Educational Environment, Depression, Stress, Substance Use, and Social Support Among Surgical Residents in Kenya

AimsLittle is known about mental health risk factors in medical residents and doctors in Sub-Saharan Africa. Residents are at a greater risk of developing depression, stress and substance abuse than the general public owing to the stressful nature of their medical training. Poor mental health in residents leads to decreased clinical efficiency and training satisfaction; it can also lead to substance dependence, self-harm and suicide.Our primary aim was to ascertain depression prevalence among medical residents in Kenya's largest national teaching and referral hospital. Secondary aims were to analyze how depression was associated with perceived stress, perceived social support, substance use, and educational environment.MethodSelf report questionnaires were administered in this cross-sectional survey to 338 residents covering eight specialties (Medicine, Psychiatry, Paediatrics, Obstetrics/Gynaecology, Anaesthesia, General Surgery, Cardiothoracic Surgery, and Ear Nose Throat Surgery). In addition to key sociodemographics, the Centres for Epidemiology Depression Scale - Revised, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Alcohol, Smoking and Substance Involvement Screening Test, and Postgraduate Hospital Educational Environment Measure were used.ResultThe mean participant age was 31.8 years and 53.4% were males. Most residents (70.4%) reported mild/no depressive symptoms 12.7% had moderate, and 16.9% had severe symptoms.High social support (71.8%) and moderate stress (61.6%) were reported by most residents. Almost half (46.3%) rated their educational environment as being more positive than negative. Out of 238 respondents 11.3% were at moderate risk of health and other problems due to cocaine use, while 13.3% (out of 240 respondents) were at risk due to alcohol. On bivariate analyses, we found significant correlations between depression, perceived stress, substance use, perceived social support, and educational environment. Multivariate analysis revealed that depression was strongly associated with: fewer hours of sleep (β = -0.683, p = 0.002), high perceived stress (β = 0.709, p < 0.001) and low perceived social support (β = -2.19, p < 0.001).ConclusionHigh perceived social support, low perceived stress, and less sleep were significantly associated with lower depression scores. A large proportion of residents were at risk of developing depression (29.6%). There were high levels of perceived social support (71.8%). A concerning proportion of residents used substances like alcohol and cocaine. This work is one of few that describe the mental health of an important and understudied population group in an LMIC. Priority must be given to protect and promote the mental health of such a vulnerable group.Data collection and analysis were funded by Kenyatta National Hospital.

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Depression and its associated factors: perceived stress, social support, substance use and related sociodemographic risk factors in medical school residents in Nairobi, Kenya

BMC Psychiatry ◽

10.1186/s12888-021-03439-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sayed Shah Nur Hussein Shah ◽

Ahmed Laving ◽

Violet Caroline Okech-Helu ◽

Manasi Kumar

Keyword(s):

Risk Factors ◽

Social Support ◽

Substance Use ◽

Depressive Symptoms ◽

Perceived Stress ◽

Associated Factors ◽

Perceived Social Support ◽

Educational Environment ◽

Sub Saharan Africa ◽

Medical Residents

Abstract Background Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya’s largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment. Methods We sampled 338 residents belonging to 8 different specialties using self administered questionnaires in this cross-sectional survey between October 2019 and February 2020. Questionnaires included: sociodemographics, the Centres for Epidemiology Depression Scale - Revised, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Alcohol, Smoking and Substance Involvement Screening Test, and Postgraduate Hospital Educational Environment Measure. Bivariate and multivariate linear regression were used to assess for risk factors for depression. Results Mean participant age was 31.8 years and 53.4% were males. Most residents (70.4%) reported no to mild depressive symptoms, 12.7% had moderate, and 16.9% had severe depressive symptoms. Most residents had high social support (71.8%) and moderate stress (61.6%). The educational environment was rated as more positive than negative by 46.3% of residents. Bivariate analyses revealed significant correlations between depressive symptoms, perceived stress, substance use, perceived social support, and educational environment. Multivariate analysis showed that depression was strongly associated with: fewer hours of sleep (β = − 0.683, p = 0.002), high perceived stress (β = 0.709, p < 0.001) and low perceived social support (β = − 2.19, p < 0.001). Conclusions Only 30% of medical residents in our study had moderate and severe depressive symptoms. Most residents in our study reported high levels of social support, and moderate levels of stress. Though their overall appraisal of medical residency experience was positive, mental health support and self-care skills in the training of medical professionals needs prioritization.

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Correlates of employment among men in substance use recovery: The influence of discrimination and social support

Journal of Prevention & Intervention in the Community ◽

10.1080/10852352.2021.1940756 ◽

2021 ◽

pp. 1-15

Author(s):

Bronwyn A. Hunter ◽

Leonard A. Jason

Keyword(s):

Social Support ◽

Substance Use

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Perceived family cohesion, social support, and quality of life in patients undergoing treatment for substance use disorders compared with patients with mental and physical disorders

Addiction Science & Clinical Practice ◽

10.1186/s13722-021-00252-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Bente Birkeland ◽

Bente Weimand ◽

Torleif Ruud ◽

Darryl Maybery ◽

John-Kåre Vederhus

Keyword(s):

Quality Of Life ◽

Social Support ◽

Substance Use ◽

Substance Use Disorders ◽

Family Cohesion ◽

Service Providers ◽

Cancer Data ◽

Physical Disorders ◽

Patient Groups

Abstract Purpose Support from family and other social network elements can be important in helping patients to cope with practical and emotional consequences of diseases. The aim of the study was to examine perception of family and social support and quality of life (QoL) in patients undergoing treatment for substance use disorders (SUDs). We compared them with patients in treatment for mental disorders (MDs) and physical disorders (PDs). Methods We used data from a national multicenter study that recruited patients (N = 518) from three treatment domains; SUD treatment units, MD treatment units, and PD treatment units (severe neurological conditions or cancer). Data on family cohesion, social support, and QoL were compared across patient groups. In addition, data on health variables was collected. We used a multiple linear regression procedure to examine how health and support variables were associated with QoL. Results Family cohesion and social support in the SUD and MD groups were rated at similarly low levels, substantially lower than in the PD group. The SUD group exhibited a somewhat lower QoL than did the PD group, but their QoL was still in the near-to-normal range. In contrast, the MD group had markedly low QoL. When examining factors associated with QoL, we found that greater family cohesion and social support were positively associated with QoL. Mental distress was the strongest factor, and was negatively associated with QoL (beta − 0.15, 95% CI = − 0.17/− 0.14, p < 0.001). Conclusion Service providers need to be aware of the weaker networks and less regulatory family and/or social support available to patients with SUDs. Providers should focus consistently on the social networks of patients and include patients’ families in treatment processes.

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Relationship of Perceived Competencies, Perceived Social Support, and Gender to Substance Use in Young Adolescents

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1097/00004583-199707000-00015 ◽

1997 ◽

Vol 36 (7) ◽

pp. 933-940 ◽

Cited By ~ 70

Author(s):

PATRICIA D. LIFRAK ◽

JAMES R. MCKAY ◽

ANTHONY ROSTAIN ◽

ARTHUR I. ALTERMAN ◽

CHARLES P. O'BRIEN

Keyword(s):

Social Support ◽

Substance Use ◽

Perceived Social Support ◽

Young Adolescents ◽

And Gender ◽

Relationship Of

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Psychiatric and Substance Use Disorders in Late Adolescence: The Role of Risk and Perceived Social Support

American Journal on Addictions ◽

10.1080/10550490590924755 ◽

2005 ◽

Vol 14 (2) ◽

pp. 124-138 ◽

Cited By ~ 11

Author(s):

Joseph H. Beitchman ◽

Edward M. Adlaf ◽

Leslie Atkinson ◽

Lori Douglas ◽

Joseph H. Beitchman ◽

...

Keyword(s):

Social Support ◽

Substance Use ◽

Substance Use Disorders ◽

Perceived Social Support ◽

Late Adolescence

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The role of chronic pain and current substance use in predicting negative social support among disadvantaged persons living with HIV/AIDS

AIDS Care ◽

10.1080/09540121.2016.1168916 ◽

2016 ◽

Vol 28 (10) ◽

pp. 1280-1286 ◽

Cited By ~ 7

Author(s):

Mary M. Mitchell ◽

Allysha C. Maragh-Bass ◽

Trang Q. Nguyen ◽

Sarina Isenberg ◽

Amy R. Knowlton

Keyword(s):

Social Support ◽

Chronic Pain ◽

Substance Use ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

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Increases in social support co-occur with decreases in depressive symptoms and substance use problems among adults in permanent supportive housing: an 18-month longitudinal study

BMC Psychology ◽

10.1186/s40359-020-00507-0 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Zhengqi Tan ◽

Eun-Young Mun ◽

Uyen-Sa D. T. Nguyen ◽

Scott T. Walters

Keyword(s):

Social Support ◽

Substance Use ◽

Depressive Symptoms ◽

Protective Factor ◽

Growth Models ◽

Parallel Process ◽

Supportive Housing ◽

Permanent Supportive Housing ◽

Substance Use Problems ◽

Over Time

Abstract Background Social support is a well-known protective factor against depressive symptoms and substance use problems, but very few studies have examined its protective effects among residents of permanent supportive housing (PSH), a housing program for people with a history of chronic homelessness. We utilized unconditional latent growth curve models (LGCMs) and parallel process growth models to describe univariate trajectories of social support, depressive symptoms, and substance use problems and to examine their longitudinal associations in a large sample of adults residing in PSH. Methods Participants were 653 adult PSH residents in North Texas (56% female; 57% Black; mean age: 51 years) who participated in a monthly health coaching program from 2014 to 2017. Their health behaviors were assessed at baseline and tracked every six months at three follow-up visits. Results Unconditional LGCMs indicated that over time, social support increased, whereas depressive symptoms and substance use problems decreased. However, their rates of change slowed over time. Further, in parallel process growth models, we found that at baseline, individuals with greater social support tended to have less severe depressive symptoms and substance use problems (coefficients: − 0.67, p < 0.01; − 0.52, p < 0.01, respectively). Individuals with a faster increase in social support tended to have steeper rates of reduction in both depressive symptoms (coefficient: − 0.99, p < 0.01) and substance use problems (coefficient: − 0.98, p < 0.01), respectively. Conclusions This study suggests that plausibly, increases in social support, though slowing over time, still positively impact depressive symptoms and substance use problems among PSH residents. Future PSH programs could emphasize social support as an early component as it may contribute to clients’ overall health.

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A Comparison of Psychosocial Factors, Substance Use Behaviors, and Sexual Behaviors by Self-Reported HIV Status Among Middle-Aged Hispanic Men Who Have Sex With Men

Hispanic Health Care International ◽

10.1177/1540415320923568 ◽

2020 ◽

pp. 154041532092356

Author(s):

Beatriz Valdes ◽

Deborah Salani ◽

Joseph P. De Santis

Keyword(s):

Social Support ◽

Substance Use ◽

Depressive Symptoms ◽

Psychosocial Factors ◽

Sexual Behaviors ◽

Hiv Status ◽

Illicit Substance Use ◽

Immunodeficiency Virus ◽

Hispanic Men ◽

Sex With Men

Introduction: Human immunodeficiency virus (HIV) is a significant health issue among Hispanic men who have sex with men (MSM). Despite existing research, no studies have compared psychosocial factors by self-reported HIV antibody status. Method: Participants ( n = 150) completed measures of social support, loneliness, depressive symptoms, substance use, and sexual behaviors. Results: Participants with a self-reported HIV-antibody positive status reported lower levels of social support and higher levels of illicit substance use. Hispanic MSM with an unknown HIV antibody status reported more sexual partners. Conclusion: More research is needed to address psychosocial factors (social support, loneliness, depressive symptoms), substance use, and sexual behaviors among Hispanic MSM.

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Young construction workers: substance use, mental health, and workplace psychosocial factors

Advances in Dual Diagnosis ◽

10.1108/add-08-2017-0013 ◽

2017 ◽

Vol 10 (4) ◽

pp. 155-168 ◽

Cited By ~ 5

Author(s):

Ken Pidd ◽

Vinita Duraisingam ◽

Ann Roche ◽

Allan Trifonoff

Keyword(s):

Mental Health ◽

Social Support ◽

Substance Use ◽

Psychological Distress ◽

Construction Industry ◽

Psychosocial Factors ◽

Job Stress ◽

Poor Mental Health ◽

Psychological Wellbeing ◽

Content Type

Purpose Young Australian workers are at elevated risk of mental health and alcohol and other drug related problems. The purpose of this paper is to examine the relationship between alcohol and drug (AOD) use, psychological wellbeing, and the workplace psychosocial environment among young apprentices in the construction industry. Design/methodology/approach A cross-sectional survey of a cohort of 169 construction industry apprentices in their first year of training was undertaken. The survey included measures of psychological distress (K10), quantity/frequency measures of alcohol and illicit drug use, and workplace psychosocial factors. Findings Construction industry apprentices are at elevated risk of AOD related harm and poor mental health. Levels of psychological distress and substance use were substantially higher than age/gender equivalent Australian population norms. Job stress, workplace bullying, and general social support accounted for 38.2 per cent of the variance in psychological distress. General social support moderated the effects of job stress and bullying on psychological distress. Substance use was not associated with psychological distress. However, workplace social support accounted for 2.1 per cent of the variance in AUDIT-C scores, and 2.0 per cent of the variance in cannabis use. Workplace bullying explained 2.4 per cent of the variance in meth/amphetamine use. Practical implications Construction trades apprentices are a high-risk group for harmful substance use and poor mental health. Study results indicate that psychosocial wellbeing interventions are warranted as a harm reduction strategy. Originality/value This is the first study of its kind to describe a cohort of Australian construction trade apprentices in terms of their substance use and psychological wellbeing. The study shows workplace psychosocial factors may predict young workers psychological wellbeing.

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