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 Table of Contents  
ORIGINAL ARTICLES
Year : 2015  |  Volume : 2  |  Issue : 3  |  Page : 113-116

Creating smiles amidst stress: A questionnaire based study


1 Intern, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
2 Head of Department, Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
3 Assistant Professor, Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Pune, Maharashtra, India

Date of Web Publication19-Nov-2015

Correspondence Address:
Vivek Sunil Nair
Intern, Sinhgad Dental College and Hospital, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2348-2915.167873

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  Abstract 

Introduction: Dentistry is considered as a stressful field in the medical profession. The study was conducted to determine the different problems faced by dental students, and the effect of these stressors on their lives. Materials and Methods: A modified dental environmental stress (D.E.S) questionnaire was administered to students of 1st year B.D.S to final year B.D.S and Interns. The questionnaire had 35 questions divided into five categories: Demographic data, living/accommodation stressors, personal stressors, academic stressors, and clinical stressors. Statistical significance between the mean D.E.S scores of gender and years of study was compared using t-test and one-way ANOVA. Results: A total of 292 students completed and returned the questionnaire with a response rate of 74.8%. The overall mean D.E.S score of females was higher (2.37 ± 0.44) when compared to males (2.23 ± 0.45). The overall D.E.S scores differed among the students of different academic years with the 2nd year students being more stressed (2.45 ± 0.52) as compared to the students of other academic years. Discussion: Understanding the various causes of stress in students is very much necessary to set up a curriculum that is student - friendly and at the same time, effective enough. Conclusion: Clinical and academic work causing increased amount of stress can be brought down by the student, if he/she simplifies their schedule, practices breathing exercises, performs yoga, etc.

Keywords: Dentistry, dental environmental stress questionnaire, stress


How to cite this article:
Nair VS, Shetty V, Kalra DD. Creating smiles amidst stress: A questionnaire based study. J Dent Res Rev 2015;2:113-6

How to cite this URL:
Nair VS, Shetty V, Kalra DD. Creating smiles amidst stress: A questionnaire based study. J Dent Res Rev [serial online] 2015 [cited 2019 Oct 23];2:113-6. Available from: http://www.jdrr.org/text.asp?2015/2/3/113/167873


  Introduction Top


“Working hard for something we don't care about is called stress. Working hard for something we care about is called passion,” says author and motivational speaker, Simon. O. Sinek. Dentistry is a profession that is gaining rapid popularity among youngsters, who view it as a passion and not merely as a “money – minting medium.” But unfortunately, students are hitting the panic button and getting stressed out in the initial years of their college life itself.

Stress, in simple terms, is a normal physical response to events that make a person feel threatened or upsets his/her balance in some way. Stress is not altogether a negative thing. Small doses of it can serve as a motivating factor, urging a person to push his mind and body, beyond self-imposed limitations. But when one is constantly in emergency mode, the mind and body have to pay the price.

Dental profession by some authors has been considered as the most stressful of all the health professions.[1] And this stress begins from the very first step into the field of dentistry that is, at the dental school. Young minds, obviously are a greater prey to stress as their zeal to succeed does not always culminate in favourable results, more so in the medical profession. Getting admitted into a top notch university itself is a stressful task. But the impediments do not end there. College life presents numerous hassles that come in the way of smooth learning. Stress affects the physical and psychological well-being of the person causing symptoms like anxiety, fear, insomnia, gastrointestinal symptoms, depression, etc.[2],[3],[4]

Sorting out these problems takes a toll on the students, physically, and mentally. It is a grave issue that needs to be extensively studied upon, as the subjects of study are crucial in adding to the quality of the medical profession of the country. It is important that the dental council sets up the curriculum, after taking into consideration the various factors that impose stress and anxiety in the students. Very few studies are directed to access the various causes of stress among undergraduate dental students in India. Hence, this research is an effort to venture into unexplored territories.

The study aims to: (a) Determine different problems faced by dental students that may serve as probable stressors, (b) determine the effect of various stressors on the lives of dental students and, and (c) determine those stressors that have maximum effect on the student's life.


  Materials and Methods Top


Verbal consent was obtained from students participating in the survey, and necessary permissions were taken from the Institutional Research Board of Sinhgad Dental College and Hospital. The questionnaires were distributed on a one-on-one basis and collected after a period of 15 min.

Study design

A cross-sectional questionnaire-based study was carried out to assess the stress among the undergraduate dental students.

Source of data/study population

The study population comprised of undergraduate students from 1st year B.D.S to final year B.D.S and Interns at Sinhgad Dental College and Hospital, Pune.

Selection criteria

Students who have enrolled for B.D.S course present on the day of the survey in various years at Sinhgad Dental College and Hospital, Pune shall be included in this study.

Sample size

All students present on the day of the survey.

Sampling method

Census method.

Instrument

In the pilot study (i.e., before forming the main questionnaire) an open-ended discussion with 20 students that is, 4 (2 males 2 females) from each academic year and batch of interns was conducted to help in modification of the dental environmental stress (D.E.S) questionnaire. This helped in designing a questionnaire with relevant questions, suitable to decipher issues that the students face during the course. The final modified D.E.S questionnaire was then prepared with 35 questions. It was face validated by two senior academic faculty members. The questionnaire is divided into two sections: Section A with demographic data (3 items) and Section B with Questions to assess the stress level among undergraduate dental students (32 items). The questionnaire is in English and includes questions which can be easily interpreted by all. It maintains the total confidentiality of the student so as to receive a truthful and uninfluenced response. Questions related to stress-inducing factors include the following sections; living/accommodation stressors (4 items), personal stressors (6 items), academic stressors (7 items), and clinical stressors (10 items). Each item is scored using a four-point scale of severity namely: (1) Not stressful at all, (2) somewhat stressful, (3) quite stressful, and (4) very stressful.

Statistical analysis

Data were compiled on MS office Excel sheet (version 2010). Descriptive analysis including frequency distribution, mean, and standard deviation were determined from the stress scores of individual items and were used to compare it with the years of study and gender. Analysis of the data was done using the Statistical Package for Social Sciences (SPSS version 17, Chicago IL, USA). Statistical significance between the mean dissociative experiences scale scores of gender and years of study was compared using t-test and one-way ANOVA. P < 0.05 was considered to be statistically significant, thus giving a 95% of the confidence level to the study.


  Results Top


A total of 292 students completed and returned the questionnaire with a response rate of 74.8%. From the study population 72 (24.2%) were males and 225 (75.8%) were females and the number of participants for each year is represented in [Table 1].
Table 1: Demographic data

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The age of the respondents ranged from 18 to 23 years. [Table 2] illustrates the mean D.E.S scores of different problems and their statistical relationships with the two investigated variables.
Table 2: Results

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The overall mean D.E.S score of females was higher (2.37 ± 0.44) when compared to males (2.23 ± 0.45). Issues like insecurity regarding professional future, exams, and the difference in opinion among clinical staff regarding treatment created more stress in females. Male students were stressed due to rules and regulations of a dental college and compulsory attendance.

The overall D.E.S scores differed among the students of different academic years with the 2nd year students being more stressed (2.45 ± 0.52) as compared to the students of other academic years. The top stressor for the students living in the hostel is the lack of homemade food, causing health problems (3.52 ± 0.75). Other top stressors for all academic years, in common are, lack of holidays (3.11 ± 0.95), compulsory attendance (2.9 ± 1.03), examination (2.85 ± 0.97), and insecurity regarding professional future (2.79 ± 0.98).

The difference in opinion between the clinical staff regarding the treatment created maximum stress (2.61 ± 0.83) in students during the clinical postings.


  Discussion Top


Understanding the various causes of stress in students is very much necessary to set up a curriculum that is student-friendly and at the same time, effective enough. All this is critical in producing the best dental professionals, as studying in a stress-free environment does wonders to their performance. Identifying the stressors that initiate fear and anxiety among students can help the academicians to device mechanisms to reduce the stress by various activities like counseling sessions, Gibberish meditation,[5] etc. Indulging in extracurricular activities like sports and regular exercises has also shown to reduce stress considerably.[6] Implementing mentorship programs in dental education will help the dental faculty to provide personal attention to the students, thus compensating for the academic related stress.

In the present study, it was noted that the stress related to living and accommodation out of the home was high in females. This could be associated with the fact that females are more attached to the family and more sensitive regarding moving away from home for study as compared to males.

Lack of time for relaxation and coursework related stress was found to be high among the 2nd year students. The contributing factors to this could be the added stress caused by the subjects studied during the year, like the basic medical and dental, along with the thought of completing the preclinical requirements.

The female students evidently seemed to be having a deep rooted insecurity regarding their professional future. This can be remedied with the support and guidance of the faculty. The rigid rules and the compulsory attendance seem to be giving the male students, sleepless nights. A more student-friendly atmosphere could lessen their worries.

One of the most significant and common reasons for stress noticed among both sexes was the difference in opinion between the clinical staff. The lack of a standardized method/criterion of evaluation is hurting the morale of the students. They are unsure about their performance, as they receive divergent feedback from their faculties.

Assessment plays a key role in the learning process. It is central, rather than peripheral to the teaching sessions provided to the students. To overcome the difficulties faced due to difference in opinion between the clinical staff, the authors would like to recommend the use of Objective Structured Clinical Evaluation [7] in the assessment of students in various clinical subjects of dentistry. This method of evaluation would benefit both stakeholders; the examiners, as it is more systematic and less time consuming and also the students, as it acts as an evaluation procedure and provides invaluable guidelines with regards to the improving their communication skills, professionalism, and basic clinical skills.

Limitations

Number of students who completed and returned the forms from 1st year B.D.S course was only 31 out of the 54 admitted to the course and from the 3rd year B.D.S course were only 28 from the 32 students present on the day of survey. This discrepancy in the sampling was due to the lower number of students admitted to the 1st year B.D.S course in the current academic year and the lower attendance of the 3rd year B.D.S students on the day of survey.


  Conclusion Top


Within the limitations of the study, there is an unequivocal revelation of the existence of stress levels in the young minds, without much gender discrimination.

This increased level of anxiety among budding dentists is itself a daunting prospect. The nature of the profession is such that it requires a calm and composed mind and demeanor, which becomes an automatic catalyst in calming down the perturbed patients. Then, there is always a perilous possibility of committing a procedural error, as a consequence of emotional instability. Failure to achieve optimum results will only bring down the self-esteem. So, if the students do not learn to get a grip on themselves now, their professional future seems bleak. It is, therefore, the need of the hour that some active measures be taken to modify their temperament.

Clinical and academic work causing increased amount of stress can be brought down by the student, if he/she simplifies their schedule, practices breathing exercises, performs yoga, etc. Listening to relaxing music and indulging in the act of praying can also reduce the distress caused due to studies considerably.[8],[9]

As Andrew Bernstein, Author and Professor of Philosophy said, “The truth is that stress doesn't come from your university, your boss, your job, or anything else. It comes from your thoughts about these circumstances.” Hence, the trick lies in putting away the thought that creates stress and choosing positive thoughts. So a dental student, stuck in the middle of numerous projects, low scores, fed up with the stringent regulations, and demands of regular attendance, should think of his/her goal and the ultimate happiness he/she will get when it is achieved; instead of getting bogged down by the presumed negativity. After all, it is of paramount significance that the ones, who are responsible for the clean and bright smiles of millions, should themselves be happy and stress-free.

Acknowledgment

We would like to thank Ms. Gopika Sasidharan for her consultation regarding the sociological and psychological aspect of Stress.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Cooper CL, Watts J, Kelly M. Job satisfaction, mental health, and job stressors among general dental practitioners in the UK. Br Dent J 1987;162:77-81.  Back to cited text no. 1
[PUBMED]    
2.
Sanders AE, Lushington K. Sources of stress for Australian dental students. J Dent Educ 1999;63:688-97.  Back to cited text no. 2
    
3.
Westerman GH, Grandy TG, Ocanto RA, Erskine CG. Perceived sources of stress in the dental school environment. J Dent Educ 1993;57:225-31.  Back to cited text no. 3
    
4.
Newton JT, Baghaienaini F, Goodwin SR, Invest J, Lubbock M, Marouf Saghakhaneh N. Stress in dental school: a survey of students. Dent Update 1994;21:162-4.  Back to cited text no. 4
    
5.
Saxena R, Shirahatti RV, Shah C, Kazi M, Bhosale A, Panchawadkar D, et al. Impact of gibberish meditation on students learning in a dental school. Int J Med Sci Public Health 2013;2:420-6.  Back to cited text no. 5
    
6.
Sugiura G, Shinada K, Kawaguchi Y. Psychological well-being and perceptions of stress amongst Japanese dental students. Eur J Dent Educ 2005;9:17-25.  Back to cited text no. 6
    
7.
Mossey PA, Newton JP, Stirrups DR. Scope of the OSCE in the assessment of clinical skills in dentistry. Br Dent J 2001;190:323-6.  Back to cited text no. 7
    
8.
Bormann JE, Smith TL, Becker S, Gershwin M, Pada L, Grudzinski AH, et al. Efficacy of frequent mantram repetition on stress, quality of life, and spiritual well-being in veterans: a pilot study. J Holist Nurs 2005;23:395-414.  Back to cited text no. 8
    
9.
White JM. Music therapy: an intervention to reduce anxiety in the myocardial infarction patient. Clin Nurse Spec 1992;6:58-63.  Back to cited text no. 9
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