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Work, Stress and Play: Students’ perceptions of factors impacting on their studies and wellbeing

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Introduction This study gathered information about life outside of the course for undergraduates studying at the School of Dentistry, Cardiff University. The aim was to explore how these external factors to the course may affect an individual's academic performance and well‐being. Materials and Methods A cross‐sectional study design was used. An online questionnaire designed for the purpose of the study was used to capture (quantitative and qualitative) data. Questions with dichotomous options, a range of statements with Likert scales (level of agreement) and open (free‐text) questions were used. Data were analysed in SPSS using simple descriptive statistics and frequency distributions. Spearman's Rho was used to explore relationships for scaled categorical data. Content analysis was used for qualitative data. Results Two thirds (n=69, 63%) of participants reported being very stressed about their studies in the previous 12 months. The majority felt that external factors to their course (e.g. lack of sleep, health issues, financial concerns, hobbies and issues with friends) had impacted on their academic lives with only 9% (n=10) stating that their lives outside dentistry had no effect. Discussion Those who felt able to pursue hobbies and activities reported a better work life balance and less stress. Questions about pursuing hobbies and sleep may help identify students at risk of being stressed or who may benefit from additional support in order to achieve a better work‐life balance. Conclusion This study has highlighted key areas for further investigation and opportunities for improving support to reduce student stress and improve well‐being. This article is protected by copyright. All rights reserved.

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... Examinations, fear of falling behind or failing the course or year, and inconsistency of feedback between clinical tutors were considered as stressors by both BDS and DHT students (Collin et al., 2020;Harris et al., 2017a). Whilst finances and student debt have been associated with higher levels of stress among BDS students and DCTs (Boyles and Ahmed, 2017;Jenkins et al., 2019;Turner et al., 2015). ...
... Nine studies recruited BDS dental students (Birks et al., 2009;Collin et al., 2020;Gorter et al., 2008;Jenkins et al., 2019;Knipe et al., 2018;Lewis and Cardwell, 2019;Lewis and Cardwell, 2020;Pau et al., 2007;Turner et al., 2015). In one study, the majority of the sample population was BDS students (n=108), but a small proportion of dental core trainees (DCTs, n=22) was also included (Boyles and Ahmed, 2017). ...
... Finances and student debt have been associated with higher levels of stress among dental students and DCTs (Boyles and Ahmed, 2017;Jenkins et al., 2019;Turner et al., 2015), while parental or family contribution to student expenses has been shown to alleviate this stress (Boyles and Ahmed, 2017). Additionally, students with greater family responsibilities have been found to experience significantly higher levels of stress (Turner et al., 2015). ...
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Available at https://www.gdc-uk.org/about-us/what-we-do/research/our-research-library/detail/report/mental-health-and-wellbeing-in-dentistry-a-rapid-evidence-assessment
... Examinations, fear of falling behind or failing the course or year, and inconsistency of feedback between clinical tutors were considered as stressors by both BDS and DHT students (Collin et al., 2020;Harris et al., 2017a). Whilst finances and student debt have been associated with higher levels of stress among BDS students and DCTs (Boyles and Ahmed, 2017;Jenkins et al., 2019;Turner et al., 2015). ...
... Nine studies recruited BDS dental students (Birks et al., 2009;Collin et al., 2020;Gorter et al., 2008;Jenkins et al., 2019;Knipe et al., 2018;Lewis and Cardwell, 2019;Lewis and Cardwell, 2020;Pau et al., 2007;Turner et al., 2015). In one study, the majority of the sample population was BDS students (n=108), but a small proportion of dental core trainees (DCTs, n=22) was also included (Boyles and Ahmed, 2017). ...
... Finances and student debt have been associated with higher levels of stress among dental students and DCTs (Boyles and Ahmed, 2017;Jenkins et al., 2019;Turner et al., 2015), while parental or family contribution to student expenses has been shown to alleviate this stress (Boyles and Ahmed, 2017). Additionally, students with greater family responsibilities have been found to experience significantly higher levels of stress (Turner et al., 2015). ...
Technical Report
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Commissioned by the General Dental Council (UK) Available at: https://www.gdc-uk.org/about-us/what-we-do/research/our-research-library/detail/report/mental-health-and-wellbeing-in-dentistry-a-rapid-evidence-assessment
... The result of this study supported Hypothesis 3, proposing that positive expectations regarding future financial security were found to be positively associated with students' well-being. According to Jenkins, Johnson & Ginley (2019), ...
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Socioeconomic characteristics have some positive or negative impacts on individuals' well-being. However, few studies have been conducted to investigate the effect of socioeconomic characteristics on university students' well-being. This study addresses this gap and presents survey results among eight European countries: France, Germany, Italy, Spain, Poland, Romania, The Russian Federation and Turkey. It was utilized an online survey based on closed-ended questions, collected from a sample (N = 796). Multiple linear regression was used to analyze the data. This study indicated that being aware of personal strength positively affected well-being. Also, positive expectations for future financial security were positively associated with university students' well-being. Having a high social interaction in society has a little positive effect on well-being. Furthermore, the study indicated the importance of government-provided social supports as students from France and Germany had a higher level of well-being score. Social and financial support may be useful to improve the overall well-being of university students. Policymakers should reconsider the significance of social welfare for society.
... Potentially even worsening this situation, the updated curriculum coming into effect in fall 2020 may even increase the workload for students. With sports activities obviously not diminishing as a result of attending dental school, students try to maintain a healthy worklife balance 11 and to counteract their risk for mental disorders. 8,9 How to cite this article: ...
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The aim of this study was to systematically review the available literature on the levels, causes, and impact of stress among dental students. The investigators searched eight electronic databases: Medline, Medline in process, Psychinfo, ERIC, Embase, Cochrane Library, Web of Science, and SCOPUS. Two independent reviewers conducted the selection, data extraction, and quality appraisal for included studies. The investigators then coded both quantitative and qualitative studies using similar codes and pooled results from studies that used the Dental Environment Stress questionnaire to demonstrate dental students' stress levels. The search initially identified 4,720 studies, of which 124 studies were included in the final qualitative synthesis and twenty-one were included in the meta-analysis. Evidence from this research showed that dental students experience considerable amounts of stress during their training. This stress is mainly due to the demanding nature of the training. In addition, studies suggest adverse effects of elevated stress on students' health and well-being. Most of the available literature is based on cross-sectional studies; thus, future longitudinal studies are needed to follow students throughout their curriculum. In addition, further research needs to explore and test stress management interventions.
Article
To examine whether engaging in multiple enjoyable activities was associated with better psychological and physiological functioning. Few studies have examined the health benefits of the enjoyable activities that individuals participate in voluntarily in their free time. Participants from four different studies (n = 1399 total, 74% female, age = 19-89 years) completed a self-report measure (Pittsburgh Enjoyable Activities Test (PEAT)) assessing their participation in ten different types of leisure activities as well as measures assessing positive and negative psychosocial states. Resting blood pressure, cortisol (over 2 days), body mass index, waist circumference, and perceived physiological functioning were assessed. Higher PEAT scores were associated with lower blood pressure, total cortisol, waist circumference, and body mass index, and perceptions of better physical function. These associations withstood controlling for demographic measures. The PEAT was correlated with higher levels of positive psychosocial states and lower levels of depression and negative affect. Enjoyable leisure activities, taken in the aggregate, are associated with psychosocial and physical measures relevant for health and well-being. Future studies should determine the extent that these behaviors in the aggregate are useful predictors of disease and other health outcomes.
Article
We explore the relationship between sleep and student performance on standardized tests. We model test scores as a nonlinear function of sleep, which allows us to compute the hours of sleep associated with maximum test scores. We refer to this as “optimal” hours of sleep. We also evaluate how the sleep and student performance relationship changes with age. We use the Panel Study of Income Dynamics-Child Development Supplement, which includes excellent control variables that are not usually available in sleep studies. We find a statistically significant relationship between sleep and test scores. We also find that optimal hours of sleep decline with age.
Article
Covariations of self-reported sleep quantity (duration) and quality (disturbances) with affective, stressful, academic, and social experiences across the first year of university in 187 Canadian students (M age=18.4) were examined with multilevel models. Female students reported sleeping fewer hours on average than did male students. In months when negative affect and general levels of stress were higher, sleep quantity was lower. Poorer sleep quality was seen in students living away from home and reporting more financial stress at baseline. In addition, sleep quality was poorer in months when negative affect and general levels of stress were higher (attenuating the effect of financial stress) and better in months when students spent more days with friends. Three themes are presented to explore the mechanisms by which sleep quantity and quality rise and fall in tandem with experiences of the first year of university.
Article
The present study was conducted to provide future researchers and dental educators with an overview of stress amongst undergraduate dental students reported in the literature. This overview is needed for the development of a new questionnaire measuring the level of stressors including students, staff and process of dental education. In addition, the review can be used to modify dental curricula to decrease such stress and produce better dentists. Our study consisted of a systematic review of 49 peer-reviewed articles published between 1966 till October 2008 in English, discussing different aspects of stress amongst undergraduate dental students. These aspects are demographic variables of stress, sources of stress, impact of stress, indicators of stress, instruments measuring stress level and management of stress. Major sources of reported stress were related to examinations, clinical requirements and dental supervisors. Studies suggest using signs and symptoms for early detection of stress and proper intervention.
Article
Sleep deprivation (SD) negatively affects various cognitive performances, but surprisingly evidence about a specific impact of sleep loss on subjective evaluation of emotional stimuli remains sparse. In the present study, we assessed the effect of SD on the emotional rating of standardized visual stimuli selected from the International Affective Picture System. Forty university students were assigned to the sleep group (n=20), tested before and after one night of undisturbed sleep at home, or to the deprivation group, tested before and after one night of total SD. One-hundred and eighty pictures (90 test, 90 retest) were selected and categorized as pleasant, neutral and unpleasant. Participants were asked to judge their emotional reactions while viewing pictures by means of the Self-Assessment Manikin. Subjective mood ratings were also obtained by means of Visual Analog Scales. No significant effect of SD was observed on the evaluation of pleasant and unpleasant stimuli. On the contrary, SD subjects perceived the neutral pictures more negatively and showed an increase of negative mood and a decrease of subjective alertness compared to non-deprived subjects. Finally, an analysis of covariance on mean valence ratings of neutral pictures using negative mood as covariate confirmed the effect of SD. Our results indicate that sleep is involved in regulating emotional evaluation. The emotional labeling of neutral stimuli biased toward negative responses was not mediated by the increase of negative mood. This effect can be interpreted as an adaptive reaction supporting the "better safe than sorry" principle. It may also have applied implications for healthcare workers, military and law-enforcement personnel.
Article
A study was conducted involving a group of 290 medical and dental students to directly compare perceived stress levels encountered during their education. A modified questionnaire based on Garbee et al.'s Dental Environmental Stress survey was provided to the students by either email or paper. The purpose of the investigation was to determine if the sources of stress reported by medical and dental students, both male and female, were due to common factors. A multivariate statistical analysis was also conducted to measure stress differences by year in school. Through factor analysis, the survey question responses were grouped into five causal categories: academic performance, faculty relations, patient and clinic responsibilities, personal life issues, and professional identity. The overall findings show that dental students had greater levels of stress than medical students in three of the five categories. The only category in which medical students demonstrated greater stress levels than dental students was in professional identity. Measures of comparative levels of stress between male and female students for either profession did not demonstrate any significant differences. Stress levels related to clinical work varied significantly between the type of professional student and his or her year in school.
Article
This study attempts to develop an empirical model of the link between stress and mental health, focusing particularly on occupational stress. Three different models were assessed-the person-stress model, the dispositional model, and the indigenous model--using structural equation modelling. The indigenous model was found to be the most predictive of mental health. In this model, personality and coping strategies precede and determine the perception of job stressors, which ultimately affect the mental well-being of the individual.
Article
Dental school and professional practice are well-documented sources of stress. Although students and dentists risk developing stress-related disorders, no empirically evaluated method for helping dental students cope with stress has been reported. A group of 17 dental students participated in a six-session program that included instruction in self-relaxation and time management; exercise and leisure planning; and cognitive modification techniques. From pre- to post-training, subjects showed improvement on a variety of self-report and physiological measures relative to a waiting-list control group. A three-month follow-up assessment revealed continued reductions in stress-related behavior. The importance of stress-management training for dental students is discussed as well as suggestions for future research.
Article
While there is ample documentation that medical training is stressful, less is known about predictive variables that might identify students who have the most difficulty in managing stress during medical training. Depression and anxiety in first year medical students were investigated in a longitudinal design. One-hundred and twenty-one medical students (81% of the class) were surveyed. The first survey took place immediately prior to the beginning of medical training (wave 1); the second survey was approximately 8 months after the beginning of classes (wave 2). Medical students who began their first year with relatively low 'A' level grades, high ratings of state anxiety and depression, high trait anxiety and low dispositional optimism, and reliance on avoidant coping strategies were found to be at higher risk for developing depression and anxiety symptoms at wave 2. Students reported increased concern about curriculum and environment, personal competence and endurance, and time to have a life outside medical school at wave 2, compared to their reports at wave 1. Increase in concerns correlated with an increase in depression and anxiety. At both surveys, use of avoidant coping strategies resulted in increased depression and anxiety; at wave 2, active coping and positive reinterpretation resulted in decreased depression and anxiety. These findings suggest characteristics of vulnerable students who might be identified early in their first year and provided with additional support. Educating students to expect an increase in concerns about environment and personal ability to manage the academic load might make these concerns less overwhelming. In addition, information about effective coping strategies (i.e. active coping efforts) and ineffective means of dealing with stress (avoidant coping efforts) might be helpful in preventing distress.
Article
For the first time in decades, conventional wisdom about survey methodology is being challenged on many fronts. The insights gained can not only help psychologists do their research better but also provide useful insights into the basics of social interaction and cognition. This chapter reviews some of the many recent advances in the literature, including the following: New findings challenge a long-standing prejudice against studies with low response rates; innovative techniques for pretesting questionnaires offer opportunities for improving measurement validity; surprising effects of the verbal labels put on rating scale points have been identified, suggesting optimal approaches to scale labeling; respondents interpret questions on the basis of the norms of everyday conversation, so violations of those conventions introduce error; some measurement error thought to have been attributable to social desirability response bias now appears to be due to other factors instead, thus encouraging different approaches to fixing such problems; and a new theory of satisficing in questionnaire responding offers parsimonious explanations for a range of response patterns long recognized by psychologists and survey researchers but previously not well understood.
Article
The present report meta-analyzes more than 300 empirical articles describing a relationship between psychological stress and parameters of the immune system in human participants. Acute stressors (lasting minutes) were associated with potentially adaptive upregulation of some parameters of natural immunity and downregulation of some functions of specific immunity. Brief naturalistic stressors (such as exams) tended to suppress cellular immunity while preserving humoral immunity. Chronic stressors were associated with suppression of both cellular and humoral measures. Effects of event sequences varied according to the kind of event (trauma vs. loss). Subjective reports of stress generally did not associate with immune change. In some cases, physical vulnerability as a function of age or disease also increased vulnerability to immune change during stressors.
Article
An apparent increase in seriously disturbed students consulting student health services in the UK has led to concern that increasing financial difficulties and other outside pressures may affect student mental health and academic performance. The current research investigated whether student anxiety and depression increases after college entry, the extent to which adverse life experiences contribute to any increases, and the impact of adversity, anxiety and depression on exam performance. 351 UK-domiciled undergraduates completed questionnaires one month before university entry and mid-course. The Hospital Anxiety and Depression Scale (HADS: Zigmond & Snaith, 1983) was administered at both time points and a modified List of Threatening Experiences (Brugha, Bebbington, Tennant, & Hurry, 1985) was administered mid-course. By mid-course 9% of previously symptom-free students became depressed and 20% became anxious at a clinically significant level. Of those previously anxious or depressed 36% had recovered. After adjusting for pre-entry symptoms, financial difficulties made a significant independent contribution to depression and relationship difficulties independently predicted anxiety. Depression and financial difficulties mid-course predicted a decrease in exam performance from first to second year. This is the first study to confirm empirically that financial and other difficulties can increase British students' levels of anxiety and depression and that financial difficulties and depression can affect academic performance. However, university life may also have a beneficial effect for some students with pre-existing conditions. With widening participation in higher education, the results have important implications for educational and health policies.
Article
To explore the impact of students' financial circumstances on their mental and physical health. The study employed a correlational design. An opportunity sample of 89 British students and 98 Finnish students completed a questionnaire which assessed their amount of debt, financial concerns, mental and physical health, smoking and drinking behaviours, work in addition to study, and perceptions of control. British students reported greater levels of debt and financial concern than Finnish students. They also reported significantly worse mental and physical health on a variety of dimensions. Financial concern was a significant linear predictor of mental and physical health, with increased financial concern being consistently associated with worse health. There was no evidence that students' smoking or drinking behaviour, work in addition to study, or perceptions of control substantially mediated the relationship between financial concern and health. The results support the position that students' financial circumstances might have serious implications for their health. It is proposed, therefore, that recent changes in government funding policies for students could have a negative impact on student health and exacerbate finance-related health inequalities. Further research is required to identify factors that may mediate or moderate the impact of financial concern on health.
Busy yet socially engaged
  • R Ramos
  • R Brauchli
  • G Bauer
  • T Wehner
  • O Hämmig
The Financial Circumstances of Final- year Dental Undergraduates in the UK
  • Kempm Edwardsh