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.