepts (90.0%) and activity levels (97.7%). Many (70.0%) felt that the classes helped reduce stress. The majority of respondents (90.0%) agreed that the classes contributed to increased feelings of social connectedness. Overall, medical students saw benefit in PA based interventions to supplement MSK course concepts. Along with increasing activity levels and promoting health behaviours, integrating PA into medical curriculum may improve comprehension of learning material, alleviate stress and foster social connectivity among medical students.
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Affiliation(s)
- Nadeesha R Samarasinghe
- Division of General Surgery, Faculty of Medicine, University of British Columbia, Vancouver V6T 1Z3, BC, Canada
| | - Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton T6G 2R3, AB, Canada
| | - Michele L Barbeau
- Anatomy and Cell Biology, University of Western Ontario, London N6A 3K7, ON, Canada
| | - Charys M Martin
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London N6A 3K7, ON, Canada
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Oberleitner LM, Baxa DM, Pickett SM, Sawarynski KE. Biometrically measured sleep in medical students as a predictor of psychological health and academic experiences in the preclinical years. MEDICAL EDUCATION ONLINE 2024; 29:2412400. [PMID: 39381987 PMCID: PMC11468015 DOI: 10.1080/10872981.2024.2412400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/30/2024] [Indexed: 10/10/2024]
Abstract
BACKGROUND Student wellness is of increasing concern in medical education. Increased rates of burnout, sleep disturbances, and psychological concerns in medical students are well documented. These concerns lead to impacts on current educational goals and may set students on a path for long-term health consequences. METHODS Undergraduate medical students were recruited to participate in a novel longitudinal wellness tracking project. This project utilized validated wellness surveys to assess emotional health, sleep health, and burnout at multiple timepoints. Biometric information was collected from participant Fitbit devices that tracked longitudinal sleep patterns. RESULTS Eighty-one students from three cohorts were assessed during the first semester of their M1 preclinical curriculum. Biometric data showed that nearly 30% of the students had frequent short sleep episodes (<6 hours of sleep for at least 30% of recorded days), and nearly 68% of students had at least one episode of three or more consecutive days of short sleep. Students that had consecutive short sleep episodes had higher rates of stress (8.3%) and depression (5.4%) symptoms and decreased academic efficiency (1.72%). CONCLUSIONS Biometric data were shown to significantly predict psychological health and academic experiences in medical students. Biometrically assessed sleep is poor in medical students, and consecutive days of short sleep duration are particularly impactful as it relates to other measures of wellness. Longitudinal, biometric data tracking is feasible and can provide students the ability to self-monitor health behaviors and allow for low-intensity health interventions.
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Affiliation(s)
- Lindsay M. Oberleitner
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Dwayne M. Baxa
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Scott M. Pickett
- Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Kara E. Sawarynski
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
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Deisz M, Papproth C, Ambler E, Glick M, Eno C. Correlates and Barriers of Exercise, Stress, and Wellness in Medical Students. MEDICAL SCIENCE EDUCATOR 2024; 34:1433-1444. [PMID: 39758502 PMCID: PMC11699034 DOI: 10.1007/s40670-024-02134-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/26/2024] [Indexed: 01/07/2025]
Abstract
Medical students report higher stress and increased mental illness than peers of similar age. Burnout and depression among medical students and physicians have also been correlated with increased risk of medical errors and decreased importance of altruistic values, such as providing care to medically underserved populations. This study works to analyze the effects of exercise, nutrition, sleep, and other factors affecting wellness and performance of medical students, as well as identifying barriers to exercise and possible solutions. A survey was distributed to medical students in the Midwest to evaluate exercise habits, dietary intake, sleep, and other factors affecting wellness. An investigation of the correlation of variables and comparison of year in school for the variables was conducted. Satisfaction with social relationship and performance in school correlated with exercise, stress, and sleep variables. Several variables, including satisfaction with exercise, social life, and performance in school, showed significant differences based on year in school. No significant findings were noted between students from the various medical institutions at which the survey was distributed regarding satisfaction with exercise, academic performance, social life, personal relationships, hours spent in clerkship/class, hours spent studying, and stress. Students tended to have higher satisfaction with school and social relationships if they engaged in exercise more often, exercised with greater intensity, and slept better. Students identified barriers to exercise including cost, availability, and lack of time. Potential solutions include a workout facility in school buildings/hospitals, allocated wellness periods for exercise, and a more consistent schedule. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-024-02134-5.
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Affiliation(s)
- McKayla Deisz
- Creighton University School of Medicine, Omaha, NE USA
| | | | - Emily Ambler
- Creighton University School of Medicine, Omaha, NE USA
| | | | - Cassie Eno
- Creighton University School of Medicine, Omaha, NE USA
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Ross JM, Watson NL, Hamlin NJ, Schmidt JE. Differences in Perceived Stress During the COVID-19 Pandemic Among Military Dental Postgraduate Residents. Mil Med 2024; 189:e2700-e2709. [PMID: 38776155 DOI: 10.1093/milmed/usae270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/30/2024] [Accepted: 05/08/2024] [Indexed: 05/24/2024] Open
Abstract
INTRODUCTION In military training settings, stress can improve focus and motivation fostering effective learning. However, high perceived stress can be debilitating resulting in poor learning and clinical errors. Multiple studies have focused on medical residency stress; but there has been minimal focus on dental residents and even less on the impact of the unique stressors from the COVID-19 pandemic. The objectives of this study were to determine the impact of the COVID-19 pandemic on perceived stress of residents in a military dental residency training program and explore the association among perceived stress and anxiety, depression, sleep quality, and social support. MATERIALS AND METHODS Dental residents (N = 20) at the Naval Postgraduate Dental School participated in this study. Residents were assessed via self-report measures quarterly from March 2020 through June 2021. The assessment included measures of anxiety (GAD-7), depression (PHQ-9), perceived stress (PSS), fatigue (FSI), and social support (DUKE-SSQ). RESULTS Before the pandemic shutdown, 60% of participants reported high perceived stress. These residents reported an initial decrease in symptoms of anxiety, depression, and fatigue compared to residents reporting low pre-pandemic perceived stress but returned to baseline levels post-shutdown. Additionally, the high stress participants reported lower social support. CONCLUSIONS Based on pre-pandemic perceived stress, participants responded differently to the impact of the pandemic shutdown. The low baseline stress participants may have a more robust sense of grit and resilience. These findings suggest that postgraduate dental training programs should integrate coping skills training opportunities, especially for residents reporting high perceived stress before residency.
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Affiliation(s)
- James M Ross
- 2nd Dental Battalion, 2nd Marines Logistics Group, 2nd Marine Expeditionary Force, Dental Clinic AS100, Camp Lejeune, NC 28542, USA
| | - Nora L Watson
- Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Nicholas J Hamlin
- Naval Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Naval Medical Leader and Professional Development Command, Bethesda, MD 20889, USA
| | - John E Schmidt
- Naval Postgraduate Dental School, Postgraduate Dental College, Uniformed Services University of the Health Sciences, Naval Medical Leader and Professional Development Command, Bethesda, MD 20889, USA
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Morgan TL, McFadden T, Fortier MS, Sweet SN, Tomasone JR. Do physical activity intensity and sedentary behaviour relate to burnout among medical students? Insight from two Canadian medical schools. CANADIAN MEDICAL EDUCATION JOURNAL 2024; 15:54-63. [PMID: 39588026 PMCID: PMC11586019 DOI: 10.36834/cmej.79169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2024]
Abstract
Background Medical school involves high expectations of medical students, which may increase their risk for burnout. Physical activity (PA) and sedentary behaviour (SB) are modifiable risk factors for burnout. However, medical students are insufficiently taught about PA and SB and may therefore be less likely to meet guideline-recommended levels of these two movement behaviours or promote them in practice. Few studies have examined the relationships between medical students' PA intensity, SB, and burnout; such examination could help clarify educational needs for improving levels of movement behaviours and their promotion. Purpose This study investigated (1) the relationships between light, moderate, vigorous, and total PA, SB, and burnout among medical students, and (2) moderate-to-vigorous PA as a moderator of the relationship between SB and burnout, to guide future curriculum renewal. Methods Medical students (N = 129) at two Canadian institutions completed online validated questionnaires assessing light, moderate, vigorous, and total PA, SB, and burnout. Results Regression analyses indicated that light PA (β = -.191, p = .039) and SB (β=-.230, p = .013) were negatively associated with burnout. Moderate-to-vigorous PA did not significantly moderate the relationship between SB and burnout. Conclusions Engaging in lighter forms of PA and SB within guideline recommendations may help mitigate medical student burnout. Competencies to promote movement behaviours may dually target medical student burnout and curriculum gaps.
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Affiliation(s)
- Tamara L Morgan
- School of Kinesiology and Health Studies, Queen’s University, Ontario, Canada
| | | | - Michelle S Fortier
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ontario, Canada
| | - Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, Quebec, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen’s University, Ontario, Canada
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Michael K, Schujovitzky D, Karnieli-Miller O. The associations between resilience, self-care, and burnout among medical students. PLoS One 2024; 19:e0309994. [PMID: 39298395 DOI: 10.1371/journal.pone.0309994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 08/22/2024] [Indexed: 09/21/2024] Open
Abstract
Burnout is a work-related stress syndrome with substantial consequences for patients, physicians, and medical students. Personal resilience, i.e., the ability to bounce back and thrive despite challenging circumstances, and certain practices, such as self-care, may protect individuals from burnout. However, limited information exists on the complex relationships between resilience, different self-care practices, and burnout. Understanding these associations is important for designing efficient interventions within medical schools. Therefore, the present study examined the direct and indirect associations through a cross-sectional study among 95 fourth-year medical students. Self-reported questionnaires measured resilience, self-care dimensions (stress management, spiritual growth, interpersonal relations, health responsibility), and burnout dimensions (emotional exhaustion, depersonalization, personal accomplishment). Data were analyzed via IBM-SPSS and PROCESS-macro. The main results demonstrated that self-care mediated the associations between resilience and burnout: stress management and interpersonal relations mediated the associations with emotional exhaustion, while spiritual growth mediated the association with personal accomplishment. These results highlight that medical students' resilience may encourage self-care behaviors, thus decreasing levels of the burnout dimensions of emotional exhaustion and personal accomplishment. Developing curricula that enhance students' resilience through applying self-care techniques in stressful situations may reduce the negative impact of burnout in healthcare.
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Affiliation(s)
- Keren Michael
- Department of Human Services, Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Dana Schujovitzky
- Faculty of Medical and Health Sciences, Department of Medical Education, Tel Aviv University, Tel Aviv, Israel
- Department of Pediatrics, Meir Medical Center, Kfar Saba, Israel
| | - Orit Karnieli-Miller
- Faculty of Medical and Health Sciences, Department of Medical Education, Tel Aviv University, Tel Aviv, Israel
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Dhachpramuk D, Sonjaipanich S, Theppiban S, In-Iw S. Exercise, mental well-being and burnout in Thai medical students in 2020-2021: an online cross-sectional survey. BMC MEDICAL EDUCATION 2024; 24:837. [PMID: 39095768 PMCID: PMC11297641 DOI: 10.1186/s12909-024-05843-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 07/30/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Within the Thai medical curriculum, its rigorous education framework, demanding schedules and high academic standards can contribute to psychological distress. Regular physical activity has consistently shown positive effects on mental health. The aim of the study was to investigate the association between exercise and psychological well-being, including depression, anxiety, and burnout, in Thai medical students, and factors related to insufficient exercise and depression. METHODS The cross-sectional study was conducted among medical students in the university hospital during 2020-2021. Participants completed self-administered questionnaires consisting of demographic data, Godin-Shephard Leisure-Time Physical Activity Questionnaire, depression screening (9Q), Thai General Health Question-28 (4 domains: somatic symptoms, anxiety and insomnia, social dysfunction, severe depression), and Maslach burnout inventory (Emotional exhaustion (EE), Depersonalization (DP), Reduced Personal Achievement (rPA). RESULTS Of the 404 participants, 50.5% were women, the mean age (SD) was 21.06 (1.8) years, and 52% were in clinical years. The prevalence of insufficient exercise was 59.6%, depression (30.2%), somatic symptoms (27.7%), anxiety (30.7%), insomnia (89.4%), social dysfunction (89.4%), high level of EE (32.4%), DP (21%), and rPA (56.7%). Insufficient exercise was associated with moderate to severe depression (OR 2.89, 95% CI 1.16-7.25), anxiety and insomnia (OR 1.56, 95% CI 1.01-2.43), social dysfunction (OR 2.51, 95% CI 1.31-4.78), burnout in part due to high rPA (OR 2.4, 95% CI 1.4-4.13), and study in clinical years (OR 1.91, 95% CI 1.28-2.87). After adjusted significant factors, only studying in the clinical year, social dysfunction, and burnout in part of rPA were related to insufficient exercise. CONCLUSIONS High rates of insufficient exercise, psychological challenges, and burnout were prevalent among medical students. To effectively address these issues, medical school should advise students to participate in regular exercise, promoting mental well-being and healthier lifestyles.
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Affiliation(s)
- Dhachdanai Dhachpramuk
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suprapath Sonjaipanich
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supparat Theppiban
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supinya In-Iw
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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El-Awaisi A, Ismail S, Sulaiman R, Kane T, El Hajj MS, Shraim M. A Qualitative Exploration of Health Profession Students' Experiences of Resilience and Burnout Using the Coping Reservoir Model during the COVID-19 Pandemic. TEACHING AND LEARNING IN MEDICINE 2024; 36:256-268. [PMID: 37159074 DOI: 10.1080/10401334.2023.2209073] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Abstract
Phenomenon: The Coping Reservoir Model is a useful theoretical and analytical framework through which to examine student resilience and burnout. This model conceptualizes wellbeing as a reservoir which is filled or drained through students' adaptive and maladaptive coping mechanisms. This dynamic process has the capacity to foster resilience and reduce burnout or the inverse. This study aimed to explore health profession students' coping mechanisms and their experiences of resilience and burnout during the unprecedented COVID-19 pandemic. Approach: Employing the Coping Reservoir Model, qualitative focus groups involving health profession students enrolled at Qatar University were conducted, in October 2020, to solicit their lived experiences of stress and burnout during the pandemic. The Coping Reservoir Model was used to structure the topic guide for the focus group discussion and the Framework Analysis Approach was used in the data analysis. Findings: A total of 43 participants comprised eight focus groups. Health profession students encountered myriad personal, social, and academic challenges during the pandemic which adversely impacted their wellbeing and their capacity for coping. In particular, students reported high levels of stress, internal conflict, and heavy demands on their time and energy. The shift to online learning and uncertainty associated with adapting to online learning and new modes of assessment were exacerbating factors. Students sought to replenish their coping reservoir through engagement in a range of intellectual, social, and health-promoting activities and seeking psychosocial support in their efforts to mitigate these stressors. Insights: Students in this region have traditionally been left to their own devices to deal with stress and burnout during their academic training, wherein the institutions focus exclusively on the delivery of information. This study underscores student needs and potential avenues that health profession educators might implement to better support their students, for instance the development and inclusion of longitudinal wellbeing and mentorship curricula geared to build resilience and reduce burnout. The invaluable contributions of health professionals during the pandemic warrant emphasis, as does an examination of the stress associated with these roles to normalize and justify inclusion of wellbeing and resilience modules within the curriculum. Actively engaging health profession students in university-led volunteer activities during public health crises and campaigns would provide opportunities to replenish their coping reservoirs through social engagement, intellectual stimulation, and consolidating their future professional identities.
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Affiliation(s)
- Alla El-Awaisi
- Department of Clincial Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Sara Ismail
- Department of Clincial Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Ruba Sulaiman
- Department of Clincial Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Tanya Kane
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Maguy Saffouh El Hajj
- Department of Clincial Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Mujahed Shraim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Collins A, Stroever S, Baronia R, Michaela J, Awal A, Singer J, Amor W, Ibrahim Y. The Effects of Positive Psychological Factors on the Mental Wellbeing of Medical Students. Cureus 2024; 16:e60702. [PMID: 38899259 PMCID: PMC11186663 DOI: 10.7759/cureus.60702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Objective A well-established association exists between academic performance and levels of depression and anxiety among medical students. However, the effects of positive psychological factors on symptoms of depression and anxiety and academic performance have not been adequately studied. This study explores the relationship between the above variables and identifies positive psychological factors that can promote medical student wellbeing. Methods Medical students were surveyed at four time points during their first two years of medical education using Qualtrics. The surveys used a five-point Likert scale to assess students' levels of loneliness, religiosity, engaged living, life fulfillment, resilience, psychological wellbeing, and symptoms of depression and anxiety. Academic performance was measured using students' Comprehensive Basic Science Examination scores. Linear mixed effect models with maximum likelihood estimation were used to investigate the relationship between positive psychological factors and scores on depression and anxiety as well as the relationship between demographic and psychological factors and exam scores. Results Seventy-two students completed the study. A significant positive correlation was observed between loneliness and symptoms of depression and anxiety, while the same symptoms had significant negative correlations with engaged living. None of the positive psychological factors were significantly predictive of exam scores. Conclusion Our findings suggest that medical students who develop meaningful relationships and live engaged lives are less likely to develop symptoms of depression and anxiety. Our study lays the groundwork for future research focusing on identifying and implementing pre-clinical curriculum changes aiming to improve medical students' mental health.
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Affiliation(s)
- Alex Collins
- Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Stephanie Stroever
- Department of Medical Education, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Regina Baronia
- Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Jansen Michaela
- Department of Medical Education, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Abdul Awal
- Clinical Research Institute, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Jonathan Singer
- Department of Psychological Sciences, Texas Tech University, Lubbock, USA
| | - Wail Amor
- Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Yasin Ibrahim
- Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, USA
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Schaffler Y, Probst T, Pieh C, Haid B, Humer E. Prevalence of mental health symptoms and potential risk factors among Austrian psychotherapists. Sci Rep 2024; 14:3888. [PMID: 38366010 PMCID: PMC10873375 DOI: 10.1038/s41598-024-54372-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/12/2024] [Indexed: 02/18/2024] Open
Abstract
This research focused on the intricacies of mental health within the psychotherapist community, a domain currently understudied. A recent study suggests a better overall mental health profile for Austrian psychotherapists compared to the general population. However, a substantial proportion of psychotherapists still exhibited scores beyond the cut-off for clinically significant mental disorders, potentially undermining the efficacy of patient outcomes. A cross-sectional study was conducted between April to June 2023, enrolling a cohort of 502 Austrian psychotherapists (79.7% female; mean age: 53.4 ± 9.26 years). The analysis leveraged indicators for symptoms of depression (PHQ-2), anxiety (GAD-2), insomnia (ISI-2), stress (PSS-4), and overall well-being (WHO-5). Key correlations were revealed using multivariable logistic regressions incorporating sociodemographic, work-related, and health behavior variables. Mental health symptoms in psychotherapists were associated with lower income, lesser physical activity, employment in outpatient facilities, less experience in the field, and a smaller patient load. Notably, physical activity emerged as a significant protective component, underscoring regular exercise as a vital self-care routine for psychotherapists. Adequate income also presented as a crucial contributor to mental health stability. These findings augment our understanding of the complex dynamics influencing psychotherapists' mental health, potentially enhancing their well-being and optimizing professional output.
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Affiliation(s)
- Yvonne Schaffler
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria
| | - Thomas Probst
- Division of Psychotherapy, Department of Psychology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Christoph Pieh
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria
| | - Barbara Haid
- Austrian Federal Association for Psychotherapy, Vienna, Austria
| | - Elke Humer
- Department of Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, Krems, Austria.
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, Vienna, Austria.
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13
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Siddique H, Maweni RM, Lupi M, Woods S, Shirazi S, Foley RW, Machando D. Resilience and burnout of healthcare workers during the early COVID-19 pandemic. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:144-150. [PMID: 38335098 DOI: 10.12968/bjon.2024.33.3.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
INTRODUCTION The COVID-19 pandemic has led to significantly more healthcare workers (HCWs) experiencing burnout than previously. This burnout is strongly associated with low resilience. Addressing organisational stresses and the introduction of resilience training will help to reduce the proportion of HCWs experiencing this phenomenon. AIMS The aim of this study was to assess the impact of the biopsychosocial changes and challenges associated with the COVID-19 pandemic on the healthcare workforce, exploring, specifically, the impact on and relationship between HCWs' resilience and burnout. METHODS An electronic opt-in survey was distributed to HCWs through hospital and professional association communications emails and websites, as well as social media. The survey consisted of demographic questions, the Oldenburg Burnout Inventory to assess burnout, Brief Resilience Scale to assess general resilience, and 10-item Connor-Davidson Resilience Scale to assess resilience during the pandemic. Univariate and multivariate analysis was undertaken to examine the relationship between these factors. RESULTS A total of 1370 HCWs completed the questionnaire, with 802 (58.5%) having burnout, 348 (25.4%) having low general resilience and 390 (28.5%) having low COVID resilience. Burnout was significantly associated with being public sector workers, low general resilience and low COVID resilience. Resilience training was found to be protective for burnout. CONCLUSION The introduction of resilience training in the workplace is a fundamental tool that will significantly benefit HCWs when working under challenging conditions.
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Affiliation(s)
- Haleema Siddique
- Core Surgical Trainee, Thames Valley Oxford Deanery, UK, Haleema
| | | | - Micol Lupi
- Registrar General Surgery, Northwest London Deanery, Chelsea and Westminster NHS Trust, London, UK
| | | | | | | | - Debra Machando
- Clinical Psychologist and PhD Candidate, University of Cape Town, South Africa
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Harris SC, Gandavarapu S, Zeeman JM. Scoping Review of Programmatic Well-Being Interventions and Outcomes to Support Pharmacy Students. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100638. [PMID: 38141955 DOI: 10.1016/j.ajpe.2023.100638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES Recent literature highlights various well-being initiatives implemented across pharmacy programs; however, there is much heterogeneity in their implementation and limited studies assessing the impact and success of these initiatives on pharmacy students' well-being. The purpose of this scoping review was to identify the effectiveness of strategies implemented by pharmacy schools to improve the well-being of pharmacy students. FINDINGS In total, 23 studies were included, and well-being strategies were categorized into 3 groups: organizational wellness programs, curriculum design and educational course activities, and specific relaxation or meditation activities. Strategies included yoga meditation, structured mindfulness courses, and self-directed mindfulness with digital smartphone applications. The majority of studies assessed outcomes of stress, burnout, and mindfulness, though other well-being domains such as resilience and belonging emerged. Some also assessed perceptions and acceptability of the interventions through qualitative approaches. SUMMARY Despite the heterogeneity of interventions and outcome measures, this review provides a comprehensive scope of well-being domains, assessment tools, interventions, and approaches targeted at pharmacy students and highlights the strongest evidence for interventions on reducing stress. Pharmacy programs can benefit from approaches at both the organization level and those fostering individual accountability by exposing students to a variety of self-help well-being strategies that develop protective factors and motivate them to sustain well-being practices themselves as a shared approach. This scoping review addresses a critical gap by gaining an understanding of the current landscape of well-being initiatives and their effectiveness to better guide pharmacy programs on strategies that are most likely to improve student well-being.
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Affiliation(s)
- Suzanne C Harris
- University of North Carolina at Chapel Hill, UNC Eshelman School of Pharmacy, Division of Practice Advancement and Clinical Education, Office of Well-being and Resiliency, Chapel Hill, NC, USA.
| | - Sathvika Gandavarapu
- Bachelor of Science in Economics with minor in Chemistry and Innovation and Entrepreneurship, Trinity College of Arts and Science, Duke University, Durham, NC.
| | - Jacqueline M Zeeman
- University of North Carolina at Chapel Hill, UNC Eshelman School of Pharmacy, Division of Practice Advancement and Clinical Education, Office of Organizational Effectiveness, Planning, and Assessment, Chapel Hill, NC, USA
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15
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Li H, Upreti T, Do V, Dance E, Lewis M, Jacobson R, Goldberg A. Measuring wellbeing: A scoping review of metrics and studies measuring medical student wellbeing across multiple timepoints. MEDICAL TEACHER 2024; 46:82-101. [PMID: 37405740 DOI: 10.1080/0142159x.2023.2231625] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
PURPOSE Studies have demonstrated poor mental health in medical students. However, there is wide variation in study design and metric use, impairing comparability. The authors aimed to examine the metrics and methods used to measure medical student wellbeing across multiple timepoints and identify where guidance is necessary. METHODS Five databases were searched between May and June 2021 for studies using survey-based metrics among medical students at multiple timepoints. Screening and data extraction were done independently by two reviewers. Data regarding the manuscript, methodology, and metrics were analyzed. RESULTS 221 studies were included, with 109 observational and 112 interventional studies. There were limited studies (15.4%) focused on clinical students. Stress management interventions were the most common (40.2%). Few (3.57%) interventional studies followed participants longer than 12 months, and 38.4% had no control group. There were 140 unique metrics measuring 13 constructs. 52.1% of metrics were used only once. CONCLUSIONS Unique guidance is needed to address gaps in study design as well as unique challenges surrounding medical student wellbeing surveys. Metric use is highly variable and future research is necessary to identify metrics specifically validated in medical student samples that reflect the diversity of today's students.
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Affiliation(s)
- Henry Li
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Tushar Upreti
- Max Rady College of Medicine, Faculty of Health Sciences, University of Manitoba Rady, Winnipeg, Canada
| | - Victor Do
- Department of Pediatrics, Faculty of Medicine, University of Toronto Temerty, Toronto, Canada
| | - Erica Dance
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Melanie Lewis
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Ryan Jacobson
- Office of Advocacy and Wellbeing, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Aviva Goldberg
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba Rady, Winnipeg, Canada
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Jestin M, Sharma S, Jhaveri D, Mitchell B, Micciche D, Venkataraman V, Lambert K. Mental health differences in medical students based on curriculum and gender. BMC MEDICAL EDUCATION 2023; 23:971. [PMID: 38115013 PMCID: PMC10731840 DOI: 10.1186/s12909-023-04946-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND The prevalence of mental health struggles among students in medical school is widely reported; however, little is known about how it is impacted by the medical school curriculum. This study aimed to evaluate differences in anxiety, depression, and emotional exhaustion in medical students based on gender, class year, and curriculum. METHODS An anonymous online survey consisting of questions from established, validated questionnaires about demographics, anxiety, depression, emotional exhaustion, and personal health behaviors was sent to 817 medical students who attended Rowan-Virtua School of Osteopathic Medicine during the Spring of 2021. When applying to this school, each of these students had the option to choose either the problem-based learning (PBL) or lecture-based learning (LBL) curriculum track. RESULTS The survey was completed by 222 students. Females experienced higher levels of anxiety, depression, and emotional exhaustion than males. Students in the PBL had lower levels of emotional exhaustion than their peers in the LBL. Increase in emotional exhaustion was most pronounced between 1st and 2nd year students. Emotional exhaustion was inversely correlated with sleep and exercise. CONCLUSIONS On average, students who were either male or in the PBL curriculum experienced less mental distress in the form of anxiety, depression, and emotional exhaustion than their peers. While gender continues to be an established factor in how mental distress is experienced, the reduced levels of emotional exhaustion in PBL students is a novel finding that can potentially shed light on how to better optimize medical education. Despite the inherent selection bias and lower number of PBL students, to our knowledge, this is the first study comparing two different curricula within a single institution. This finding along with a focus on good sleep and exercise habits may provide a path for improving mental health in medical students.
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Affiliation(s)
- Maxim Jestin
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA.
| | - Shelly Sharma
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | - Deval Jhaveri
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | | | - Dean Micciche
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | | | - Kathryn Lambert
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
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Tran DS, Nguyen DT, Nguyen TH, Tran CTP, Duong-Quy S, Nguyen TH. Stress and sleep quality in medical students: a cross-sectional study from Vietnam. Front Psychiatry 2023; 14:1297605. [PMID: 38025426 PMCID: PMC10680167 DOI: 10.3389/fpsyt.2023.1297605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background The COVID-19 pandemic has resulted in significant global social and economic disruptions, as well as changes in personal attitude and behavior. The purpose of this research is to assess the sleep quality and stress levels of medical students. Method Data was collected from medical students over the course of a month in 2021. A total of 4,677 students at the University of Medicine Pham Ngoc Thach were invited to complete an anonymous web-based survey, which included the Pittsburgh Sleep Quality Questionnaire Index (PSQI) for measuring sleep quality and the COVID-19 Student Stress Questionnaire (CSSQ) for evaluating stress. Results A total of 1,502 students participated in our survey. More than half of the participants exhibited poor quality of sleep as indicated by their PSQI score. Many students reported going to bed after midnight and spending time on their smartphones. Among the students surveyed, 21.84% experienced low levels of stress (CSSQ ≤6), 63.38% had mild stress (7 ≤ CSSQ score ≤ 14), 14.78% reported high levels of stress (CSSQ >14). Conclusion This study showed a high prevalence of poor sleep quality in the surveyed students, which could be attributed to changes in their behavior following the COVID-19 outbreak. Mild stress was also frequently observed, and it may be related to sleep disorders in this population. These important findings provide valuable insights for making recommendations, including lifestyle modifications to improve sleep quality.
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Affiliation(s)
- Duc-Si Tran
- Sleep Lab Unit, University of Medicine Pham Ngoc Thach, Ho Chi Minh City, Vietnam
| | - Duy-Thai Nguyen
- National Institute for Control of Vaccines and Biologicals, Hanoi, Vietnam
- Department of Physiology, Vietnam University of Traditional Medicine, Hanoi, Vietnam
| | - Thai-Hang Nguyen
- Sleep Lab Unit, University of Medicine Pham Ngoc Thach, Ho Chi Minh City, Vietnam
| | - Cao-Thinh-Phuoc Tran
- Sleep Lab Unit, University of Medicine Pham Ngoc Thach, Ho Chi Minh City, Vietnam
| | - Sy Duong-Quy
- BioMedical Research and Sleep Lab Center, Lam Dong Medical College, Dalat, Vietnam
| | - Thanh-Hiep Nguyen
- Sleep Lab Unit, University of Medicine Pham Ngoc Thach, Ho Chi Minh City, Vietnam
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Alreshidi SM. Compassion fatigue prevalence and risk factors among Saudi psychiatric nurses: A cross-sectional study. Medicine (Baltimore) 2023; 102:e35975. [PMID: 37960724 PMCID: PMC10637429 DOI: 10.1097/md.0000000000035975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
In recent times, compassion fatigue is increasingly being recognized as a damaging outcome associated with the stress experienced by psychiatric nurses. In addition to affecting their job performance work-related stress undermines nurses' physical and emotional well-being. However, there is a lack of research on compassion fatigue that specifically focuses on psychiatric nurses working in Saudi Arabia. This cross-sectional study investigated the prevalence and factors associated with compassion fatigue among Saudi psychiatric nurses. The study participants were asked to complete a demographic questionnaire and the Arabic form of the Professional Quality of Life Scale. Statistical analyses, including one-way ANOVA, t-tests, the Levene test, and multiple linear regression, were employed to assess variables related to compassion fatigue. The survey spanned 158 psychiatric nurses from the Mental Health Complex located in Riyadh City. The mean scores for compassion satisfaction, burnout, and secondary traumatic stress were 39.72 ± 6.881, 24.29 ± 5.386, and 26.94 ± 6.973, respectively. The analysis revealed that variables such as age range (36-55 years) and an associated degree or lower explained 5.2% of the variance in compassion satisfaction. Age range (18-25 years), exercise frequency, and years of nursing experience collectively accounted for 8.4% of the variables contributing to burnout. The age range (25 to 35 years) and working night shifts also explained 5% of the variance in secondary traumatic stress. The findings indicated that compassion satisfaction, burnout, and secondary traumatic stress among the population of psychiatric nurses working in Saudi Arabia were at a moderate level. A higher frequency of healthy lifestyle practices, such as regular exercise, and being in an older age range, were positively associated with compassion satisfaction and negatively associated with burnout and secondary traumatic stress.
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Affiliation(s)
- Salman M. Alreshidi
- Community and Psychiatric Mental Health Nursing Department, College of Nursing, King Saud University, Riyadh City, Saudi Arabia
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Lo Moro G, Corezzi M, Bert F, Buda A, Gualano MR, Siliquini R. Mental health and adherence to Mediterranean diet among university students: an Italian cross-sectional study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2451-2461. [PMID: 34519625 DOI: 10.1080/07448481.2021.1970567] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study is aimed to explore severe mental illness (SMI), mental well-being (MWB), and Mediterranean Diet adherence (MedDiet) among university students. PARTICIPANTS University students in Northern Italy (sample size = 502). METHODS Cross-sectional survey was conducted in 2019. The questionnaires included Warwick-Edinburgh Mental Well-Being Scale for MWB, K6 for SMI, Mediterranean Diet Adherence Screener for MedDiet. Multivariable regressions were mainly performed (p < .05 as significant). RESULTS MWB was high in 3.93% of the participants and low in 23.97%. SMI was probable in 21.87%. MedDiet adherence was high in 2.19% and low in 35.06%. Mainly, poor/very poor perceived health, Economics/Legal/Strategic Sciences courses, and not being on time with exams showed associations with both lower MWB and probable SMI. Gender and some lifestyle, dietary, and university factors predicted MedDiet. MWB and MedDiet were positively associated. CONCLUSIONS This study found high levels of mental issues and low MedDiet. Modifiable factors at university level should be investigated to design preventive interventions.
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Affiliation(s)
- Giuseppina Lo Moro
- Department of Public Health Sciences, University of Torino, Torino, Italy
| | - Michele Corezzi
- Department of Public Health Sciences, University of Torino, Torino, Italy
| | - Fabrizio Bert
- Department of Public Health Sciences, University of Torino, Torino, Italy
| | - Alessia Buda
- Degree Course in Dietistics, University of Torino, Torino, Italy
| | | | - Roberta Siliquini
- Department of Public Health Sciences, University of Torino, Torino, Italy
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Torres-McGehee TM, Emerson DM, Flanscha-Jacobson A, Uriegas NA, Moore EM, Smith AB. Energy Availability, Mental Health, and Sleep Patterns of Athletic Trainers. J Athl Train 2023; 58:788-795. [PMID: 36913639 PMCID: PMC11215732 DOI: 10.4085/1062-6050-0547.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
CONTEXT Engaging in exercise and appropriate nutritional intake improves mental health by reducing anxiety, depression, and sleep disturbances. However, few researchers have examined energy availability (EA), mental health, and sleep patterns in athletic trainers (ATs). OBJECTIVE To examine ATs' EA, mental health risk (ie, depression, anxiety), and sleep disturbances by sex (male, female), job status (part time [PT AT], full time [FT AT]), and occupational setting (college or university, high school, or nontraditional). DESIGN Cross-sectional study. SETTING Free living in occupational settings. PATIENTS OR OTHER PARTICIPANTS A total of 47 ATs (male PT ATs = 12, male FT ATs = 12; female PT ATs = 11, female FT ATs = 12) in the southeastern United States. MAIN OUTCOME MEASURE(S) Anthropometric measurements consisted of age, height, weight, and body composition. Energy availability was measured through energy intake and exercise energy expenditure. We used surveys to assess the depression risk, anxiety (state or trait) risk, and sleep quality. RESULTS Thirty-nine ATs engaged in exercise, and 8 did not exercise. Overall, 61.5% (n = 24/39) reported low EA (LEA); 14.9% (n = 7/47) displayed a risk for depression; 25.5% (n = 12/47) indicated a high risk for state anxiety; 25.5% (n = 12/47) were at high risk for trait anxiety, and 89.4% (n = 42/47) described sleep disturbances. No differences were found by sex and job status for LEA, depression risk, state or trait anxiety, or sleep disturbances. Those ATs not engaged in exercise had a greater risk for depression (risk ratio [RR] = 1.950), state anxiety (RR = 2.438), trait anxiety (RR = 1.625), and sleep disturbances (RR = 1.147), whereas ATs with LEA had an RR of 0.156 for depression, 0.375 for state anxiety, 0.500 for trait anxiety, and 1.146 for sleep disturbances. CONCLUSIONS Although most ATs engaged in exercise, their dietary intake was inadequate, they were at increased risk for depression and anxiety, and they experienced sleep disturbances. Those who did not exercise were at an increased risk for depression and anxiety. Energy availability, mental health, and sleep affect overall quality of life and can affect ATs' ability to provide optimal health care.
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Opoku MA, Kang SW, Choi SB. The influence of sleep on job satisfaction: examining a serial mediation model of psychological capital and burnout. Front Public Health 2023; 11:1149367. [PMID: 37693724 PMCID: PMC10483141 DOI: 10.3389/fpubh.2023.1149367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 08/11/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction This study draws on the conservation of resources theory to investigate whether the loss of sleep can trigger the loss of additional resources that are necessary for work. Methods Using cross-sectional design of 322 call center employees working at a government-owned public bank in South Korea, we test the study hypotheses using regression and bootstrapping indirect effects analyses. Results The results of analyses show that insufficient sleep increases employee burnout and that psychological capital mediates this relationship. We also find that insufficient sleep decreases job satisfaction via a serial mediation model such that insufficient sleep reduces psychological capital, which in turn increases burnout, and ultimately results in lower job satisfaction. Discussion The findings reinforce the previous assessment that although sleep is a non-work factor, its impact spills over to the workplace. Theoretically, this study goes beyond direct effect to uncover the underlying or mediating mechanisms that account for the impact of the sleep-burnout relationship and the sleep-job satisfaction relationship. For managers, the results highlight the significance of sleep to employees' overall health and well-being and thus underscore the need to foster a work culture that recognizes and prioritizes employee sleep needs.
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Affiliation(s)
- Mavis Agyemang Opoku
- Gordon S. Lang School of Business and Economics, University of Guelph, Guelph, ON, Canada
| | - Seung-Wan Kang
- College of Business, Gachon University, Seongnam, Republic of Korea
| | - Suk Bong Choi
- College of Global Business, Korea University, Sejong City, Republic of Korea
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Joseph A, Mayer DC. A Qualitative Analysis of Student and Preceptor Resiliency Discussions During Introductory Pharmacy Practice Experiences. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100104. [PMID: 37597907 DOI: 10.1016/j.ajpe.2023.100104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/27/2022] [Accepted: 11/09/2022] [Indexed: 08/21/2023]
Abstract
OBJECTIVE The primary objective of this qualitative study was to describe key themes discussed by student pharmacists and preceptors related to recognizing burnout and maintaining wellbeing during an experiential assignment. METHODS This qualitative study used directed content analysis to examine themes that emerged from discussions between student pharmacists and preceptors as part of a required lifelong learning interview during Introductory Pharmacy Practice Experiences that took place between August 2019 and May 2020. Iterative axial coding was used to develop and redefine codes systematically until consensus was reached and a final codebook was established. All responses were coded using the consensus categories. RESULTS From the 228 interviews analyzed, 3 overarching themes emerged: causes of burnout, manifestations or symptoms of burnout, and strategies to manage stress and burnout. Preceptors identified the mechanics of the job and feeling extreme pressure or worry as 2 major causes of burnout, which manifest as physical exhaustion, mental exhaustion, and poor work performance. To manage stress, preceptors reported using personal and work-positive coping strategies. CONCLUSION The major themes derived from the analysis-causes of burnout, manifestations of burnout, and strategies to manage stress-align with what is already known about health care provider wellbeing. Although it remains unknown if this type of wellness intervention is effective at changing student stress management habits, results indicate that the intervention sparked conversations that could assist students in establishing a baseline of knowledge on the topic and supply students with a toolkit of resiliency strategies.
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Affiliation(s)
- Andrea Joseph
- Thomas Jefferson University, Jefferson College of Pharmacy, Philadelphia, PA, USA
| | - Danielle C Mayer
- Thomas Jefferson University, Jefferson College of Pharmacy, Philadelphia, PA, USA.
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Carlos KM, Ahmadi H, Uban KA, Riis JL. Behavioral and psychosocial factors related to mental distress among medical students. Front Public Health 2023; 11:1225254. [PMID: 37575125 PMCID: PMC10413116 DOI: 10.3389/fpubh.2023.1225254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/26/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Physicians die by suicide at rates higher than the general population, with the increased risk beginning in medical school. To better understand why, this study examined the prevalence of mental distress (e.g., depressive symptoms and suicide risk) and behavioral and psychosocial risk factors for distress, as well as the associations between mental distress and risk factors among a sample of medical students in a pre-COVID-19-era. Methods Students enrolled in a large California medical school in 2018-2019 (N = 134; 52% female) completed questionnaires assessing sociodemographic characteristics, depression and suicide family history, health behaviors, and psychosocial wellbeing. Assessment scores indexing mental distress (e.g., depressive symptoms, thoughts of suicide in the past 12 months, suicide risk, and history of suicidality) and risk factors (e.g., stress, subjective sleep quality, alcohol use, impostor feelings, and bill payment difficulty) were compared across biological sex using chi-squared tests, and associations between mental distress and risk factors were determined through logistic regression. Results Elevated mental distress indicators were observed relative to the general public (e.g., 16% positive depression screen, 17% thought about suicide in previous 12 months, 10% positive suicide risk screen, and 34% history of suicidality), as well as elevated risk factors [e.g., 55% moderate or high stress, 95% at least moderate impostor feelings, 59% poor sleep quality, 50% screened positive for hazardous drinking (more likely in females), and 25% difficulty paying bills]. A positive depression screen was associated with higher stress, higher impostor feelings, poorer sleep quality, and difficulty paying bills. Suicidal ideation in the previous 12 months, suicide risk, and a history of suicidality were independently associated with higher levels of impostor feelings. Discussion Higher scores on assessments of depressive symptoms and suicidal thoughts and behaviors were related to several individual-level and potentially modifiable risk factors (e.g., stress, impostor feelings, sleep quality, and bill payment difficulties). Future research is needed to inform customized screening and resources for the wellbeing of the medical community. However, it is likely that the modification of individual-level risk factors is limited by the larger medical culture and systems, suggesting that successful interventions mitigate suicide risk for medical providers need to address multiple socio-ecological levels.
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Affiliation(s)
- Kathleen M. Carlos
- Program in Public Health, Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, United States
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
| | - Hedyeh Ahmadi
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
| | - Kristina A. Uban
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
- Developing Brains Laboratory, Program in Public Health, Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Jenna L. Riis
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
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Gao WJ, Hu Y, Ji JL, Liu XQ. Relationship between depression, smartphone addiction, and sleep among Chinese engineering students during the COVID-19 pandemic. World J Psychiatry 2023; 13:361-375. [PMID: 37383286 PMCID: PMC10294134 DOI: 10.5498/wjp.v13.i6.361] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/07/2023] [Accepted: 04/24/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND Existing research has demonstrated that depression is positively related to smartphone addiction, but the role of sleep has not been discussed thoroughly, especially among engineering undergraduates affected by the coronavirus disease 2019 pandemic. AIM To evaluate sleep as a mediator of the association between smartphone addiction and depression among engineering undergraduates. METHODS Using a multistage stratified random sampling method, a cross-sectional survey was conducted among 692 engineering undergraduates from a top engineering university in China, and data were collected by self-reported electronic questionnaires. The data included demographic characteristics, such as age, gender, the Smartphone Addiction Scale-Short Version (SAS-SV), the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index. Pearson correlation and multiple linear regression analyses were used to examine the association between smartphone addiction and depression, while structural equation models were established to evaluate the possible mediating role of sleep. RESULTS Based on the cutoffs of the SAS-SV, the rate of smartphone addiction was 63.58 percent, with 56.21 percent for women and 65.68 percent for men, among 692 engineering students. The prevalence of depression among students was 14.16 percent, with 17.65 percent for women, and 13.18 percent for men. Smartphone addiction was positively correlated with depression, and sleep played a significant mediating effect between the two, accounting for 42.22 percent of the total effect. In addition, sleep latency, sleep disturbances, and daytime dysfunction significantly mediated the relationship between depression and smartphone addiction. The mediating effect of sleep latency was 0.014 [P < 0.01; 95% confidence interval (CI): 0.006-0.027], the mediating effect of sleep disturbances was 0.022 (P < 0.01; 95%CI: 0.011-0.040), and the mediating effect of daytime dysfunction was 0.040 (P < 0.01; 95%CI: 0.024-0.059). The influence of sleep latency, sleep disturbances, and daytime dysfunction accounted for 18.42%, 28.95%, and 52.63% of the total mediating effect, respectively. CONCLUSION The results of the study suggest that reducing excessive smartphone use and improving sleep quality can help alleviate depression.
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Affiliation(s)
- Wen-Juan Gao
- Institute of Higher Education, Beihang University, Beijing 100191, China
- School of Public Administration, Beihang University, Beijing 100191, China
- Research Center for Beijing Higher Education Development, Beihang University, Beijing 100191, China
| | - Yan Hu
- Institute of Higher Education, Beihang University, Beijing 100191, China
- School of Public Administration, Beihang University, Beijing 100191, China
- Research Center for Beijing Higher Education Development, Beihang University, Beijing 100191, China
| | - Jun-Lin Ji
- Institute of Higher Education, Beihang University, Beijing 100191, China
- School of Public Administration, Beihang University, Beijing 100191, China
- Research Center for Beijing Higher Education Development, Beihang University, Beijing 100191, China
| | - Xin-Qiao Liu
- School of Education, Tianjin University, Tianjin 300350, China
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Park CH, Kwon J, Lee JT, Ahn S. Impact of Criterion Versus Norm-Referenced Assessment on the Quality of Life in Korean Medical Students. J Korean Med Sci 2023; 38:e133. [PMID: 37128877 PMCID: PMC10151616 DOI: 10.3346/jkms.2023.38.e133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/11/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Medical students are known to be subjected to immense stress under competitive curricula and have a high risk of depression, burnout, anxiety and sleep disorders. There is a global trend of switching from norm-referenced assessment (NRA) to criterion-referenced assessment (CRA), and these changes may have influenced the quality of life (QOL), sleep phase, sleep quality, stress, burnout, and depression of the medical students. We hypothesized that there is a significant difference of QOL between CRA and NRA and that sleep, stress, burnout, and depression are the main contributors. METHODS By administering an online survey regarding QOL and its contributors to Korean medical students, 365 responses from 10 medical schools were recorded. To clarify the complex relationship between the multiple factors in play, we applied nonlinear machine learning algorithms and utilized causal structure learning techniques on the survey data. RESULTS Students with CRA had lower scores in stress (68.16 ± 11.29, 76.03 ± 12.38, P < 0.001), burnout (48.09 ± 11.23, 55.93 ± 13.07, P < 0.001), depression (12.77 ± 9.82, 16.44 ± 11.27, P = 0.003) and higher scores in QOL (95.79 ± 16.20, 89.65 ± 16.28, P < 0.001) compared with students with NRA. Multiple linear regression, permutation importance of the random forest model and the causal structure model showed that depression, stress and burnout are the most influential factors of QOL of medical students. CONCLUSION Medical students from schools that use CRA showed higher QOL scores, as well as lower burnout, stress and depression when compared with students from schools that use NRA. These results may be used as a basis for granting justification for the transition to CRA.
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Affiliation(s)
- Ce Hwan Park
- Inje University College of Medicine, Busan, Korea
| | - Jihyeon Kwon
- Inje University College of Medicine, Busan, Korea
| | - Jong Tae Lee
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
| | - Sangzin Ahn
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan, Korea.
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Esguerra S, Chiu FT, Espinoza A, Williams D, Clithero-Eridon A. Are medical students happy despite unhappy conditions: a qualitative exploration of medical student cohorts during disruptive conditions. BMC MEDICAL EDUCATION 2023; 23:214. [PMID: 37020246 PMCID: PMC10073778 DOI: 10.1186/s12909-023-04203-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Shortly after the World Health Organization declared the SARS-CoV-2 outbreak a worldwide pandemic, medical school governing bodies issued guidance recommending pausing clinical rotations. Prior to the availability of COVD-19 vaccines, many schools implemented exclusively online curriculums in the didactic and clinical years. These unprecedented events and paradigm changes in medical education could contribute to trainee burnout, wellness, and mental health. METHODS This single-institution study interviewed first, second, and third-year medical students from a medical school in the southwestern United States. A semi-structured interview was conducted with paper-based Likert scale questions rating perceived happiness were administered both at the time of the interview and one year later in order to understand how their student experience and happiness were impacted. In addition, we asked participants to describe any major life events they experienced since the first interview. RESULTS Twenty-seven volunteers participated in the original interview. Twenty-four from the original cohort participated in the one-year follow-up. Happiness as a sense of self and who you "should be" was challenged during the pandemic and changes in happiness over time were not systematic across classes. Stress was caused not only by the pandemic which was experienced by all, but by a tripartite state of individual circumstances, academic workload requirements, and the world at large. Primary themes from the interviews were clustered around the individual, learner, and future professional levels and focused on the primacy of relationships, emotional wellness, stress management, professional identity, and impacts of educational disruptions. These themes created risk factors for developing imposter syndrome. Students demonstrated resiliency across cohorts and were able to utilize a variety of strategies to achieve and maintain both physical and mental health, but the primacy of relationships both personally and professionally was noted. CONCLUSION Medical students' identities as individual persons, a learner, and future medical professionals were all impacted by the pandemic. The results from this study suggest that the COVID-19 pandemic and changes in the learning format and environment may create a new risk factor in the development of imposter syndrome. There is also an opportunity to re-consider resources to achieve and maintain wellness during a disrupted academic environment.
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Affiliation(s)
| | | | | | - Dan Williams
- Family & Community Medicine, University of New Mexico, PhD University of New Mexico School of Medicine, 1 UNM, Albuquerque, NM, MSC09-5040, 87131, USA
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Kuzmin MY, Tyumentseva DP, Marianian AY. Healthy And Unhealthy Lifestyles As Factors Of Occupational Burnout In Obstetrics And Gynecology Physicians. RUSSIAN OPEN MEDICAL JOURNAL 2023. [DOI: 10.15275/rusomj.2023.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
This article investigates healthy and unhealthy lifestyles and its components (physical activity, drinking alcohol, consumption of caffeinated products, tobacco use) as factors of occupational burnout in obstetrics and gynecology physicians. Material and Methods. A total of 132 physicians and nurses from the different clinics of Irkutsk were surveyed. We used Maslach Burnout Inventory (MBI), SF-12, and Godin Leisure-Time Exercise Questionnaire. Results: Differences in healthy and unhealthy lifestyles between physicians and nurses employed in obstetrics and gynecology, with or without a high burnout, were revealed. According to the obtained results, the frequency of alcohol consumption was directly related to burnout. In study subjects engaged in low and moderate physical activity, burnout occurred briefly or rarely. The differences became more pronounced when we excluded physicians and nurses with poor physical health from consideration, because they did not exercise much. According to the results of logistic regression, the probability of burnout and reduced level of quality of life among physicians and nurses increased with a bigger family size, lower work experience, and less time spent on moderate physical activity. Conclusion: Healthy and unhealthy lifestyles can cause healthcare employee burnout. Physicians and nurses with a high burnout consumed stronger alcohol and spent less time in moderate physical activity.
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Shi C, Luo JM, Xiao Y. The association of sleep quality and burnout among Chinese medical residents under standardized residency training in a tertiary hospital. Sleep Breath 2023; 27:379-386. [PMID: 35460049 PMCID: PMC9033310 DOI: 10.1007/s11325-022-02621-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/22/2022] [Accepted: 04/15/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE To investigate the impact of sleep quality and chronotype on job burnout among medical residents under standardized residency training (SRT) in a tertiary hospital in Beijing, China. METHODS Medical residents in the Department of Internal Medicine of Peking Union Medical College Hospital were assessed by Morning and Evening Questionaire-5 (MEQ-5), Pittsburgh sleep quality index (PSQI), and Maslach Burnout Inventory-General Survey (MBI-GS). Factors associated with burnout were analyzed. RESULTS A total of 142 respondents returned completed questionnaires. Burnout was present in 85 (60%) residents. Prevalence of high emotional exhaustion, high depersonalization, and low personal accomplishment were 51%, 28%, and 18%, respectively. The global PSQI score of residents was 5.9 ± 2.4, and the self-reported sleep duration was 6.2 ± 0.8 h/day. The MEQ-5 distribution skewed towards morningness, with a median score of 14.5 [13.0, 16.3]. Poor daytime function significantly predicted emotional exhaustion and depersonalization. Chronotypes were not associated with any of the burnout components. CONCLUSION Sleep-related daytime dysfunction was strongly related to burnout. Strategies protecting the sleep of residents should be incorporated into the SRT programs for both efficiency and sustainability considerations.
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Affiliation(s)
- Chuan Shi
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science (CAMS) and Peking Union Medical College (PUMC), Beijing, 100730, China
| | - Jin-Mei Luo
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science (CAMS) and Peking Union Medical College (PUMC), Beijing, 100730, China.
| | - Yi Xiao
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science (CAMS) and Peking Union Medical College (PUMC), Beijing, 100730, China
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da Silva Rodrigues G, Noronha NY, Almeida ML, Sobrinho ACDS, Watanabe LM, Pinhel MADS, de Lima JGR, Zhang R, Nonino CB, Alves CRR, Bueno Júnior CR. Exercise training modifies the whole blood DNA methylation profile in middle-aged and older women. J Appl Physiol (1985) 2023; 134:610-621. [PMID: 36701486 DOI: 10.1152/japplphysiol.00237.2022] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
This is a longitudinal single-arm clinical trial aimed to investigate whether exercise training would modify the whole blood methylation profile in healthy women. A total of 45 subjects were engaged in an exercise training protocol during a 14-wk follow up, consisting of aerobic cardiorespiratory and muscle strength exercises. Subjects were evaluated at baseline (PRE), after 7 wk of exercise training (POST 7), and after 14 wk of exercise training (POST 14). Functional primary outcomes included anthropometric, blood pressure, biochemical measurements, physical tests, and global health assessments. Blood samples were collected at each time point to determine the methylation profile using a DNA methylation array technique screening up to 850k different sites. Exercise training decreased blood pressure and triglyceride levels and enhanced physical performance, including upper- and lower-body maximum strength. Moreover, exercise training improved markers of quality of life. In the array analysis, 14 wk of exercise training changed the methylation of more than 800 sites. Across these differentially methylated sites, we found that differentially methylated sites in the promoter region were more hypermethylated after exercise training, suggesting that this hypermethylation process may affect the transcription process. When inputting the differentially methylated sites in pathway analysis, we found several metabolic pathways, including AMPK signaling, TGF-β signaling, and insulin signaling. This study demonstrates that exercise training promotes a robust change in the whole blood methylation profile and provides new insights into the key regulators of exercise-induced benefits.NEW & NOTEWORTHY We have shown that exercise training lowers blood pressure and triglyceride levels, improves physical performance, and improves quality of life in middle-aged and elderly women. Regarding epigenetic data, we noticed that more than 800 sites are differentially methylated in whole blood after physical training. We emphasize that the differentially methylated sites in the promoter region are more hypermethylated after physical training. In addition, this study shows that key members of metabolic pathways, including AMPK signaling, TGF-β signaling, and insulin signaling, are among the genes hypermethylated after physical exercise in older women.
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Affiliation(s)
| | - Natália Y Noronha
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Mariana L Almeida
- College of Nursing of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Andressa C da S Sobrinho
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Lígia M Watanabe
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Marcela A de S Pinhel
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - João G R de Lima
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Ren Zhang
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Carla B Nonino
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Christiano R R Alves
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Carlos R Bueno Júnior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.,College of Nursing of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.,School of Physical Education and Sport of Ribeirão Preto, University of Sao Paulo, Sao Paulo, Brazil
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Kong LN, Yao Y, Chen SZ, Zhu JL. Prevalence and associated factors of burnout among nursing students: A systematic review and meta-analysis. NURSE EDUCATION TODAY 2023; 121:105706. [PMID: 36577286 DOI: 10.1016/j.nedt.2022.105706] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To systematically estimate the global prevalence of burnout among nursing students, and examine the associated factors of burnout in this population. DESIGN A systematic review and meta-analysis. REVIEW METHODS AND DATA SOURCES PubMed, Embase, Web of Science, and CINAHL were searched from inception to June 30th, 2022. Two researchers independently screened studies, extracted data and assessed the quality of included studies. The random-effects model was used to estimate the global prevalence of burnout among nursing students. Subgroup analysis, meta-regression analysis, publication bias, and sensitivity analysis were also conducted. RESULTS A total of 21 studies were included, involving 10,861 nursing students. In the random-effects model, the pooled prevalence of burnout was 23.0 % (95 % CI = 15.6-30.5 %) in nursing students. The pooled prevalence of emotional exhaustion, depersonalization, and reduced personal accomplishment was 47.1 %, 32.2 %, and 43.5 %, respectively. Main associated factors of burnout included demographic (e.g., age and grade), educational (e.g., workload, academic satisfaction, and incivility experience), physical (e.g., sleep quality and physical activity), and psychological (e.g., self-efficacy and personality traits) factors. CONCLUSIONS Burnout is common in nursing students, with demographic, educational, physical, and psychological factors affecting their burnout. Early screening of burnout and interventions to prevent and reduce burnout should be considered for nursing students.
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Affiliation(s)
- Ling-Na Kong
- School of Nursing, Chongqing Medical University, Chongqing, China.
| | - Yu Yao
- School of Nursing, Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Shuo-Zhen Chen
- Clinical Nursing Teaching and Research Section, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Jia-Lu Zhu
- Nursing Department, The Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Chu WM, Ho HE, Lin YL, Li JY, Lin CF, Chen CH, Shieh GJ, Chan WC, Tsan YT. Risk Factors Surrounding an Increase in Burnout and Depression Among Health Care Professionals in Taiwan During the COVID-19 Pandemic. J Am Med Dir Assoc 2023; 24:164-170.e3. [PMID: 36592937 PMCID: PMC9747695 DOI: 10.1016/j.jamda.2022.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 11/18/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES This study aimed to investigate the risk factors surrounding an increase in both burnout levels and depression among health care professionals in Taiwan through use of a longitudinal study design. DESIGN This is a 2-year observational study that took place from January 2019 to December 2020. SETTING AND PARTICIPANTS Data among health care professionals were extracted from the Overload Health Control System of a tertiary medical center in central Taiwan. METHODS Burnout was measured through use of the Chinese version of the Copenhagen Burnout Inventory (C-CBI), whereas depression was ascertained by the Taiwanese Depression Questionnaire. Each participant provided both burnout and depression measurements during a nonpandemic period (2019) as well as during the COVID pandemic era (2020). Risk factors surrounding an increase in burnout levels and depression were analyzed through a multivariate logistic regression model with adjusting confounding factors. RESULTS Two thousand nineteen participants completed the questionnaire over 2 consecutive years, including 132 visiting doctors, 105 resident doctors, 1371 nurses, and 411 medical technicians. After adjustments, sleeplessness, daily working hours >8, and stress due to one's workload were all found to be risk factors for an increase in depression levels, whereas sleeplessness, lack of exercise, and stress due to one's workload were all found to be risk factors for an increase in personal burnout level. Being a member of the nursing staff, a younger age, sleeplessness, and lack of exercise were all risk factors for an increase in work-related burnout levels. CONCLUSIONS AND IMPLICATIONS Poor sleep, lack of exercise, long working hours, and being a member of the nursing staff were risk factors regarding an increase in personal burnout, work-related burnout levels and depression among health care professionals. Leaders within the hospital should investigate the working conditions and personal habits of all medical staff regularly and systematically during the COVID-19 pandemic and take any necessary preventive measures, such as improving resilience for nursing staff, in order to best care for their employees.
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Affiliation(s)
- Wei-Min Chu
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan,School of Medicine, Chung Shan Medical University, Taichung, Taiwan,Education and innovation Center for Geriatrics and Gerontology, National Center for Geriatrics and Gerontology, Aichi, Japan,Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hsin-En Ho
- Department of Family Medicine, Taichung Armed Force General Hospital, Taichung, Taiwan,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan,National Defense Medical Center, Taipei, Taiwan
| | - Yu-Li Lin
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan,Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jhih-Yan Li
- Ming Crown Industry Company, Changhwa, Taiwan
| | - Cheng-Fu Lin
- Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Cing-Hua Chen
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan,Department of Occupational Safety and Health Office, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Gow-Jen Shieh
- Department of Occupational Safety and Health Office, Taichung Veterans General Hospital, Taichung, Taiwan,Department of Top Hospital Administration, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wei-Cheng Chan
- Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Tse Tsan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Occupational Safety and Health Office, Taichung Veterans General Hospital, Taichung, Taiwan.
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Schmickler JM, Blaschke S, Robbins R, Mess F. Determinants of Sleep Quality: A Cross-Sectional Study in University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2019. [PMID: 36767422 PMCID: PMC9915447 DOI: 10.3390/ijerph20032019] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
When entering the university setting, poor sleep quality is reportedly prevalent among students and has been linked to a range of adverse health outcomes, including reduced academic performance. Moreover, determinants of sleep quality are not yet fully understood. This study was designed to (1) assess the prevalence of poor sleep quality and (2) identify determinants of sleep quality in German university students. In total, 1,684 undergraduate and graduate students (50.6% female, mean age 22.87 ± 3.15 years) from multiple academic disciplines completed a cross-sectional online survey assessing socio-demographic, health, and study-related indicators and sleep quality using the Pittsburgh Sleep Quality Index (PSQI). In our sample, 820 (48.7%) met the PSQI cut-off score (>5) for poor sleep quality. Multiple regression analysis showed that older age, being a business student, lower subjective social status, poorer self-rated health, stress, exhaustion, and poor academic performance significantly predicted poor sleep quality. Our findings document a high prevalence of poor sleep quality among university students and suggest that business students, especially, might be exposed to a greater risk for poor sleep quality. Furthermore, the results of this study are valuable for academic staff to develop tailored interventions to promote healthy sleep-in university students.
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Affiliation(s)
| | - Simon Blaschke
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
| | - Rebecca Robbins
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Filip Mess
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
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Edmonds VS, Chatterjee K, Girardo ME, Butterfield RJ, Stonnington CM. Evaluation of a Novel Wellness Curriculum on Medical Student Wellbeing and Engagement Demonstrates a Need for Student-Driven Wellness Programming. TEACHING AND LEARNING IN MEDICINE 2023; 35:52-64. [PMID: 35107397 DOI: 10.1080/10401334.2021.2004415] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 09/15/2021] [Indexed: 06/14/2023]
Abstract
PROBLEM Medical training is stressful and has well-established implications for student wellbeing. Despite widespread efforts to reduce student burnout through wellness programming in medical schools, there is a paucity of literature examining students' perception of wellness and engagement with these programs. As such, we sought to evaluate: 1) medical students' level of engagement with a multifaceted wellness curriculum, 2) factors students perceived as important to wellbeing, and 3) associations with longitudinal measures of wellbeing and perceived stress. Intervention: A multipronged wellness curriculum was instituted at Mayo Clinic Alix School of Medicine-AZ (MCASOM-AZ) in 2017. This includes mental health services, curriculum-embedded seminars, wellness committee (composed of students, faculty, and administration) driven programming, and student proposed wellness activities that are reviewed and funded by the committee. The authors invited students at our institution to complete questionnaires at three timepoints during the 2018-2019 academic year. Questionnaires asked participants to rank eight factors from least to most important to their overall wellbeing. Participants self-reported their participation in each prong of the wellness curriculum and ranked the impact of each on their overall wellbeing. Their wellbeing and perceived stress were measured at each timepoint using validated psychological instruments. Context: As MCASOM-AZ opened in 2017, the student body at the time of study consisted of first- and second-year medical students. All students had the opportunity to engage with all aspects of the wellness curriculum and participate in this study, however participation was elective and all responses were anonymous. Of the MCASOM-AZ student body comprised of 100 students, 58 consented to participate in the study, 41.4% of which were Year 1 and 58.6% of which were Year 2 students. Participant age and gender were collected and were representative of the larger student body. Impact: Students engaged most with student-initiated wellness. They perceived unscheduled time as most impactful to their overall wellbeing with student-initiated activities as second-most impactful. Students with higher perceived stress were more likely than others to use mental health resources, which otherwise ranked lower in importance. Ranking academic performance as important to wellbeing was associated with higher wellbeing. There was no difference in wellbeing between students who participated in the wellness curriculum and those who did not. However, overall student wellbeing increased over the course of the year while perceived stress decreased. Lessons Learned: Medical school programs may benefit from allowing students to direct or contribute to the design of their own wellness curriculum. Additionally, medical education should work toward creating a more supportive learning environment with improved flexibility in order to better meet students' individual needs without compromising their education. Despite having low utilization rates overall, mental health resources remain an important aspect of student support services as they are used by students under greater amounts of perceived stress than their peers. UNLABELLED Supplemental data for this article is available online at https://doi.org/10.1080/10401334.2021.2004415 .
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Affiliation(s)
- Victoria S Edmonds
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | | | - Marlene E Girardo
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, USA
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Occupational Burnout Is Linked with Inefficient Executive Functioning, Elevated Average Heart Rate, and Decreased Physical Activity in Daily Life - Initial Evidence from Teaching Professionals. Brain Sci 2022; 12:brainsci12121723. [PMID: 36552182 PMCID: PMC9775632 DOI: 10.3390/brainsci12121723] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/03/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Burnout is becoming a global pandemic jeopardizing brain health, with a huge impact on quality of life, available workforce, and the economy. Knowledge of the impact of burnout on cognition, physiology, and physical activity (PA) in daily life allows for an improved understanding of the health consequences and everyday ramifications of burnout. Twenty-eight volunteers participated in a three-day recording of daily physiology and PA, including heart rate (HR) and daily steps, with a wearable device. They filled in questionnaires screening for burnout (BBI-15), depression (BDI), and executive functions (EFs) in daily life (BRIEF-A). The subjects with burnout had more challenges in EFs, higher average HRs and lower numbers of steps in daily life than those without it. The BBI-15 scores correlated positively with the BDI scores and BRIEF-A indices and negatively with the awake HR variability (HRV) and daily steps. The metacognition index correlated negatively with the HRV. In conclusion, burnout is linked with compromised EFs along with alterations in cardiac physiology and PA in daily life. Such alterations may be easily detected with wearable devices, opening possibilities for novel biomarkers of burnout and other neuropsychiatric disorders. We suggest that physical activity and heart and brain health are intimately intertwined and that burnout interacts with each of them bidirectionally.
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Leuchter RK, Stuber ML, McDonald AL, Croymans DM. Relationship between exercise intensity and stress levels among U.S. medical students. MEDICAL EDUCATION ONLINE 2022; 27:2027651. [PMID: 35048776 PMCID: PMC8786247 DOI: 10.1080/10872981.2022.2027651] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 11/14/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Physical activity may protect the mental health of medical students, yet it is unknown which types and intensities of physical activity have the greatest potential to improve medical student well-being. OBJECTIVE We characterize the relationship between exercise intensity and stress levels of U.S. medical students, thereby informing the design of future well-being interventions. DESIGN Two cross-sectional validated surveys assessing stress and physical activity were administered one year apart at the David Geffen School of Medicine at UCLA. A total of 1,046 out of 1,392 medical students responded (75%). An ordered logistic regression was used to determine the association between stress and each level of exercise intensity (inactivity, moderate-activity, and health-enhancing physical activity [HEPA]). These exercise intensity groupings were compared to the CDC guidelines for aerobic exercise. RESULTS While achieving either moderate-activity or HEPA is compliant with the CDC guidelines for aerobic exercise, the additional intensity of exercise required to achieve HEPA was associated with a 26% increase in the probability of being in the lowest stress quartile and a 22% decrease in the probability of being in the highest stress quartile. Medical student physical activity levels were on-par with the national average per the CDC exercise guidelines (65% vs. 58%), but medical student HEPA levels were significantly lower than the national average (27% vs. 64%; OR 0.21; 95% CI 0.12-0.37). CONCLUSIONS There is a large disparity in rates of the highest intensity physical activity (HEPA) between medical students and the age-adjusted national average, which has previously been overlooked by the binary CDC exercise guidelines. The fact that HEPA levels are not optimized and more strongly associated with lower stress levels relative to less intense forms of exercise makes it a promising new target for future well-being interventions among medical trainees.
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Affiliation(s)
- Richard K. Leuchter
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Margaret L. Stuber
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Austin L. McDonald
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Daniel M. Croymans
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Taylor CE, Scott EJ, Owen K. Physical activity, burnout and quality of life in medical students: A systematic review. CLINICAL TEACHER 2022; 19:e13525. [PMID: 36052814 PMCID: PMC9826463 DOI: 10.1111/tct.13525] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/08/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Medical students are at risk of burnout and reduced quality of life (QoL). The risk of burnout doubles from third to sixth year of medical school, and medical students have an 8%-11% lower QoL than nonmedical students. It is imperative to prevent this, as burnout and reduced QoL is independently associated with errors in practice. This systematic review aims to examine whether physical activity/exercise is associated with burnout and/or QoL in medical students. METHODS Articles were identified through database searches of Embase, Medline, PsycINFO, Scopus and Web of Science. Studies were included if both physical activity/exercise and burnout or QoL were measured and limited to those focussing on medical students. Risk of bias was assessed using accredited cohort and cross-sectional checklists. A narrative synthesis was conducted due to heterogeneity in the dataset. FINDINGS Eighteen studies were included, comprising 11,500 medical students across 13 countries. Physical activity was negatively associated with burnout and positively associated with QoL. Furthermore, the findings were suggestive of a dose-response effect of physical activity on both burnout and QoL; higher intensities and frequencies precipitated greater improvements in outcomes. CONCLUSIONS This multinational review demonstrates that physical activity is associated with reduced burnout and improved QoL in medical students. It also identifies a paucity of research into the optimal intensity, frequency, volume and mode of physical activity. Further research, building on this review, is likely to inform the long overdue development of evidence-based, well-being curricula. This could involve incorporating physical activity into medical education which may improve well-being and better prepare students for the demands of medical practice.
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Affiliation(s)
| | - Emma J. Scott
- Warwick Medical SchoolUniversity of WarwickCoventryUK
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Rafie F, Habibi M, Nekouei AH, Kakoei S, kakoei S. Oral health-related quality of life and associated factors in athlete and non-athlete students. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00995-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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The Effect of Learning Burnout on Sleep Quality in Primary School Students: The Mediating Role of Mental Health. Healthcare (Basel) 2022; 10:healthcare10102076. [PMID: 36292523 PMCID: PMC9602333 DOI: 10.3390/healthcare10102076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/09/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022] Open
Abstract
Due to the growth of research on sleep, mental health, and learning burnout on healthy growth and its related public health significance of adolescents, this study aimed to provide a deeper understanding of the effect of mental health and learning burnout on sleep among primary school students. The sleep quality (subjective sleep quality, sleep time, sleep latency, sleep duration, sleep efficiency, sleep disturbance, and daytime dysfunction), mental health, and learning burnout (exhaustion, learning cynicism, and reduced efficacy) of 900 students of grades 3–6 in primary schools were assessed in 2020. The PSQI scores of participants were 4.19 ± 2.545, of which a number of 322 (39.03%) students had sleep disturbance (PSQI scores ≧ 5). Binary logistic regression analysis showed that screen time (OR = 1.518, 95% CI: 1.164–1.980), ranking status (OR = 0.659, 95% CI: 0.480–0.907), learning burnout (OR = 1.088, 95% CI: 1.067–1.108), and mental health (OR = 4.672, 95% CI: 1.954–11.173) were the influencing factors for sleep quality of grade 3–6 students. According to the mediation effect analyses, mental health played a mediating effect (58.73% of the total effect) on the relationship between learning burnout and sleep quality. In conclusion, primary school students in Hunan of China have prominent sleep problems, and the daytime dysfunction caused by sleep problems is the most serious. Learning burnout positively predicted poorer sleep quality, and mental health played a mediating effect on the relationship between learning burnout and sleep quality.
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McKinley B, Daines B, Allen M, Pulsipher K, Zapata I, Wilde B. Mental health and sleep habits during preclinical years of medical school. Sleep Med 2022; 100:291-297. [PMID: 36148761 PMCID: PMC9461239 DOI: 10.1016/j.sleep.2022.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 07/18/2022] [Accepted: 09/02/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The purpose of this non interventional study was to define changes in anxiety, depression, and sleep quality of medical students in their first two years of medical school while considering potential risk factors of self-reported chronic disease, sleep quantity, year of medical school and exercise habits. Since this study was ongoing during the COVID-19 pandemic, its effect was also evaluated. PARTICIPANTS /METHODS: A cohort of 197 medical students was evaluated longitudinally using survey methods to quantify changes from pre-medical school and summer break to each semester in medical school throughout years one and two. This study was performed from July 2019 through June 2021. Data was analyzed using Generalized Linear Mixed Models (GLMMs) on the numeric responses of General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Sleep Quality (SQ-3) and Pittsburg Sleep Quality Index (PSQI). Additional assessments evaluated exercise habits, chronic disease, and impact of COVID-19 Pandemic. The COVID-19 Pandemic was evaluated directly in the model (pre- and post-COVID-19 period variable), and through additional questions on their perceived effect. RESULTS Depression, anxiety, and sleep habits displayed a cyclical change that was associated with the academic/seasonal cycle. The COVID-19 pandemic was never found significant. Medical students who had a chronic disease diagnosis and fewer hours of sleep had increased severity. Exercise did not play a role. CONCLUSION Based on our sample, the main driver for depression, anxiety, and poor sleep quality appears to be the academic/seasonal cycle, while the COVID-19 pandemic did not have an impact on mental health.
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Affiliation(s)
- Blake McKinley
- Department of Primary Care, Rocky Vista University College of Osteopathic Medicine, Ivins, UT, 84738, USA
| | - Bryan Daines
- Department of Primary Care, Rocky Vista University College of Osteopathic Medicine, Ivins, UT, 84738, USA
| | - Mitchell Allen
- Department of Primary Care, Rocky Vista University College of Osteopathic Medicine, Ivins, UT, 84738, USA
| | - Kayd Pulsipher
- Department of Primary Care, Rocky Vista University College of Osteopathic Medicine, Ivins, UT, 84738, USA
| | - Isain Zapata
- Department of Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine Parker, CO, 80134, USA.
| | - Benjamin Wilde
- Department of Primary Care, Rocky Vista University College of Osteopathic Medicine, Ivins, UT, 84738, USA.
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Alahdab F. Medical Students Will Take Care of the People, We Need to Take Care of Them. Avicenna J Med 2022; 12:97-99. [PMID: 36092383 PMCID: PMC9458351 DOI: 10.1055/s-0042-1755183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Fares Alahdab
- Houston Methodist Research Institute, Houston, Texas, United States
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Acharya SR, Moon DH, Chun JH, Shin YC. COVID-19 and mental health: Anxiety disorders among immigrants due to COVID-19 outbreak in South Korea. Int J Psychiatry Med 2022; 57:323-337. [PMID: 34425688 PMCID: PMC9209883 DOI: 10.1177/00912174211042695] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic has affected various facets of health. While mental health became a major concern during the COVID-19 outbreak, the impact on the migrants' mental health has still been neglected. The purpose of this study was to examine the COVID-19 outbreak's impact on the mental health of immigrants in South Korea. METHODS A total number of 386 immigrants in South Korea participated in this quantitative cross-sectional study. The standardized e-questionnaire, including the General Anxiety Disorder (GAD-7) scale, was used to measure the anxiety level. Logistic regression analysis was performed to find out the determinants of anxiety disorders among immigrants. RESULTS The prevalence of severe anxiety among immigrants was found to be 47.2%. Female immigrants (28.6%) had a lower anxiety disorder than males (71.4%). Immigrants who were married, living alone, had a low income, had a history of health problems were suffered from moderate to severe anxiety. Immigrants who were unemployed (OR 2.302, 95% CI = 1.353-3.917) and lost their jobs due to the COVID-19 outbreak (OR 2.197, 95% CI = 1.312-3.678) have a higher anxiety disorder. Immigrants aged over 30 years were found to suffer from a high level of anxiety (OR 2.285, 95% CI = 1.184-4.410). Relief support from the government was significantly associated with anxiety disorder among immigrants (p < 0.01, OR = 3.151, 95% CI = 1.962-5.061). CONCLUSION With very limited studies on immigrants' mental health during the COVID-19 pandemic, this paper provides scientific research evidence of the COVID-19 outbreak's impact on the mental health of migrants. Our study has consequences for implementing integrated psychological interventions and health promotion strategies for the well-being of immigrants' mental health.
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Affiliation(s)
- Shiva Raj Acharya
- Department of Public Health, Busan Medical Campus, Inje University, Busan, South Korea,Shiva Raj Acharya, Department of Public Health, Busan Medical Campus, Inje University, Busan, South Korea.
| | - Deog Hwan Moon
- Department of Public Health, Busan Medical Campus, Inje University, Busan, South Korea
| | - Jin Ho Chun
- Department of Preventive Medicine, Busan Medical Campus, Inje University, Busan, South Korea
| | - Yong Chul Shin
- Department of Occupational Health and Safety, Inje University, Gimhae, South Korea
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Chatterjee K, Edmonds VS, Girardo ME, Vickers KS, Hathaway JC, Stonnington CM. Medical students describe their wellness and how to preserve it. BMC MEDICAL EDUCATION 2022; 22:510. [PMID: 35764972 PMCID: PMC9241274 DOI: 10.1186/s12909-022-03552-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite widespread efforts to create wellness programming in medical schools, there is a paucity of literature examining students' perception of wellness and perceptions of these programs. With the inaugural class at the Arizona campus of Mayo Clinic Alix School of Medicine (MCASOM-AZ), an opportunity arose to establish an empirically evaluated wellness curriculum that most inclusively and effectively enables medical students to flourish for years to come. The initial wellness offerings included mental health, academic success, and disability services, curriculum-embedded seminars, wellness committee driven programming, and student-proposed wellness activities. We aimed to improve the relevance and impact of medical school wellness curricula by soliciting in-depth and longitudinal perspectives of medical students themselves. As MCASOM-AZ opened in 2017, the student body at the time of study consisted of first- and second-year medical students. METHODS Employing a mixed methods analysis of qualitative and longitudinal quantitative data, first- and second-year students at a MCASOM-AZ were invited to respond to an anonymous, online year-long survey (baseline, six months and 12 months) during the 2018-2019 academic year and participate in a structured, in-depth and in-person, peer-to-peer interview about their conceptions of wellness and the MCASOM-AZ wellness curriculum and resources. Qualitative data was coded for themes using thematic analysis strategies by independent raters. RESULTS Nearly half of eligible students completed the baseline survey,1/3 completed all 3 time-points, and 1/5 participated in an in-depth interview. Participant age, gender, and year of school were representative of the larger student body. Although individual conceptions varied, Wellness was consistently highly valued. Family, Academic Performance, and Friends emerged as most important to well-being across time-points. Academic work arose as the largest barrier to wellness. Analysis of qualitative data revealed five themes. Despite individual differences in approaches to wellness, wellbeing was interrelated to the learning environment; mandatory wellness efforts that didn't address the medical culture met with skepticism. CONCLUSIONS Interview responses provided understanding and context by which to interpret questionnaire responses. Academics was critical to students' identity and wellness, while also the largest barrier. Suggested curricular improvements include restructuring academic work, seamlessly integrating wellness within coursework, and offering optional individualized approaches.
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Affiliation(s)
- Krishanu Chatterjee
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, USA.
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| | - Victoria S Edmonds
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, USA
- Department of Urology, Mayo Clinic, AZ, Phoenix, USA
| | - Marlene E Girardo
- Department of Quantitative Heath Sciences, Mayo Clinic, Phoenix, AZ, USA
| | - Kristin S Vickers
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Julie C Hathaway
- Office of Patient Education Research, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
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Önder İ, Önder AN, Güven Yıldırım E. Burnout and engagement in university students: relationships with morningness-eveningness preferences, average sleep length and social jetlag. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2022.2088662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- İsmail Önder
- Faculty of Education, Department of Mathematics and Science Education (Matematik ve Fen Bilimleri Eğitimi Bölümü), Sakarya University (Sakarya Üniversitesi Eğitim Fakültesi), Hendek, Turkey
| | - Ayşe Nesibe Önder
- Gazi Faculty of Education, Department of Mathematics and Science Education (Matematik ve Fen Bilimleri Eğitimi Bölümü, Fen Bilgisi Eğitimi Anabilim Dalı), Gazi University (Gazi Üniversitesi Gazi Eğitim Fakültesi), Turkey
| | - Ezgi Güven Yıldırım
- Gazi Faculty of Education, Department of Mathematics and Science Education (Matematik ve Fen Bilimleri Eğitimi Bölümü, Fen Bilgisi Eğitimi Anabilim Dalı), Gazi University (Gazi Üniversitesi Gazi Eğitim Fakültesi), Turkey
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Yan L, Zhong X, Yang L, Long H, Ji P, Jin X, Liu L. Gender Differences in Job Burnout, Career Choice Regret, and Depressive Symptoms Among Chinese Dental Postgraduates: A Cross-Sectional Study. Front Public Health 2022; 10:832359. [PMID: 35570907 PMCID: PMC9091559 DOI: 10.3389/fpubh.2022.832359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/04/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Job burnout, career choice regret, and depressive symptoms among medical students have received widespread attention. However, little is known about the role of gender in these areas for dental postgraduates. This study aimed to explore gender differences in job burnout, career choice regret, and depressive symptoms among Chinese dental postgraduates. METHODS The data were collected from an epidemiological survey conducted by our group from February 2021 to March 2021. We used a self-administered questionnaire covering demographic characteristics, the Maslach Burnout Inventory, the Primary Care Evaluation of Mental Disorders scale, and the Career Choice Regret scale. Univariate and multivariable analyses were performed to explore influencing factors. RESULTS A total of 558 valid dental postgraduate questionnaires were included in this study. The prevalence of job burnout, career choice regret, and depressive symptoms exceeded 30% in males and females. The prevalence of job burnout was 4.7% higher in females than in males; career choice regret was 12.2% higher in females than in males (P < 0.05), and depressive symptoms were 4.9% higher in females than in males. The multivariable analysis showed that factors associated with job burnout for males were sleep time and career choice regret for females. The influencing factors on career choice regret for females were postgraduate entrance examination score, sleep time, and job burnout. Depressive symptoms were a common influencing factor for job burnout and career choice regret in male and female dental postgraduates. Also, job burnout and depressive symptoms had the highest odds ratio for influencing factors on each other. CONCLUSION Over 30% of dental postgraduates suffered from job burnout, career choice regret, and depressive symptoms, and incidences were higher in females. A discrepancy of influencing factors existed between male and female dental postgraduates. Targeted measures should be taken to change this situation.
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Affiliation(s)
- Li Yan
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiaogang Zhong
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lu Yang
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Huiqing Long
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Ping Ji
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Stomatological Association, Chongqing, China
| | - Xin Jin
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Li Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
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Prabhat A, Kumar A, Bhardwaj SK. Prolonged Lockdown due to COVID-19 Alters Sleep-Wake Timings and Negatively Affects Self-esteem, Personality, Depression and Anxiety in College-Going Indian Students. SLEEP AND VIGILANCE 2022; 6:199-210. [PMID: 35411332 PMCID: PMC8985745 DOI: 10.1007/s41782-022-00200-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/23/2022] [Accepted: 03/18/2022] [Indexed: 01/10/2023]
Abstract
Purpose COVID-19 forced the shutdown of colleges and socialization around the world including India and prolonged lockdown could have a significant impact on sleep, mood, emotion and anxiety in students. Here, we designed a survey to assess the effect of lockdown on sleep-wake, self-esteem, depression and anxiety via the survey on 321 Indian college-going students. Methods We assessed the effect of lockdown on sleep-wake (wake up, get up, bed and sleep timing, total time in bed and sleep duration) and self-esteem and depression on students via various questions. Results We found that students delayed sleep timing by 1 h in lockdown than pre-lockdown days. Specifically, urban male populations were late sleeper than any other group. However, total sleep duration did not differ between groups. In self-esteem questions, most students agreed that they were of no good, felt nervous, displeased, and frustrated about performance in lockdown. Depression and anxiety questionnaire gave more significant results related to mood and mental health. More than 50% of students agreed that they faced a lack of concentration, had been feeling irritated and angry, felt fatigued and tired, and everything had been a failure during lockdown days. Conclusion Overall, the survey suggests that lack of social life and prolonged lockdown affect the sleep-wake cycle, self-esteem, anxiety and depression of Indian students. Supplementary Information The online version contains supplementary material available at 10.1007/s41782-022-00200-9.
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Affiliation(s)
- Abhilash Prabhat
- Department of Zoology, Chaudhary Charan Singh University, Meerut, Uttar Pradesh 250004 India
| | - Ashwani Kumar
- Department of Zoology, Chaudhary Charan Singh University, Meerut, Uttar Pradesh 250004 India
| | - Sanjay Kumar Bhardwaj
- Department of Zoology, Chaudhary Charan Singh University, Meerut, Uttar Pradesh 250004 India
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Hossain MJ, Ahmmed F, Khandokar L, Rahman SMA, Hridoy A, Ripa FA, Emran TB, Islam MR, Mitra S, Alam M. Status of psychological health of students following the extended university closure in Bangladesh: Results from a web-based cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000315. [PMID: 36962237 PMCID: PMC10021959 DOI: 10.1371/journal.pgph.0000315] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/09/2022] [Indexed: 12/27/2022]
Abstract
Students' severe affective mental distress has emerged as significant public health attention globally because of the disastrous effects of coronavirus disease 2019 (COVID-19). The current study aimed at exploring the prevalence of two alarming psychological distresses, depression and anxiety, among university students following a prolonged shutdown of educational institutions in Bangladesh. A cross-sectional online-based study was conducted by deploying two standard scales to assess the depression and anxiety among Bangladeshi students from various universities amid the 2nd stream of the COVID-19 pandemic. A total of 568 Bangladeshi university students participated in this questionnaire-based survey through various social media platforms. Frequency and percentage distribution as univariate, chi-square (χ2) test as bivariate, and logistic regression as multivariate analyses were applied to investigate the prevalence of depression and anxiety and their associated various sociodemographic factors. After cleaning and eliminating the partial data, we analyzed 465 responses, where 42% were female and 64.3% were from public universities. Both mental disorders were prevalent in more than 50% of Bangladeshi university students. The students from the private universities were two times and 2.7 times more depressed and anxious, respectively than the students from the public universities. In addition, the students who became incomeless had significantly more anxiety (adjusted odds ratio [AOR] = 1.711; p = 0.018) than those who did not lose income source during the COVID-19 lockdown. The present study revealed that more than 50% of Bangladeshi university students were suffering from depression and anxiety. Several effective measures must be assured by the concerted efforts of university authorities, educationalists, and the Government to alleviate these distressing mental health burdens.
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Affiliation(s)
- Md. Jamal Hossain
- Department of Pharmacy, State University of Bangladesh, Dhanmondi, Dhaka, Bangladesh
| | - Foyez Ahmmed
- Department of Statistics, Comilla University, Kotbari, Cumilla, Bangladesh
| | | | - S. M. Abdur Rahman
- Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh
| | - Asaduzzaman Hridoy
- Department of Statistics, Comilla University, Kotbari, Cumilla, Bangladesh
| | - Farhana Alam Ripa
- Department of Pharmacy, Brac University, Mohakhali, Dhaka, Bangladesh
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
| | - Md. Rabiul Islam
- Department of Pharmacy, University of Asia Pacific, Farmgate, Dhaka, Bangladesh
| | - Saikat Mitra
- Department Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh
| | - Morshed Alam
- Institute of Education and Research, Jagannath University, Dhaka, Bangladesh
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Dudo K, Ehring E, Fuchs S, Herget S, Watzke S, Unverzagt S, Frese T. The association of sleep patterns and depressive symptoms in medical students: a cross-sectional study. BMC Res Notes 2022; 15:109. [PMID: 35317836 PMCID: PMC8939186 DOI: 10.1186/s13104-022-05975-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 02/14/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Mental health is a fundamental aspect in ensuring the stable and successful professional life of future physicians. Depressive symptoms can negatively affect the work-life-balance and efficiency at work of medical students. To date, there have been very few studies involving medical students that examine the association between single sleep characteristics and the outcome of the Beck Depression Inventory-II score. Therefore, the aim of the present study is to investigate this possible association. A classroom survey using socio-demographic characteristics, the Beck Depression Inventory-II, and the Pittsburgh Sleep Quality Index was conducted amongst students at a German medical school from December 2017 to September 2018. Data analysis was performed with descriptive statistics and binary logistic regression. Results Of the students surveyed, 19% showed depressive symptoms with a Beck Depression Inventory-II score over 13 and 42% of these cases were moderate or severe. The occurrence of relevant depressive symptoms was associated with lower sleep quality, higher sleep latency, and the consumption of sleeping pills. In general, female students and students from abroad had a higher risk of depressive symptoms. Addressing these relevant findings in medical school can increase awareness of mental health.
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Affiliation(s)
- Katrin Dudo
- Institute of General Practice & Family Medicine, Faculty of Medicine, Martin Luther University of Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Emilia Ehring
- Institute of General Practice & Family Medicine, Faculty of Medicine, Martin Luther University of Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Stephan Fuchs
- Institute of General Practice & Family Medicine, Faculty of Medicine, Martin Luther University of Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
| | - Sabine Herget
- Department of General Practice, Medical Faculty of the University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Stefan Watzke
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, University Hospital Halle (Saale), Julius-Kühn-Straße 7, 06112, Halle (Saale), Germany
| | - Susanne Unverzagt
- Institute of General Practice & Family Medicine, Faculty of Medicine, Martin Luther University of Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Thomas Frese
- Institute of General Practice & Family Medicine, Faculty of Medicine, Martin Luther University of Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
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March-Amengual JM, Cambra Badii I, Casas-Baroy JC, Altarriba C, Comella Company A, Pujol-Farriols R, Baños JE, Galbany-Estragués P, Comella Cayuela A. Psychological Distress, Burnout, and Academic Performance in First Year College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063356. [PMID: 35329044 PMCID: PMC8953100 DOI: 10.3390/ijerph19063356] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 12/20/2022]
Abstract
Background: The first years of university can be very challenging for students. Previous research has focused on the study of the prevalence of burnout and of psychological distress in medical students. The aim of this study was to investigate the prevalence of psychological symptoms and burnout reported by first-year students, the relationship between these variables and their academic performance, and the differences between health and non-health sciences students. Methods: An observational study with a cross-sectional design was performed. Students of health sciences (medicine, nursing, physiotherapy, psychology), and non-health sciences (biology, social sciences, business management, and engineering) undergraduate programs completed the Brief Symptom Inventory (BSI-18) and the Maslach Burnout Inventory-Student Survey (MBI-SS). Students’ grades for the first semester were collected. Results: A sample of 506 students participated. Prevalence of psychological distress was 27.1% and burnout was 7.3%. Academic performance was unaffected in relation to either psychological distress or burnout. Non-health sciences students showed a greater risk of depression. Conclusions: This study provides evidence of the high prevalence of psychological distress in the first year of college. Even when burnout prevalence was low, the results suggest the need to introduce prevention programs to improve the psychological wellbeing of these students.
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Affiliation(s)
- Jaume-Miquel March-Amengual
- Chair in Medical Education, Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain; (J.-M.M.-A.); (J.-C.C.-B.); (C.A.); (A.C.C.); (R.P.-F.); (A.C.C.)
- Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain;
| | - Irene Cambra Badii
- Chair in Medical Education, Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain; (J.-M.M.-A.); (J.-C.C.-B.); (C.A.); (A.C.C.); (R.P.-F.); (A.C.C.)
- Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain;
- Chair in Bioethics, Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain
- Correspondence:
| | - Joan-Carles Casas-Baroy
- Chair in Medical Education, Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain; (J.-M.M.-A.); (J.-C.C.-B.); (C.A.); (A.C.C.); (R.P.-F.); (A.C.C.)
| | - Cristina Altarriba
- Chair in Medical Education, Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain; (J.-M.M.-A.); (J.-C.C.-B.); (C.A.); (A.C.C.); (R.P.-F.); (A.C.C.)
| | - Anna Comella Company
- Chair in Medical Education, Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain; (J.-M.M.-A.); (J.-C.C.-B.); (C.A.); (A.C.C.); (R.P.-F.); (A.C.C.)
| | - Ramon Pujol-Farriols
- Chair in Medical Education, Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain; (J.-M.M.-A.); (J.-C.C.-B.); (C.A.); (A.C.C.); (R.P.-F.); (A.C.C.)
| | - Josep-Eladi Baños
- School of Medicine, Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain;
| | - Paola Galbany-Estragués
- Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain;
| | - Agustí Comella Cayuela
- Chair in Medical Education, Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain; (J.-M.M.-A.); (J.-C.C.-B.); (C.A.); (A.C.C.); (R.P.-F.); (A.C.C.)
- Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Universitat de Vic–Universitat Central de Catalunya, 08500 Vic, Spain;
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Prevalence and Associated Factors of Depression in Medical Students in a Northern Thailand University: A Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10030488. [PMID: 35326966 PMCID: PMC8951317 DOI: 10.3390/healthcare10030488] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/17/2022] [Accepted: 03/03/2022] [Indexed: 02/04/2023] Open
Abstract
This study was conducted to investigate the prevalence and associated factors of depression in medical students. This cross-sectional study investigated the prevalence and associated factors of depression in medical students from May 2018 to April 2019. Depression was diagnosed using the nine-item Patient Health Questionnaire. We evaluated the following potential predictors: demographic data, stressors, psychiatric comorbidities, emotional intelligence (EI), and perceived social support. The association between potential factors and depression was analyzed using multiple logistic regression analysis. The prevalence of depression was 149 of 706 students with 12.5% suicidality. Second- and fourth-year medical students were high-risk groups. Risk factors identified were insufficient income, physical illness, and previous psychiatric illness. Depression in medical students likely coincides with anxiety, internet addiction, sleep problems, and loneliness. Highly associated stressors were personal relationships, physical health, mental health, difficulties in social relationships, satisfaction with grades, and boredom with medical education. Protective EI factors included emotional self-control, problem-solving abilities, inner peace, and life satisfaction. Up to 21.1% of medical students had depression. In this study, among multiple known risk factors of depression, we found that EI is the novel protective factor against depression among medical students. EI training might be protective intervention for medical students in the future.
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Fowler LA, Kumte N. The effect of COVID-19 pandemic stay-at-home orders on sleep deprivation in medical students: a retrospective study. SN SOCIAL SCIENCES 2022; 2:29. [PMID: 35311182 PMCID: PMC8917251 DOI: 10.1007/s43545-022-00323-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 02/09/2022] [Indexed: 11/25/2022]
Abstract
Abstract The COVID-19 pandemic required medical schools to transition to online learning due to mandated stay-at-home orders. This created a drastic change in the learning environment and behavior of medical students, as well as increased stress about school and the pandemic, which may have impacted sleep. This study assessed medical student sleep timing, duration and quality retrospectively using the Pittsburgh Sleep Quality Index (PSQI) and a sleep questionnaire to determine changes prior to and following the stay-at-home orders. In addition, perceptions of stress related to COVID-19 and to school, as well as age and gender, were examined using a survey to determine relationships to sleep variables. Repeated-measures MANOVAs showed that medical student sleep timing changed significantly, shifting sleep and wake times later on both weekdays and weekends (p < 0.001). In addition, sleep quality significantly worsened post-COVID as compared to pre-COVID, with most subscales of the PSQI worsening after the stay-at-home order, especially in males. Older students had significantly longer sleep duration than younger students post-COVID. Sleep duration did not change significantly, and stress was not significantly related to sleep quality. Interestingly, sleep medication usage significantly increased post-COVID, with more students using sleep medications more frequently after the stay-at-home order (p < 0.05). This study represents the first research to assess how medical student sleep timing, quality and medication use was affected by the stay-at-home order due to the COVID-19 pandemic. Graphical abstract ![]()
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Affiliation(s)
- Lauren A. Fowler
- University of South Carolina School of Medicine Greenville, Greenville, SC USA
| | - Nabihah Kumte
- University of South Carolina School of Medicine Greenville, Greenville, SC USA
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