Mental Stress in Medical Students during the Pandemic and Their Relation to Digital and Hybrid Semester—Cross-Sectional Data from Three Recruitment Waves in Germany
Abstract
:1. Introduction
1.1. Students’ Stress Perception and Wellbeing during the Pandemic
1.2. Support of Students by Their Universities: Adjustment of Leaning Formats
1.3. Aim of the Study
2. Materials and Methods
2.1. Description of the Study Sample
2.2. Measures
2.2.1. Stress Perception
2.2.2. Wellbeing
2.2.3. Life Satisfaction
2.2.4. Work Engagement
2.2.5. Cool Down
2.3. Statistical Analyses
3. Results
3.1. Description of the Study Sample
3.2. Changes of Stress Perception and Psychological Wellbeing in the Study Sample
3.3. Correlations between Indicators of Stress and Psychological Wellbeing
3.4. Predictors of Wellbeing, Stress Perception and Work Engagement
4. Discussion
4.1. Stress Perception of Students during the Pandemic
4.2. Wellbeing of Students
4.3. Predictors of Students Stress Perception, Psychological Wellbeing and Work Satisfaction
4.4. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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KERRYPNX | All Students (W1 + W4 + W7) | Students W1 | Students W4 | Students W7 | Significance p |
---|---|---|---|---|---|
Number (n and %) | 1061 (100%) | 327 (30.8%) | 242 (22.8%) | 490 (46.1%) | |
Participants (% of all medical students) | 53 | 59 | 36 | 62 | |
Gender (%) | n.s. 1,2 | ||||
female | 58.4 | 55.0 | 60.6 | 59.6 | |
male | 41.1 | 45.0 | 39.4 | 39.4 | |
diverse | 0.5 | 0.0 | 0.0 | 1.0 | |
Mean age (years) | 24.4 ± 3.4 | 24.1 ± 3.3 | 24.4 ± 3.4 | 24.6 ± 3.6 | n.s. 1,2 |
Mean semester (semester) | 4.6 ± 3.0 | 4.8 ± 2.7 | 3.9 ± 3.2 | 4.8 ± 3.1 | <0.001 1; n.s. 2 |
Phase of the study (%) | <0.001 1; n.s. 2 | ||||
Preclinical (1–4) | 58.1 | 47.3 | 73.5 | 53.5 | |
Clinical (5–13) | 41.9 | 52.7 | 26.5 | 46.5 | |
WHO-5 scores < 13 (%) | 28.1 | 14.9 | 34.2 | 35.3 | <0.001 1; n.s. 2 |
Satisfaction with medical studies (BMLSS. item H3) | 4.5 ± 1.3 | 4.7 ± 1.0 | 4.5 ± 1.2 | 4.2 ± 1.5 | n.s. 1,2 |
Support Satisfaction (BMLSS-Support) | 72.8 ± 1.36 | 74.6 ± 1.3 | 74.3 ± 1.3 | 69.6 ± 1.5 | n.s.1,2 |
All Medical Students (Semester 1 to 13) | Preclinical Students 1 (Semester 1–4) | Clinical Students (Semester 5–13) | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | Mean | SD | Compared with | p | n | Mean | SD | Compared with | p | n | Mean | SD | Compared with | p | |
plStress perception (PSS) | W1: 321 | 23.3 | 5.15 | W4 | <0.001 ** | W1: 136 | 22.0 | 4.93 | W4 | <0.001 ** | W1: 60 | 24.5 | 5.07 | W4 | <0.001 ** |
W4: 324 | 11.7 | 6.58 | W7 | <0.001 ** | W4: 136 | 14.2 | 6.01 | W7 | <0.001 ** | W4: 60 | 14.2 | 5.66 | W7 | n.s. | |
W7: 465 | 17.0 | 3.73 | W1 | <0.001 ** | W7: 136 | 17.1 | 3.39 | W1 | <0.001 ** | W7: 60 | 16.4 | 4.63 | W1 | <0.001 ** | |
Wellbeing (WHO-5) | W1: 324 | 17.2 | 4.21 | W4 | <0.001 ** | W1: 138 | 17.8 | 3.74 | W4 | <0.001 ** | W1: 62 | 16.2 | 4.55 | W4 | n.s. |
W4: 237 | 13.8 | 4.89 | W7 | n.s. | W4: 138 | 13.0 | 4.84 | W7 | n.s. | W4: 62 | 14.8 | 5.24 | W7 | n.s. | |
W7: 472 | 13.8 | 5.14 | W1 | <0.001 ** | W7: 138 | 13.7 | 4.96 | W1 | <0.001 ** | W7: 62 | 14.9 | 5.24 | W1 | n.s. | |
Life satisfaction (BMLSS) | W1: 326 | 81.8 | 11.63 | W4 | 0.047 * | W1: 127 | 84.0 | 10.04 | W4 | <0.001 ** | W1: 51 | 79.2 | 11.69 | W4 | n.s. |
W4: 218 | 79.5 | 13.85 | W7 | 0.036 * | W4: 127 | 77.5 | 14.00 | W7 | 0.036 * | W4: 51 | 83.6 | 14.28 | W7 | n.s. | |
W7: 457 | 75.6 | 15.01 | W1 | <0.001 ** | W7: 127 | 74.7 | 13.92 | W1 | <0.001 ** | W7: 51 | 78.9 | 13.61 | W1 | n.s. | |
Work engagement (UWES) | W1: 319 | 4.0 | 0.93 | W4 | n.s. | W1: 114 | 4.2 | 0.79 | W4 | n.s. | W1: 45 | 3.9 | 1.08 | W4 | n.s. |
W4: 202 | 3.8 | 0.94 | W7 | n.s. | W4: 114 | 3.9 | 0.89 | W7 | n.s. | W4: 45 | 3.6 | 1.11 | W7 | n.s. | |
W7: 459 | 3.7 | 1.0 | W1 | 0.014 * | W7: 114 | 3.7 | 0.99 | W1 | <0.001 ** | W7: 45 | 3.7 | 0.79 | W1 | n.s. | |
Satisfaction university support (T2) | W1: 193 | 4.7 | 1.04 | W4 | n.s. | W1: 121 | 5.1 | 0.84 | W4 | <0.001 ** | W1: 51 | 4.3 | 1.25 | W4 | n.s. |
W4: 193 | 4.5 | 1.23 | W7 | 0.003 * | W4: 121 | 4.5 | 1.18 | W7 | n.s. | W4: 51 | 4.5 | 1.51 | W7 | n.s. | |
W7: 193 | 4.1 | 1.50 | W1 | <0.001 ** | W7: 121 | 4.5 | 1.13 | W1 | <0.001 ** | W7: 51 | 3.9 | 1.59 | W1 | n.s. | |
Satisfaction student support (T1) | W1: 185 | 4.7 | 1.11 | W4 | n.s. | W1: 118 | 4.9 | 0.92 | W4 | 0.005 * | W1: 49 | 4.3 | 1.41 | W4 | n.s. |
W4: 185 | 4.6 | 1.17 | W7 | n.s. | W4: 118 | 4.5 | 1.17 | W7 | n.s. | W4: 49 | 4.9 | 1.14 | W7 | n.s. | |
W7: 185 | 4.6 | 1.33 | W1 | n.s. | W7: 118 | 4.6 | 1.35 | W1 | 0.019 * | W7: 49 | 4.8 | 1.07 | W1 | n.s. | |
Satisfaction student cohesion (T3) | W1: 188 | 4.2 | 1.38 | W4 | n.s. | W1: 120 | 4.7 | 1.01 | W4 | 0.020 * | W1: 48 | 3.9 | 1.33 | W4 | n.s. |
W4: 188 | 4.4 | 1.29 | W7 | n.s. | W4: 120 | 4.3 | 1.29 | W7 | n.s. | W4: 48 | 4.4 | 1.28 | W7 | n.s. | |
W7: 188 | 4.2 | 1.44 | W1 | n.s. | W7: 120 | 4.4 | 1.36 | W1 | n.s. | W7: 48 | 4.3 | 1.14 | W1 | n.s. | |
Cool down (CDI) | W1: 307 | 16.3 | 6.18 | W4 | n.s. | W1: 71 | 15.6 | 5.73 | W4 | n.s. | W1: 37 | 17.0 | 5.24 | W4 | n.s. |
W4: 166 | 15.1 | 6.80 | W7 | n.s. | W4: 71 | 14.8 | 6.20 | W7 | n.s. | W4: 37 | 15.3 | 8.55 | W7 | n.s. | |
W7: 390 | 15.9 | 8.07 | W1 | n.s. | W1: 71 | 14.4 | 7.55 | W1 | n.s. | W7: 37 | 14.9 | 6.23 | W1 | n.s. |
All Medical Students (Semester 1 to 13) | Female Students | Male Students | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | Mean | SD | Compared with | p | n | Mean | SD | Compared with | p | n | Mean | SD | Compared with | p | |
Stress perception (PSS) | W1: 321 | 23.3 | 5.15 | W4 | <0.001 ** | W1: 130 | 23.9 | 4.97 | W4 | <0.001 ** | W1: 83 | 22.3 | 5.13 | W4 | <0.001 ** |
W4: 324 | 11.7 | 6.58 | W7 | <0.001 ** | W4: 130 | 14.8 | 6.29 | W7 | <0.001 ** | W4: 83 | 12.6 | 5.33 | W7 | <0.001 ** | |
W7: 465 | 17.0 | 3.73 | W1 | <0.001 ** | W7: 130 | 17.6 | 3.50 | W1 | <0.001 ** | W7: 83 | 15.8 | 4.40 | W1 | <0.001 ** | |
Wellbeing (WHO-5) | W1: 324 | 17.2 | 4.21 | W4 | <0.001 ** | W1: 132 | 17.1 | 4.23 | W4 | <0.001 ** | W1: 84 | 16.6 | 4.07 | W4 | 0.003 * |
W4: 237 | 13.8 | 4.89 | W7 | n.s. | W4: 132 | 13.6 | 4.86 | W7 | n.s. | W4: 84 | 14.1 | 4.83 | W7 | n.s. | |
W7: 472 | 13.8 | 5.14 | W1 | <0.001 ** | W7: 132 | 13.0 | 5.04 | W1 | <0.001 ** | W7: 84 | 14.8 | 4.95 | W1 | 0.037 * | |
Life satisfaction (BMLSS) | W1: 326 | 81.8 | 11.63 | W4 | 0.047 * | W1: 122 | 81.6 | 11.75 | W4 | n.s. | W1: 72 | 81.6 | 11.16 | W4 | n.s. |
W4: 218 | 79.5 | 13.85 | W7 | 0.036 * | W4: 122 | 78.6 | 14.69 | W7 | n.s. | W4: 72 | 80.9 | 11.88 | W7 | n.s. | |
W7: 457 | 75.6 | 15.01 | W1 | <0.001 ** | W7: 122 | 74.7 | 13.75 | W1 | <0.001 ** | W7: 72 | 77.7 | 13.44 | W1 | n.s. | |
Satisfaction university support (T2) | W1: 193 | 4.7 | 1.04 | W4 | n.s. | W1: 118 | 4.7 | 1.05 | W4 | n.s. | W1: 70 | 4.7 | 1.06 | W4 | n.s. |
W4: 193 | 4.5 | 1.23 | W7 | 0.003 * | W4: 118 | 4.5 | 1.20 | W7 | 0.002 * | W4: 70 | 4.7 | 1.13 | W7 | n.s. | |
W7: 193 | 4.1 | 1.50 | W1 | <0.001 ** | W7: 118 | 3.9 | 1.54 | W1 | <0.001 ** | W7: 70 | 4.5 | 1.21 | W1 | n.s. | |
Satisfaction student support (T1) | W1: 185 | 4.7 | 1.11 | W4 | n.s. | W1: 114 | 4.7 | 1.08 | W4 | n.s. | W1: 67 | 4.7 | 1.16 | W4 | n.s. |
W4: 185 | 4.6 | 1.17 | W7 | n.s. | W4: 114 | 4.5 | 1.21 | W7 | n.s. | W4: 67 | 4.9 | 1.06 | W7 | n.s. | |
W7: 185 | 4.6 | 1.33 | W1 | n.s. | W7: 114 | 4.5 | 1.34 | W1 | n.s. | W7: 67 | 4.7 | 1.21 | W1 | n.s. | |
Satisfaction student cohesion (T3) | W1: 188 | 4.2 | 1.38 | W4 | n.s. | W1: 117 | 4.2 | 1.32 | W4 | n.s. | W1: 68 | 4.4 | 1.29 | W4 | n.s. |
W4: 188 | 4.4 | 1.29 | W7 | n.s. | W4: 117 | 4.2 | 1.32 | W7 | n.s. | W4: 68 | 4.6 | 1.25 | W7 | n.s. | |
W7: 188 | 4.2 | 1.44 | W1 | n.s. | W7: 117 | 4.2 | 1.44 | W1 | n.s. | W7: 68 | 4.4 | 1.24 | W1 | n.s. | |
Work engagement (UWES) | W1: 319 | 4.0 | 0.93 | W4 | n.s. | W1: 107 | 4.0 | 0.88 | W4 | n.s. | W1: 67 | 3.9 | 1.00 | W4 | n.s. |
W4: 202 | 3.8 | 0.94 | W7 | n.s. | W4: 107 | 3.8 | 0.86 | W7 | n.s. | W4: 67 | 3.9 | 0.95 | W7 | n.s. | |
W7: 459 | 3.7 | 1.0 | W1 | 0.014 * | W7: 107 | 3.6 | 0.88 | W1 | 0.004 * | W7: 67 | 3.8 | 0.96 | W1 | n.s. | |
Cool down (CDI) | W1: 307 | 16.3 | 6.18 | W4 | n.s. | W1: 76 | 16.1 | 6.45 | W4 | n.s. | W1: 44 | 16.0 | 5.00 | W4 | n.s. |
W4: 166 | 15.1 | 6.80 | W7 | n.s. | W4: 76 | 14.9 | 5.50 | W7 | n.s. | W4: 44 | 14.6 | 6.85 | W7 | n.s. | |
W7: 390 | 15.9 | 8.07 | W1 | n.s. | W7: 76 | 14.8 | 7.57 | W1 | n.s. | W7: 44 | 17.0 | 8.99 | W1 | n.s. |
Semester | Stress Perception (PSS) | Wellbeing (WHO-5) | Life Satisfaction (BMLSS) | Support Satisfaction (BMLSS-Support) | Work Engagement (UWES) | Cool Down (CDI) | |
---|---|---|---|---|---|---|---|
Semester | 1 | ||||||
Stress perception | 0.110 ** | 1 | 0.039 | ||||
Wellbeing | −0.029 | −0.039 | 1 | ||||
Life satisfaction | 0.040 | −0.235 ** | 0.309 ** | 1 | |||
Support Satisfaction | −0.173 ** | −0.164 ** | 0.192 ** | 0.474 ** | 1 | ||
Work Engagement | −0.183 ** | −0.145 ** | 0.239 ** | 0.432 ** | 0.302 ** | 1 | |
Cool Down | 0.074 | 0.257 ** | −0.096 ** | −0.318 ** | −0.270 ** | −0.190 ** | 1 |
Beta | T | p | 95% Confidence Interval | |||
---|---|---|---|---|---|---|
Lower Limit | Upper Limit | |||||
Dependent variable: WHO-5 in W1 F = 15.9. p < 0.0001; R2 = 0.10 | ||||||
Model 2 | (constant) | 9.595 | <0.0001 | 8.780 | 13.312 | |
Satisfaction with university’s support | 0.181 | 2.792 | 0.006 | 0.193 | 1.115 | |
Satisfaction with studies | 0.175 | 2.692 | 0.008 | 0.196 | 1.261 | |
Dependent variable: WHO-5 in W4 F = 14.8. p < 0.0001; R2 = 0.17 | ||||||
Model 3 | (constant) | 2.036 | 0.043 | 0.106 | 6.646 | |
Satisfaction with studies | 0.249 | 3.441 | 0.001 | 0.421 | 1.552 | |
Satisfaction with university’s support | 0.234 | 3.231 | 0.001 | 0.350 | 1.445 | |
Clinical phase of studies | 0.151 | 2.328 | 0.021 | 0.246 | 2.972 | |
Dependent variable: WHO-5 in W7 F = 47.5. p < 0.0001; R2 = 0.36 | ||||||
Model 5 | (constant) | −0.863 | 0.388 | −3.350 | 1.305 | |
Satisfaction with studies | 0.398 | 7.301 | <0.0001 | 1.029 | 1.788 | |
Clinical phase of studies | 0.197 | 4.713 | <0.0001 | 1.175 | 2.855 | |
Satisfaction with university’s support | 0.191 | 3.374 | 0.001 | 0.257 | 0.973 | |
Satisfaction with fellow students’ support | 0.136 | 3.225 | 0.001 | 0.197 | 0.814 | |
Male gender | 0.118 | 3.007 | 0.003 | 0.410 | 1.957 |
Beta | T | p | 95% Confidence Interval | |||
---|---|---|---|---|---|---|
Lower Limit | Upper Limit | |||||
Dependent variable: PSS in W1 F = 18.4. p < 0.0001; R2 = 0.16 | ||||||
Model 3 | (constant) | 15.119 | <0.0001 | 25.830 | 33.562 | |
Satisfaction with studies | −0.303 | −5.446 | <0.0001 | −2.085 | −0.978 | |
Clinical phase of studies | 0.159 | 2.858 | 0.005 | 0.518 | 2.807 | |
Male gender | −0.109 | −2.038 | 0.042 | −2.252 | −0.040 | |
Dependent variable: PSS in W4 F = 17.1. p < 0.0001; R2 = 0.08 | ||||||
Model 1 | (constant) | 13.805 | <0.0001 | 18.101 | 24.135 | |
Satisfaction with studies | −0.284 | −4.141 | <0.0001 | −1.977 | −0.701 | |
Dependent variable: PSS in W7 F = 24.5. p < 0.0001; R2 = 0.14 | ||||||
Model 3 | (constant) | 30.669 | <0.0001 | 21.571 | 24.526 | |
Satisfaction with studies | −0.278 | −5.900 | <0.0001 | −0.955 | −0.478 | |
Male gender | −0.185 | −4.119 | <0.0001 | −1.989 | −0.704 | |
Satisfaction with cohesion among students | −0.102 | −2.175 | 0.030 | −0.500 | −0.025 |
Beta | T | p | 95% Confidence Interval | |||
---|---|---|---|---|---|---|
Lower Limit | Upper Limit | |||||
Dependent variable: UWES in W1 F = 78.8. p < 0.0001; R2 = 0.21 | ||||||
Model 1 | (constant) | 9.065 | <0.0001 | 1.589 | 2.471 | |
Satisfaction with studies | 0.459 | 8.877 | <0.0001 | 0.322 | 0.506 | |
Dependent variable: UWES in W4 F = 24.3. p < 0.0001; R2 = 0.21 | ||||||
Model 2 | (constant) | 9.090 | <0.0001 | 2.121 | 3.297 | |
Satisfaction with studies | 0.436 | 6.586 | <0.0001 | 0.235 | 0.436 | |
Clinical phase of studies | −0.148 | −2.242 | 0.026 | −0.580 | −0.037 | |
Dependent variable: UWES in W7 F = 168.8. p < 0.0001; R2 = 0.28 | ||||||
Model 1 | (constant) | 16.540 | <0.0001 | 1.856 | 2.356 | |
Satisfaction with studies | 0.533 | 12.993 | <0.0001 | 0.317 | 0.430 |
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Büssing, A.; Zupanic, M.; Ehlers, J.P.; Taetz-Harrer, A. Mental Stress in Medical Students during the Pandemic and Their Relation to Digital and Hybrid Semester—Cross-Sectional Data from Three Recruitment Waves in Germany. Int. J. Environ. Res. Public Health 2022, 19, 11098. https://doi.org/10.3390/ijerph191711098
Büssing A, Zupanic M, Ehlers JP, Taetz-Harrer A. Mental Stress in Medical Students during the Pandemic and Their Relation to Digital and Hybrid Semester—Cross-Sectional Data from Three Recruitment Waves in Germany. International Journal of Environmental Research and Public Health. 2022; 19(17):11098. https://doi.org/10.3390/ijerph191711098
Chicago/Turabian StyleBüssing, Arndt, Michaela Zupanic, Jan P. Ehlers, and Angelika Taetz-Harrer. 2022. "Mental Stress in Medical Students during the Pandemic and Their Relation to Digital and Hybrid Semester—Cross-Sectional Data from Three Recruitment Waves in Germany" International Journal of Environmental Research and Public Health 19, no. 17: 11098. https://doi.org/10.3390/ijerph191711098