Peri-Traumatic Distress and Its Relationship to Resilience and Coping Among Medical Students in Malaysia During COVID-19 Lockdown

Background: Medical students are not spared from the challenges related to the Covid-19 lockdown. The fear and uncertainties may lead to traumatic symptoms and test their resilience and sense of coping. Thus, this study aims to determine the prevalence of peri-traumatic distress symptoms and its association with the level of resilience and the coping strategies used during the lockdown among medical students.Materials and Methods: This was a cross-sectional online questionnaire survey involving medical students from a public university in Malaysia. It was conducted during the COVID-19 lockdown or Movement Control Order (MCO) where the students were asked to fill in the COVID-19 Peri-traumatic Distress Index (CPDI), Brief COPE Inventory, and Connor Davidson Resilience Scale (CDRS-25).Results: A total of 282 clinical and 172 pre-clinical medical students were involved. Peri-traumatic distress symptoms were reported by 27% out of the total students. This study found that those who were having peritraumatic distress symptoms were from the pre-clinical years, had poor internet access, as well as lower resilience levels, and used more dysfunctional coping strategies. Pre-clinical medical students with difficult internet access were eight times more likely to have peritraumatic distress symptoms.Conclusions: Given the high level of peri-traumatic distress symptoms reported by medical students during the lockdown, it is vital to identify the vulnerable students, assess their needs and risks to mental health problems during this challenging time as the pandemic is still ongoing with countries going in and out of lockdown depending on the cases at the time. The university administration for each University in Malaysia will need to have a clear academic guideline and policy as well as providing improved infrastructure to minimize the distress faced by medical students.

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Lockdown during COVID-19 Pandemic: The Psychological Responses and Coping Strategies among Medical Students in a Public University in Malaysia

Ulum Islamiyyah ◽

10.33102/uij.vol33no1.279 ◽

2021 ◽

pp. 4-22

Author(s):

Chuong Hock Ting ◽

Aik Kai Tew ◽

Joel Petrus Chin ◽

Jia Yi Lim ◽

Rubeni Siva ◽

...

Keyword(s):

Medical Students ◽

Coping Strategies ◽

Mental Health Problems ◽

Demographic Data ◽

World Health ◽

Psychological Responses ◽

Online Questionnaire ◽

Depression Anxiety Stress Scale ◽

Avoidance Coping ◽

Brief Cope

World Health Organization (WHO) had promulgated Coronavirus Disease 2019 (COVID-19) as a pandemic in the early year 2020. Following that, the National Security Council of Malaysia had announced the implementation of the Movement Control Order (MCO) in March 2020 to curb the disease. This social distancing measure had inevitably induced undesirable psychological responses among the public, including medical students. In this study, we aim to determine the psychological responses of medical students during the MCO period and their coping strategies. This cross-sectional study was conducted among 245 medical students of Universiti Malaysia Sarawak (UNIMAS) from 24th to 30th April 2020, using an online questionnaire comprising demographic data, Depression, Anxiety, Stress Scale (DASS-21), and Brief COPE questionnaire. Nearly 30% of medical students experienced stress, anxiety, or depression. Among all, 9.4% had reported severe anxiety. There were significant differences between avoidance coping strategies and negative psychological responses. In general, the medical students preferred approach coping strategies (M = 29.19, SD = 9.27). Religion (M= 5.62, SD =2.10) was the most favored coping strategy while the least had abused substance (M=2.16, SD.77). A significant statistical difference was revealed in the choice of coping between the genders, for positive reframing, religion, humour, and substance abuse. Pre-clinical students were noted to have significant stress and anxiety levels and more inclined to use avoidance coping strategies. Psychological interventions are essential to address the mental health problems among university students during current and future disasters based on the understanding of their coping strategies.

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Psychological Impairment and Coping Strategies during the COVID-19 Pandemic among Students in Pakistan: A Cross-Sectional Analysis

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2020.397 ◽

2020 ◽

pp. 1-22

Author(s):

Muhammad Salman ◽

Noman Asif ◽

Zia Ul Mustafa ◽

Tahir Mehmood Khan ◽

Naureen Shehzadi ◽

...

Keyword(s):

Mental Health ◽

Coping Strategies ◽

Cross Sectional Study ◽

Depression Score ◽

Online Questionnaire ◽

Cross Sectional ◽

Brief Cope ◽

Significant Impairment ◽

Psychological Impairment ◽

And Coping

Abstract High levels of stress are expected when crises affect people’s lives. Therefore, this web-based, cross-sectional study was conducted among university students from Pakistan to investigate the psychological impairment and coping strategies during COVID-19 pandemic. Google forms were used to disseminate the online questionnaire to assess anxiety (Generalized Anxiety disorder-7), depression (Patient Health Questionnaire-9) and the coping strategies (Brief-COPE). A total of 1134 responses (age 21.7±3.5 years) were included. The frequency of students having moderate-severe anxiety and depression (score ≥ 10) were ≍ 34% and 45%, respectively. The respondents’ aged ≥ 31 years had significantly lower depression score than those ≤ 20 years (p = 0.047). Males had significantly less anxiety (6.62 ± 5.70 vs 7.84 ± 5.60, p = 0.001) and depression (8.73 ± 6.84 vs 9.71 ± 7.06, p = 0.031) scores. Those having family member, friend or acquaintances infected with disease had significantly higher anxiety score (8.89 ± 5.74 vs 7.09 ± 5.56, p < 0.001). Regarding coping strategies, majority of respondents were found to have adopted religious/spiritual coping (6.45 ± 1.68) followed by acceptance (5.58 ± 1.65), self-distraction (4.97 ± 1.61) and active coping (4.81 ± 1.57). In conclusion, COVID-19 cause significant impairment on mental health of the students. The most frequent coping strategy adopted by students were religious/spiritual and acceptance coping. During epidemics mental health of students should not be neglected.

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Perceived Stress and Coping Strategies among First Year Undergraduate Medical Students: A Cross-Sectional Study, Thrissur District, Kerala

Global Journal of Medical Research ◽

10.34257/gjmrkvol19is4pg9 ◽

2019 ◽

pp. 9-12

Author(s):

Maria Mathew ◽

Navya C J ◽

Vidhu M Joshy

Keyword(s):

Medical Students ◽

Coping Strategies ◽

Perceived Stress ◽

High Stress ◽

Cross Sectional Study ◽

First Year ◽

Sectional Study ◽

Undergraduate Medical Students ◽

Cross Sectional ◽

Brief Cope

Coping strategies used by an individual for stress determine its effect on health and the body’s functioning. Academic challenges make the first year medical students disparately susceptible to it. A cross-sectional study was conducted among the first year undergraduate medical students of a private medical college in Thrissur, Kerala to find the prevalence of stress and the coping strategies used with the help of pretested and validated questionnaire containing the Perceived Stress Scale 10 (PSS-10) and Brief COPE Inventory. 73% of the students had moderate stress and, 20% of the students had high-stress scores. Self-distraction and religion {(6.66 ±1.52), (6.55 ±1.58)}were the most common coping strategies used by the boys and girls respectively. The prevalence of stress was high among the first year undergraduate medical students and those with high-stress scores were found to use maladaptive coping strategies.

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Risk of Depression Among MMT Patients: Does Coping Strategies and Perceived Social Support Play a Role?

Substance Abuse Research and Treatment ◽

10.1177/11782218211049407 ◽

2021 ◽

Vol 15 ◽

pp. 117822182110494

Author(s):

Suzaily Wahab ◽

Tee Chun Keat ◽

Amirul Danial Azmi ◽

Raynuha Mahadevan ◽

Eni Rahaiza Muhamed Ramli ◽

...

Keyword(s):

Social Support ◽

Coping Strategies ◽

Mental Health Problems ◽

Methadone Maintenance ◽

Perceived Social Support ◽

Cross Sectional Study ◽

Coping Mechanism ◽

Cross Sectional ◽

Self Blame ◽

Brief Cope

Introduction: Patients receiving methadone maintenance therapy (MMT) experience higher level of stress and are at greater risk of developing mental health problems such as depression which could potentially affect both quality of life and treatment outcomes. This cross-sectional study is aimed at understanding the relationship between psychosocial factors such as social support, coping, and depression among patients receiving MMT in a Malaysian Hospital. Methods: One hundred and ninety-six patients attending MMT program were recruited. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depression, Multidimensional Scale of Perceived Social Support (MSPSS) was used to assess participants’ perceived social support, and the Brief COPE questionnaire was used to assess coping strategies. The diagnosis of depression was made using Mini-International Neuropsychiatric Interview (MINI). Results: About 13.8% of our sample were diagnosed with depression. From our analysis, it was found that having higher levels of perceived social support (OR = 0.462, 95% CI 0.238-0.899, P < .05), the use of active and emotion focused coping mechanism (OR = 0.231, 95% CI 0.095-0.565, P < .005), and support seeking and self-distraction coping mechanism (OR = 0.196, 95% CI 0.074-0.521, P < .001) was associated with lower likelihood of depression. On the contrary, the use of dysfunctional coping strategies such as denial, behavioral disengagement, and self-blame was associated with increased likelihood of depression (OR = 9.384, 95% CI 3.081-28.581, P < .001). Conclusion: Active and emotion focused along with support and self-distraction coping strategies, and higher levels of perceived social support may serve as a buffer against depression in patients receiving MMT.

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Inverse Correlation between Stress and Adaptive Coping in Medical Students

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.5115 ◽

2020 ◽

Vol 8 (E) ◽

pp. 623-629

Author(s):

Zafar Rasheed ◽

Ali Shariq ◽

Abdulmonem Alsalhi ◽

Saleh Almesned ◽

Saud Alhussain ◽

...

Keyword(s):

Medical Students ◽

Coping Strategies ◽

General Health Questionnaire ◽

Inverse Correlation ◽

Cross Sectional Study ◽

Female Students ◽

Living Alone ◽

Adaptive Coping ◽

Cross Sectional ◽

Brief Cope

BACKGROUND: Medical students in their academic years are generally under stress but very few studies revealed the relationship between the stress and how the students manage to adapt these stressful conditions. AIM: The aim of the study was to investigate the levels of stress and their adaptive coping in the 1st 3 years medical students and also to determine the factors associated with adaptive coping strategies. METHODS: This is a descriptive cross-sectional study conducted on 441 medical students of Qassim University from September-October 2019. First 3 years medical students were randomly selected and their stress levels or adaptive coping strategies were determined by general health questionnaire (GHQ-12) and strategies coping mechanisms (SCM), respectively. The 5-points Likert scale was used for scoring and the data obtained were further validated by DASS and Brief COPE scales. RESULTS: Out of 441 medical students, 39.2% agreed to participate. The data showed that the level of stress among students was highest during their 1st year academic blocks, followed by 2nd and 3rd year students. Interesting, the adaptive coping among them was found highest during the academic blocks of 3rd year students, followed by the 2nd and 1st year students. Importantly, female students showed better adaptation against stress. Students living with their parents avoided stress in better ways as compared to those who were living alone. CONCLUSION: This is the first study that shows an inverse correlation between the stress and adaptive coping in medical students of Qassim University. The data concluded that adaptation of stress in the 3rd-year students was the highest followed by 2nd and 1st year medical students. Moreover, female students adapted well against stress and students living alone showed worse adaptation of stress.

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Psychological Impact of COVID-19 on Pakistani University Students and How They Are Coping

10.1101/2020.05.21.20108647 ◽

2020 ◽

Cited By ~ 4

Author(s):

Muhammad Salman ◽

Noman Asif ◽

Zia Ul Mustafa ◽

Tahir Mehmood Khan ◽

Naureen Shehzadi ◽

...

Keyword(s):

Mental Health ◽

University Students ◽

Coping Strategies ◽

Psychological Impact ◽

Depression Score ◽

Spiritual Coping ◽

Anxiety And Depression ◽

Online Questionnaire ◽

Cross Sectional ◽

Brief Cope

AbstractBackgroundCOVID-19 is spreading quickly, causing great deal of fear and unrest in the public. We aimed to assess the psychological impact of COVID-19 on university students and their coping strategies.MethodsThis web-based, cross-sectional study was conducted among students of four Pakistani higher education institutions. Google forms were used to disseminate the online questionnaire to assess anxiety (GAD-7), depression (PHQ-9), sources of distress (14-items) and the coping strategies (Brief-COPE).ResultsA total of 1134 responses (age 21.7 ± 3.5 years) were included. The frequency of students having moderate-severe anxiety and depression (score ≥ 10) were ≈ 34% and 45%, respectively. The respondents’ aged ≥ 31 years had significantly lower depression score than those below 30 years. Males had significantly less anxiety and depression scores than females. Additionally, those having a family member, friend or acquaintance infected with the disease had significantly higher anxiety score. The main sources of distress were the changes in daily life due to the ongoing pandemic. Regarding coping strategies, majority of respondents were found to have adopted religious/spiritual coping (6.45 ± 1.68) followed by acceptance (5.58 ± 1.65).ConclusionsCOVID-19 have significant adverse impact on students’ mental health. The most frequent coping strategy adopted by them are religious/spiritual coping, acceptance, self-distraction and active coping. It is suggested that mental health of students should not be neglected during epidemics.

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Evaluation and Comparison of Medical Students Stressors and Coping Strategies among Undergraduate Preclinical and Clinical Year Students Enrolled in Medical School of Arsi University, Southeast Ethiopia

Education Research International ◽

10.1155/2021/9202156 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Leta Melaku ◽

Guta Bulcha

Keyword(s):

Medical Students ◽

Medical School ◽

Coping Strategies ◽

Mental Health Problems ◽

Statistical Significance ◽

High Stress ◽

Active Coping ◽

Stressful Events ◽

Cross Sectional ◽

And Coping

Background. The transition into higher education is stressful as university students face many stressful events. Medical students must deal with stressors specific to medical education. While many students adjust effectively to the university context, large proportions of students are at risk of developing mental health problems. The objective of the present study was to evaluate the most common medical student’s stressors and coping strategies among undergraduate students enrolled in the Medical School of Arsi University and their association with educational year levels. Methods. An Institutional based cross-sectional study was conducted on 265 medical students by systematic random sampling. Data were collected by pretested self-administrative questionnaire and analyzed by SPSS-21 software. Logistic regression analysis was employed, and statistical significance was accepted at p < 0.05 . Result. In the present study, 5 questionnaires were rejected for incompleteness, giving a response rate of 98.1%. The top sources of stress were lack of time to review, conflict with teacher(s), and uncertainty of what was expected. ARS domain was the main cause of high stress, followed by IRS and TLRS. Religious coping, active coping, positive reframing, and planning were the most commonly used coping strategies. When preclinical year students were compared with the clinical years, TLRS and DRS domains were identified as the most common cause of stress in the preclinical years. Furthermore, instrumental support, behavioral disengagement, acceptance, religion, self-blame, and emotional support were the most commonly used coping strategies in the preclinical years compared to the clinical years. Conclusion. We observed that academic-related stressors followed by interpersonal and intrapersonal stressors are the major stressors faced by students. Active coping strategies were the most commonly employed ones rather than avoidant strategies. Stress reduction interventions were recommended.

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How medical students cope with stress: a cross-sectional look at strategies and their sociodemographic antecedents

BMC Medical Education ◽

10.1186/s12909-021-02734-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Adam Neufeld ◽

Greg Malin

Keyword(s):

Medical Students ◽

Coping Strategies ◽

Online Survey ◽

Medical Training ◽

Participation Rate ◽

Well Being ◽

Clinical Learning Environment ◽

Cross Sectional ◽

Brief Cope ◽

Student Coping

Abstract Background Medical training can be highly stressful for students and negatively impact their mental health. Important to this matter are the types of coping strategies (and their antecedents) medical students use, which are only characterized to a limited extent. A better understanding of these phenomena can shed additional light on ways to support the health and well-being of medical students. Accordingly, we sought to determine medical students’ use of various coping reactions to stress and how their gender and year of study influence those behaviours. Methods A total of 400 University of Saskatchewan medical students were invited to complete an online survey. Using the Brief COPE inventory, we assessed students’ reported use of various adaptive and maladaptive coping strategies. Descriptive and comparative statistics were performed, including multivariate analysis of variance, to explore how gender and year influenced coping strategies. Results The participation rate was 49% (47% males and 53% females). Overall, the students’ coping strategies were mostly adaptive, albeit with a few exceptions. Females used more behavioural disengagement, while males used less emotional and instrumental support. Additionally, third years used more denial to cope with stress than students in any other year. Conclusions While few studies report significant sociodemographic effects on medical student coping, our findings raise the possibility that males and females do engage in different coping strategies in medical school, and that the clinical learning environment in third year may provoke more dysfunctional coping, compared to pre-clinical stages of training. Potential explanations and implications of these results are discussed.

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STRESS, STRESSORS, AND COPING STRATEGIES BETWEEN PRE-CLINICAL AND CLINICAL MEDICAL STUDENTS AT UNIVERSITI TUNKU ABDUL RAHMAN

Malaysian Journal of Public Health Medicine ◽

10.37268/mjphm/vol.20/no.1/art.503 ◽

2020 ◽

Vol 20 (1) ◽

pp. 175-183

Author(s):

Retneswari Masilamani ◽

Mohammed Abdulrazzaq Jabbar ◽

Chang Swee Liang ◽

Hilary Lim Song You ◽

Lai Jian Kai Jonathan ◽

...

Keyword(s):

Medical Students ◽

Coping Strategies ◽

General Health Questionnaire ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Brief Cope ◽

Study Population ◽

And Coping ◽

Self Administered Questionnaire

Stress in medical education has been inevitable among medical students. However, the prevalence of stress among pre-clinical and clinical medical students differed by year of study. There were several stressors reported to affect medical students. Therefore, effective coping strategies were applied to manage the stress faced by medical students. The aim of this study was to determine the prevalence of stress, stressors and coping strategies comparing pre-clinical and clinical Universiti Tunku Abdul Rahman (UTAR) medical students, and the associated stressors and stress among them. This was a cross-sectional study with a study population of 223 medical students. Universal sampling was used. A self-administered questionnaire which included socio-demographic characteristics, the General Health Questionnaire (GHQ-12), the Medical Students Stressor Questionnaire (MSSQ) and the Brief COPE Inventory were used in this study. The overall prevalence of stress among medical students was 48.15%. Clinical students had a higher prevalence of stress (53.73%) compared to pre-clinical students (39.02%). Year 3 students had the highest prevalence of stress (64.58%) compared to other years of study. Nearly 1 out of 2 medical students were stressed (48.15%). Academic Related Stressor ranked the highest and Acceptance was the most practiced coping strategy. The only associated stressor with stress was Academic Related Stressor.

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Medical Students Viewpoints towards Development of Telemedicine Methods at Army University of Medical Sciences

Applied Health Information Technology ◽

10.18502/ahit.v2i2.7987 ◽

2021 ◽

Author(s):

Nahid Mehrabi ◽

Fatemeh Kalroozi ◽

Mohammad Hassan Kazemi-Galougahi ◽

Erfan Kazemi ◽

Leila Gholamhosseni ◽

...

Keyword(s):

Medical Students ◽

High Speed ◽

Community Support ◽

Internet Access ◽

Organizational Factors ◽

Exclusion Criterion ◽

Medical Sciences ◽

Cross Sectional ◽

Positive View ◽

Positive Attitudes

Aim: The study aimed to investigate the viewpoints of medical students towards the development of telemedicine methods at the Army of the Islamic Republic of Iran (AJA) University of Medical Sciences. Method: This cross-sectional, descriptive-analytical study, which lasted 4 months, was performed on 117 medical students of AJA University of Medical Sciences in 2021. In doing so, a Stratified sampling method and researcher-made questionnaire were used to collect data. Thus, the inclusion criterion was being a medicine student and the exclusion criterion was the incomplete completion of the questionnaire. Results: Students showed the most positive view (90.6%) regarding organizational factors to having a codified program in telemedicine development, and the most positive view towards high-speed Internet access (92.3%) concerning technology factors. In addition, as far as the stakeholders were concerned, they had the most positive view (70.1%) on community support for telemedicine development. As for information literacy, 88.9% emphasized computer and Internet skills. Also, 83.8% had the most positive view on raising awareness for telemedicine development regarding environmental factors. Conclusion: To sum up, the students had the most positive attitudes towards comprehensive telemedicine development plan, high-speed Internet access, and community support for telemedicine development, computer skills, Internet, and awareness. Hence, it is recommended to enhance these factors to help the development and implementation of telemedicine in medical education.

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