OF NORTH COASTAL ANDHRA PRADESH
1 2 3
*Dr.V.RamyaSri,Dr.B.DeviMadhavi,Dr.K.KesavaLakshmiPrasad
1Postgraduate,CommunityMedicine,AndhraMedicalCollege,VisakhapatnamIndia.(*CorrespondingAuthor)
2ProfandHOD,CommunityMedicine,AndhraMedicalCollege,VisakhapatnamIndia.
3Assistantprofessor,CommunityMedicine,AndhraMedicalCollege,VisakhapatnamIndia.
ABSTRACT
Introduction:Stressisanexternalconstraintwhichupsetsindividualmentallyandphysically Stresshasincreasedsignificantlyinrecentyears.Aunitednationreport th labelledstressas“The20 centuryepidemic”.Medicaleducationisinherentlydemandingandstressfull,researchershaveshownthatpostgraduatedoctorsareunder highlevelofstressduetoworkoverload,timepressuretomeetdeadlines,workdemandsaffectingpersonalandhomelife.Thisisofimportancebecausethereare reportsofpostgraduatescommittingsuicideandisknownthatqualityofcarethatthephysiciansgiveisdirectlyrelatedtotheirownhealth.Objective:Toassessthe perceived stress among first year post graduates. Methodology: An Analytical Cross-sectional study was done among postgraduates. Perceived stress scale by SheldonCohenwasusedforthisstudy Basedontheirscorespostgraduateswerecategorizedasmild,moderateandseverelystressed.Result:Majorityofthesubjects belongtoagegroup24-29years.18%subjectsperceivedlowstress,62%subjectsperceivedmoderatestress,20%subjectsperceivedhighstress.Conclusion:Nearly 80% Moderate to severe perceived stress was observed among First year post graduates.There is a need for focused stress management programs to incorporate healthycopingstrategiesinpostgraduatemedicalstudents.
KEYWORDS:PerceivedStress,PostGraduateStudents,ClinicalNon-clinicalDepartments.
INTRODUCTION:
Stressisthementalandphysicalresponseandadaptationbyourbodiestothereal or perceived changes and challenges in our lives.Astressor is any real or perceivedphysical,social,orpsychologicaleventorstimulusthatcausesourbodies toreactorrespond.
1 Medicaleducationisinherentlystressfulanddemanding. Postgraduatemedical students(medicalresidents)usuallyhavelongworkinghours,needtofacevarious clinical emergencies, and also have academic as well as research works in theirtrainingperiod.Hence,theyarevulnerabletosufferfromstressandrelated 2disorders.
Chronicstressinmedicalprofessionalsmayhaveanegativeimpactonlearning, performance, problem-solving and decision-making abilities, and ultimately patientcare.Itleadstoapredispositiontomedicalillnesses,suchascardiovasculardisorders,pepticulcers,asthmaandmanymore,whichisawell-knownfact. Anystressifleftunattendedcanleadtoburnoutandcanpredisposetheindividual to psychiatric disorders such as depression and anxiety, substance use, and evensuicide.Incidenceofsuicideamongyoungmedicalprofessionalsisshow3 ing an upward trend. Hence, addressing to stress-related psychological problemsinmedicalresidentsisanecessityofthehour
Thisstudyisanattempttoincreasetheawarenessaboutstressfacedbypostgraduatemedicalstudentsandtheirwaysofdealingwithit
OBJECTIVE:
Toassesstheperceivedstressamongfirstyearpostgraduates
MATERIALSANDMETHODS:
StudyDesign:Cross-sectionalAnalyticalstudy
StudySetting:AndhraMedicalCollege
StudyPopulation:FirstYearPostgraduates.
SampleSize:103postgraduatesn=z21-α/2/2×(1−×)/×2,α=0.05,p=0.4,d=0.1
SamplingTechnique:simplerandomsampling
InclusionCriteria:Firstyearpostgraduateswhowerewillingtoparticipatein study
ExclusionCriteria:Firstyearpostgraduateswhoarenotwillingtoparticipate inthestudy,studentswithpreexistingpsychiatricillnesses
StudyPeriod:onemonth,2019
StudyTools: Thestudytoolwasstructuredself-administeredquestionnaire It
hadtwoparts:
1. Socio-Demographic details include name, age, gender, marital status, department.
2. PerceivedStressScalebyCohen
Cohen'sPerceivedStressScale(PSS-10)(1983)wasusedtoassesstheperceived stress of the students. The Perceived Stress Scale (PSS), 10-item scale was administeredtoassesstheperceptionofstressintheresidents.Itisameasureof thedegreetowhichsituationsinone'slifeareappraisedasstressful.Thequestions in the PSS ask about feelings and thoughts during the last month. The respondents answer each PSS question on a Likert scale (never, almost never, sometimes,fairlyoften,orveryoften).
EthicalConsiderations
Institutionalethicscommitteeclearancewasobtained.
Informedconsentwasobtainedfromtheparticipants.
StudyVariables
Independent Variables: Socio-Demographic characters (age, gender, marital status)
DependentVariables:Perceivedstressscores
RESULTS:
Atotalof103firstyearpostgraduatestudentswereincludedinthestudy Outof whichmaleswere36(35%)innumberandfemales67(65%).Agerangingfrom 24to43butmostofthemwereintheagegroupof24to26meanagewas25.87 +/-2.91
Meanperceivedstressscores20.38,SD+/-6.82.Majority62(60%)ofthestudy subjectshadmoderateperceivedstress,21(20%)ofstudysubjects hadhighperceivedstress,17(18%)hadlowperceivedstress,.
AstudybyM.KSwamietal showedthat therewasnosignificantdifferencein MeanscoresSDofPerceivedstressbetweenMedicineresidents18.28+/-(5.47) andSurgeryresidents 17.22(3.52)withapvalueof0.39.'–(5)
RahulBansaletal.showedthatabout76.7%ofmalesurgicalresidentshadlow perceivedstressscoreswhereas40%offemalesurgicalresidentshadmoderate perceived stress scores, which was statistically significant (P = 0.01). Among nonsurgical residents, 83.3% males and 40% females had moderate perceived stresslevelsandwasstatisticallysignificant(P<0.00).(3)
CONCLUSION:
Nearly80%postgraduatesperceivedmoderatetoseverestress.
Postgraduatemedicalstudentswithhigherlevelsofperceivedstresshavehigher self-reported psychological morbidity The findings indicate need for regular stressmanagementprogrammesforpostgraduatemedicalstudentswithfocuson inculcating healthy coping strategies.This will help enhance their physical and psychologicalwellbeingandimproveproductivity Creatingahealthyenvironment in the department, appreciation of efforts and motivation is very much essential.PoliciesandRegulationsinPostgraduatemedicaleducationwhichcan reduce risk and stress in residents like increasing the number of PG seats, decreasingnumberofworkinghours,istheneedofthehour
Acknowledgements:
IthankmyHODDrBDeviMadhavimamforguidingmethroughoutthestudy I thankmyAssistantProfessorDr.kkeshavaLakshmiPrasadsirandmycollegues forhelpingmeincollectingthedata.Ithankmyseniorsforhelpingmeindata analysis.
Financialsupportandsponsorship:Nil.
The proportion of males with low perceived stress is 8(7.7%) and females is 10(9.7%);24(23%)males 40(38.8%) females hadmoderateperceivedstress and4(3.8%)males,17(16.5%)femaleshadhighperceivedstress.
FemalePG'Sperceivedmorestress(38%infemales>23%inmales)butitisstatisticallyinsignificantpvalue=0.4
Conflictsofinterest:Therearenoconflictsofinterest
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Majority49(48%)ofthepostgraduateofclinicaldepartmentperceivedmoderate stresscomparedtonon-clinicaldept15(15%);14(14%) clinicaldept4(4%)non clinical dept post graduates had low perceived stress; 19(18%) clinical dept, 2(2%)nonclinicaldeptpostgraduateshadmoderateperceivedstress.Therewas nosignificantdifferenceofperceivedstressscoresbetweentheclinicalandnonclinicaldeptpg'spvalue=0.7
DISCUSSION:
In this study 80% of post graduate students had moderate to high perceived stress.SimilarlyGobburet.alshowedthatprevalenceofperceivedstressseems tobehighamongpostgraduatemedicalstudents(1);Maswadietal.showedthat majorityofthemedicalresidents(73%)hadmoderatelevelofstress,18%ofthe medical residents had high level of stress, and 9% had mild level of stress(4). TheaveragePSSscoredifferedsignificantlyaccordingtogender N.KSainietal showed that out of 930 resident doctors, (17.7%) had mild stress,(12.2%) had moderatestress,and (2.9%)wereseverelystressed.(2)
In the present study female PG'S perceived more stress (38% females > 23% males)butitisstatisticallynotsignificantpvalue=0.4 whereasstresslevelwas significantlyhigheramongfemalesaccordingtoMaswadiatal.(4)
In this study the post-graduates were classified into clinical and non-clinical departmentsinwhichMajority(48%)ofthepostgraduateofclinicaldepartment perceivedmoderatestresscomparedtonon-clinicaldept(15%) andtherewasno significantdifference(0.4)