Abstract Title
Stress, coping and psychological adaptation in the Romanian and international first year medical students

Authors

Popescu Codruta Alina* Bob Mihai*
Buzoianu Anca Dana* Junjan Veronica**

Theme

3II International

INSTITUTION

University of Medicine and Pharmacy 'Iuliu Hatieganu' - Social Sciences
**University of Twente, Institute of Innovation and Governance Studies, Netherlands

Background

The number of international students in Romanian Medical Universities is growing in recent years, together with the increase of travel to study within the EU. International students are a special group for every university, because they face a lot of stressful situations in the host country due, for instance, to different academic demands, cultural context, language differences. There are differences between long term study (such as deciding to migrate to pursue a complete degree), or short term study (such as an exchange programme of one semester). A particularly interesting case is represented by the recent increase in international student who decide to study Medicine abroad.  Longer duration of studies, impact of following this specific degree in a foreign language, cultural differences, are expected to weigh in more in this field of study than in a different one.

Summary of Work

Objective: The purpose of this study was to assess associations between psychological adaptation and stress coping strategies in international and domestic students studying General Medicine at the University of Medicine and Pharmacy ''Iuliu Hatieganu'' Cluj-Napoca, Romania

Method: The study recruited 421 first year students: 267 Romanian and 154 international students (English section). The participation in the study was 90 % of the students. Stress-coping strategies were measured by Coping Orientation of Problem Experience questionnaire. STAI Anxiety Scale was used to measure anxiety. NEO-FFI was used to measure personality. Academic stress was measures by Medical Student Stressor Questionnaire MSSQ. Written consent was obtained from the participants. Completion of the questionnaires was voluntary. Permission was obtained from the medical schools and Ethical Committee of University of Medicine and Pharmacy ''Iuliu HaČ›ieganu'' prior to the start of the study. The questionnaires were distributed to students 2 months after the beginning of the first semester.

Summary of Results

Table 1: Demographics characteristics of the sample

 

Romanian students

International students (english section)

 

men

women

men

women

sex (N, %)

86, 32.2%

181, 67.8%

79, 51.3%

75, 48.7%

age (Mean ± SD)

19.77±2.32

 

19.08±.92

 

21.02±3.21

 

20.34±2.85

 

Parents (N, %)

doctors (yes) (

41 (15.3%)

44 (28.6%)

mother, higher education

206 (76.9%)

105 (68.2%)

father, higher education

190 (70.9%)

112 (72.7%)

marital status (N, %)

single

171 (64%)

110 (71.4%)

in a relationship

96 (36%)

42 (27.3%)

married

 

2 (1.3%)

A total of 267 Romanian student responded. 181 (67.8%) were female students. Average age was 19 year in female students and 19.8 years in male students. 76.9% students' mothers' education and 70.9% students' fathers' education were higher education. 15.3% of the students had one of both parents physicians. Students' relationship status were 171 (64%) single and 96 (36%) in a relationship.

A total of 154 International students (English section) responded. 75 (48.7%) were female students. Average age was 20.34 year in female students and 21.2 years in male students. 68.2% students' mothers' education and 72.7% students' fathers' education were higher education. 28.6% of the students had one of both parents physicians. Students' relationship status were 110 (71.4%) single, 42 (27.3%) in a relationship and 2 (1.3%) married. The international students came from 19 countries. The students come from EU country (41.6% from Germany), but also from places such as US and Canada. Also there are a lot of students from Arab countries and Israel.

Table 2: The main stressors ranked by mean degree of stress as perceived by the medical students (identified by the MSSQ)

Stressor

Mean Value

Tests/examinations

2.9142

Falling behind in reading schedule

2.6978

Large amount of content to be learnt

2.7948

Lack of time to review what have been learnt

2.7313

Heavy workload

2.3955

Participation in class presentation

2.2761

Need to do well (imposed by others)

2.0485

Feeling of incompetence

2.2985

Unable to answer questions from patients

2.3209

Talking to patients about personal problems

1.6754

Facing illness or death of the patients

2.2388

Verbal or physical abuse by other student(s)

1.4328

Verbal or physical abuse by teacher(s)

1.8246

Verbal or physical abuse by personnel(s)

1.3806

Conflict with teacher(s)

1.8769

Unwillingness to study medicine

1.3955

Parental wish for you to study medicine

1.0112

Not enough feedback from teacher (s)

1.4739

Uncertainty of what is expected of me

1.6754

Lack of recognition for work done

1.791

 

The stressors ranked based on the degree of stress they caused as perceived by the students is shown in Table 2. All the stressors were related to academic matters. The top stressors are exams, falling behind in learning schedule, large amount of content to be learnt, heavy workload and lack of time to review what have been learnt.

 

Table 3 Correlations between academic stress and personality variables

 

STAI-Y2 trait anxiety

Spearman's rho

.466**

p

.000

N

267

Neuroticism

Spearman’s rho

.449**

p

.000

N

267

Extraversion

Spearman’s rho

-.158**

p

.010

N

267

Openness

Spearman’s rho

-.019

p

.758

N

267

Agreeableness

Spearman’s rho

-.029

p

.637

N

267

Conscientiousness

Spearman’s rho

-.127*

p

.037

N

267

We performed correlations between academic stress and personality variables. STAI trait anxiety and neuroticism were significantly and positively correlated with academic stress. Conscientiousness and Extraversion were significantly and negatively correlated with academic stress.

Conclusion

Several studies have examined the relationship between personality type and stress. Personality traits may influence a person’s  perception of or reaction to stressful situations (Vollrath, 2001).

Medical students carry certain personality traits such as perfectionism or performance-based self-esteem, that make them vulnerable to mental distres (Enns, 2001 & Dahlin, 2007). The students from our sample have showed high scores on neuroticism and conscientiousness. Neuroticism is strongly associated with a propensity to experience negative emotions (Matthews, Deary, &Whiteman, 2009). In our study STAI trait anxiety and neuroticism were significantly and positively correlated with academic stress.

The differences between male and female students are similar with other researches, Coulston (2012) had found higher scores on neuroticism in females than in males, which is in accordance with a higher depression rate for women in the general population (Dahlin, 2005).

Regarding academic stress, the top stressors were related with academic matters: test and examinations, large amount of contents to be learnt, lack of time to review what has been learnt, falling behind in reading schedule and heavy workload. The findings are similar with others studies, although the instruments used to measured academic stressors were different (Firth 1986, Gutrie 1998, Saipanish 2003, Yosoff 2010).

References
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  4. Matthews, G., Deary, I. J., & Whiteman, M. C. 2009 Personality traits. Cambridge: Cambridge University Press.
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  8. Guthrie E., Black D., Bagalkote H., Shaw C., Campbell M., Creed F. 1998 Psychological stress and burnout in medical students: a five-year prospective longitudinal study J R Soc Med 91(5):237-43.
  9. Saipanish, R., 2003 Stress among medical students in a Thai medical school. Med Teach 25(5):502-6.
  10. Yusoff, M.S.B., Rahim, A.F.A., Yaacob, M.J. 2010 The development and validity of the Medical Student Stressor Questionnaire (MSSQ), ASEAN J Psychiatr, 11(1). Available online at http://www.aseanjournalofpsychiatry.org/oe11105.htm.
Background
Summary of Work
Summary of Results
Conclusion
References
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