Burnout among medical students in Cyprus: A cross-sectional study

Objectives The primary aim was to estimate the burnout prevalence among all medical students at the Medical School of the University of Cyprus. Secondary aims were to ascertain the predictors of burnout and its relationship with lifestyle habits, sleep quality and mental health. Background Burnout in the healthcare sector has drawn significant scientific attention over the last few years. Recent research underscored the large burden of profession-related burnout among medical students. Materials and methods An anonymous questionnaire was administered to all 189 eligible candidates. This included demographic and lifestyle characteristics. Sleep quality was assessed via the Pittsburg Sleep Quality Index, mental health was assessed via the mental health (MH) domain of the 36-item Short Form Health Survey (SF-36) and burnout with the Maslach Burnout Inventory–Student Survey (MBI-SS). Results Overall response rate was 96.3%. The burnout prevalence was 18.1%. There was a significant linear effect of between the year of studies and the burnout frequency [F(1) = 5.09, p = 0.024], implying that with increasing academic year there were more students with burnout, especially after the 4th year of education which signifies the beginning of clinical education. Students with burnout were more likely to have poor sleep quality (90.9% vs. 60.8%, odds ratio 4.33, p = 0.023) and worse mental health (MH score 40.2 ± 17.7 vs 62.9 ± 20.3, p<0.001). Alcohol consumers had more symptoms of cynicism and less feelings of efficacy than non-alcohol consumers. Moreover, less feelings of efficacy were significantly associated with more alcohol consumption among alcohol consumers. Conclusions Burnout is prevalent in medical students and increases significantly during the clinical years. Students with burnout have worse sleep and mental health and might use alcohol as a coping mechanism. Implementing prevention strategies of burnout may be beneficial.

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Medical Studies during the COVID-19 Pandemic: The Impact of Digital Learning on Medical Students’ Burnout and Mental Health

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010349 ◽

2021 ◽

Vol 18 (1) ◽

pp. 349

Author(s):

Panagiotis Zis ◽

Artemios Artemiadis ◽

Panagiotis Bargiotas ◽

Antonios Nteveros ◽

Georgios M. Hadjigeorgiou

Keyword(s):

Mental Health ◽

Medical Students ◽

Emotional Exhaustion ◽

Short Form ◽

Maslach Burnout Inventory ◽

Junior Doctors ◽

Digital Learning ◽

Student Survey ◽

Medical Studies ◽

The Impact

Objectives: The aim of this ecological study was to investigate what the impact of digital learning due to the COVID-19 pandemic was on the burnout and overall mental health (MH) of medical students. Background: During the unprecedented era of the COVID-19 pandemic, the majority of countries worldwide adopted very strong measures. Universities closed their doors, and education continued through digital learning lectures. Methods: An anonymous questionnaire was administered to all 189 eligible candidates before and during the COVID-19 pandemic. Mental health was assessed via the MH domain of the 36-item Short Form Health Survey (SF-36) and burnout with the Maslach Burnout Inventory—Student Survey (MBI-SS). Results: The overall response rate was 81.5%. The overall burnout prevalence did not differ significantly between the two periods (pre-COVID-19 18.1% vs. COVID-19 18.2%). However, the burnout prevalence dropped significantly in year 4 (pre-COVID-19 40.7% vs. COVID-19 16.7%, p = 0.011), whereas it increased significantly in year 6 (pre-COVID-19 27.6% vs. COVID-19 50%, p = 0.01). When looking at each MBI-SS dimension separately, we found that emotional exhaustion decreased significantly in year 4 but increased in year 6, and cynicism increased in all years. The overall MH deteriorated significantly between the two periods (pre-COVID-19 58.8 ± 21.6 vs. COVID-19 48.3 ± 23, p < 0.001). Conclusions: Digital learning in medical studies carries significant risks. Not only does the MH deteriorate, but cynicism levels also increase. Emotional exhaustion was found to increase particularly in final year students, who struggle with the lack of clinical experience just before they start working as qualified junior doctors.

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Sleep Quality and Mental Health of Medical Students in Greece During the COVID-19 Pandemic

Frontiers in Public Health ◽

10.3389/fpubh.2021.775374 ◽

2021 ◽

Vol 9 ◽

Author(s):

Anna Eleftheriou ◽

Aikaterini Rokou ◽

Aikaterini Arvaniti ◽

Evangelia Nena ◽

Paschalis Steiropoulos

Keyword(s):

Mental Health ◽

Medical Students ◽

Sleep Quality ◽

Sleep Disturbances ◽

Online Survey ◽

Female Students ◽

Poor Sleep ◽

Special Focus ◽

Cross Sectional ◽

Health Parameters

Background-Aim: Medical students have been greatly affected by the COVID-19 pandemic due to their educational program, which comprises theoretical knowledge and also clinical duties, making them vulnerable to viral exposures and possibly affecting their everyday life. The aim of this study was to explore changes in sleep and mental health parameters among medical students in Greece during the second year of the pandemic.Methods: This cross-sectional study comprised students of all medical schools in Greece (n = 7), using an anonymous online survey. Participants completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Fatigue Severity Scale (FSS), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9). Statistical analysis was conducted with the use of SPSS v.26 (IBM SPSS, Armonk NY, USA).Results: Out of the 562 received responses, 559 met the inclusion criteria. The largest proportion of the respondents came from 4th-year (27.8%) and the majority of the sample were females (69.8%). Only 5.9% of the participants reported having been infected by SARS-COV-2. Most of the respondents experienced insomnia (65.9%, mean AIS score: 7.59 ± 4.24), poor sleep quality (52.4%, mean PSQI score: 6.6 ± 3.25) and increased fatigue (48.5%, mean 35.82 ± 11.74). Moderate to severe symptoms of anxiety (mean 9.04 ± 5.66) and depression (mean 9.36 ± 6.15) were noted. Suicidal ideation was found in 16.7% of the sample, while use of sleeping pills in the previous month was reported by 8.8% (n = 47). Further analysis revealed independent associations between sleep and mental health parameters. Higher AIS score was associated with greater FSS score; higher PSQI scores with higher GAD-7 and PHQ-9 scores. Additionally, female students were found to be significantly more affected than males by the COVID-19 pandemic, displaying higher levels of insomnia, sleep disturbances, anxiety and depression. In addition, those with a history of COVID-19 infection or in close proximity with a positive case reported significantly more significant post-traumatic symptoms in IES-COVID-19 questionnaire.Conclusions: In the aftermath of the COVID-19 pandemic, prevalence of sleep and mental health disorders among Greek medical students is significant, highlighting the need for better surveillance of students' wellbeing and subsequent counseling, with special focus on female students and other affected groups.

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Poor Sleep Quality among Medical Students in International Islamic University Malaysia (IIUM) and Its Association with Mental Health and other Factors

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v19i2.1564 ◽

2020 ◽

Vol 19 (2) ◽

Author(s):

Said AH ◽

Yusof MZ ◽

Mohd FN ◽

Azmi MANH ◽

Mohd Hanapiah H ◽

...

Keyword(s):

Mental Health ◽

Logistic Regression ◽

Medical Students ◽

Sleep Quality ◽

Multiple Logistic Regression Analysis ◽

Cross Sectional Study ◽

Poor Sleep ◽

Multiple Logistic Regression ◽

Poor Sleep Quality ◽

Cross Sectional

INTRODUCTION: Poor sleep quality is a common problem experienced by medical students worldwide. Therefore, this study aimed to measure the prevalence of poor sleep quality among medical students in International Islamic University Malaysia (IIUM) and its association with mental health and other factors. MATERIALS AND METHODS: A cross-sectional study using convenience sampling was conducted among 500 medical students in IIUM Kuantan. A validated self-reported questionnaire including sociodemographic, socioeconomic, lifestyle, Pittsburgh Sleep Quality Index and Depression Anxiety Stress Score 21 was distributed from 15th July to 31st August 2019. Descriptive statistics were used to measure the prevalence of poor sleep quality. Chi- square test, Fisher’s exact test, independent sample T-test, and multiple logistic regression were used to measure the association between risk factors and sleep quality. RESULT: The response rate was 91.2%. The prevalence of poor sleep quality was 59.6%. Multiple logistic regression analysis revealed level of study (clinical year (AOR=0.44, 95% CI: 0.29 - 0.66) and depression (yes (AOR: 1.71, 95% CI 1.03-2.83) contributed independently on poor sleep quality among medical students. There was no significant relationship between tahajjud practice and poor sleep quality. CONCLUSION: More than half of IIUM medical students have poor sleep quality. Those students who were in the pre-clinical year and had depression were independently associated with the occurrence of poor sleep quality. Early intervention is compulsory to overcome this problem among medical students in IIUM.

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A cross-sectional survey on sleep quality, mental health, and academic performance among medical students in Saudi Arabia

BMC Research Notes ◽

10.1186/s13104-019-4713-2 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 6

Author(s):

Abdullah Murhaf Al-Khani ◽

Muhammad Ishaque Sarhandi ◽

Mohamed Saddik Zaghloul ◽

Mohammed Ewid ◽

Nazmus Saquib

Keyword(s):

Mental Health ◽

Academic Performance ◽

Medical Students ◽

Sleep Quality ◽

Screen Time ◽

Pittsburgh Sleep Quality Index ◽

Poor Sleep ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Prevalence Of Depression

Abstract Objective Adequate sleep is integral to better mental health and facilitates students’ learning. We aimed to assess sleep quality among medical students and to see whether it was associated with their mental health (e.g., depression, anxiety, and stress) and academic performance. Results A total of 206 responded, and 95 of them had complete data on demography, lifestyle, academic performance, sleep quality (Pittsburgh Sleep Quality Index), and mental health (Depression Anxiety Stress Scales). The prevalence of poor sleep was 63.2%; it was higher among students who were physically inactive and had more screen time. Poor sleepers demonstrated higher academic performance than sufficient sleepers (p = 0.04). The prevalence of depression, anxiety, and stress were 42%, 53%, and 31% respectively. Sleep quality was significantly associated with depression (p = 0. 03), anxiety (p = 0.007), and stress (p = 0.01).

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Association of severity of depressive symptoms with sleep quality, social support and stress among Pakistani medical and dental students: A cross-sectional study

Global Psychiatry ◽

10.2478/gp-2019-0019 ◽

2019 ◽

Vol 2 (2) ◽

pp. 211-220

Author(s):

Ahmed Waqas ◽

Aqsa Iftikhar ◽

Zahra Malik ◽

Kapil Kiran Aedma ◽

Hafsa Meraj ◽

...

Keyword(s):

Social Support ◽

Depressive Symptoms ◽

Medical Students ◽

Sleep Quality ◽

Severe Depression ◽

Dental Students ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Cross Sectional ◽

Medical And Dental Students

AbstractObjectivesThis study has been designed to elucidate the prevalence of stress, depression and poor sleep among medical students in a Pakistani medical school. There is a paucity of data on social support among medical students in Pakistan; an important predictor of depressive symptoms. Therefore, this study was also aimed to demonstrate the direct and indirect impact of social support in alleviating depressive symptoms in the study sample.MethodsThis observational cross-sectional study was conducted in Lahore, Pakistan, where a total of 400 students at a medical school were approached between 1st January to 31st March 2018 to participate in the study. The study sample comprised of medical and dental students enrolled at a privately financed Pakistani medical and dental school. The participants responded to a self-administered survey comprising of five parts: a) demographics, b) Pittsburgh Sleep Quality Index (PSQI), c) Patient Health Questionnaire-9 (PHQ-9), d) Multidimensional Scale of Perceived Social Support (MSPSS) and e) Perceived Stress Scale-4 (PSS-4). All data were analysed using SPSS v. 20. Linear regression analysis was used to reveal the predictors of depression.ResultsIn total, 353 medical students participated, yielding a response rate of 88.25%. Overall, poor sleep quality was experienced by 205 (58.1%) students. Mild to severe depression was reported by 83% of the respondents: mild depression by 104 (29.5%), moderate depression by 104 (29.5%), moderately severe depression by 54 (15.3%) and severe depression by 31 (8.8%) respondents. Subjective sleep quality, sleep latency, daytime dysfunction and stress levels were significantly associated with depression symptoms. Social support was not significantly associated with depressive symptoms in the regression model (Beta = -0.08, P < 0.09); however, it acted as a significant mediator, reducing the strength of the relationship between depressive symptoms and sleep quality and stress.ConclusionsAccording to our study, a large proportion of healthcare (medical and dental) students were found to be suffering from mild to moderate depression and experienced poor sleep quality. It is concluded that social support is an important variable in predicting depressive symptomatology by ameliorating the effects of poor sleep quality and high stress levels.

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The Current Situation of Internet Addiction and Its Impact on Sleep Quality and Self-Injury Behavior in Chinese Medical Students

Psychiatry Investigation ◽

10.30773/pi.2019.0131 ◽

2020 ◽

Vol 17 (3) ◽

pp. 237-242

Author(s):

Yanqiu Wang ◽

Ying Zhao ◽

Ling Liu ◽

Yan Chen ◽

Dong Ai ◽

...

Keyword(s):

Medical Students ◽

Sleep Quality ◽

Internet Addiction ◽

Detection Rate ◽

Poor Sleep ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Self Injury ◽

Chinese Medical Students ◽

Self Harm

Objective The purpose of this cross-sectional survey is to explore the current state of Internet addiction (IA) in Chinese medical students and its connection with medical students’ sleep quality and self-injury behavior.Methods Respondents were came from Wannan Medical College, China. The Young’s Internet Addiction Test, Pittsburgh Sleep Quality Index (PSQI), Self-Harm Questionnaire were used in this cross-sectional survey. A total of 3,738 medical students were investigated, 1,552 (41.52%) males, 2,186 (58.48%) females. T-test, chi-square test and MANOVA were used for data analysis.Results Of the 3,738 medical students, 1,054 (28.2%) reported having IA, 1,126 (30.1%) reported having poor sleep quality, 563 (15.1%) having self-harm behaviors. IA tends to be more female, upper grade students. The sleep quality of IA was worse than that of non-IA (χ<sup>2</sup>=54.882, p<0.001), and the possibility of self-injury was higher than non-IA (χ<sup>2</sup>=107.990, p<0.001).Conclusion This survey shows that the IA detection rate of medical students was 28.2%. Females, higher grade students had a higher IA detection rate. The low sleep quality and self-injury behavior of medical students are associated with IA.

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The Continuing Effect of COVID-19 Pandemic on Physical Well-Being and Mental Health of ICU Healthcare Workers in Turkey: A Single-Centre Cross-Sectional Later-Phase Study

Journal of Intensive Care Medicine ◽

10.1177/08850666211070740 ◽

2021 ◽

pp. 088506662110707

Author(s):

Huseyin Duru

Keyword(s):

Mental Health ◽

Sleep Quality ◽

Healthcare Workers ◽

Well Being ◽

Poor Sleep ◽

Health Issues ◽

Cross Sectional ◽

Mental Health Issues ◽

Heavy Workload ◽

Median Change

Background This study aimed to evaluate the effect of COVID-19 pandemic on physical well-being and mental health of ICU healthcare workers (HCWs). Methods A total of 51 ICU HCWs working at a tertiary care hospital were included in this cross-sectional study conducted before (January 2019-January 2020) and during (January 2021-April 2021) COVID-19 pandemic. Data on sociodemographic and work-related characteristics, COVID 19 history and current mental health issues via Hospital Anxiety-Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), Eating Attitudes Test (EAT-40), Suicidal Ideation Scale (SIS) and Maslach Burnout Inventory (MBI) were recorded. Results Overall, 62.7% of participants were nurses, heavy workload (working ≥200 h/month) was reported by 76.5% of participants and previous history of COVID-19 was confirmed by 62.7%. Current mental health issues involved poor sleep quality in majority (96.1%) of participants, anxiety (51.0%), depression (51.0%) in at least half of them and a moderate degree of emotional exhaustion Heavy workload was associated with more remarkable decrease in sleep duration (median change: −0.5 vs. −1.0 h/day, P = .020), Vit B12 (median change: 60[−48-293] vs. −65[−371-262] pg/mL, P < .001) and Vit D (median change: −1.6[−13.1-20] vs. −9.7[−39.7-21.8] ng/mL, P = .004) during pandemic, while working hours per month were also significantly higher in those with versus without anxiety (264[150-390] vs. 240[150-264] h, P = .003) and with versus without depression (264[150-390] vs. 240[150-264] h, P = .037). Conclusion Our findings indicate high prevalence of mental health issues including anxiety and depression as well as poor sleep quality and emotional burnout among ICU HCWs, particularly those with heavy workload.

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Negative and positive predictive relationships between coping strategies and the three burnout dimensions among Hungarian medical students

Orvosi Hetilap ◽

10.1556/oh.2014.29949 ◽

2014 ◽

Vol 155 (32) ◽

pp. 1273-1280 ◽

Cited By ~ 1

Author(s):

Szilvia Ádám ◽

Anikó Nistor ◽

Katalin Nistor ◽

Anikó Hazag

Keyword(s):

Medical Students ◽

Protective Factors ◽

Coping Strategies ◽

Maslach Burnout Inventory ◽

Cross Sectional Study ◽

Personal Accomplishment ◽

Effective Management ◽

Student Survey ◽

Cross Sectional ◽

Health Maintenance

Introduction: Effective management and prevention of widespread burnout among medical students in Hungary require thorough understanding of its relations to coping strategies, which lacks sufficient data. Aim: To explore the prevalence of burnout and its relations to coping strategies among medical students. Method: Cross-sectional study with 292 participants. Burnout was assessed by the Maslach Burnout Inventory-Student Survey. Coping strategies were evaluated by the Folkman–Lazarus Ways of Coping Questionnaire and questions about health-maintenance behaviours. Associations between burnout and coping strategies were explored with linear regression analyses. Results: The prevalence of high-level burnout was 25–56%. Both problem-focused coping and support-seeking were protective factors of exhaustion and cynicism, however, they predicted reduced personal accomplishment. Emotion-focused coping predicted exhaustion and cynicism and correlated negatively with reduced personal accomplishment. Health-maintenance behaviours were protective factors for exhaustion and predicted reduced personal accomplishment. Conclusions: Deployment of coping strategies that target the most prevalent burnout dimension may improve effective management of burnout.

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Effects of Electroacupuncture on Stress-Related Symptoms in Medical Students: A Randomised Placebo-Controlled Study

Acupuncture in Medicine ◽

10.1136/acupmed-2013-010408 ◽

2014 ◽

Vol 32 (1) ◽

pp. 4-11 ◽

Cited By ~ 13

Author(s):

Marcio Dias ◽

Guillermo Coca Vellarde ◽

Beni Olej ◽

Ana Emília Teófilo Salgado ◽

Ighor de Barros Rezende

Keyword(s):

Medical Students ◽

Sleep Quality ◽

Maslach Burnout Inventory ◽

Controlled Study ◽

Control Group ◽

Life Questionnaire ◽

Student Survey ◽

Before And After ◽

Mental Symptoms ◽

Continuous Frequency

Objective To assess the effects of electroacupuncture (EA) on relieving stress-related symptoms—sleep disorders, anxiety, depression and burnout—in medical students. Methods Eighty-two students were randomised into an EA treatment group (n=30), a sham TENS group (n=18) and an untreated control group (n=34). EA was applied at a continuous frequency of 2 Hz to the limbs, face, ears and scalp for 20 min once a week, over 6–8 weeks. Sham transcutaneous electrical nerve stimulation (TENS) was performed on similar sites for the same number of times in each session and for the same length of time. Outcome measurements included a comparison of the indices obtained by different self-applied questionnaires before and after treatment. The surveys used were the Mini-Sleep Questionnaire (MSQ), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), the Beck Depression and Anxiety Inventories (BDI and BAI) and the Maslach Burnout Inventory—Student Survey (MBI-SS), in addition to the Quality of Life Questionnaire—abbreviated version (WHOQOL-bref). Results EA significantly improved scores on the MSQ, PSQI, BDI and the cynicism and academic efficacy (AE) dimensions of the MBI-SS in relation to the control. Sleep quality (MSQ) improved from 36.9 (SD 7.6) to 25.0 (5.7) with EA, 37.6 (6.0) to 32.1 (6.9) with sham TENS, and 36.5 (5.9) to 33.6 (6.7) in the controls (p=0.0000). Compared with the sham TENS group, EA significantly reduced scores on the PSQI. Score improvements in the sham TENS group in relation to control group were significant in the MSQ, BDI and AE. In the EA group, the number of students with better scores after intervention was significantly higher for the MSQ, PSQI, ESS and BAI. This only occurred for the MSQ in the sham TENS group and for the MSQ and ESS in the control group. Conclusions EA significantly reduced stress-related mental symptoms. The improvement obtained by sham TENS compared with the control group confirmed the presence of a placebo effect resulting from the treatment ritual.

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“DOES EXCESSIVE INTERNET USAGE DISRUPT CIRCADIAN RHYTHM? – SPOTLIGHT ON A LOOMING BEHAVIOURALADDICTION AMONG MEDICAL STUDENTS”

10.36106/ijsr/0229051 ◽

2020 ◽

pp. 1-5

Author(s):

R. Barath ◽

C.P. Rabindranath ◽

Bindu Menon ◽

Mathan. K ◽

Mithun Prasad. V

Keyword(s):

Medical Students ◽

Sleep Quality ◽

Internet Addiction ◽

Mental Health Problems ◽

Poor Quality ◽

Internet Usage ◽

Poor Sleep ◽

Quality Of Sleep ◽

Cross Sectional

Background: In recent years the internet had become the most indispensable tool for students for learning, entertainment, and communication. Internet over-usage had emerged as a major problem among students causing the emergence of a problem that is defined as internet addiction (IA) which affects sleep and leads to several mental health problems. This study is the step toward understanding the effect of internet addiction on sleep quality among medical college students in Pondicherry. Methods: This was a cross-sectional study. It is a questionnaire-based study administrated among 298 consenting medical students. The participants were assessed by proforma containing demographic details, variables related to internet use, questionnaires of Internet Addiction Test, and Pittsburgh Sleep Quality Index for Sleep quality. Statistical data were analysed by SPSS-25. Results: A total of 287 students participated; 113 (39.4%) were males and 174 (60.6%) are females. Out of which Average users were 244 (85.01%) and problematic internet usage was 43 (14.99%), whereas poor sleep quality is found in 132 (45.99%) individuals. A significant correlation was found between internet addiction and the quality of sleep. Conclusions: Participants with problematic internet users were more likely to have a poor quality of sleep and vice versa.

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