DEAL-based intervention for the reduction of depression, denial, self-blame and academic stress: a randomized controlled trial

ABSTRACT

This study aimed to evaluate effectiveness of a DEAL-based based intervention on medical students' depression symptoms, coping strategies and perceived stressors. A parallel randomized controlled trial was conducted on a government medical school in Malaysia. A total of 171 medical students consented to participate in the study. A 4-h educational workshop that was designed based on the DEAL model was conducted on the medical students. Depression, coping strategies and perceived stressors were measured by Beck's Depression Inventory, Brief COPE and Medical Student Stressor Questionnaire respectively. The mixed model ANCOVA was applied to determine the effect of intervention. Partial eta squared [h2 partial] was used to estimate effect size. 171 medical students were randomized into study groups by draw lots [control = 83 and intervention = 88]. 18 medical students withdrew from the study before 32nd week, leaving 153 medical students [control = 80 and intervention = 73] for analysis. The intervention group significantly experienced lower depression symptoms [p = 0.017, eta[2] partial = 0.037], less frequent of denial [p = 0.002, eta[2] partial = 0.063], less frequent of self-blame [p = 0.002, h2 eta[2] = 0.064] and lower perceived academic stress [p = 0.009, h2 eta[2] = 0.044] than the control group. The results support the positive impacts of the DEAL-based intervention on the medical students' mental health. It is a promising intervention to be adopted by medical schools due to it consumes minimal amount of time, money, training and man power as well as simple to be implemented