Ambiente educacional y bienestar mental de los residentes de posgrados médicos y quirúrgicos en Medellín, Colombia

Introducción: Uno de los momentos más importantes en la vida de un médico ocurre cuando realiza la especialización médica. Este periodo impone estrés y exigencias académicas, lo cual, junto con el ambiente educacional, permite un mayor o menor bienestar mental. El objetivo del estudio es determinar cómo se relacionan el ambiente educacional y el bienestar mental de los residentes de Medicina. Métodos: Estudio transversal analítico en residentes de especialidades clínico-quirúrgicas. El ambiente educacional se evaluó mediante la escala Postgraduate Hospital Educational Envioro-ment Meassure (PHEEM) y el bienestar mental, con la escala de Warwick-Edinburgh (EBMWE). Se determinó la correlación lineal de Pearson. Se tomó el consentimiento informado y se obtuvo la aprobación del comité de ética universitario. Resultados: Integraron la población de estudio 131 estudiantes, el 43,8% varones, con una mediana de edad de 28 [intervalo intercuartílico, 4] arios. El 87,9% de los residentes respondieron a la encuesta. Hubo un 65,9% de posgrados médicos y un 34,1% de quirúrgicos. La puntuación media en la PHEEM fue de 107,96 ± 18,88; en la subescala de emociones positivas, 29,32 ± 5,18 y en funcionamiento positivo, 23,61 ± 3,57, con una media total de bienestar mental de 52,96 ± 8,44. Se encontró una moderada correlación positiva entre puntuación total de la PHEEM y cada una de las 2 subescalas de bienestar mental (p <0,001). Conclusiones: Se encontró una correlación positiva entre una mejor percepción del ambiente educacional y el bienestar mental de los residentes de especialidades clínicas-quirúrgicas con mayor bienestar mental

Introduction: One of the most important moments in a doctor's life occurs when they do a medical residency. This period imposes stress and academic demands, which, together with the educational environment, allows for greater or lesser mental wellbeing. The objective of this study was to determine how the educational environment and mental wellbeing of medical residents are related. Methods: Analytical cross-sectional study, in residents of clinical-surgical specialties. The educational environment was assessed using the Postgraduate Hospital Educational Environment Measure (PHEEM), and mental wellbeing was assessed with the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Pearson's linear correlation was determined. Informed consent and approval by the university ethics committee were obtained. Results:The study population comprised 131 students, 43.8% male, with a median age of 28 years (interquartile range 4). In total, 87.9% of residents answered the survey. Of these, 65.9% were doing medical residencies and 34.1% surgical residencies. The mean PHEEM score was 107.96 ± 18.88, the positive emotions subscale was 29.32 ± 5.18 and positive functioning 23.61 ± 3.57, with a mean total mental wellbeing of 52.96 ± 8.44. A positive and moderate correlation was found between the total PHEEM score and each of the two mental wellbeing subscales (p < 0.001). Conclusions: A positive correlation was found between a better perception of the educational environment and mental wellbeing by residents of clinical and surgical specialties with greater mental wellbeing.

Mental Health of University Students in Northern Malaysia

Context/Background: Today, poor mental health is one of the most neglected diseases although it is one of the leading causes of disabilities in both developed and developing countries. This mental health issue be-comes a problem among university students too. This study was aimed to determine the prevalence and asso-ciated factors of depression, anxiety, and stress (DAS) among university students. Methodology: A cross-sectional study was carried out in a private university of northern Malaysia during 2020. A random sample of 161 students were included and DASS-21 was used to determine the prevalence of DAS. Multiple logistic regression analysis was performed to examine the associated factors. Results: The prevalence of DAS among students were 34.8%, 42.2%, and 33.5%, respectively. In contrast to years 2 and 4, the prevalence of all types of mental disorders were lower in years 1 and 3. The students’ living area, residence, academic year, and parental income were significantly associated with anxiety whereas the age group of the students and parent’s income did so for depression. The variables; age group, academic year and parent’s income were identified as significant determinants for the presence of stress among students. Conclusions: The significant extent of the mental health problems was detected among university students in Malaysia. Despite the small sample, this analysis indicates that opportunities exist to improve campus-based mental health education and psychological support among university students.

Self-care among the Helping Professionals: A Systematic Literature Review

@#Introduction: Self-care is important in all aspect of our life. Generally, the concept of self-care is not a new term that attracted scholars to conduct relevant studies. Despite the number of self-care research on specific group or issues on the self-care practices, the comprehensive of self-care from the aspect of types, relation and factors of self-care has been relatively limited. Hence, this review synthesizes the available research exploring self-care issues among the helping professionals. Methods: A systematic review was conducted for papers published from year 2017-2021 included qualitative, quantitative, and mixed methods articles. Meanwhile, a Reporting Standards for Systematic Evidence Syntheses (ROSES) was adopted for current study. Two main journal databases, Scopus, Web of Science and additionally Google Scholar and PsycArticles were utilised. Results: The search yield 26 articles that can be analysed systematically. Outcome included identify types of self-care emphasized by helping professionals, relation, and factors influence self-care. Conclusion: Finding synthesizes the latest research on self-care, and highlights the benefits of self-care for the helping professionals. Finally, a number of recommendations were discussed at the end of the research.

Alleviate Examination Anxiety and conserve Mental Health of the Adolescent Students: the future of the nation

Adolescents are the potential human resources of every nation. Various determinants may influence the mental and physical well-being of the youth. Examination anxiety is one such. It is a prevalent problem for many adolescent students; affecting approximately 10-40 percent of all students. Yoga can act as one of the best alternative methods of treatment. It aims at creating and preserving a proper balance between the body and the mind. 61 adolescent students, of age group 14-16 years, suffering from examination anxiety participated in this study. Examination Anxiety Scale for adolescents, developed and standardized by the investigators, was used for assessing examination anxiety. The subjects were divided into two groups randomly- the experimental group and the control group. The experimental group participated in the yoga intervention program for six weeks, whereas, the control group did not participate in the same. After six weeks, both the groups were assessed again. The result showed that the mean examination anxiety score reduced from 71.70 to 68.80 for the experimental group and it was statistically significant at (P<0.05). For the male and the female experimental groups, the mean examination anxiety score reduced from 71.84 to 68.92, and 72.12 to 68.71, respectively. For the male group, reduction in examination anxiety score was not statistically significant (P =0.106) whereas, for the female group changes were statistically significant (P <0.05). From the result, it can be concluded that yoga has a significant effect on attenuating the examination anxiety. Further, the result showed that yoga reduced examination anxiety in both males and females. However, the positive effect of yoga intervention was more significant in females than in males

An interprofessional interventional approach to improve the mental well-being of medical students for better academic performances

Background: Medical students are the future doctors who are the primary caregivers for the society. High level of stress can obstruct the learning of medical students by impairing their concentration, problem solving, and decision-making skills. Improving mental well-being of medical students will ensure community safety. The stakeholders need to realize positive role of mental well-being on academic performance of students. This will not only benefit the students as well as the society as a whole. Aim and Objective: The present study was innovatively planned to determine the impact of the motivational sessions on relieving perceived stress and anxiety of the students along-with impact of such sessions on motivation for learning. Materials and Methods: An interventional cross-sectional study was designed for 2nd year MBBS students. A module comprising of eight sessions for improving mental well-being of undergraduate students was designed by an interprofessional team comprising a medical teacher, clinical phycologist, psychiatrist, and medical students. The pre-validated scales used were Hamilton Anxiety Rating Scale (HAM-A) to assess anxiety level, Perceived Stress Scale to assess perceived stress, and Motivated Strategies for Learning Questionnaire to measure the types of learning strategies and academic motivation of college students. Results: About 64% (n = 46) of the participants were male and 36% (n = 26) were female students. The present study showed no significant association between the gender and stress. It was seen that number of students with high perceived stress before the session were reduced by as much as 72.41% and that of students with highest motivation for learning strategies doubled from 18 to 36 (100% improvement).The difference in means of HAM-A scores in post-test and pre-tests is highly significant (P = 0.01). The students were very much satisfied with the mode and content of the module. They expressed that these sessions made them feel thought of and cared for. Conclusion: It is strongly recommended to apply this interprofessional interventional approach to improve the mental well-being of medical students for better academic performances.

Study of Inter-Relationship Between Perceived Workplace Discrimination, Job Stress, Mental Well-Being, And Job Performance of Teachers

Background: This study was planned to investigate the consequences of perceived workplace discrimination on job stress, mental well-being, and teachers' job performance in higher education. A conceptual model was proposed to illustrate the relationship between the study variables. Methodology: A correlational research design was adopted, and convenience sampling was used for data collection of 200 teachers. The participants of this study represented different streams of science and arts and were asked to fill questionnaires to collect relevant information on the subject matter. Results: Results show that (a) workplace discrimination is significantly positively related to perceived job stress, negatively related to mental well-being and overall job performance. Further, stepwise regression analysis shows that perceived job stress, job tenure, and workplace discrimination explain significant contributions (job stress emerged as best predictors of job performance) to the job performance of teachers and while job stress and gender explain significant contributions (job stress again emerged as best predictors of mental well-being) to the mental well-being of teachers. Results have been discussed in light of previous studies.

Need Satisfaction And Mental Well Being Among Working And Non-Working University Students In Pakistan: A Gender Perspective

@#The purpose of the study was to investigate the relationship between need satisfaction and mental well-being among university students in perspective of gender and job status. The sample was randomly selected from different universities of Islamabad, comprised of (N=160; n=80: working; n=40 males, n=40 females, n=80: n=40 males, n=40 females non-working) university students. Age range was 20 to 40. Basic need satisfaction scale was used to measure the satisfaction of basic needs and The Warwick-Edinburgh Mental Well-being Scale was used to assess the mental well-being. Results found that Basic Need Satisfaction and Mental Wellbeing has significant relationship (r=0.30, p=0.000) among university students. Results revealed that there was a significant difference of basic need satisfaction (t=-4.68, p<0.000) and mental wellbeing ((t=3.21, p<0.002) between male working and female working students. Female working students have high basic need satisfaction (M=88.93, SD=19.47) and Mental well-being (M=52.88, SD=9.14) than male working students. While no significant difference of Basic Need Satisfaction (t=0.64) and Mental Wellbeing (t=-1.31) among overall sample in perspective of gender and job status.

Social Connectedness in Physical, Mental and Social Health

We are constantly reminded to take care of ourselves. We need a healthy and balanced diet, with regular exercises, and good quality rest. However, research has shown that social connectedness also plays an essential and critical function to our physical and mental well-being. Many studies have shown that lack of social connection is a predictor of social isolation, resulting in greater detriment to health. Strong social connectedness is associated with increased longevity, strengthening of ones’ immune system, faster recovery from disease and, hence, a lengthening of one’s life. Studies have also shown that people who feel more connected to others in relationships tend to generate a positive feedback loop in communicating and maintaining healthy social and emotional well-being with others in the family, workplace and community. This decreases the propensity to antisocial behaviour, isolation behaviour or poor mental health. Individuals with strong connectedness were observed to have lower rates of anxiety and depression; and higher self-esteem and were more empathic towards self and others, resulting in better emotional and psychological well-being. Social connectedness is a broad topic and can be reviewed from various perspectives. This article will review the concept from a psychological perspective of self, exploring the importance of practicing compassion intervention in social connectedness and self-care.

Traducción, adaptación al español y validación de la Escala de Bienestar Mental de Warwick-Edinburgh en una muestra de adultos mayores argentinos / Translation, Spanish adaptation and validation of the Warwick-Edinburgh well-being scale in a sample of Argentine older adults / Tradução, adaptação ao espanhol e validação da escala de bem-estar mental de Warwick-Edinburgh em uma mostra de adultos maiores argentinos

El estudio analiza las propiedades psicométricas y la estructura factorial de la Escala de Bienestar Mental de Warwick- Edinburgh luego de realizar la traducción directa y revertida y su adaptación al español. Se validó la escala mediante su aplicación a una muestra de 910 adultos mayores argentinos, con edades comprendidas entre 71 y 96 años (media 81.4 años; DE 10.9 años). Se obtuvieron los siguientes indicadores: distribución de respuestas, consistencia interna, confiabilidad test-retest, validez de constructo, y se realizó un análisis factorial exploratorio y confirmatorio. En cuatro de los ítems se debieron modificar los términos para mantener la equivalencia conceptual con el original. El índice de confiabilidad alfa de Cronbach (0.89), la correlación ítem-escala total (0.41-0.78), el índice test-retest medido mediante el coeficiente de correlación intra-clase (CCI) (0.91) mostraron un nivel satisfactorio. El análisis factorial confirmatorio mostró un RMSEA de 0.054, considerado aceptable; un valor CFI igual a 0.963, un valor de NNFI 0.925 (levemente inferior al deseado) y un GFI con un valor de 0.991. Se obtuvo una solución de dos factores, por lo cual no se pudo sostener la hipótesis de uni-dimensionalidad de la escala original. Se concluye que la escala traducida y adaptada al español para una muestra de adultos mayores no institucionalizados tiene un ajuste adecuado, con alta consistencia interna y buena confiabilidad test-retest, con iguales valores de constructo que el instrumento original, lo que permitiría su uso en la población adulta mayor.

The study assesses psychometric properties and factorial structure of the Warwick-Edinburgh mental well-being scale after forward and backward translations and Spanish adaptation. The scale was validated by applying it to a sample of 910 Argentine elders, with ages ranging from 71 and 96 years (media 81.4 years; SD 10.9 years). The following measures were obtained: response distributions, internal consistency, test-retest reliability, construct validity and exploratory and confirmatory factor analysis. In four of the original items, phrasing was modified to keep conceptual equivalence with the original instrument. Reliability (Cronbach's alpha 0.89), item-total scale (0.41-0.78) and test-retest measured by intra-class correlation coefficient (ICC) (0.91) were deemed appropriate. Confirmatory factorial analysis showed a RMSEA = 0.054, considered acceptable, a CFI = 0.963, a NNFI = 0.925 (slightly below the accepted value) and a GFI = 0.991. A two factor solution was obtained so it was not possible to hold the single dimensional hypothesis as in the original scale. The translated and adapted scale shows an appropriate level of adjustment, high internal consistency and good test-retest reliability, with the same construct validity as the original instrument which allows its use among the elderly population.

O estudo analisa as propriedades psicométricas e a estrutura fatorial da Escala de Bem-estar Mental de Warwick-Edinburgh depois de realizar a tradução direta e revertida e sua adaptação ao espanhol. Validou-se a escala mediante sua aplicação a uma mostra de 910 adultos maiores argentinos, com idades compreendidas entre 71 e 96 anos (média 81.4 anos; DE 10.9 anos). Obtiveram-se os seguintes indicadores: distribuição de respostas, consistência interna, confiabilidade teste-reteste, validade de constructo, e realizou-se uma análise fatorial exploratória e confirmatória. Em quatro dos itens tiveram que ser modificados os termos para manter a equivalência conceitual com o original. O índice de confiabilidade alfa de Cronbach (0.89), a correlação item-escala total (0.41-0.78), o índice teste-reteste medido mediante o coeficiente de correlação intra-classe (CCI) (0.91) mostraram um nível satisfatório. A análise fatorial confirmatória mostrou um RMSEA de 0.054, considerado aceitável; um valor CFI igual a 0.963, um valor de NNFI 0.925 (levemente inferior ao desejado) e um GFI com um valor de 0.991. Obteve-se uma solução de dois fatores, pelo qual não de pôde sustentar a hipótese de uni-dimensionalidade da escala original. Concluise que a escala traduzida e adaptada ao espanhol para uma mostra de adultos maiores não institucionalizados tem um ajuste adequado, com alta consistência interna e boa confiabilidade teste-reteste, com iguais valores de constructo que o instrumento original, o que permitiria seu uso na população adulta maior.

The Role of Breastfeeding in Postpartum Maternal Weight Loss, Body Satisfaction, Well-being and Confidence Losing Weight.

Background: Evidence shows that breastfeeding has a major role to play in public health, promoting health and preventing disease in the short and long-term for both mother and infant (NICE [1]). In addition to the established benefits, exclusive breastfeeding is suggested as an effective method of weight loss during the postpartum period due to the increased energy costs of lactation (Hatsu et al. [2]).However this potential benefit is very dependent on the duration of exclusive breast-feeding. Breastfeeding may also be related to improved maternal mental well-being (Mezzacappa [3]). This aim of the study is to assess the role of breastfeeding in postpartum women on weight loss through self-reported weight measurements pre-pregnancy and current weights and to compare levels of mental well-being with those women who were not breastfeeding. Methods: Postpartum women, who had given birth in the last year, were invited to complete an online SurveyMonkey questionnaire, live from 12/10/12 to 09/11/12, posted on pregnancy forums – selected because there was no charge attached to the posting. The questionnaire, including 84 questions, was developed from previous questionnaires written by the University of Nottingham MAGIC study team to explore the predictors of weight management in post-partum women. For this research responses to seven questions were analysed. An independent t-test was conducted to investigate the relationship of breastfeeding with weight change postpartum. A Mann-Whitney U Test used to analyse the relationship between breastfeeding and maternal body satisfaction, well-being and confidence returning to pre-pregnancy weight. This data was nonparametric and was scored on a scale with a mean score used to calculate statistical significance. Ethical approval was obtained on the 18/5/2012 from the University of Nottingham School of Sociology and Social Policy. Results: The sample of 1405 postpartum women ranged in age from under 20 years to 49 years with 50.9% breastfeeding and 49.1% non-breastfeeding. No statistical significance was found between breastfeeding and postpartum weight loss. Breastfeeding women were significantly more satisfied with their body (p<0.01) compared to those not breast-feeding. The study also found a positive correlation between breastfeeding and well-being. Breastfeeding women reported feeling more calm and peaceful (p<0.005). Breastfeeding women were significantly less likely to feel downhearted and low (p<0.002). But there was no statistical difference in energy levels. Breastfeeding women were significantly more confident about losing their gestational weight (p<0.01). Discussion: Breastfeeding was not associated with improved postpartum weight loss but those women who were breast-feeding felt more confident about being able to lose weight and return to their pre-pregnancy weight compared to those women not breast-feeding. The study did find a positive correlation between breastfeeding and increased body satisfaction and maternal mental well-being. Study limitations are that the respondents were at different stages postpartum and the responses were not definite as to the duration of breastfeeding or its exclusivity. Also the pregnancy forums selected may have introduced some bias into the study sample and thus the findings may not be truly representative. Conclusion: This research may help introduce new strategies to help promote breastfeeding as a positive experience improving mother’s self-confidence and reducing depressive feelings. More research is required to further explore the links between breastfeeding and maternal self-esteem and self-worth. Being more confident about losing weight may be beneficial in postpartum weight management but this requires further study.

Stress and its risk factors in medical students: An observational study from a medical college in India.

Objectives: Stress in medical students is well established. It may affect academic performance and lead to anxiety, depression, substance abuse, and burnouts. There is limited data on stress in Indian medical students. We conducted an analytical observational study to assess the magnitude of stress and identify possible "stressors" in medical students of a teaching hospital in Kolkata. Materials And Methods: This questionnaire-based study was conducted in the Institute of Post Graduate Medical Education and Research, Kolkata with consenting undergraduate students of 3 rd , 6 th , and 9 th (final) semesters, during lecture classes in individual semesters on a particular day. The students were not informed about the session beforehand and were assured of confidentiality. The first part of the questionnaire captured personal and interpersonal details which could be sources of stress. The rest comprised three rating scales - the 28-item General Health Questionnaire to identify the existence of stress, the Warwick-Edinburgh mental well-being scale to assess the mental well-being, and the revised version of the Lubben social network scale to assess the social networking. The responses and scores were compared between the three semesters as well as between various subgroups based on baseline characteristics. Results: Data from 215 respondents were analyzed - approximately 75% were male, 45% came from rural background, 25% from low-income families, and 60% from vernacular medium. Totally, 113 (52.56%; 95% confidence interval: 43.35-61.76%) students were found to be stressed, without significant difference in stress incidence between the semesters. About 60% of the female students were stressed in contrast to 50% of the males, but this observed difference was not statistically significant. The mental well-being and social networking of stressed respondents suffered in comparison to their non-stressed counterparts. Conclusions: The stress incidence in medical students in this institution in India is high and is negatively affecting their mental well-being. Further multicentric and longitudinal studies are needed to explore the incidence, causes, and consequences of stress in our setting.