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The Influence of Coping Strategies and Social Support on the Level of Perceived Stress In Medical Students

의과대학생에서 스트레스 대처방식과 사회적 지지가 스트레스의 지각에 미치는 영향

  • Lee, I Re (Department of Medical Education, Yonsei University College of Medicine) ;
  • Kim, Min-Kyeong (Department of Medical Education, Yonsei University College of Medicine) ;
  • Kim, Hae Won (Department of Medical Education, Yonsei University College of Medicine)
  • 이이레 (연세대학교 의과대학 의학교육학교실) ;
  • 김민경 (연세대학교 의과대학 의학교육학교실) ;
  • 김혜원 (연세대학교 의과대학 의학교육학교실)
  • Received : 2020.09.23
  • Accepted : 2020.11.13
  • Published : 2021.04.30

Abstract

Objective : We aimed to examine the demographic factors and personal resources that affect medical students' perceived stress. In particular, the extent to which coping strategies and social support influenced perceived stress was investigated. Methods : A total of 321 medical students, which consisted of 116 first-year students, 100 second-year students, and 105 third-year students, participated in the present study. The levels of perceived stress, coping style, and perceived social support were measured by the perceived stress scale, the ways of coping scale, and the multi-dimensional scale of perceived social support, respectively. The influence of coping style and social support on perceived stress was examined by multiple linear regression, after controlling for age, sex, grade, and medical school entrance type. Results : The perceived stress level was significantly different between undergraduate-entry and graduate-entry medical students (18.39 vs. 16.38, t=2.625, p=0.009). Other sociodemographic factors did not affect the extent to which medical students experienced stress. The multiple regression model was significant (p<0.001), and active problem-focused coping (p<0.001) and social support from friends (p=0.003) were associated with a lower level of perceived stress. Conclusion : Our results suggest that problem-focused strategies and supportive relationships with friends may play a role in reducing medical students' stress levels. These findings have implications for teaching students how to approach stressful situations and encouraging students to build communities among themselves may help students manage stress during medical school effectively.

Keywords

References

  1. Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. J Med Educ 2005;39:594-604. https://doi.org/10.1111/j.1365-2929.2005.02176.x
  2. Bjorksten O, Sutherland S, Miller C, Stewart T. Identification of medical student problems and comparison with those of other students. J Med Educ 1983;58:759-767.
  3. Ryu S. Quality of life and depressive symptoms and suicidal ideation in medical college students. J Soonchunhyang Med Sci 2009;14:149-158.
  4. Han SS, Lee SY, Choi WS, Kim SJ, Park SB, Lee SY. Depression and its influencing factors among korean medical and engineering students in urban areas using zung self-rating depression scale. Korean J Fam Med 2009;30:539-548. https://doi.org/10.4082/kjfm.2009.30.7.539
  5. Firth J. Levels and sources of stress in medical students. Br Med J (Clin Res Ed) 1986;292:1177-1180. https://doi.org/10.1136/bmj.292.6529.1177
  6. Roh MS, Jeon HJ, Kim H, Han SK, Hahm BJ. The prevalence and impact of depression among medical students: a nationwide cross-sectional study in South Korea. Acad Med 2010;85:1384-1390. https://doi.org/10.1097/ACM.0b013e3181df5e43
  7. Guthrie E, Black D, Bagalkote H, Shaw C, Campbell M, Creed F. Psychological stress and burnout in medical students: a five-year prospective longitudinal study. J R Soc Med 1998;91:237-243. https://doi.org/10.1177/014107689809100502
  8. Mosley TH Jr PS, Neral SM, Dubbert PM, Grothues CA, Pinto BM. Stress, coping, and well-being among third-year medical students. Acad Med 1994;69:765-767. https://doi.org/10.1097/00001888-199409000-00024
  9. Shapiro SL, Shapiro DE, Schwartz GE. Stress management in medical education: a review of the literature. Acad Med 2000;75:748-759. https://doi.org/10.1097/00001888-200007000-00023
  10. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer Pub. Co.;1984.
  11. Dumont M, Provost MA. Resilience in adolescents: Protective role of social support, coping strategies, self-esteem, and social activities on experience of stress and depression. Journal of Youth and Adolescence 1999;28:343-363. https://doi.org/10.1023/A:1021637011732
  12. Billings AG, Moos RH. The role of coping responses and social resources in attenuating the stress of life events. J Behav Med 1981;4: 139-157. https://doi.org/10.1007/BF00844267
  13. Alzayyat A, Al-Gamal E. Correlates of stress and coping among Jordanian nursing students during clinical practice in psychiatric/mental health course. Stress Health 2016;32:304-312. https://doi.org/10.1002/smi.2606
  14. Wu L, Farquhar J, Ma J, Vidyarthi AR. Understanding Singaporean medical students' stress and coping. Singapore Med J 2018;59:172-176. https://doi.org/10.11622/smedj.2018044
  15. Ko JK, Yoon TY, Park JH. The effects of coping style on subjective well-being among medical students. Korean J Med Educ 2007;19: 225-233. https://doi.org/10.3946/kjme.2007.19.3.225
  16. Thompson G, McBride RB, Hosford CC, Halaas G. Resilience among medical students: The role of coping style and social support. Teach Learn Med 2016;28:174-182. https://doi.org/10.1080/10401334.2016.1146611
  17. Thoits PA. Social support as coping assistance. Journal of Consulting and Clinical Psychology 1986;54:416. https://doi.org/10.1037/0022-006X.54.4.416
  18. Park HS, Son CN, Oh SW. The effects of stress, social support, dys-functional attitude and coping style upon depression. Korean Journal of Clinical Psychology 1993;12:179-196.
  19. Gong SJ, Lee EH. Mediation effect of coping between life stress and depression in female college students. The Korean Journal of Woman Psychology 2006;11:21-40.
  20. Popa-Velea O, Diaconescu L, Mihailescu A, Jidveian Popescu M, Macarie G. Burnout and its relationships with alexithymia, stress, and social support among Romanian medical students: a cross-sectional study. Int J Environ Res Public Health 2017;14:560. https://doi.org/10.3390/ijerph14060560
  21. Shao R, He P, Ling B, Tan L, Xu L, Hou Y, et al. Prevalence of depression and anxiety and correlations between depression, anxiety, family functioning, social support and coping styles among Chinese medical students. BMC Psychol 2020;8:38. https://doi.org/10.1186/s40359-020-00402-8
  22. Lee WS, Oh YJ, Byun DY. The academic stress, depression and social support of graduate medical school students. Korean Journal of Social Welfare Research 2013;37:45-70.
  23. Cohen S, Williamson G. Perceived stress in a probability sample of the US In S. Spacapam & S. Oskamp (Eds.), The social psychology of health: Claremont Symposium on Applied Social Psychology (pp. 31-67). Newbury Park, CA: Sage;1988.
  24. Lee J, Shin C, Ko YH, Lim J, Joe SH, Kim S, et al. The reliability and validity studies of the Korean version of the Perceived Stress Scale. Korean Journal of Psychosomatic Medicine 2012;20:127-134.
  25. Folkman S, Lazarus RS. If it changes it must be a process: study of emotion and coping during three stages of a college examination. J Pers Soc Psychol 1985;48:150-170. https://doi.org/10.1037/0022-3514.48.1.150
  26. Yoon T. The influence of stress coping on psychological well-being: the mediating effect of meaning in life [dissertation]. Suwon: Ajou University;2016.
  27. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The Multidimensional scale of perceived social support. J Pers Assess 1988;52:30-41. https://doi.org/10.1207/s15327752jpa5201_2
  28. Park H, Nguyen T, Park H. Validation of multidimensional scale of perceived social support in middle-aged Korean women with diabetes. Asia Pac J Soc Work 2012;22:202-213. https://doi.org/10.1080/02185385.2012.691719
  29. Zvauya R, Oyebode F, Day EJ, Thomas CP, Jones LA. A comparison of stress levels, coping styles and psychological morbidity between graduate-entry and traditional undergraduate medical students during the first 2 years at a UK medical school. BMC Research Notes 2017;10:93. https://doi.org/10.1186/s13104-017-2395-1
  30. Kim JH, Jang EY, Kim DH, Choi JH, Park YC. Mental health of medical school students and the effects of their strategy for enhancing self-esteem. Korean J Med Educ 2011;23:295-304. https://doi.org/10.3946/kjme.2011.23.4.295
  31. Denovan A, Dagnall N, Dhingra K, Grogan S. Evaluating the Perceived Stress Scale among UK university students: implications for stress measurement and management. Studies in Higher Education 2019;44:120-133. https://doi.org/10.1080/03075079.2017.1340445
  32. Kwak DI, Choi YK, Lim HJ, Oh HJ, Jung IK, Lee MS. A study on the stress, copying and general well-being of medical students. Korean J Med Educ 2000;12:227-239. https://doi.org/10.3946/kjme.2000.12.2.227
  33. Heins M, Fahey SN, Leiden LI. Perceived stress in medical, law, and graduate students. Journal of Medical Education 1984;59:169-179.
  34. Seedhom A, Kamel E, Mohammed E, Raouf N. Predictors of perceived stress among medical and nonmedical college students, Minia, Egypt. International Journal of Preventive Medicine 2019;10:107-107. https://doi.org/10.4103/ijpvm.ijpvm_6_18
  35. Kim NC, Kim SH, Lhm HK, Kim JH, Jung HS, Park JC, et al. Comparison of Stress and Life Satisfaction Between Non-Medical and Medical College Students. Korean Journal of Psychosomatic Medicine 2015;23:47-56.
  36. Haglund MEM, aan het Rot M, Cooper NS, Nestadt PS, Muller D, Southwick SM, et al. Resilience in the third year of medical school: a prospective study of the associations between stressful events occurring during clinical rotations and student well-being. Academic Medicine 2009;84:258-268. https://doi.org/10.1097/acm.0b013e31819381b1
  37. D'Zurilla TJ. Problem-solving training for effective stress management and prevention. J Cogn Psychother 1990;4:327-354. https://doi.org/10.1891/0889-8391.4.4.327
  38. Tempski P, Bellodi PL, Paro HB, Enns SC, Martins MA, Schraiber LB. What do medical students think about their quality of life? A qualitative study. BMC Med Educ 2012;12:106. https://doi.org/10.1186/1472-6920-12-106
  39. Yamada Y, Klugar M, Ivanova K, Oborna I. Psychological distress and academic self-perception among international medical students: the role of peer social support. BMC Med Educ 2014;14:256. https://doi.org/10.1186/s12909-014-0256-3
  40. Ell K. Social networks, social support, and health status: a review. J Social Service Review 1984;58:133-149. https://doi.org/10.1086/644168
  41. House JS, Landis KR, Umberson D. Social relationships and health. Science 1988;241:540-545. https://doi.org/10.1126/science.3399889
  42. Cohen S. After effects of stress on human performance and social behavior: a review of research and theory. Psychol Bull 1980;88:82-108. https://doi.org/10.1037/0033-2909.88.1.82
  43. Kim YS, Kim EJ, Lim SW, Shin DW, Oh KS, Shin YC. Association of self-reported job stress with depression and anxiety. Anxiety and Mood 2015;11:38-46.