Stress, subjective well-being and its link to the academic performance amongst medical students of a tertiary care setting

Panneerselvam Periasamy; Suganthi Vajiravelu; Sasikala Gunasekaran

doi:10.4103/cmrp.cmrp_55_22

ORIGINAL ARTICLE

Year : 2023 | Volume : 13 | Issue : 1 | Page : 15-17

Stress, subjective well-being and its link to the academic performance amongst medical students of a tertiary care setting

Panneerselvam Periasamy¹, Suganthi Vajiravelu², Sasikala Gunasekaran³
¹ Department of Physiology, Vinayaka Mission's Research Foundation (Deemed to be University), Salem, Tamil Nadu, India
² Department of Physiology, Vinayaka Mission's Kirupananda Variyar Medical College and Hospital, Salem, Tamil Nadu, India
³ Department of Nursing, Government Erode Medical College Hospital, Erode, Tamil Nadu, India

Date of Submission	17-Jun-2022
Date of Decision	22-Dec-2022
Date of Acceptance	02-Feb-2023
Date of Web Publication	24-Feb-2023

Correspondence Address:
Dr. Panneerselvam Periasamy
Department of Physiology, Government Erode Medical College, Perundurai, Erode, Tamil Nadu
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cmrp.cmrp_55_22

Abstract

Background: Understanding medical students' mental health using subjective well-being indicators is important because it will allow for the creation of positive psychology-based intervention techniques as well as the implementation of main and secondary psychiatric disorder prevention procedures for medical students. These indicators may help to improve the overall quality of health care provided by these future professionals to the general public.
Aims: The aim of the present study was to assess the levels of stress and subjective well being as well as factors related to it and their link to the academic performance amongst medical students of a tertiary care setting.
Materials and Methods: This is a 3-month cross-sectional survey that took place amongst medical students at a tertiary care medical college in Salem, India, between January and March 2022. Students from all academic years, from first year to internship, were included in this study. The study included all students who were willing to participate and gave their informed consent.
Results: Of the total 492 respondents, 288 (58.5%) were females and 204 (41.5%) were males. 29.7% of the study participants belonged to the first year of the MBBS course. 43.9% of the study participants possess a very good academic performance and majority (86.6%) of the students have regular attendance towards classes.
Conclusion: Taken together, the findings of studies like these could inform preventive interventions aimed at reducing medical students' distress and promoting future doctors' well-being.

Keywords: Academic performance, medical students, stress, subjective well-being

How to cite this article:
Periasamy P, Vajiravelu S, Gunasekaran S. Stress, subjective well-being and its link to the academic performance amongst medical students of a tertiary care setting. Curr Med Res Pract 2023;13:15-7

How to cite this URL:
Periasamy P, Vajiravelu S, Gunasekaran S. Stress, subjective well-being and its link to the academic performance amongst medical students of a tertiary care setting. Curr Med Res Pract [serial online] 2023 [cited 2023 Jun 9];13:15-7. Available from: http://www.cmrpjournal.org/text.asp?2023/13/1/15/370514

Introduction

Stress and depression disorders, as well as burnout syndrome, are quite common amongst medical students worldwide.^[1] Variables related to students' personalities, problems inherent in the process of becoming a physician and recurring stress induced by university courses themselves are all risk factors for these disorders.^[2] Overall, medical students' mental health is harmed during their stay in medical school because they acquire risky coping techniques, such as alcohol drinking, rather than seeking medical help for their psychological concerns, even though they live in a health-care atmosphere.^[3] Issues with doctor–patient interactions as well as low academic achievement, are linked to mental diseases and psychological stress.^[4] Subjective well-being (SWB) is linked to a person's satisfaction experiences, which includes a cognitive component that refers to life satisfaction and an emotional component that refers to happy emotions. Subjective well-being, as well as happiness, have been linked to positive life outcomes.^[5] Understanding medical students' mental health using SWB indicators is important because it will allow for the creation of positive psychology-based intervention techniques as well as the implementation of main and secondary psychiatric disorder prevention procedures for medical students. These indicators may help to improve the overall quality of health care provided by these future professionals to the general public.^[6]

Therefore, the aim of the present study was to assess the levels of stress and SWB as well as factors related to it and their link to the academic performance amongst medical students of a tertiary care setting.

Materials and Methods

This is a 3-month cross-sectional survey that took place amongst medical students at a tertiary care medical college in Salem, India, between January and March 2022. Students from all academic years, from first year to internship, were included in this study after getting relevant approvals and Institutional Ethical Committee clearance from the medical college with reference number: GEMC/2022/013. The study included all students who were willing to participate and gave their informed consent. Individuals with chronic conditions and those who refused to give their consent were excluded from the study. Two different scoring tools were used to measure the levels of stress and SWB. The Perceived Stress Scale (PSS) developed by Cohen et al. was used to measure the degree of stress on which the participants rated the statements of the 14-item PSS from 0 (never) to 4 (very often) scale.^[7] The Subjective Well-Being Scale developed by Campbell was used to assess the subjective well-being of the study participants. The scores on this scale ranged from 1 to 7.^[8]

Statistical analysis

The acquired data were analysed using IBM SPSS (the Statistical Package for the Social Science) v24.0 software, Armonk, New York, USA, to draw relevant inferences. Chi-square was used to determine the gender-based connection between groups. The P value was used to evaluate significant differences between groups, whose value <0.05 was considered statistically significant.

Results

Of the total 492 respondents, 288 (58.5%) were females and 204 (41.5%) were males. 29.7% of the study participants belonged to the first year of the MBBS course. 43.9% of the study participants possess a very good academic performance and majority (86.6%) of the students have regular attendance towards classes [Table 1]. 39.4% of the study participants have been observed to have no stress with a P = 0.057, whereas 32.9% had mild levels of stress with a P = 0.031, which was statistically significant, along with moderate levels of stress with a P = 0.026 as scored by the PSS [Table 2]. Majority (67.4%) of the study participants have positive affect on their life and over 59.2% have medium levels of satisfaction in their lives.

Table 1: Socio-demographic characteristics of study participants (n=492)

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Table 2: Levels of stress amongst the respondents (n=492)

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Discussion

In this study, the levels of stress and SWB were assessed amongst medical students of a tertiary care setting. The levels of stress were higher in the first-year students when compared to the other years of study. This could be attributed to the new curriculum's recent introduction, students taking more responsibility for their own learning and a shift from traditional teacher-centred teaching to self-directed student-centred teaching.^{[9],[10],[11]} In this study, female students had higher mean stress scores than male students, which could be attributed to their higher self-esteem, feeling less capable and proclivity to over-report symptoms. There were very little differences in the mean scores of subjective well-being when compared between males and females, which is similar to a study by Turashvili and Japaridze^[12] This study observed no differences in the well-being found amongst students with different academic performances, which is a similar finding by Alkhalaf^[13] Academic achievement is strongly inversely connected to depression and significantly favourably correlated with subjective happiness and life satisfaction, according to a study from Pakistan that involved 300 university students.^[14] Significant disparities in life satisfaction levels were found amongst medical students of various ages in a study conducted in China. In addition, students from cities and towns, who were the only kid in the family and whose parents had better educational levels reported greater levels of life satisfaction in the same study.^[15] GPA and gender were also linked to higher levels of enjoyment amongst medical students, according to a study by Iranian researchers Moghadam et al.^[16] Student anxiety and stress can be decreased with the aid of stress management programmes and interventions, especially those that are cognitive behaviorist therapy (CBT) based. In addition to their immediate impact on stress management, these treatments may reduce stigma and be a more acceptable means of addressing students' mental health issues, closing the treatment gap and maybe acting as a springboard for subsequent therapy.^[17] Utilising a variety of data sources and data collection techniques led to the creation of new knowledge about the implementation process, which is crucial for the interpretation of effect evaluations and the creation of upcoming interventions.

Conclusion

More research is needed to confirm the findings of this study on larger samples, and longitudinal studies are needed to better understand the causal relationships between individual variables and mental health outcomes. Taken together, the findings of studies like these could inform preventive interventions aimed at reducing medical students' distress and promoting future doctors' well-being.

Financial support and sponsorship

Nil

Conflicts of interest

There are no conflicts of interest.

References

1.	Ragab EA, Dafallah MA, Salih MH, Osman WN, Osman M, Miskeen E, et al. Stress and its correlates among medical students in six medical colleges: An attempt to understand the current situation. Middle East Curr Psychiatry 2021;28:75.
2.	Gazzaz ZJ, Baig M, Al Alhendi BS, Al Suliman MM, Al Alhendi AS, Al-Grad MS, et al. Perceived stress, reasons for and sources of stress among medical students at Rabigh Medical College, King Abdulaziz University, Jeddah, Saudi Arabia. BMC Med Educ 2018;18:29.
3.	Sinha R. Chronic stress, drug use, and vulnerability to addiction. Ann N Y Acad Sci 2008;1141:105-30.
4.	Grover S, Sahoo S, Bhalla A, Avasthi A. Psychological problems and burnout among medical professionals of a tertiary care hospital of North India: A cross-sectional study. Indian J Psychiatry 2018;60:175-88. [PUBMED] [Full text]
5.	Das KV, Jones-Harrell C, Fan Y, Ramaswami A, Orlove B, Botchwey N. Understanding subjective well-being: Perspectives from psychology and public health. Public Health Rev 2020;41:25.
6.	Winzer R, Lindberg L, Guldbrandsson K, Sidorchuk A. Effects of mental health interventions for students in higher education are sustainable over time: A systematic review and meta-analysis of randomized controlled trials. PeerJ 2018;6:e4598.
7.	Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24:385-96.
8.	Campbell A. Subjective measures of well-being. Am Psychol 1976;31:117-24.
9.	Inam SB. Anxiety and depression among students of a medical college in Saudi Arabia. Int J Health Sci (Qassim) 2007;1:295-300.
10.	Simhachalam Kutikuppala LV, Vadugu S, Salaam MA, Sundara Kiran AN, Sathvika MV. A cross-sectional study on the preponderance of stress and depression among medical students and their association with various recent factors. CHRISMED J Health Res 2020;7:219-22.
11.	Bayram N, Bilgel N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Soc Psychiatry Psychiatr Epidemiol 2008;43:667-72.
12.	Turashvili T, Japaridze M. Psychological well-being and its relation to academic performance of students in Georgian context. Probl Educ 2012;49:73.
13.	Alkhalaf A. Positive and negative affect, anxiety, and academic achievement among medical students in Saudi Arabia. Int J Emerg Ment Health Hum Resil 2018;20:397.
14.	Bukhari SR, Khanam SJ. Relationship of academic performance and well-being in university students. Pak J Med Res 2017;56:126-30.
15.	Wang Q, Wang L, Shi M, Li X, Liu R, Liu J. Empathy, burnout, life satisfaction, correlations and associated socio-demographic factors among Chinese undergraduate medical students: An exploratory cross-sectional study. BMC Med Educ 2019;19:341.
16.	Moghadam M, Rezaei F, Ghaderi E, Rostamian N. Relationship between attachment styles and happiness in medical students. J Fam Med Prim Care 2016;5:593-9.
17.	Bonnesen CT, Jensen MP, Madsen KR, Toftager M, Rosing JA, Krølner RF. Implementation of initiatives to prevent student stress: Process evaluation findings from the Healthy High School study. Health Educ Res 2020;35:195-215.