Burnout,depression and suicidal ideation in dental and dental hygiene students

Introduction

The aim of this study was to assess the relationship between burnout, depressive symptoms and suicidal ideation in dental and dental hygiene students and to evaluate the influence of gender, programme type and year of study.

Subjects and methods

Third‐ and fourth‐year dental (DS) and first‐ and second‐year hygiene students (DHS) completed the Patient Health Questionnaire (PHQ‐9) and an abbreviated Maslach Burnout Inventory online as measures of depressive symptoms/suicidality and burnout, respectively. The statistical analyses included summary statistics and tests for intergroup comparisons (chi‐square) to evaluate the influence of gender, programme type (DHS or DS) and year of study. Correlations between depression, suicidality and burnout were also conducted.

Results

A total of 32 dental hygiene and 119 dental students participated. 40% of the dental and 38% of the hygiene students met criteria for burnout. No differences were found between years or between programmes. Nine per cent of both dental and hygiene students were above the cut‐off for moderate depressive symptoms, but there were no statistical differences between the third‐ and fourth‐year dental and the first‐ and second‐year hygiene students. Six per cent of the dental and 9% of the dental hygiene students were above the cut‐off for clinically significant suicidal ideation, but there were no statistical differences between dental and hygiene students. There were no differences noted in the dental students based on gender for any of the measures. Depression was significantly associated with all three subscales of burnout. Suicidal ideation was only significantly related to the lack of personal accomplishment subscale of burnout.

Discussion

These findings suggest the need for introducing preventive measures for such affective states in dental and dental hygiene training programmes.     

Psychological stress in undergraduate dental students: baseline results from seven European dental schools

OBJECTIVES: To determine the degree of psychological distress, the experience of emotional exhaustion, and the extent of stress associated with course work in dental students and to compare these measurements among seven European dental schools. DESIGN: Multi-centred survey. SETTING: Dental Schools at Amsterdam, Belfast, Cork, Greifswald, Helsinki, Liverpool and Manchester. PARTICIPANTS: 333 undergraduate first-year dental students. MEASURES: General Health Questionnaire (GHQ12), Maslach Burnout Inventory (MBI), Dental Environment Stress Questionnaire (DES), demographic variables. PROCEDURE: Questionnaire administered to all students attending first year course. Completed questionnaires sent to central office for processing. RESULTS: Seventy-nine percent of the sampled students responded. Over a third of the students (36%) reported significant psychological distress (morbidity) at the recommended cut-off point (>3 on GHQ). These scores were similar to those reported for medical undergraduates. Twenty-two percent recorded comparatively high scores on emotional exhaustion. A wide variation in these 2 measurements was found across schools (p's<0.001). Stress levels indicated by the DES were less variable (p>0.5). Some evidence showed that contact with patients and the level of support afforded by living at home may be protective. CONCLUSION: Higher than expected levels of emotional exhaustion were found in a large sample of first-year undergraduate dental students in Europe.     

Psychological stress and health in undergraduate dental students: fifth year outcomes compared with first year baseline results from five European dental schools

Psychological stress in undergraduate dental students: fifth year outcomes compared with first year baseline results from five European dental schools. Objective: To compare the levels of a series of health‐related indicators from a cohort of fifth year dental students from five European schools with their first year scores, and to investigate the relationship between these follow‐up measures. Methods: Burnout was measured using the Maslach Burnout Inventory (MBI), consisting of three scales: Emotional Exhaustion (EE, α = 0.90), Depersonalisation (α = 0.80) and Personal Accomplishment (α = 0.72). Physical health was measured by the Physical Symptoms Questionnaire (α = 0.82), psychological distress was measured using the General Health Questionnaire (GHQ, α = 0.89) and student stress was captured using seven subscales of the Dental Environment Stress questionnaire (DES, α = 0.92). A total of 132 fifth year students responded from five dental schools (Manchester, Belfast, Cork, Helsinki and Amsterdam), a 51% response. Results: Fifth year students showed relatively high mean MBI scores when compared with first year results, especially on EE; 39% could be labelled ‘high scorers’; 44% of the students met the criteria for ‘cases’ on the GHQ. Highest mean scores on the DES were obtained on the subscales: Study Obligations, Patient‐Related Aspects and Study Pressure respectively. Between schools interesting differences were detected on all variables. As hypothesised, a clear direct effect of stress on both burnout and physical symptoms was shown. An indirect effect of stress on mental health via burnout was shown. Conclusions: Dental students showed a negative development through the years from first to fifth year with regard to EE and psychological distress. Both burnout constructs related to physical and mental health. It is recommended that dental faculty focus on the importance of prevention and intervention of stress amongst undergraduates.     

Stress amongst dental students: a systematic review

The present study was conducted to provide future researchers and dental educators with an overview of stress amongst undergraduate dental students reported in the literature. This overview is needed for the development of a new questionnaire measuring the level of stressors including students, staff and process of dental education. In addition, the review can be used to modify dental curricula to decrease such stress and produce better dentists. Our study consisted of a systematic review of 49 peer‐reviewed articles published between 1966 till October 2008 in English, discussing different aspects of stress amongst undergraduate dental students. These aspects are demographic variables of stress, sources of stress, impact of stress, indicators of stress, instruments measuring stress level and management of stress. Major sources of reported stress were related to examinations, clinical requirements and dental supervisors. Studies suggest using signs and symptoms for early detection of stress and proper intervention.     

Attitudes toward National Health Insurance: dentists, dental students, and dental hygiene students

The attitudes toward National Health Insurance held by 126 second year dental students and 108 second year dental hygiene students enrolled in the state of Wisconsin, U.S.A., were measured and compared with the attitudes held by practicing dentists in the U.S.A. Although some similarities were noted, marked differences were revealed, with students, generally, preferring broader coverage and more government involvement than practicing dentists. There is virtually no published data in this area, and more research is needed, as the success or failure of any National Health Insurance plan depends critically on the altitudes of both health care providers and those studying to become health care providers.     

Oral health behaviour and its determinants amongst Iranian dental students.

OBJECTIVES: To study the oral health behaviour (OHB) of Iranian senior dental students in relation to their gender, background characteristics, knowledge of preventive care, and attitudes towards preventive dentistry. MATERIALS AND METHODS: Using a cluster random sampling approach, a questionnaire survey was conducted with 327 senior dental students in seven dental schools. The questionnaire covered age, gender, parents' employment in dentistry, previous academic education in dental hygiene, oral self-care, most recent dental check-up, knowledge of preventive dentistry and attitudes towards it. Attending a dental check-up by a dentist or a classmate within the last year was defined as preventive care use. Chi-square test and logistic regression models were used for statistical analyses. RESULTS: Women reported significantly higher frequencies of tooth brushing (P < 0.001), fluoridated toothpaste use (P = 0.001) and flossing (P < 0.001) compared with men. Respondents who had been previously educated as dental hygienists had lower frequencies of eating sugary snacks (P < 0.001) and paid more attention to preventive care (P = 0.03) than others. Those with more extensive knowledge of preventive care reported higher frequencies of using fluoridated toothpaste (P = 0.05). Reported frequencies of brushing were higher amongst those with more positive attitudes (P = 0.03). In logistic regression models, having at least one parent employed as a dentist was significantly associated with higher frequencies of eating sugary snacks (P = 0.047, OR = 0.3) and more frequent preventive care use (P = 0.048, OR = 2.9). CONCLUSION: Education and training in preventive measures should be effective enough to overcome background characteristics. There is room for improving the OHB of Iranian dental students.     

Preparing for the dental team: investigating the views of dental and dental care professional students.

There is growing evidence to support the contention that interprofessional education (IPE) at both pre and post-qualification levels will improve professionals' abilities to work more effectively in a team and to communicate more effectively with colleagues and patients. This body of evidence, however, is primarily concerned with nursing, medical and associated professionals and students, and there are few studies that include dental students and particularly where learning occurs with the dental care professions (DCP). The purpose of this study was to examine the attitudes of dental and DCP students to IPE and to highlight some of the barriers to developing programmes for these students. It was also intended to examine the students' awareness of dental and DCP roles and responsibilities. Two questionnaires, the Readiness for Interprofessional Learning Scale (RIPLS) and a dental roles and responsibilities questionnaire, were distributed to all 5 years of dental students (n = 189) based at Queen's University Belfast (QUB), both years of the dental hygiene students (n = 8) also based at QUB, as well as to final year dental nursing students based at Belfast Institute of Further and Higher Education (BIFHE) (n = 64). The results indicated that dental and DCP students had a positive attitude to IPE as a means to improve teamwork and communication skills but there are potential obstacles as demonstrated by the differing perceptions of each of the three groups about the roles of the other. Some aspects of practice, involving personal care and advice to patients, were regarded by all groups as a shared role but the dental hygiene students regarded themselves as having a shared role in several tasks identified by dental and dental nurse students as the sole role of the dentist. Dental hygiene students in this study did not see their role as primarily to support the dentist but more as a partner in care. Professional identity and its development are issues that must be considered by dental and DCP educators developing IPE initiatives.     

Aptitude testing and the selection of dental students

This paper discusses the problems involved in the selection of dental students and the need for some form of aptitude testing. It describes the situation in the United Kingdom both in the past and the present, and then describes in detail the situation in North America (both in the United States and Canada). The Dental Admission Test, its history and the research into its development are described with particular emphasis on the dexterity, perceptual and aptitude components of the test. More recent research into dexterity and aptitude testing of dental students is also covered. However, it is apparent that many questions remain unanswered.     

Psychological well-being and perceptions of stress amongst Japanese dental students

The purpose of this study was to investigate the relationship between Psychological General Well Being (PGWB) and perceived sources of stress amongst dental students in Japan. Second to sixth year dental students of Tokyo Medical and Dental University were invited to participate in the questionnaire survey. The questionnaire collected information on demographic and social background, lifestyle behaviours, the PGWB index and the Dental Environment Stress (DES) questionnaire. A total of 320 students (56% male) participated, with a response rate of 91%. Male students had significantly higher PGWB scores and lower DES scores than female students (P < 0.05). There were no significant differences in the year of study for DES mean score and PGWB total score. Students whose first choice of admission was dentistry experienced less stress than those whose first choice was another discipline (P < 0.05). Students who regularly exercised showed significantly lower stress levels and higher well-being status than those students who did not exercise (P < 0.01). Correlational analysis showed an inverse relationship between PGWB and DES scores (r = -0.544, P < 0.001). Multiple regression analysis revealed that DES mean score was significantly related to gender, first choice of admission and PGWB total score. It is suggested that perception of stress amongst Japanese dental students is influenced by gender, dentistry as first choice for admission and students' general well-being.     

Stress, burnout and health in the clinical period of dental education

The study examined the extent of stress, burnout and health problems experienced by fourth and fifth year dental students from the three universities of Dresden, Freiburg and Bern. The objectives of the study were to: (i) identify frequent sources of stress and to report the prevalence rates of burnout and health problems in dental students, (ii) determine the rate of students suffering from severe burnout symptoms and (iii) identify stress factors related to the burnout symptoms of emotional exhaustion and depersonalization. A total of 161 dental students from Dresden, Freiburg and Bern participated in the study. They completed the Psychosocial Stress Inventory, the Maslach Burnout Inventory and the Health Survey Questionnaire. Frequent sources of stress were limitation of leisure time, examination anxiety and the transition stress that was related to the adaptation to the demands of the clinical phase of dental education. Few differences existed between the students of the fourth and the fifth study year. Study-related stress was lowest in Bern and considerably higher in Dresden. Differences of mean levels of burnout symptoms were found only for the burnout dimension of emotional exhaustion. Students from Dresden and Freiburg were more emotionally exhausted than students from Bern, students from Dresden also reported more health problems than students from Bern or Freiburg. Ten per cent of the dental students suffered from severe emotional exhaustion, 17% complained about a severe lack of accomplishment and 28% reported severe depersonalization symptoms. Forty-four per cent of the variance of emotional exhaustion was explained by study-related factors such as lack of leisure time, examination anxiety and transition stress. The only predictor of depersonalization was a lack of social integration, accounting for 3% of the variance. A lack of social integration may be an indicator of low social competence which may cause difficulties in dealing with patients adequately and therefore result in depersonalization. The results indicate a need to identify the group of students who may have insufficient social skills for dealing adequately with the patients, and to train them accordingly.     

Impact of public health and higher education policies on the profile of final-year Brazilian dental students: Challenges and future developments

Introduction

Brazil has experienced transformations in higher education and health services, including launching more inclusive public policies focused on these two areas.

Objective

To evaluate the profile of final-year dental students from a Brazilian public university from 2010 to 2019, accompanied by changes in public health and higher education policies.

Methods

A prospective observacional study was carried out with final-year dental students. A self-applicable semi-structured questionnaire was applied.

Result

Six-hundred and seventy-seven students participated, of which 71.5% were women, 72.9% aged between 21 and 25 years, 96.2% single, and 96.4% were without children. Over ten years, it was possible to identify trends in the profile explained by implementing public policies toward more inclusive access to Brazilian higher education by socioeconomically disadvantaged individuals. Students who completed the course between 2018 and 2019 did not have the state capital city (the wealthiest area) as their origin city and had lower parental education and income levels than dental students graduating between 2010 and 2011. Moreover, working as a primary care dentist in the Brazilian National Health System was considered a professional possibility by 61.4% of the students, and has gained prominence significantly over time, ranging from 21.1% in 2010 to 72.9% in 2019 (p < .05).

Conclusion

Over the study period, concomitantly to advances in public health and higher education policies in Brazil, more diverse access to public dental education was observed, allowing students from low socioeconomic positions to take the education. Changes have also impacted the students' perspectives regarding the need for postgraduate training and a career in public health dentistry. However, these trends need to be consolidated, and public policies continued and strengthened.     

A comparative evaluation of computer literacy amongst dental educators and students

A task-oriented questionnaire was designed, aiming to quickly assess competence with the use of computers. The questionnaire consisted of distinct computer-related skills, representing various competences in educational computer use. A total score from 0 to 49 was calculated upon completion of the questionnaire, based on the sum of all the positively identified competences. The questionnaire was distributed to an international group of leading dental educators during the DentEd Global Congress in Prague in 2001 and to a cohort of first year dental students (2001) in the Dental Faculty, University of Malmo, Sweden. Certain attitudes towards the role of information and communication technology (ICT) in dental education were also measured through Visual Analogue Scales in the educator's group. A total of 149 questionnaires were collected from the educators' group and 58 from the dental students. There was no significant difference in the average computer competence score between the two groups. The educators' group average score was 20.7 (SD 9.9) and students' average was 18.1 (SD 8.5). A significant positive correlation (r = 0.395277, P < 0.0001) was found between the competence measured by the questionnaire and the year of graduation in the educators' group. The attitudes towards the role of ICT in dental education amongst the educators were very positive, regardless of their competence with computers, year of graduation or academic position. The results from this study indicate that there is wide diversity in computer competence amongst both students and academic staff. In addition, students' actual competence in the use of computers might not be as high as is often perceived through self-assessment and ordinal scales.     

Characteristics and study motivation of Danish dental students in a longitudinal perspective

This survey encompasses 3 comparable datasets of newly admitted dental students in 1972 (n=236), 1982 (n=197), and 1994 (n=108). The objectives of the survey were to describe selected socio-demographic characteristics of dental students and to analyze possible changes over time as well as possible changes in the reasons reported by the students for choosing dentistry as a career, their motivations and their expectations concerning the study and the profession of dentistry. The results showed that the ratio of women to men remained unchanged at 6:4 in all 3 cohorts of students and that the students were increasingly recruited from the 2 upper social classes. The motives for choosing dentistry mainly included altruistic motives, the desire for varied work with the opportunity to put theory into practice, economic rewards, and the implicit social status. Compared to the 1972 students, those in 1994 placed greater emphasis on social status as a motive, on the opportunity to work in the biological and scientific field, and on the ready availability of work outside Denmark. The students in all 3 years had strong altruistic motives for choosing dentistry, and it would seem that this stable continuity in the cohort of dental students would ensure the continuous controlled development of dentistry in the new millennium.