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Cultivating psychological well-being in Hong Kong's future doctors
Medical Teacher
Abstract
There has been much recent attention on psychological well-being and pastoral care for medical students. This study examines psychological morbidity (depression, anxiety and stress) in Hong Kong medical students, as well as their concerns, coping mechanisms and their help-seeking. Medical students in Hong Kong reported a higher level of psychological morbidity as compared with other tertiary education students. Their main concerns include examinations, stress, career, adjusting to the new medical curriculum and commitment to the course. The coping skills adopted were largely adaptive. Maladaptive coping skills like 'denial', 'self-blame' and 'behavioural disengagement' were highly correlated with depression, anxiety and stress scores. Most of the students concerned wanted support services that were specifically tailored to their needs and at least partly provided by people who had been through medical training themselves. The faculty at the University of Hong Kong is establishing a Programme for Effective Transition and Student Support (PETSS) to provide a multi-faceted support system for its medical students. The findings in this study help to ensure that the services provided will be relevant, accessible and acceptable to the students.
... [14] Medical students are under high-stress levels; therefore, there is a crucial need to obtain adequate sleep to maintain physical and cognitive well-being and achieve their goals. [15] Many factors are responsible for changes in sleep habits, such as the use of the Internet and social media, not going to sleep until late, and using central nervous system stimulants such as caffeine. [1] Furthermore, the lifestyle of each individual may affect the mode of sleep. ...
... It assesses the severity of night-time and daytime insomnia symptoms over the past 2 weeks and has been validated as a clinical instrument for screening insomnia. It is interpreted in four categories of diagnosis: no clinically significant insomnia (0-7), subthreshold insomnia (8)(9)(10)(11)(12)(13)(14), moderate clinical insomnia (15)(16)(17)(18)(19)(20)(21), and severe clinical insomnia (22)(23)(24)(25)(26)(27)(28). The ISI scale had a high level of internal consistency, as determined by a Cronbach's alpha of 0.828. ...
Objectives
This study aims to investigate predictors of insomnia and their prevalence among medical students from different levels, as well as the impact of insomnia on academic performance.
Methods
This multicenter cross-sectional study was conducted on medical students of different levels at 37 medical colleges in Saudi Arabia from March 2020 to June 2020. An online survey was used for data collection. The survey included questions on the demographics of students and two scales: the Insomnia Severity Index (ISI) and the Pittsburgh Sleep Quality Index (PSQI). The Statistical Package for the Social Sciences Program was used to analyze the data, and demographics were represented using descriptive statistics. Associations were tested using either the Chi-square test, Pearson correlation, or Spearman’s correlation based on the types of variables. P <0.05 was considered significant.
Results
The study included 2413 medical students; the mean ± standard deviation of the ISI and PSQI was 11.6 ± 6.2 and 8.4 ± 3.7, respectively. The ISI results showed that only 27% had no clinical insomnia, while 39% had subthreshold insomnia. The ISI was negatively and significantly associated with exercise ( r = −0.49, P = 0.016), meals ( r = −0.088, P = 0.0001), and drinking water ( r = −0.057, P = 0.005). The negative predictors of poor sleep quality included study year ( B = −0.106, P < 0.05) and water intake ( B = −0.568, P < 0.01).
Conclusion
A few proportions of medical students complained of moderate insomnia, and a lower proportion suffered severe insomnia. Lower academic performance was associated with insomnia and poor sleep quality. Various predictors of insomnia were identified; however, these predictors can be modified.
... Sleep problems are particularly significant among medical students (Yassin et al., 2020) due to the daunting and challenging academic workload they are confronted with (Azad et al., 2015;Wong et al., 2005). Lawson et al. (2019) reported that 66 % of medical students at the University of Ghana went to bed between 10 pm and 12 am, 85 % woke up before 6 am, and the majority slept for an average of five hours per night. ...
... Sleep disorders are linked to sleep quality and pattern, in which the current population under study reported shorter sleep hours and fairly good sleep quality (Zafar, Ansari, 2020). These are significant issues of concern that school authorities, counsellors, and academic advisors must engage students to deal with (Wong et al., 2005) since they can affect their academic work (Yassin et al., 2020) and mental wellbeing (Guo et al., 2017;Randler, Vollmer, 2013;Saghir et al., 2018). ...
This study assesses the prevalence of sleep disorders and quality among medical students. A total of 221 (61.5 % males, 38.5 % females; mean±SD age = 22.07 ± 2.45 years) respondents were conveniently selected from all six levels using a cross-sectional survey design. The study results show that most medical students sleep after 11 pm and wake up after 6 am, with an average of 5hrs of sleep each night. They do not induce their sleep with pills, and their sleep quality is fairly good, with a latency of fewer than 15 minutes. There is little nocturnal wakening, if any, due mainly to the use of the washroom at night. Most of them experience daytime sleepiness, and a substantial number experience morning tiredness. The top 5 sleep disorders reported by the students are nightmares, narcolepsy, insomnia, restless leg syndrome/periodic leg movement disorder, and circadian rhythm disorders. The prevalence of sleep disorders and issues among medical students is high. There is a need for medical schools to recognise to assist students in developing healthy sleep patterns as they manage their academic workload. The university system must strengthen existing academic and social supports for student mental wellness. Our findings have implications for medical education, policy, and research in Ghana and beyond.
... For example, studies have confirmed almost one-third of individuals suffer from insomnia (Mellinger et al., 1985). Medical students is one section of the general population that is particularly sensitive to poor sleep, possibly as a result of the long duration and high intensity of study, clinical obligations that include emotionally challenging employment and lifestyle choices (Wong et al., 2005 Abdulghani et al., 2012). Another study confirmed that analysis of the relation between academic performance and sleep disorders indicates a significant relationship between abnormal Epworth Sleepiness Scale (ESS) scores, total sleeping hours, and academic performance (Abdulghani et al., 2012). ...
... Sleep disorders affect a lot of people (Ferrie et al., 2011), one group of people who seem to be especially vulnerable to lack of sleep is medical students potentially as a result of the extensive and intense school schedule and clinical commitments (Wong et al., 2005). ...
Background: Sleep is a reversible state of disconnection from the environment which helps the body and mind to recover and rest. Sleep could be interrupted by a numerous number of disorders and suffering from sleep disorders could affect a person physically and mentally. This study was done to assess the prevalence of sleep disorders and different modalities of using sleep medicine to improve sleep quality among medical students of Umm Al-Qura University. Methods: A descriptive cross-sectional study conducted at Umm Al-Qura University in Makkah, Saudi Arabia using electronic survey in September 2021. The study population was Umm Al-Qura university undergraduate medical students from the 2nd year to intern level. In Results: Of the 342 students who participated in the study, 55.6% of them had at least one sleep disturbance. Narcolepsy was the most often reported sleep condition among students (43.9%), followed by insomnia (29.5%). According to the data, 38.6% of people in our population sleep between 6 and 8 hours per day, compared to 47.4% who sleep less than 6 hours daily. While interns made the fewest complaints about sleep issues, second-year medical students made the most. Conclusion: Our study found that sleep disorders prevalence is high among medical students. We recommend increasing the awareness about the important of sleep and activating the role of academic mentors or advisors and provide the support for junior medical students.
Keywords: management, sleep disorders, medical students, Makkah, Saudi Arabia
... [6] Medical students are more vulnerable to poor sleep, presumably because of the long duration of the course, exhaustive syllabus, night duties, and wrong lifestyle choices. [7] Sleep is essential for memory consolidation, learning, analytical thinking, and decision making, which translates into a better academic performance for the students. [8] Sleep deprivation has an adverse impact not only on the overall health of the students but also on their cognitive functions and motor activity, which leads to poor academic performance. ...
... There is a crucial need for sound and adequate sleep in these students so that they can maintain their cognitive and physical well-being for not only their academic performance but also the nature of the job they perform. [7] Yogic breathing or pranayama reportedly helps in improvement of health along with reducing the effects of stress on the body. In this yogic breathing practice, alternative nostril breathing is the most commonly performed exercise and is considered to help in relieving mental stress along with promoting physical and mental balance. ...
Background:
Various recent studies have reported that exclusive right nostril breathing (RNB) and left nostril breathing (LNB) has an immediate and sustained effect under various medical conditions. In the present study, we evaluated the effect of short-term left nostril breathing on various sleep parameters in medical students.
Methods:
We hypothesized that the increase in vagal tone because of LNB can help in improving the quality of sleep. The baseline sleep quality was documented before the start of study in the case and the control group using the 'Pittsburgh Sleep Quality Index' (PSQI) questionnaire. A PSQI global score of more than 5 indicates poor sleep quality. The case group practiced LNB in a graduated manner for a period of 4 weeks. Thereafter, sleep quality was documented for both the groups using the PSQI questionnaire.
Results:
Practicing LNB significantly lowered all the seven component scores (p < 0.05) and the global PSQI score in the case group (p-value < 0.0001), suggesting that this practice effectively improved the sleep quality in the individuals of this group.
Conclusions:
Overall, this study suggested that exclusive LNB practice could serve as an important lifestyle modification that can be incorporated in the routine of medical students for improving their sleep quality.
... In a survey among medical university students, daytime sleepiness occurred in 35% of Malaysian students, 30.6% of Indian students, and 46.5% of Brazilian medical adepts [15,52,53]. It is believed that high sleepiness among medical students is associated with many hours of classes, study, clinical practice, often including night duty, and significant stress and mental strain [54]. ...
... Here, we observed that the percentage of students with normal sleep time increased from 20.97% to 28.44%, p < 0.001, while sleep satisfaction decreased from 30.09% to 25.20%, p < 0.001. It is clear that delayed falling asleep can reduce the amount of slowwave sleep, significantly deteriorating its quality and exacerbating sleep problems [53,54]. Similar findings were also observed among Spanish students as there was an increase in sleep time in the initial period of the pandemic [25]. ...
Sleep disorders are a serious health problem worldwide, and insomnia is their most common manifestation. An increasing number of people have insomnia every year, young adults, especially. Due to the importance that sleep has in almost every aspect of our lives, the need to monitor disturbances in circadian rhythms has arisen. Therefore, this study aimed to assess the prevalence of sleep disorders among Polish students, including their quality of life (QOL) and drug use patterns. The study also investigated associations between sleep, QoL, and drug use. The study was conducted in 2016–2021 based on the self-made sociodemographic questionnaire, as well as standardized psychometric tools: Athens Insomnia Scale (AIS), Epworth Sleepiness Scale (ESS), and Manchester Short Assessment of quality of life (MANSA). A total of 14,844 students participated in the study. The majority were women (80.7%), of which 3425 (23.1%) were medical students, with the most numerous representing medical and dental faculties, 1884 (57.2%). Before the COVID-19 pandemic, 52.1% of the surveys were collected; 54.1% of respondents had insomnia as indicated by the AIS scores, and 26.1% displayed sleepiness during the day. Female students, the first-year college students, more often suffered from sleep disorders. Drug use was widespread among Polish students, correlating with sleep assessment results and QoL. In conclusion, sleep disorders are a significant clinical problem among Polish students. Female and junior students’ years are more prone to sleep deprivation. Insufficient sleep can be associated with a lower QoL score and psychoactive substance use. The effects of the COVID-19 pandemic on sleep are not conclusive, because there was decreasing quality for longer sleep durations. In order to analyze these associations, there is a need for further in-depth study.
... 15 Medical students are a subset of the population that are more liable to develop sleep disorders and sleep deprivation; this is likely attributed to long intensive study, clinical tasks and high academic loads. 16 Sleep disorders affect students' quality of life, their general health and academic performance -consequently it is important to detect these disorders prior to the deepening of the problem. 17 Sleep deprivation in medical students is found to affect cognitive functions. ...
... This was seen in previ-ous studies reporting high prevalence of sleep disorders in medical students. 16 These sleep disorders influence memory consolidation, learning capacity, physiological functions and general health. [4][5][6]21 At least one sleep disorder was found in 73.7% of this study population. ...
Background: Sleep disorders are a common medical problem and can affect health and quality of life. There are multiple types of sleep disorders such as obstructive sleep apnea, insomnia, narcolepsy, restless legs/periodic limb movement disorder, circadian rhythm disorders, sleepwalking and nightmares. Medical students appear to be more liable to develop sleep disorders due to their high academic load.
Design and Methods: This study seeks to estimate the prevalence of sleep disorders among Umm Al-Qura University medical students and associated risk factors. This cross-sectional study was conducted at the Faculty of Medicine of Umm Al-Qura University in Makkah, Saudi Arabia. A self administrated questionnaire was used to collect the data including socio-demographic data and sleep-50 questionnaire. Four hundred and thirty-eight (438) medical students from the second year to the sixth year were recruited to the study.
Results: Three hundred and twenty-three participants (73.8%) complained of at least one sleep disorder. The most prevalent sleep disorder among students was narcolepsy at 226 (51.6%). Female students, second year students and students spending significant time watching television or on smartphones were more affected than others with p values of 0.001, 0.005, and 0.004, respectively.
Conclusions: Sleep disorders are common among medical students. It is essential to detect and address them before their condition deteriorates.
... In the recent years, sleepiness and sleep problems are endemic in the population [3]. Medical students are a subgroup of the general population who appear to be especially vulnerable to poor sleep quality, perhaps due to the long duration and high intensity of study, clinical duties that include overnight on-call duties, work that can be emotionally challenging, and lifestyle choices [4]. ...
... This difference might be due to heavier academic load and their different lifestyles [10]. Medical students are a subgroup of the general population who are susceptible to poor sleep, for heavy clinical duties, long duration of study, on-call duties, challenging workplace, and different lifestyle [4]. We did not find any association between sex and sleep quality in our study population. ...
Methods:
In this cross-sectional study, 315 medical students chosen by stratified random sampling participated in the academic year 2018-2019. The Pittsburgh Instrument and DASS-21 questionnaire were used to evaluate sleep quality and anxiety, depression, and stress, respectively. Also, demographic, educational, and socioeconomic information was collected. SPSS 16 software was used for data analysis.
Results:
Out of 300 students who completed the questionnaires, 165 (55%) were male, with a mean age of 21.94 ± 2.28 years old. The prevalence of poor sleep quality was 51.3%. We did not find significant associations among age, sex, and poor sleep quality. Concurrent psychological symptoms such as stress, depression, and anxiety were significantly associated with sleep disorders. After adjusting variables in the multivariable regression model, depression (OR = 2.81, 95% CI: 1.35-5.87; p = 0.006) and the number of hours spent on using smartphones in 24 hours (OR = 1.13, 95% CI: 1.02-1.25; p = 0.01) were significantly associated with poor sleep quality among medical students.
Conclusion:
The prevalence of poor sleep quality among medical students was high, and we found that increased use of smartphones during the day and depression were associated with sleep disorders.
... Medical students are especially vulnerable to poor sleep quality. 1 Sleep related disorders are prevalent in high number among medical students throughout the world. 2,3 Sleep is a very important parameter for the consolidation memories and that being sleep deprived reduces one's ability to learn. 4 Quality of sleep can be categorized into subjective and objective aspects. ...
... 5 Prevalence of poor sleep quality is higher among undergraduate medical students compared to students from other fields. 1 Poor sleep quality effects academic performance and also effects intelligence and cognitive functions which is key for medical professionals. 6 In Nepal, medical students have poorer attitude of sleep hygiene. ...
Introduction:
Medical students are under constant stress due to demanding academic load, fear of exam failure and hectic schedules. These factors can lead to poor sleep quality among medical students. Sleep quality of medical students not only determine their academic performance but is also important in determining long term effect on cognitive, psychosocial, behavioural as well as physical health of individuals. Although there are not enough recent studies to assess sleep quality of students, it is necessary to evaluate the condition of sleep among students. This study aims to find out the prevalence of poor sleep quality among medical students.
Methods:
This descriptive cross-sectional was conducted among undergraduate medical students of Kathmandu Medical College from October to November 2019 after taking ethical clearance from Institutional Review Committee of a tertiary care hospital before collecting data from participants. Subjects were recruited by simple random sampling from students of first, second, third and final years and were asked to fill the self-reported questionnaires, using Pittsburgh Sleep Quality Index. Descriptive statistical analysis was done using Statistical Software for Social Sciences version 24.
Results:
Out of 217 selected medical students, 96 (44.23%) of students have poor sleep quality with prevalence among male and female students as 41 (39.8%) and 55 (48.2%) respectively. The mean duration of sleep among students was 6.7±1.6 hours.
Conclusions:
Significant numbers of medical students have poor sleep quality which may affect their academic performance and may have long term impact on their health. Efforts must be directed towards educating about the sleep hygiene as well as proper time management skills.
... Chronically insufficient sleep is endemic and has been declared as a public health problem by the Centres for Disease Control [3]. Medical students are one subgroup of the general population who appear to be especially vulnerable to poor sleep, may be attributed to the long duration and high intensity of study, lack of proper knowledge of sleep, and high academic demands [4]. A number of studies in humans have indicated possible pathophysiologic mechanisms to support the biologic plausibility of an association between sleep deprivation and future cardiovascular risk [5,6]. ...
... Our observations of both shorter and longer sleep duration than recommended 7 hours of sleep and increased prevalence of poor sleep quality among medical college students are in parallel with previous studies [37,38]. Medical students are one subgroup of the general population who appear to be especially vulnerable to poor sleep, perhaps due to the long duration and high intensity of study, clinical duties that include overnight on-call duties, work that can be emotionally challenging, and lifestyle choices [4]. ...
Background: Recent studies in human have indicated possible pathophysiologic mechanisms to support the biologic plausibility of an association between sleep deprivation and future cardiovascular risk. In addition, emerging evidence suggests that inflammatory markers are elevated in sleep-deprived individuals. However, the relationship between sleep duration and inflammatory markers is still unclear.The aim of this study was to investigate associations between self-reported sleep duration, sleep quality, and high sensitivity C-reactive protein (hs-CRP) levels among medical students of a medical college in Chhattisgarh, India. Materials and Methods: A total of 150 Students (94 male, 56 female) of Government Medical College, Rajnandgaon, Chhattisgarh in the age group of 20 to 30 years were randomly enrolled in the present study. Blood samples were analyzed for fasting blood glucose and hs-CRP. Sleep duration and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Results: In the present study, a significant variation in serum hs-CRP levels with different sleep categories was observed (P<0.0001), with the hs-CRP levels being highest (Mean ± SD; 1.13±0.85 mg/L) in short duration (<6 hours) followed by long duration (>8hours) sleepers (Mean± SD; 0.79±0.41mg/L). In both linear and logistic regression analysis model adjusted for various risk factors for cardiovascular disease, short sleep duration was significantly associated with elevated serum hs-CRP levels. Conclusion: Our findings suggest that in¬flammatory mechanisms may play a role in the cardiovascular risk associated with sleep deprivation.
... University life is challenging for most university students. In their transition from youth to young adulthood, they often suffer from a high level of psychological distress (Watson et al., 2008) due to demanding academic standards, excessive academic responsibilities, social connections with peers , heavy coursework load, adjustment to a new environment, concerns about their future career (Wong et al., 2005) and academic expectations of parents, teachers and students themselves (Tan & Yates, 2011). A large-scale study across 12 nations found that 51.1% of the university student participants scored above the General Health Questionnaire-12 (GHQ-12) ≥3 cut-off point; 29% had suicidal ideation and 7% reported suicide attempt (Eskin et al., 2016). ...
This study investigated the trend of the mental health status of Hong Kong university students before and during the 2019 social movement and COVID-19 pandemic. A total of 960 Hong Kong university students completed an online questionnaire in 11 cohorts from 2016 to 2021 in a trend study. In the sample, 68.5% showed various levels of depressive symptoms, and 49.4% were identified to be at-risk for developing mental health problems. The percentage of students with various levels of depressive symptoms and at-risk cases increased from 41.5% and 24.4% in 2016 to 80.0% and 60.0% in 2021, respectively. Overall deterioration of mental health was observed for Hong Kong university students from 2016 to 2021. Furthermore, results showed that positive thoughts, sense-making coping, and resilience functioned as significant protective factors, while negative thoughts and suicidal ideation acted as significant risk factors of various mental health outcomes of Hong Kong university students.
... 6 Sleep disorders and poor sleep quality have been recognised as common health issues among medical students, 7 8 which are driven by their heavy workload and study load and regular night shifts when practising in clinical settings. 9 10 The prevalence of sleep disorders among medical students is remarkable. For instance, 19% of Chinese medical students reported poor sleep quality, and 70% experienced sleeplessness. ...
Objective
This study explored factors associated with sleep quality among medical students in Vietnam.
Design
Cross-sectional study.
Setting
The study was conducted from December 2019 to February 2020 among medical students in Vietnam.
Participants
Medical students were defined as those enrolled in undergraduate medical programmes. 1284 medical students who met the inclusion criteria participated in this study.
Outcome measures
The Pittsburgh Sleep Quality Index (PSQI) was used to measure participants’ sleep quality, with a score of 5 or higher indicating poor sleep quality. Multivariable logistic and linear regression models were employed to identify the factors associated with poor sleep quality.
Results
36.6% of the study participants had poor sleep quality. There were statistically significant differences in the percentage of poor sleep quality across genders, health-related quality of life, morbidity status and depression (p<0.05). Depression (Coef.=0.54, 95% CI 0.17, 0.91 and OR=1.50, 95% CI 1.13, 1.99) and any morbidity (Coef.=0.64, 95% CI 0.28, 0.99 and OR=1.44, 95% CI 1.09, 1.88) were factors associated with higher PSQI Score and increased risk of poor sleep quality. In contrast, higher health-related quality of life scores (EuroQOL-5 dimensions-5 Levels Index: OR=0.01; 95% CI 0.002, 0.03 and Coef.=−7.11; 95% CI −8.65, −5.56; and EuroQOL-Visual Analogue Scale: OR=0.99; 95% CI 0.98, 1.00 and Coef.=−0.03; 95% CI −0.04, −0.01) were related to lower PSQI Score and reduced risk of poor sleep quality.
Conclusions
This study reveals that health conditions and psychological well-being were associated with sleep quality among medical students. Reducing stress, improving quality of life and improving morbidity have the potential to improve the sleep quality of medical students.
... Another study on Saudi medical students showed that 73.8% of the students complained of at least one sleep disorder like narcolepsy, obstructive sleep apnea, sleep walking and nightmares [18]. Medical students are more vulnerable to sleep deprivation and sleep problems because of the high academic load, intensive study hours, and other clinical tasks such as preforming physical examination, obtaining patient medical history, making clinical decisions and interpreting laboratory and radiological data [19]. Previous studies demonstrated that sleep deprivation, daytime sleepiness, going late to bed and waking up early may affect academic achievements and learning ability [2,[20][21][22][23][24][25][26]. ...
Background
Sleep is an active process that affects human health and quality of life. Sleep is essential for learning and memory consolidation. Good sleep is required for good academic performance. Sleep disorders are common among medical students, due to the high academic load, stressful life, and hectic schedule. Therefore, this study aims to assess sleep quality among medical students.
Methods
A cross-sectional study was conducted among medical students at King Khalid University by using the Pittsburgh sleep quality index (PSQI) to assess sleep duration, sleep efficiency, sleep latency, and global PSQI score. Participants were enrolled from second to sixth year. Bivariate and multivariate logistic regression were used to predict factors related to poor sleep quality.
Results
Out of 514 medical students, 453 (88.1%) of students exhibited poor sleep quality. Fourth year students were less likely to have poor sleep quality (AOR, 0.381; CI, 0.158–0.934) p = 0.035 and students with regular sleep schedule were more likely to be good sleepers (AOR,0.349; CI, 0.129–0.940) p = 0.037. Additionally, students who had more than five courses per semester more frequently had daytime sleepiness p = 0.03. However, Insufficient sleep was not significantly affected by factors like gender, different age groups, number of courses per semester, daytime sleeping, and students with varying Grade Point Averages (GPA).
Conclusion
Poor sleep quality is common among medical students, which may affect academic performance and general health. It is essential to educate them about good sleep hygiene and time management skills.
... Studies have shown that approximately one-third of medical students worldwide suffer from depression [12], which is greater than the general population [13,14]. While depression itself can lead to sleep disturbances or vice versa, medical students themselves possess an increased susceptibility to abnormalities in their sleep pattern, due to additional risk factors such as prolonged and intense study schedules, demanding clinical responsibilities that include overnight on-call duties, emotionally taxing work, lifestyle choices, and extensive use of social media [15]. As a result of these factors, the prevalence of sleep disturbances is higher among medical students than non-medical students [16,17]. ...
Introduction
While research has examined the connections between sleep quality, smartphone addiction, and depressive symptoms in general, no studies focused on undergraduate medical students in Nepal have specifically tested the complex relationship between these factors. Therefore, this study aimed to investigate the interaction between smartphone addiction, sleep quality, and depressive symptoms among undergraduate medical students of Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Methods
A cross-sectional study was conducted among 212 undergraduate medical students at Maharajgunj Medical Campus, Tribhuvan University, Nepal. Sleep quality, smartphone addiction, and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index, Smartphone Addiction Scale Short Version, and Patient Health Questionnaire-9. Data were analyzed using IBM SPSS version 26 via the bootstrap model approach.
Results
Out of the total participants, 67.9% were male. Males showed higher scores in smartphone addiction and depressive symptoms than females (b = 5.3, Bca 95% CI:1.2, 9.1, p < 0.05). The unadjusted model indicated that the presence of smartphone addiction explained 36.5% of the indirect impact of sleep quality on depressive symptoms. However, in the adjusted model, after introducing socio-demographic, behavioral, and educational variables as covariates, this percentage decreased to 33.02%.
Conclusion
This study highlights the significant role of both smartphone addiction and sleep quality in mediating the indirect effect on depressive symptoms among undergraduate medical students. Smartphone addiction emerged as a key mediator of depressive symptoms, indicating a potentially important factor in mental health. Investigating this relationship further through longitudinal studies will be crucial for developing effective preventative and therapeutic approaches.
... [14,15] During internship, students are expected to navigate through clinical duties that embrace long on-call duties, emotional challenges, and exhaustion related to witnessing human misery. [16] Hence, sleep is of particular interest in medical students because of the relationship between sleep and stress and the potential impact of stress on learning the art of quality patient care. [17] Cognition and fine learning skills are impaired due to sleep loss creating lacunae in learning the technical aspects of medical academic curriculum and patient care. ...
Background
Medical students are vulnerable to sleep disturbances as they navigate life through academic stress, long on-call duties, emotional challenges, and exhaustion. Insufficient sleep negatively affects cognitive functions and fine motor skills, leading to deficiencies in attention, increased drowsiness while driving, propensity for risk-taking behavior, heightened risk of depression, impaired interpersonal relationships, and the potential to impact learning technical aspects of curriculum as well as delivering quality patient care.
Objectives
The objective of this study was to measure the sleep quality and its determining factors among undergraduate medical students of a teaching institute in Telangana, South India.
Methodology
A cross-sectional study was conducted among 401 undergraduate medical students. A semi-structured questionnaire including the sociodemographic details, medical history, and screen time, followed by the Pittsburgh Sleep Quality Index (PSQI) which assesses the time of quality sleep, frequency of troubled sleep, etc., over the last 1 month was used. The quality of sleep score of >5 indicates poor sleep quality.
Results
The mean age was 20.41 years (standard deviation [SD] =2.08). Known comorbidities were present among 17 (4.2%), and 13 (3.2%) had psychiatric conditions. Poor sleep quality was present among 70% of medical undergraduates. The mean global PSQI score was 6.22 (SD = 2.9). The factors found significantly associated with poor sleep quality were academic stress ( P = 0.009; odds ratio [OR] = 2.154 [CI = 1.250–3.713]), headache and self-medication ( P = 0.008; OR = 1.868 [CI = 1.178–2.964]), and nighttime screen use ( P < 0.001; OR = 18.12 [CI = 5.48–59.87]).
Conclusion
Sleep deprivation and poor sleep quality is a major concern among medical undergraduates. It is important to have a proper sleep–wake routine and maintain good sleep hygiene. This includes reducing the use of screens before bedtime and addressing any underlying health conditions, including mental health issues, to improve sleep quality and overall well-being.
... Medical students are a subset of the population that are more liable to develop sleep disorders and sleep deprivation; this is likely attributed to long intensive study, clinical tasks and high academic loads [11] . Sleep disorders affects students' quality of life, their general health and academic performance consequently it is important to detect these disorders prior to the deepening of the problem [12] . ...
... 5 Medical students are amongst a subgroup of the population who are found to be at risk of poor quality of sleep attributable to their long hours of study, duties, and emotionally challenging jobs. 6 Several studies have looked into the relationship between quality of sleep and academic achievement. A study reported more than 40% of the study subjects with sleep-related problems with 6% having insomnia, 3.7% with daytime sleepiness, and 2.3% with poor sleep quality. ...
... Meanwhile, medical students are very prone to bad quality of sleep due to intense and demanding physical and emotional training during study [29]. In addition, depressive and anxious symptoms are found in students with big financial burden, high academic stres, and bad quality of sleep [30]. ...
Stress, anxiety, and depression are common psychological disorder reported among medical students worldwide. During the COVID-19 pandemic era, medical students are burdened with high academic demand and pressure, despite the quarantine and limitations. Such psychological disorders are frequently found in undergraduate students, especially in medical students, which could lead to more problematic mental health issues and may affect professionalism and, ultimately, patient safety and care. This article reviews the risk factors associated with stress, anxiety, and depression among medical students during the COVID-19 pandemic. Abundant literatures were found related to this topic, but only a few important and informative research articles were included in this review. This review provides a bigger picture of the current psychological condition among Indonesian medical students. Medical students in Indonesia had varying levels of stress, anxiety, and depression with various associated academic and non-academic risk factors.
... Additionally, many students are dealing with a variety of stressors outside of their medical school, including family, social, emotional, and physical issues. [3,4] Maintaining healthy physical, mental, and emotional health depends on getting enough sleep, which is also one of the most crucial aspects of life. [5] Sleep quality is a hardto-define phenomenon that can be evaluated on both quantitative and qualitative grounds. ...
Background
Due to the rigorous academic standards and demanding professionals, the medical field is thought to be a stressful subject of study. This has a negative impact on the student’s mental and physical health. The long-term effects of this study will have an impact on identifying major issues that our students are facing, which will ultimately improve the level of medical treatment offered by future doctors.
Materials and Methods
This cross-sectional study was conducted from October to December 2020 at a tertiary care institution in Tamil Nadu, India for three months. After getting the necessary ethical permissions from the institution with reference number GEMC/2020/002, the undergraduate students from the first year to the internship were included in the study.
Results
The educational status of the students indicated that around 147 (31.1%) of respondents belonged in the first year. The mean + Pittsburgh Sleep Quality Index (PSQI) was observed to be 6.33 + 2.13, where undesirable sleep quality was predominant among 370 (78.3%) of the respondents with a p-value of less than 0.0001. The majority of the students (70.1%) have normal levels of stress which were significant with a p-value of 0.0027.
Conclusion
Medical students experience poor sleep and ongoing stress, which can result in harmful behaviors like overindulging in junk food and a reduced likelihood of exercising. They are undeniably more prone to developing chronic illnesses. If these issues are not addressed, they will affect the medical care that is given to their incoming patients.
... One subgroup of the general population that appears to be particularly susceptible to sleep problems is medical students, possibly as a result of their prolonged and intense study schedules, clinical responsibilities that include overnight on-call shifts, emotionally taxing jobs, and lifestyle choices (2). ...
Insomnia is the perception of inadequate sleep resulting in a variety of outcomes. It can lead to a continual sensation of exhaustion, anxiety, and burnout, which seriously impact the performance level. Medical personnel ranging from medical students to consultants are susceptible to sleeplessness. The management and prevention of insomnia require various levels of intervention. Individual-level interventions include setting sleep schedules, using beds properly, abstaining from drinking, and exercising regularly. Similar recommendations at the institutional level include improving the medical curriculum, making the workplace flexible, and keeping an eye on the burnout rate. Unfortunately, there is a shortage of verifiable information that justifies more research.
... 17,18 Long duration and intensity of studies, emotionally challenging work and overnight on-call duties with long working hours have been identified as causative factors for sleep deprivation. 5,6,19,20 For this survey, the LSEQ was chosen instead of the PSQI. Indeed, the PSQI evaluates sleep over the last month and more and therefore gives a general longitudinal assessment, which would not be useful to evaluate sleep disorders during the night prior to HFS. ...
Objective:
The stress level of participants in high-fidelity simulation stems from various factors but may result in anticipatory anxiety causing sleep disturbances during the night prior to simulation. The objective of this survey was to determine the change in sleep quality of residents during the night prior to the simulation.
Methods:
The survey was proposed for 1 year to all residents at the beginning of the simulation, in 10 simulation centres. The questionnaire combined demographics and the Leeds Sleep Evaluation Questionnaire using visual analogue scales divided into 4 sleep qualitative domains. The primary outcome was the prevalence of sleep disturbance (>10 mm on 1 domain). Secondary outcomes were the prevalence of severe sleep disturbance (>25 mm), as well as qualitatively and quantitatively reported explanatory sleep parameters.
Results:
Among respondents, 66% [95% CI: 63 to 69] of residents had more than 10 mm and 27% [95% CI: 24 to 30] had more than 25 mm of sleep disturbance. Residents with a sleep disturbance of more than 10 mm had fewer hours of sleep (6.4 [standard deviation=1.8] vs 7.3 [standard deviation=1.3], difference: -0.9 [95% CI: -1.1 to -0.7]; P < .0001), with a higher number of night-time awakenings (1.3 [standard deviation=1.5] vs 0.7 [standard deviation=0.9], difference: 0.6 [95% CI: 0.4 to 0.8]; P < .0001).
Conclusion:
Among residents participating in the simulation, a high prevalence of change in sleep quality during the night before the simulation was noted. Strategies to help residents achieve better sleep prior to simulation should be explored.
... Poor sleep patterns have shown to negatively affect cognitive performance including working memory, and thus further lead to a declining academic performance [27][28] . Among the general population, medical students are especially more vulnerable to sleep deprivation, most notably due to the long hours of study required from them 29 . The average reported sleeping time of medical students in our study is 6.1 hours (SD=1.5). ...
Introduction: Current literature supports that lifestyle habits of physicians strongly influence the health behaviors of their patients. In this stance, identifying the health habits of medical students and implementing interventions to refine them may become a pillar for improved patient care. However, information on the lifestyle habits of medical students remains limited, especially in the Middle East. Therefore, the objective of this study is to evaluate the health habits of medical students studying in a medical school located in the Middle East.
Methods: In this cross-sectional study, data collection was primarily done via the administration of an anonymous online questionnaire. The questionnaire was sent to all medical students studying at the Saudi Arabian based Shaqra University College of Medicine using the institution's email. It evaluated the participants' health habits, willingness to change health habits, as well as the perceived barriers to change. Descriptive statistics were performed and data was analyzed using SPSS version 24.0. Fisher's exact tests were used to determine the associations between categorical variables and Pearson correlations for continuous variables.
Results: From the total (912) Shaqra Univeristy medical student participants, 647 completed the questionnaire with a response rate of 70.94%. From this, 298 students engaged in weekly exercise activities, where the pre-clinical year students had a higher level of physical activity compared to clinical years. Furthermore, the average sleep time was 6.1 hours. Those who slept for less than 8 hours were considerably more likely to skip breakfast and smoke compared to those who slept longer. Of the 647 students, 156 reported eating breakfast every day. Moreover, 77.13% reported never smoking, 13.14% are current smokers and 9.74% are previous smokers. Amongst current smokers, the most prevalent barrier to change was stress and nicotine addiction. Students with poor diet and physical activity reported to have "lack of time" as the main concern.
Conclusions: Various unfavorable health habits were evident in the results of this study, such as low levels of sleep and physical activity. Since these poor health habits are likely to also be practiced later in life, the authors of the study encourage the implementation of interventions that work on improving the health habits of medical students.
... Researchers have correlated sleep duration with performance and subjective alertness [9,10] . Medical students seem to be susceptible to inadequate sleep possibly as a consequence of the academic requirements of their medical training [11] . The sleep-wake cycle of medical students is characterized by insufficient sleep duration, delayed sleep onset, and occurrence of day-time sleepiness, [12,13] which, has been found to affect cognitive function in medical students [14] About 70% of surveyed Hong Kong medical students self-reported sleep deficit with no significant gender and age differences [15] . ...
This cross-sectional comparative study was conducted among 322 medical students (females = 156; 48.44%; males = 166; 51.56%), aged 18+ years, of either gender, in Western India to determine their sleep patterns. After explaining about the study and obtaining written informed consent, the participants were administered a pre-tested questionnaire. There was significant (Z=2.123; p=0.033) gender difference in the age distribution of participants. The differences among those staying in hostels and those staying at their homes were not significant. 130 (40.37%) respondents reported sleep disturbances due to change of environment. 52.56% female students reported that they did not experience sleep disturbances during menses. Significant gender differences were also found in sleep duration of less than six hours (Z=2.049; p=0.040), sleeping before midnight (Z=2.561, p=0.010). Students of both used mobile phones at night. The findings of this study indicate that the students require counseling and support.
... 10 Medical students are a vulnerable subgroup for sleep di culties owing to the intensity of their studies over a long duration. 11 In addition, medical students present with more sleep di culties, compared to students studying law or economics. 12 Research into sleep issues in medical students is required because of the known relationship between sleep, mental illness and students' academic performance. ...
Background: An increase in the prevalence of eating disorders (EDs), sleep problems, and stress in the general population and medical students is becoming an area of concern. This study was designed to determine the incidence of sleep and EDs in medical students and to assess the relationship between these factors and stress levels.
Methods: A descriptive, cross-sectional study was performed, and the data were collected using a self-administered, structured questionnaire via instant chat groups and social media advertisements between September and December 2019. Medical students (years 1–6) (n = 1100) enrolled at the College of Medicine and Medical Science, Arabian Gulf University, Bahrain, were recruited in the study. The electronic survey included questions on the participants’ demographic characteristics. The tools utilized were the Pittsburg Sleep Quality Index (PSQI), the 26-Item Eating Attitudes Test (EAT-26), and the 10-Item Perceived Stress Scale (PSS-10). The data were analyzed using Stata® (version 17.0).
Results: Responses were received from 730 participants out of 1100 (67%). 649 (58%) were included in the final analysis,68% women and (32%) men. The mean age of the participants was 22.73 ± 2.31 years. Mean body mass index (BMI) was 25.56 ± 5.6 kg/m2 (55% had a normal BMI). The mean EAT-26, PSQI, and PSS-10 scores were 16.99 ± 9.09, 38.00 ± 3.13, and 25.67 ± 6.97, respectively. The prevalence of EDs, poor sleep quality, and stress symptoms was 32% (95% confidence interval [CI]: 28.01–35.32), 67% (95% CI: 62.62–70.05), and 50% (95% CI: 46.07–53.93), respectively. Univariate logistic regression analysis revealed that female sex was a risk factor for EDs, sleep problems, and stress (odds ratio of 2.10, 95% CI: 1.30–3.45).
Conclusions: Counseling services should be offered to medical students affected by anxiety, poor eating habits, and morbid obesity at the start of the first year of university. Medical students with sleeping problems require special attention throughout their time at college. Strategies to mitigate stress while studying should be given.
Trial registration: Not applicable.
... Adequate sleep is essential for them to maintain their physical and mental wellbeing. 15 Prevalence of insomnia, excessive daytime sleepiness, snoring, sleep apnoea, teeth grinding and nightmare are among individuals with internet addiction. 2 Since, not many studies are available in Tamil Nadu among medical students, this study was carried out to assess the association between IGDs and sleep problems. ...
Background: Excessive online gaming poses a big problem among the growing generation. It leads to poor quality of sleep among students.Methods: It is a cross-sectional study done among medical college students of a tertiary care hospital, Kanchipuram district, Tamil Nadu for a period of 6 months (May to October 2019). 376 students participated in this study. Data was collected using self-administered questionnaire containing IGDS9-SF and ISI scales. Data was analysed using SPSS version 21.Results: Of the 376 participants, 220 (58.51%) were males and 156 (41.49%) were females. Prevalence of internet gaming disorder (IGD) was 4.25%. Among the 376 participants, 73(19.4%) had moderate severity insomnia. Correlation was significant between internet gaming and insomnia severity.Conclusions: The result of the study shows that prevalence of IGD was low among medical college students in the Kanchipuram district and there was medium correlation between IGD and insomnia.
... Additionally, other sleep disturbances, including sleep deprivation [12], poor sleep quality [12][13][14], and excessive daytime sleepiness [13], have been reported with high prevalence among medical students in various countries. Medical students are generally more exposed to poor sleep due to emotional stress from laborious coursework and abnormal sleep-wake pattern from night shifts [15]. ...
Introduction: Insomnia is a common disease in all societies and age groups. Among them, medical students are one of the population most susceptible to sleep problems. Studies from many countries have shown high prevalence of insomnia among medical students. Sleep diary is the gold standard for evaluating subjective insomnia and other sleep disorders. This research aims to study the prevalence of insomnia in Vietnamese medical students, associated factors, and their sleep patterns. Method: In a cross-sectional survey using stratified random sampling, a total of 176 medical students was recruited, each completed a self-administered questionnaire and a 7-consecutive-day sleep diary. Demographic data and lifestyle factors were obtained from the questionnaire, while sleep patterns and quality were collected from the sleep diary. We performed data analysis using SPSS ver 22, p<0.05 was statistically significant. Results: Overall, out of 176 participants, 93 (52.8%) were affected by insomnia. On average, students acquired 6.2 hours of sleep each night. 70.94% of the recorded nights had total sleep time (TST) less than 7 hours. Associated factors of insomnia include sleep environment, sleep efficiency (SE), bedtime, falling asleep time, get up time, self-reported sleep quality. Conclusion: The findings of our study revealed the high prevalence of insomnia among medical students. From recorded sleep data, we observed that sleep deprivation is also a common issue faced by the study participants. The valuable insights provided by sleep diary proved to be crucial in evaluating sleep patterns and quality.
... Chan, 1999;Tan & Yates, 2011). This pressure may be particularly pronounced in medical students who manifest a greater degree of psychological distress, including perceived stress, depressive symptoms and anxiety, than other university students (Wong et al., 2005). A survey on medical students from the University of Hong Kong also revealed that majority of medical students were screened positive for minor psychiatric disorders and up to 95% of them were burned out (Chau et al., 2019). ...
Introduction: The demanding nature of medical and health sciences studies can cause stress among students in these disciplines affecting their wellbeing and academic performance. The Perceived Stress Scale (PSS-10) is a widely used measure of perceived stress among medical students and healthcare professionals that has not yet been validated among medical and health sciences students in Hong Kong. The aim of this study is to establish the construct validity and reliability of the PSS-10 in this context. Methods: 267 final year medical and health sciences students were surveyed using the PSS-10. The data were analysed using exploratory factor analysis for construct validity and Cronbach’s alpha coefficient and corrected item-total correlations for reliability. Results: Exploratory factor analysis revealed a two-factor structure for PSS-10, with Cronbach’s alpha of 0.865 and 0.796, indicating good internal consistency. Corrected item-total correlations showed satisfactory correlation ranged from 0.539 to 0.748 for all items and their respective subscale. Both tests supported PSS-10 as a two-factor scale. Conclusion: The PSS-10 is a valid measure for assessing perceived stress in Hong Kong medical and health sciences students.
... Its prevalence is twofold high among medical students as compared to general populations (Azad et al. 2015;Brown et al. 2001;Waqas et al. 2015). Medical students have a more stressful academic program related to long duration of study year, high intensity of study, overnight clinical duties (Abdulghani et al. 2012;Sahraian and Javadpour 2010;Wong et al. 2005). A review study conducted in Brazil showed that 51.5%, of medical students had poor sleep quality (Pacheco et al. 2017). ...
Abstract Purpose Poor quality of sleep has a negative effect on academic performance of medical students. Quantity and quality of sleep in addition to average sleep time are strongly linked with students’ learning abilities, poor academic performance and poor interpersonal relationship which predispose them to mental illnesses. This study is aimed to assess magnitude and correlates of sleep quality among medical students in Ethiopia. Method An institutional based cross-sectional study was conducted among 576 undergraduate medical students. Data was collected by using interviewer administered structured questionnaires. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The collected data were entered in to Epi-data version 3.1and analyzed using SPSS version 20. Logistic regression was used to identify the potential determinants of quality of sleep among undergraduate medical students. P-values less than 0.05 were considered statistically significant and strength of the association was presented by adjusted odds ratio with 95% C.I. Result The prevalence of poor sleep quality among undergraduate medical students was 62% (95%CI, 57.9, 65.3). The mean age (±SD) of the respondents was 21.5(±2.4), with age ranging from 18 to 28 and about 310 (53.8%) were males. Factors like, being depressed (AOR = 1.92,95%CI 1.16,3.19), poor social support (AOR = 5.39,95%CI 2.33,2.49), being stressed (AOR = 2.04,95%CI 1.26,3.31), and poor sleep hygiene (AOR = 3.01,95%CI 1.75,5.18) were associated with poor sleep quality at p-value
... The prevalence of sleep disturbances in medical students is higher than in non-medical students [1,3]. There are many reasons to the high prevalence of sleep problems in medical students, including many hours of classes and study, clinical clerkships that include overnight work, emotional stress, choices concerning lifestyle and many hours using virtual social media [4,5]. ...
Background
It has been previously shown that a high percentage of medical students have sleep problems that interfere with academic performance and mental health.
Methods
To study the impact of sleep quality, daytime somnolence, and sleep deprivation on medical students, we analyzed data from a multicenter study with medical students in Brazil (22 medical schools, 1350 randomized medical students). We applied questionnaires of daytime sleepiness, quality of sleep, quality of life, anxiety and depression symptoms and perception of educational environment.
Results
37.8% of medical students presented mild values of daytime sleepiness (Epworth Sleepiness Scale - ESS) and 8.7% presented moderate/severe values. The percentage of female medical students that presented ESS values high or very high was significantly greater than male medical students (p < 0.05). Students with lower ESS scores presented significantly greater scores of quality of life and perception of educational environment and lower scores of depression and anxiety symptoms, and these relationships showed a dose-effect pattern. Medical students reporting more sleep deprivation showed significantly greater odds ratios of presenting anxiety and depression symptoms and lower odds of good quality of life or perception of educational environment.
Conclusions
There is a significant association between sleep deprivation and daytime sleepiness with the perception of quality of life and educational environment in medical students.
... Medical study is one of the most stressful fields, and poor sleep is more common among medical students than nonmedical students [23]. As studies reported, medical students have a more stressful academic program related to long duration of study year and overnight clinical duties which affect their habits of sleep and result in sleep difficulties [24][25][26]. A study conducted in developing countries showed that 32.5%-76% of medical students suffer from poor sleep quality [27,28]. ...
Background:
Good sleep hygiene plays an important role in human health. Medical students are notorious for insufficient and irregular sleep habits which are linked with students' learning abilities, poor academic performance, and poor interpersonal relationship which predispose them to mental illnesses. However, it has not been studied among medical students in Ethiopia.
Method:
This institution-based cross-sectional study was conducted among 576 undergraduate medical students selected by using a stratified sampling technique. Sleep hygiene (SHI) was assessed by a 13-item sleep hygiene questionnaire. Binary logistic regression was used to identify the potential determinants of poor sleep hygiene among undergraduate medical students. Variables with p values less than 0.05 were considered statistically significant, and the strength of the association was presented by adjusted odds ratio with 95% C.I.
Result:
The prevalence of poor sleep hygiene practice among undergraduate medical students was 48.1% (95% 43.7, 52.1). After adjusting for the possible confounders, being female (AOR = 1.53, 95% CI 1.03, 2.26), having depressive symptoms (AOR = 3.55, 95% CI 2.26, 5.59), with stress symptoms (AOR = 2.41, 95% CI 1.61, 3.60), and having anxiety symptoms (AOR = 2.2, 95% CI 1.42, 3.31) were associated with poor sleep hygiene practice at p value < 0.05.
Conclusion:
Almost half of the medical students had poor sleep hygiene practice. Routine screening of depressive and stress symptoms and education about sleep hygiene are warranted among medical students.
... The results of the present study are consistent with the findings that students belonging to medical and allied sciences appear to be vulnerable to poor sleep due to duration and intensity of their curriculum, clinical duties and both pre-clinical clinical assignments. 19 This burden can be assessed by the fact that as while researchers have estimated sleep disorders in the general population to be around 15-35%, medical students showed a prevalence of insomnia of 30%. 20 As per Jiang et al., who documented the prevalence of insomnia among university students from 9.4% to 38.2%, the prevalence of insomnia among medical, dental and nursing students in on the higher side as stated above and as per the findings of the present study. ...
INTRODUCTION: Insomnia is a risk factor for various physical and mental disorders as well can affect the academic performance of a student(s). AIM: To assess the prevalence of insomnia among university going students (medical, dental and nursing streams) in the South Asian continent during the lockdown due to the COVID-19 pandemicMATERIALS AND METHOD: The present study was conducted amongst 743 medical, dental and nursing undergraduate students residing in South Asia using convenience sampling. Data was collected using a pre-tested and pre-validated questionnaire [the Athens Insomnia Scale (AIS)] using google forms and had a total of 8 questions (score range 0-3) . Final scores (the individual AIS score) were obtained by adding the scores for each question (range 0 -24). The higher the score was, the worse was the sleep quality; students with score of ≥ 6 were considered insomniac. Data Analysis was done using SPSS version 21.012 by using the independent samples t-test, and multiple logistic regression.RESULTS: A total of 921 entries were recorded, out of which 743 were complete and hence, were included in the study (response rate: 80.7%). Insomnia was reported in 421 (56.7%) students, out of which, the highest was seen among dental (62.7%), followed by medical (59.8%) and nursing (45.3%) undergraduates. The highest range of AIS was observed among females (6-22) and dental students (6-21). Gender differences revealed a significant association among females in both range obtained (t-test) (p=0.03) as well as the multiple linear regression analyzing insomnia in relation to gender (p=0.03).CONCLUSION: There is a need to regularly assess insomnia among students and to take preventive measures incase of high prevalence is found among them, especially while pursuing academics online and from their homes due to the pandemic.
... Among college students, medical students are under particularly high levels of stress, hence the crucial need for adequate refreshing sleep (to maintain cognitive and physical well-being) to achieve their goals [22]. A previous study showed a high prevalence of symptoms and an elevated risk of several sleep disorders among medical students [12]. ...
Background
Thyroid disorders affect the life quality of patients in various aspects. The present work aims at investigating the effect of thyroid hormonal status on the quality of life (QoL) among patients receiving Levothyroxine at the level of primary healthcare.
Methods
All patients receiving Levothyroxine at an academic primary healthcare center were included in a cross-sectional evaluation. QoL was measured by the Thyroid-Related Patient-Reported Outcome questionnaire (ThyPRO). The conducted analysis was based on the last thyroid hormones level during the last year and questionnaire scores where higher scores indicated lower QoL.
Results
We included 127 patients; all domains of their QoL questionnaire were affected. The highest scored domain of the ThyPRO was tiredness, while the least was goiter symptoms. An association between the affected QoL and thyroid hormones could not be built. Certain domains of the ThyPRO were influenced by the existence of comorbid diseases.
Conclusions
QoL was impacted in patients receiving Levothyroxine, regardless of hormonal status. Management of comorbid diseases and patients’ concerns are advised to be taken into consideration to achieve a satisfying treatment. We highly recommend the integration of health life quality assessments in primary health care systems.
... during , similar to a previous study by Cellini et al. (2020) in Italy. Medical students are especially prone to poor sleep quality because of the physically and emotionally challenging and intense training they undertake (Wong et al., 2005). Poor sleep affects neurocognitive and psychomotor performance, emotional wellbeing, working capacity, academic performance, physical and mental health as well as quality of life (Al-Khani et al., 2019;Flores, 2009;Giri, Baviskar & Phalke, 2013;Mume, Olawale & Osundina, 2011). ...
Background: The COVID-19 pandemic is found to affect the mental health of the population. Undergraduate medical students are especially prone to mental health disorders and hence could be more vulnerable to the impact of the pandemic. Methods: A prospective longitudinal study was conducted on 217 undergraduate medical students in a medical college at Chennai, India. Depression, anxiety,
and stress levels were recorded using Depression Anxiety Stress Scale 21 Items (DASS21) before and during the COVID-19 outbreak in India in December 2019 and June 2020, respectively. In the follow-up survey, in addition to DASS21, the Pittsburgh Sleep Quality Index to assess sleep quality and a self-administered questionnaire to assess the impact of COVID-19 related stressors were used. The selfadministered
questionnaire assessed the status of COVID-19 testing, interactions
with COVID-19 patients, self-perceived levels of concerns and worries related to academics (COVID-19-AA (academic apprehensions)) and those pertaining to the self and family/friends (COVID-19-GA (general apprehensions)). Cross-sectional and longitudinal comparison of overall scores of depression, anxiety, and stress and scores stratified by gender, year of study, place of residence and monthly family
income were performed. Predictors for depression, anxiety, and stress during COVID-19 were investigated using adjusted binary logistic regression analysis and results were expressed as adjusted odds ratio with 95% confidence interval (CI). A P value < 0.05 was considered statistically significant. Results: The average scores of depression, anxiety, and stress during the baseline survey were 7.55 ± 7.86, 4.6 ± 6.19 and 7.31 ± 7.34 with the prevalence (95% Cl) of 33.2% [27–39.9%], 21.2% [16–27.2%] and 20.7% [15.5–26.7%]; in follow-up
survey, the mean scores were 8.16 ± 8.9, 6.11 ± 7.13 and 9.31 ± 8.18 with the prevalence being 35.5% [29.1–42.2%], 33.2% [27–39.9%] and 24.9% [19.3–31.2%] for depression, anxiety, and stress respectively. There was a significant increase in both the prevalence and levels of anxiety and stress (P < 0.001), with depression remaining unchanged during COVID-19, irrespective of gender, year of study, place of residence and family’s monthly income. Poor sleep quality, higher levels of baseline depression, anxiety, and stress, higher COVID-19-GA, COVID-19 patients in family/friends and direct interactions with COVID-19 patients were found to be significant predictors of negative mental health in undergraduate medical students. COVID-19-AA was not significantly associated with depression, anxiety, and stress. Conclusion: The COVID-19 pandemic appears to negatively affect the mental health of the undergraduate medical students with the prevalence and levels of anxiety and stress being increased, and depression symptoms remaining unaltered. Addressing and mitigating the negative effect of COVID-19 on the mental health of this population is crucial.
... = ≥ ≥ Among college students, medical students are under particularly high levels of stress, hence the crucial need for adequate refreshing sleep (to maintain cognitive and physical well-being) to achieve their goals [22]. A previous study showed a high prevalence of symptoms and an elevated risk of several sleep disorders among medical students [12]. ...
Background: Sleep quality is of paramount importance for human health. This multi-site study measures the proportion and types of self-reported sleep disorders in medical students and evaluates their association with academic performance by Grade Point Average (GPA).
Materials and methods: A cross-sectional survey was conducted on medical students from two medical schools in Jordan during the 2018/2019 academic year. The study utilized the SLEEP-50 questionnaire to estimate the proportion of several sleep disorders and their effects on daily functioning. Below average GPAs were considered poor academic performance.
Results: 1041 medical students' online surveys were analyzed from two medical schools' campuses, representing a 29.7% response rate. Their mean age was 22 ± 2.1 years (ranging from 18 to 37) and 52.6% were female. The mean body mass index was 24.2 ± 4.4 kg/m 2. According to the SLEEP-50 questionnaire, the prevalence of sleep disorders among studied medical students ranged from 0.6% for sleep state misperception (SSM) to 23.1% for hypersomnia. Using binary logistic regression, after adjusting for gender and obesity, poor academic performance was associated with a risk for insomnia [adjusted odds ratio (OR) = 1.96, p < 0.001]; affective disorder [OR = 2.24, P < 0.001]; SSM [OR = 6.40, p = 0.045]; narcolepsy [OR = 9.54, p = 0.045]; and circadian rhythm disorders [OR = 2.03, p < 0.001].
Conclusion: Sleep disorders are common among medical students. Several sleep disorders were associated with poor academic performance. Proper diagnosis and treatment of sleep disorders may remedy this issue.
... 14,15 Medical students are increasingly vulnerable to poor sleep due to large academic loads, overnight on-call duties, and emotionally challenging work environments. 16,17 Considerable evidence supports the importance of good sleep quality for optimal neurocognitive and psychomotor performance. Sleep improves cognitive competences such as consolidation and encoding of memories, crucial for retaining a significant amount of complex factual knowledge. ...
Introduction
Sleep parameters have been shown to correlate with academic performance. Current studies assessing sleep in doctor of pharmacy (PharmD) students rely on self-reported sleep parameters and academic performance. The objectives of this study were to describe and compare sleep parameters in pharmacy students using actigraphy and sleep diaries and to assess the correlation of sleep parameters with academic performance.
Methods
This prospective cohort study with convenience sampling assessed sleep parameters in pharmacy students. Thirty-five students completing the second year of a PharmD program participated in the study. Participants wore actigraph watches and maintained sleep diaries for seven consecutive days during the spring and fall semesters, while classes were in session, except for one week prior to exams and the week of exams. Academic performance was tracked during fall and spring semesters.
Results
Actigraphy and sleep diaries showed significant differences in sleep latency (SL), actual sleep time (AST), wake bouts, and sleep efficiency (SE). Actigraphy results indicated that the participants fell asleep faster (SL), slept a shorter duration (AST), had more wake bouts, and lower SE than results reported in the sleep diaries. SE and SL from the sleep diaries positively correlated with the fall semester pharmaceutical sciences course and overall spring semester academic performance. Actigraphy recorded AST correlated with performance in both semesters' clinical sciences courses.
Conclusions
The results of actigraphy differed from the sleep diaries. More studies are needed to assess differences in detection of sleep parameters using sleep diaries and actigraphs.
... Their own health and their attitudes toward healthy lifestyles can influence their future practice. [11] Learning and memory processing are greatly influenced by adequate sleep. In students, sleep-impaired sleep quality will harm academic performance [9] and cause emotional exhaustion and burnout. ...
Background: Academic pressure and its associated stress are responsible for disturbances in the circadian cycle of the students, Medical students have a stressful academic career, so it is important to identify those students with sleep issues, extent of issues and factors contributing to it. The aim of the current study is to determine the frequency of poor sleep quality among fourth and fifth year medical students at Faculty of Medicine, Benghazi university; using the PSQI. Materials and Methods: An observational, cross-sectional study conducted anonymously and voluntarily with undergraduate fourth and fifth year medical students at faculty of medicine, Benghazi university.150 students were assessed using the Pittsburgh Sleep Quality Index (PSQI). Results: 150 medical students were participated in the study, 95(63.3%) were females and 55 (36.7%) were males. The sample's mean age was 26.1 ± 1.1 years (range = 23–30 years). More than half the sample (52.7%) were sleeping alone, 44.7% were sharing a room with a roommate, and 2.7% were married . The calculated means of total PSQI, nocturnal sleep duration, and sleep latency were 7.04 ± 3.47 hours, 6.23 ± 1.51 hours, 38.7 ± 39.1 minutes, respectively. The average wake-up time and The average bedtime were 7.45 ± 1.5, and 4.49 ± 7.06respectively. 115 (76.67%) students were poor sleeper and the prevalence of poor sleep quality was slightly higher among females than males (76.8%) and (74.4%) respectively with P = 0.004. Younger students were about two and half times more prone to have poor sleep quality compared to older participants (OR=2.4; 95% CI: 1.62-3.55). Conclusion: Poor sleep quality is common among our medical students. It established that most medical students have a poor sleep quality, which could be related to their sleep habits. This study highlights a strong need for integrating sleep hygiene education for young students, to improve their sleeping practices and consequent physical and mental health.
... Compared to general population scores, medical students sleep less and have more sleep-related problems. This is probably due to several reasons: the long duration of the academic achievement, demanding clinical study, a lot of practical duties that include overnight on-call activities, a hard work that can be emotionally challenging (increasing the level of burnout), a high level of consummation of energy drinks, coffee or dietary supplements, and, not to be neglected, their lifestyle choices (38). Also, sleep is closely related to good physical and psychological health and academic performance (39)(40)(41). ...
DEPRESSION, ANXIETY AND STRESS AMONG MEDICAL STUDENTS
(Abstract): The aim of the study is to gather some data regarding the levels of dep ression, anxiety and stress among medical students. Material and methods: a number of 190 students provided answers to an online questionnaire. A socio-demographic data sheet and a psychological tool were administrated (Depression, Anxiety and Stress Scale-DASS 21). Data were analyzed using SPSS program, version 21. Results: The mean age for the sample is 21.38 (±2.18), with a majority of female participants (79.5%). Independent samples t Tests showed statistically significant differences between male and female students concerning depression (t(88) = 4.40, p < .001), anxiety (t(88) = 4.25, p < .001) and stress (t(88) = 4.70, p < .001). More specifically, women scored higher than men on all subscales of the DASS-21: depression (Mwomen = 18.58, Mmen = 10.92), anxiety (Mwomen = 14.95, Mmen = 7.94) and stress (Mwomen = 15.37, Mmen = 7.48. The results showed significant negative correlations between the three scales of the DASS-21 and the hours students sleep per night: depression (r =-.253, p < .001), anxiety (r =-.210, p = .004), and stress (r =-.249, p = .001). Statistically significant differences in stress according to participants' body mass index were also identified. Students who rate themselves as consuming alcohol and carbonated drinks more frequently also score higher on depression. Conclusions: Stress, anxiety and depression are a real problem for medical students during their academic training.
... The sample size was calculated to be 475 students which increased to 505 students to compensate for non response. It was taken from different grades (1)(2)(3)(4)(5)(6) according to the proportion students in each grade (stratification with allocation). ...
... 4 Medical students are more prone to have poor quality of sleep, sleep deprivation, and irregular sleep/wake patterns because of stress, greater academic commitments, long duration and high intensity of study till immediately before going to bed, overnight on-call duties, emotionally challenging work, lifestyle choices, and early class starting time. 5,6,7,8 Several studies, reported that the prevalence of sleep complaints among medical students exceeded that of the general population. 9 Studies conducted in Spain, 10 Lithuania, 11 Iran, 12 Pakistan, 13 Brazil, 14 China 15 and Malaysia found poor sleep quality in .3% of medical students. ...
BACKGROUND
Medical students are more prone to have poor sleep quality because of stress, and greater academic commitments. Studies
from different countries have reported that medical students have daytime sleepiness, poor sleep quality, and higher prevalence
of sleep complaints than the general population. But these studies differed on the effect of gender on sleep. There is a correlation
between sleep quality and academic performance of college students. Daytime sleepiness affects performance.
METHODS
We conducted a cross sectional analytical study on the sleep quality assessed by Pittsburgh Sleep Quality Index (PSQI), the
sleep quality reported by students and the daytime sleepiness assessed by Epworth Sleepiness Scale (ESS) among 272 first and
second year MBBS students of Govt. Medical College, Kottayam. Statistical analysis was done using SPSS Version 22.0. χ2-test
was used to evaluate the association between the variables, independent samples t-test for continuous variables, Pearson’s test
for correlation, Mann-Whitney U test to compare the sleep quality and daytime sleepiness of first-years with those of secondyears and multinomial logistic regression analysis for confounding factors
RESULTS
Most of the first and second year MBBS students have good quality of sleep as per self-reporting and as assessed by PSQI and
have higher normal daytime sleepiness. The poorer the sleep quality assessed by PSQI, the greater is the daytime sleepiness.
Gender does not affect the quality of sleep and daytime sleepiness. Second year students have better sleep quality than first
year students.
CONCLUSIONS
Most of the first and second year MBBS students in our institution have good sleep quality and higher normal daytime sleepiness.
Poorer the sleep quality, greater is the daytime sleepiness. Gender has no effect on sleep quality or daytime sleepiness.
... = ≥ ≥ Among college students, medical students are under particularly high levels of stress, hence the crucial need for adequate refreshing sleep (to maintain cognitive and physical well-being) to achieve their goals [22]. A previous study showed a high prevalence of symptoms and an elevated risk of several sleep disorders among medical students [12]. ...
Rationale: Medical school is a critical period of making a successful and productive physician. Maintaining adequate and refreshing sleep is important for the cognitive and physical wellbeing of medical students in order to achieve their goals. The presence of sleep disorder(s) may negatively impact academic performance. The aim of
this study is to describe the risk of having sleep disorders among medical students and it’s relation with academic performance.
Methods: The study was conducted at the Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. We utilized a web-based SLEEP-50 questionnaire by Spoormaker et al to estimate the
risk of various sleep disorders; obstructive sleep apnea (OSA),
insomnia, periodic limb movement disorder/restless leg syndrome (PLMD/RLS) and circadian rhythm disorders (CRD). The cumulative grade point average (GPA) was used to define academic performance and those with GPA < 3.0 were considered to have low academic
performance.
Results: The survey was completed by 846 medical students; their mean age was 22.4 ± 2.1 (range, 18-37 years) and 51.5% were females. One-third of students were in pre-clinical years and two-thirds were in clinical years. Their mean GPA was 3.24 ± 0.51 and 256 (30.3%) had low academic performance. According to SLEEP-50 questionnaire, 340 (40.2%) had risk of at least one sleep disorder; OSA (12.4%), insomnia (18.7%), PLMD/RLS (14.2%) and CRD (13.9%). Mean GPA was lower in students at risk for OSA (p=0.031), insomnia (p=0.001) and CRD (p<0.001). The risk of having low academic performance was higher in students who had a risk of OSA [odds ratio (OR) =1.57, 95% confidence interval (CI) (1.03-2.39), p=0.037], insomnia [OR=1.59, 95% CI (1.11-2.28), p=0.012], and CRD [OR=1.71, 95% CI (1.50-2.56), p=0.008]. RLS/PLMD was not associated with low academic performance, p=0.152.
Conclusions: Medical students with sleep disorders, mainly OSA, insomnia and CRD are at increased risk of having low academic performance. There should be more awareness of this association as early recognition and treatment may have a favorable influence on academic performance.
OBJECTIVE
This study investigated the psychological effect of the coronavirus disease 2019 (COVID-19) outbreak on medical students in China.
METHODS
In February 2020, an online survey was performed using a WeChat app with an online survey program to collect and analyze the effects of the COVID-19 outbreak on the mental health of medical students across China.
RESULTS
Overall, 757 medical students responded to the survey. About 2.24% reported middle and high levels of anxiety since the COVID-19 outbreak began, and 14.40% reported middle and high levels of depression. Bachelor's students and those whose residence registration was located in a rural area were more likely to have anxiety and depression, compared with postgraduates and students whose residence registration location was an urban area, respectively.
CONCLUSIONS
The COVID-19 epidemic is associated with a low but real rate of psychological trauma in the medical students of China, and protective programs are needed to lessen this adverse effect.
Introduction: Much attention has been paid to the problem of sleep disorders in young people recently. Medical university students are at higher risk for sleep disturbances potentially leading to decreased attention, poor personal well-being and academic performance, since their schoolwork pressure is higher than that of students of other universities. Objective: To study the prevalence of sleep disorders among medical university students. Materials and methods: In fall 2022, we conducted an anonymous questionnaire-based survey of 680 students of the Smolensk State Medical University using the Pittsburgh Sleep Quality Index (PSQI) to assess the quality of sleep and sleep disorders in the randomly selected representative sample. Statistical data analysis was carried out in Microsoft Excel. Results: Poor sleep quality was established in 75.9 % of the medical students surveyed. The mean sleep duration was estimated to be 6 hours and 12 minutes. Maximum disorders were found in the subjective assessment of sleep quality in 3.5 % of the respondents; in sleep delay – in 3.1 %; in sleep duration – in 7.2 %; in sleep efficiency – in 1.5 %; in the use of sleeping medication – in 5.3 %; and in daytime dysfunction – in 17.4 % of the examined. We observed poor sleep quality in all the subjects but noted that sleep disorders were more common in the second and third-year students. Conclusions: Sleep disorders in student youth include problems with the quality, schedule and duration of sleep and daytime dysfunction. They are more frequent in junior students. Female students are at higher risk. Awareness of sleep disturbances students are experiencing and appropriate preventive measures can help maintain not only high academic performance, but also physical and mental health.
Introduction: Sleep deprivation is a growing problem, especially among medical students who must meet high academic standards, as well as, their parent’s expectations. Since poor sleep quality and daytime sleepiness have important consequences in the mental health of medical undergraduate students, the management of these problems would begin with and be guided by assessment of these sleep-related and mental health parameters.
Aim: To evaluate the sleep quality and effects of sleep deprivation on the psychological well-being and mental health of undergraduate medical students.
Materials and Methods: This was a cross-sectional descriptive study conducted by Department of Psychiatry, G.S. Medical College and Hospital, Pilkhuwa, Hapur, Uttar Pradesh, India, on undergraduate students, for a period of a month in May 2022. Four hundred medical undergraduate students from 1st, 2nd, 3rd part 1 and 3rd part 2 Bachelor in Medicine and Bachelor in Surgery (MBBS) years, who fulfilled the inclusion and exclusion criteria, were enrolled in the present study after their informed consent was taken. Epworth Sleepiness Scale (EPSS), Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scale 21 (DASS-21), and Psychological General Well-Being Index (PGWBI) were used to assess the participants. Sleep quality and sleepiness were correlated with anxiety depression, stress, and subjective general well-being using Spearman’s coefficient with significance at 0.05 and 0.001 levels.
Results: The study participants were in the age group of 17-24 years and majority of the students (n=130, 32.5%) were 20-year-old. Females accounted for near half of the study participants (n=190, 47.5%). Most of the students in the participant group had poor sleep quality with a mean of 6.75±1.811 and issues of daytime sleepiness (10.68±3.481). The DASS-21 revealed severe anxiety (15.5±2.473) and moderate stress (22.89±3.396) levels. Significant positive correlation was seen between the anxiety (r=0.110; p-value
Objectives: This pilot study developed an adventure-based cognitive behavioral intervention (aCBI) program and tests its effectiveness in improving the mental health of Chinese university students in Hong Kong. Method: A total of 217 undergraduate students participated in an aCBI program in the form of an interdisciplinary general education course in a university in Hong Kong. A battery of standardized online questionnaires was administered to the students before joining and upon completion of the course, and at a 3-month follow-up test. Results: The participants showed a significant reduction of psychological distress, perceived stress, depressive symptoms, and negative thoughts and emotions and a significant increase of positive thoughts upon immediate completion of the program. The positive effects maintained at the 3-month follow-up test. Conclusion: The integration of cognitive behavioral intervention and adventure training in a class setting might be an effective and feasible approach for the mental health counseling of university students.
Background: Anxiety can cause insomnia or sleep disturbances. Sleep disorders are characterized by abnormal sleep patterns that interfere with daily activities. This study aims to describe the relationship between the incidence rate and the severity of insomnia in medical students in the preclinical phase of the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada. Methods: This research is an observational study with a cross-sectional design. This research was conducted online and carried out from October 2020 to June 2021. Data collection was carried out for 2 weeks using Jotform as a data retrieval medium. The questionnaire used is generalized anxiety disorder-7 (GAD-7) to measure the level of anxiety and insomnia severity index to evaluate the severity of insomnia. Spearman's Rank analysis test was conducted to determine the correlation between anxiety levels and the severity of insomnia. Results: A total of 130 respondents participated in this study. The majority of respondents are women (71.53%) and are more than 20 years old. Based on Spearman's rank analysis, there was a relationship between anxiety level and insomnia severity (ρ = 0.394), and it was statistically significant with a p-value = 0.000 (p<0.05). Conclusion: There is a relationship between the level of anxiety and the severity of insomnia in medical students in the preclinical phase of FK-KMK Universitas Gadjah Mada.
Sleep disturbance is a common health problem that can influence the quality of life. There are several types of sleep disorders, such as obstructive sleep apnea, insomnia, narcolepsy, periodic limb movement disorder, and circadian dysregulation. Medical students are probably more prone to sleep disturbances due to their extreme academic stress. In this research, the incidence of sleep disturbance among medical students was examined, and the concomitant risk factors were determined. That was one-time research. A questioning was used to collect social, demographic and sleeping data. 678 1st, 2nd and 3rd year medical students were surveyed. 29% complained of at least one sleep disturbance. The most widely spread sleep disturbance observed among 51.8% medical students included insomnia (initial insomnia and sleep maintenance). 4th year students and those who spend much time on smartphones were more prone to sleep disturbances. Sleep disturbances are common among medical students. They need to be discovered and paid attention to before the situation gets worse.
Objective:
To analyze the dynamics and sleep quality in medical students during 2005-2009 years and evaluate possible factors influencing this process.
Material and methods:
The study included 2788 medical 1st, 4th and 6th year students (1919 girls, 869 young men). All participants underwent comprehensive psychophysiological testing. Self-reported questionnaire containing 45 questions about sleep quality, sleep hygiene, chronotype, behaviour was administered. Five hundred and seventeen girls and 260 young men were studied twice.
Results and conclusion:
During 14 years, a negative sleep quality trend was observed in university students of all groups. The poor sleep group in 2019 consisted of 12.0-13.4% of girls and 8.2-18.4% of young men. About half of students have rated their own sleep as good (48.9-58.3% of girls and 52.2-55.4% of young men). From the first up to last semester of the study sleep quality is getting worse. The prospective analysis revealed the greater negative prognostic impact of self-reported poor sleep on academic performance in girls compared with young men. In the 4th year of the study, there were many poor-sleepers of both genders required more years of study for successful academic achievement. Students reported poor sleep were more activated and performed psychometrical tasks faster. Sleep quality, especially in girls, was significantly correlated with 19 psychosocial factors. The reliable marker of poor sleep may be feeling of lack of time both in girls (r= -0.32, p<0.01; r= -0.29, p<0.01; r= -0.22, p<0.05, respectively) and young men (r= -0.21, p<0.05; r= -0.34, p<0.01; r= -0.27, p<0.05, respectively) in their 1st, 4th and 6th study year, and the consequence was the slower transition to active functioning in the morning and lower health self-evaluation.
Objective:
To evaluate the association between sleep-wake rhythm and cardiometabolic parameters.
Material and methods:
103 participants, aged 25-64 years, underwent actigraphy study with Actigraph Actilife GT3X + device (USA) for 7 days. We assessed actigraphy indicators (physical activity and sleep data), anthropometric indicators, blood pressure and laboratory parameters. Actigraphy data was processed using the nparACT package in the R program with the calculation of nonparametric indicators: intraday variability, interday stability, the average level of lowest activity for five hours (L5) and ten hours with the highest activity (M10), relative amplitude is the ratio of M10/L5.
Results:
The nonparametric analysis showed an association of the higher night activity with sleep effectiveness, wake after sleep onset, indicators of physical activity. A more stable sleep pattern is associated with more steps, less weight and waist circumference, lower levels of diastolic blood pressure, creatinine and insulin. Increased fragmentation of sleep patterns is associated with increased CRP and increased sedentary time. Participants with higher activity contrast have less waist circumference, hips and body mass index, lower levels of CRP and insulin.
Conclusions:
Rhythm and quality of sleep are important parameters associated with cardiometabolic indicators. Stable sleep patterns, higher activity during the day and lower night activity are associated with a more favorable condition of cardiovascular system.
Background: Learning process in medical school is a big stressor for the students. Many researchers have reported higher distress and related psychological health problems in medical students than in general population and non-medical students. This study explored how distress affects Indonesian medical students in FMAU, and its association with academic performance and demographic factors.Method: Cross sectional study was conducted on 185 subjects in the third year medical student of FMAU between April-May 2013. Level of stress was measured using Indonesian version of General Health Questionnaire-12 (GHQ-12), with Liker scale indicator (distress is when the score is >15). Demographic variables such as gender, source of finance, and economic status were assessed in the study. Academic performance was measured by cumulative Grade Point Average (GPA) and last semester GPA. Analyses were done using SPSS.Results: This study identified 35.7% of students were in distress, with average GHQ-12 score 13.42+SD4.97. No association was found between admission pathway, academic performance and distress. However, the study revealed that female students had higher risk of distress (p<0.05).Conclusion: Risk of distress is relatively high in medical students. However, there is no association between demographic factors, academic performance and distress. Further research needs to be conducted to explore risk factors that cause distress of medical students in Indonesian context.
Objective:
This study aims to determine the prevalence and the association of stress with sleep quality among medical students at King Abdulaziz University (KAU), Jeddah, Saudi Arabia.
Methods:
A cross-sectional study was done among 326 medical students of KAU using a stratified random sampling technique. An electronic self-administered questionnaire was used. Kessler Psychological Distress Scale (K10) and Pittsburgh Sleep Quality Index (PSQI) were used to assess the stress and sleep quality, respectively.
Results:
The overall students who experienced stress were 65%. The prevalence of poor sleep quality (total PSQI score ≥5) was 76.4%. There was a strong association between stress and poor sleep quality (value of Cramer's V = 0.371, P < 0.001), and it showed that the increase in stress level is a significant predictor of poor sleep quality.
Conclusion:
A high prevalence of stress and poor sleep quality was found among the students and the study confirms a strong association between them. We recommend establishing courses focusing on educating the students about proper sleep hygiene and how to deal with the stressful environment.
The study aims to find the influence of the job stress on the doctor’s performance in the public hospitals of Peshawar city. No doubt the profession of doctors is very respectable and they are doing a good work serving the people of society but their work environment must have some sort of influence on their performance as well. That’s why this study was taken in to consideration to study the doctors’ performance in the public hospitals. This study was designed to assess the doctor’s performance in public hospitals only. Sample size was drawn on the basis of simple random sampling technique as the data was of quantitative in nature. Data was collected through a questionnaire which was developed by the research himself and to find the reliability and validity a pilot test was done with the data collection tool which showed some mistakes and those mistakes were rectified. Due to limited time period and resources of the researcher, the researcher has drawn 150 sample size of the total population of the doctors in the public hospitals of Peshawar city. A total of 150samples (50 from each public hospitals respectively of Peshawar) data were collected .Out of 150 study participants; it was observed that doctors in KTH, LRH and HMC were suffering from job stress collectively. Their performance was affected and the result of this study highlight the significant result in which it was concluded that job stress had a negative impact on the doctor’s performance in the public hospitals of Peshawar.
This longitudinal study investigated the relative importance of correlates of psychological distress in first year medical students (N = 312) in September and May. Anxiety levels were one SD above the mean when compared with nonpatient levels in both September and May, and the percentage of students reporting depression doubled over the study period. Problem-focused coping decreased, emotion-focused coping increased, and satisfaction with social supports decreased over the year. In contrast, type A behavior and anger expression were more stable. Students distressed in September were at higher risk for distress in May. Students distressed in May were also characterized by higher scores for suppressed anger and type A behavior in May, even after controlling for distress in September.
Studies of coping in applied settings often confront the need to minimize time demands on participants. The problem of participant response burden is exacerbated further by the fact that these studies typically are designed to test multiple hypotheses with the same sample, a strategy that entails the use of many time-consuming measures. Such research would benefit from a brief measure of coping assessing several responses known to be relevant to effective and ineffective coping. This article presents such a brief form of a previously published measure called the COPE inventory (Carver, Scheier, & Weintraub, 1989), which has proven to be useful in health-related research. The Brief COPE omits two scales of the full COPE, reduces others to two items per scale, and adds one scale. Psychometric properties of the Brief COPE are reported, derived from a sample of adults participating in a study of the process of recovery after Hurricane Andrew.
We describe the vicissitudes of depressed mood for one medical school class that was assessed repeatedly overtime, from the first day of medical school until several months short of graduation, using the Beck Depression Inventory (BDI). Using an arbitrarily defined BDI cutoff point of 14 or greater, at least 12% of the class showed considerable depressive symptoms at any assessment during the first three years; the largest fraction (25%) was symptomatic near the end of the second year. The median class BDI score increased almost threefold during the first two years. Students were likely to be in a similar class ranking at all assessments, indicating that for many students dysphoric mood was enduring. Those with BDI scores of 21 or greater were more likely to quit medical school. Students with high scores for dysphoria were not more likely to evidence a family history of major depression or concomitant substance abuse. Women medical students were not more vulnerable to depressed mood than men.
This paper presents evidence from three samples, two of college students and one of participants in a community smoking-cessation program, for the reliability and validity of a 14-item instrument, the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The PSS showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomatology, utilization of health services, social anxiety, and smoking-reduction maintenance. In all comparisons, the PSS was a better predictor of the outcome in question than were life-event scores. When compared to a depressive symptomatology scale, the PSS was found to measure a different and independently predictive construct. Additional data indicate adequate reliability and validity of a four-item version of the PSS for telephone interviews. The PSS is suggested for examining the role of nonspecific appraised stress in the etiology of disease and behavioral disorders and as an outcome measure of experienced levels of stress.
Medical schools' emphasis on technical excellence is sometimes at the expense of social and emotional development. This paper describes a programme, orchestrated by a vital Well-Being Committee, that involves students in a wide range of activities to enhance social and emotional well-being. The primary prevention of emotional impairment is the goal.
This review addresses medical career development in the United Kingdom. This differs from other countries, and the structure of both undergraduate and postgraduate medical education is described in some detail. Problems identified from research surveys are given, and some of the proposals made to solve them are discussed. It is concluded that three main issues need to be addressed: greater attention needs to be paid to educational processes; teachers and their teaching must be valued; and appropriate support systems should be provided for medical students and trainees.
Using a standardized measure of depression at three assessment points, to examine depression in medical students during their training.
Students entering the University of Massachusetts Medical School in the fall in 1987, 1988, and 1989 were mailed a recruitment letter and baseline questionnaire four weeks prior to the start of classes. Subsequent assessments took place in the middles of year 2 and year 4 and included only the students who had participated in the baseline assessment. The baseline assessment included the Center for Epidemiological Studies Depression (CES-D) scale, the Bortner Type A Behavior scale, the Spielberger Trait Anger scale, and the Spielberger Anger Expression scale. In addition, the baseline package included a rating of perceived stress, a demographics questionnaire, and a social-life survey. The follow-up assessments included the CES-D scale, the rating of perceived stress level, and the social-life survey. Analytic methods used were univariate descriptive statistics, correlation, and multiple-linear-regression analyses, two-sample t-tests, analysis of variance, and chi-square tests.
Of the initial pool of 300 students, 264 responded at the baseline assessment (88% response rate; 53% men); 171 of these participated in the year-2 assessment (65% response rate; 51% men), and 126 participated in the year-4 assessment (48% response rate; 48% men); a total of 99 students participated in all three assessments. CES-D scores > or =80th percentile were obtained for 18% of the entering students. This rose to 39% at year 2 and 31% at year 4 (p = .0001). No gender difference was found at baseline; however, the women experienced higher depression levels than did the men at year 2 (p = .004) and at year 4 (p = .04). Overall, gender and increases in perceived stress (from baseline to year 2) were significant predictors of increased CES-D scores (from baseline to year 2; p = .01 and p = .0001, respectively). For the women, increased perceived stress, angerin, and frequency of social contacts outside work/school were significant predictors of the magnitude of increases in CES-D scores (baseline to year 2; p = .0001, p = .02, and p = .03, respectively).
These preliminary data support the view that, upon entering medical school, students' emotional status resembles that of the general population. However, the rise in depression scores and their persistence over time suggest that emotional distress during medical school is chronic and persistent rather than episodic. Also, the women had more significant increases in depression scores than did the men.
Concerns about the quality of medical care provided by health services appear to be increasing. Deficits in care are frequently found to be associated with stress and with the apparent lack of recognition of psychological problems when they occur in doctors. This paper looks briefly at the levels and sources of stress, depression and alcoholism in doctors, and the relationship of these to the care they provide. It goes on to use the research findings on causation to propose a system of organisational and individual primary and secondary interventions to address these psychological problems. The paper focusses upon a longitudinal study which follows up 314 medical students over 11 years, but also uses other relevant recent literature to discuss the issues that arise.
Despite an increased risk of suicide among physicians we lack studies on prevalence and predictors of suicidal ideation among medical students and young doctors.
A prospective study of Norwegian medical students (n=522) re-examined after the first postgraduate year, comprising suicidal thoughts and attempts, perceived study stress, job stress, and personality.
The previous year prevalence of suicidal thoughts was 14% at both points of time. The lifetime prevalence was 43%, while 8% had planned suicide, and 1.4% had attempted suicide. Suicidal ideation in medical school was predicted by lack of control, personality trait, single marital status, negative life events and mental distress (anxiety and depression). In the first postgraduate year, mental distress was the most important predictor, but before controlling for this variable, job stress, vulnerability (neuroticism), single status, and less working hours were independent predictors. Prospectively, suicidal thoughts and vulnerability as student predicted postgraduate suicidal ideation.
The level of suicidal thoughts was high, but the level of attempts was low. Clinical implications: Preventive efforts should be directed both at the students' abilities to cope with stress and at mental health services for young doctors. LIMITATIONS OF STUDY: The lower response rate at follow-up (57%) may reduce external validity.
Because medical education is known to be demanding and stressful, Case Western Reserve University developed a programme which included a wellness elective which focused on stress reduction and personal wellness.
The purpose of this study was to explore students' perceptions of medical school stress and to assess their perspective on the wellness elective.
The essays of 60 medical students enrolled in the wellness elective were used.
The essays were analysed using qualitative methodology. Results were validated by questionnaires mailed to the students 2 years later.
It was found that the students felt that: (1) wellness issues should be important for physicians; (2) their own wellbeing had been diminished by the burden of information to be learned in medical school; (3) talking to peers was a useful coping mechanism, and (4) the elective gave permission to engage in wellness activities without additional guilt.
Based on the students' responses, a wellness elective could be a useful addition to the first- or second-year medical curriculum.
Medical students experience significant stress and stress-related problems. The benefits of support during training are described in this paper. Recently, student support systems have become increasingly stretched as medical schools merge, courses become modular and staff face increasing clinical and research pressures. The pastoral support system at St Bartholomew's and the Royal London School of Medicine has been changed in response to an evaluation of the old system of personal tutors. Pastoral care is now provided by a group of willing staff members known to have an interest in student welfare. The group is known as the 'Pastoral Pool' (PP).
Students and staff PP members completed similar questionnaires addressing their expectations of the PP and identifying the need for support systems in general. Pastoral Pool activity was investigated using confidential record sheets stating the frequency, duration and content of each PP encounter.
Students were aware of the PP and many would consider using it. Staff and students agreed over the functions of the PP. Students frequently expressed concerns over confidentiality within the system. Uptake was low, with only 3% of students approaching the PP and the majority of PP work performed by only two staff members. The content of meetings was often multifactorial and usually on a subject within the PP remit.
The PP is beneficial because pastoral care is provided only by dedicated staff members with an interest in student welfare. Membership is small enough to enable staff training and development. However, the system relies on self-referral by students. Rather than preventing problems arising, it therefore provides secondary support to those students insightful enough to identify their problems and motivated enough to seek help.