Objective: Medical training has always been regarded as a highly stressful environment to students. This article described a preliminary data on impact of a stress-management programme on medical students’ stress level. Methods: This is a quasi-experimental before after comparison study design. The programme was run over half-day and convenient sampling method was applied. Sample size as calculated for this preliminary study was 38. The 12 items General Health Questionnaire (GHQ-12) was administered prior to the programme and four months later. Data was analysed using SPSS version 12. Results: 34 participants were involved in this study. This study found that there was a significant difference in participants’ GHQ-12 scores before and after the programme (p<0.001). It also found that the percentage of distressed participants to have significantly reduced after they went through the programme (p<0.05). Conclusion: This study showed that the programme is a promising stress-management programme with the evidence of positive impact on the medical students’ mental health by improving and reducing their stress level. Apart from that it is a well accepted programme by the medical students. Perhaps similar approach can be considered relevant to be incorporated in other set up.

Objective: Postgraduate medical training has always been regarded as a highly stressful environment to students. This article described an initial finding on prevalence and sources of stress among postgraduate students. Method: This is a cross-sectional study conducted on postgraduate students in the School of Medical Sciences, Universiti Sains Malaysia. Sample size as calculated for this preliminary study was 38 and convenient sampling method was applied. The 12 items General Health Questionnaire (GHQ-12) and Postgraduate Stressors Questionnaire (PSQ) were administered during a workshop involving postgraduate students. Data was analysed using SPSS version 12. Results: Thirty three participants participated in this study. This study found that the prevalence of distressed postgraduate students was 36.4%. The top ten stressors were tests and examinations, large amount of content to be learnt, time pressure to meet deadlines, doing work beyond ability, work overload, unfair assessment by superior, fears of making mistakes that can lead to serious consequences, doing work that mentally straining, work demands affect my personal and home life, and lack of time to review what have been learnt. Conclusion: This study found that there was a high prevalence of distressed postgraduate students. It also found that the Introduction Postgraduate medical training environment has always been regarded as highly stressful to students. The stressors of medical training and its associated negative consequences to the mental, emotional and physical health, particularly for undergraduate medical students, have been described in many studies [1-10], however, for postgraduate students there is very limited data on this. It is noteworthy that generally excessive and ASEAN Journal of Psychiatry, Vol.11 (2): July – December 2010 major stressors were related to academic and performance pressure

Objective: To determine the construct validity and the internal consistency of the Medical Student Stressor Questionnaire (MSSQ) among medical students hence in the future it could be used as a valid and reliable instrument to identify stressors among medical students. Methods: The blueprint for the development of MSSQ was developed after a review of literature on the subject and a discussion with experts in the field. It comprised of 40 items with six hypothetical groups. The face validity of the questionnaire was established through discussion with 141 final year medical students whereas content validity was established through discussion with experts from field of Medical Education and Psychiatry. It was administered to a total of 761 medical students. Data was analysed using Statistical Package Social Sciences (SPSS) version 12. Factor analysis was applied to test construct validity of the MSSQ. Reliability analysis (Cronbach’s alpha and item total correlation) was applied to test internal consistency of the MSSQ. Results: The total Cronbach’s alpha value of the MSSQ was 0.95. All the preliminary 40 items were included in the MSSQ as the items had item total correlation value of more than 0.3. The items were loaded nicely into the six pre-determined hypothetical groups as their factor loading values were more than 0.3. Conclusion: This study showed that MSSQ had good psychometric value. It is a valid and reliable instrument in identifying stressors among medical students.

Objective: To determine the sensitivity, specificity and internal consistency of the Malay version GHQ-12 among medical student population. This study determined the appropriate GHQ-12 score to detect distressed medical students. Methods: The Malay version of GHQ-12 was derived based on two sources which were the original version GHQ-12 and the validated Malay version 30-items GHQ. The GHQ-12 and the Malay version Beck Depression Inventory-II (BDI-II) were administered to a total of 141 medical students. Distress diagnoses were made based on the Malay version BDI-II. ROC curve analysis was applied to determine the sensitivity and specificity of the GHQ-12 by testing against the BDI-II. Reliability analysis (Cronbach’s alpha and item total correlation) was applied to test internal consistency of the GHQ-12. The analysis was done using SPSS version 12.Results: The GHQ-12 sensitivity and specificity at cut-off point of 3/4 was 81.3% and 75.3% respectively with positive predictive value (PPV) of 62.9% as well as area under ROC curve more than 0.7. The Cronbach’s alpha value of the GHQ-12 was 0.85.Conclusion: This study showed the Malay version GHQ-12 is a valid and reliable screening tool in detecting distressed medical students. The GHQ-12 score equal to or more than 4 was considered as significant distress.

Background: Being in medical school has always been regarded as highly stressful. Excessive stress causes physical and mental health problems. Persistent stress can impair students’ academic achievement and personal or professional development. The aim of this study is to explore the nature of stress among medical students by determining the prevalence, sources and pattern of stress and the factors affecting it. Methods: We chose a cross-sectional study design utilizing validated questionnaires, the 12 items General Health Questionnaire (GHQ-12) and Medical Student Stressor Questionnaire (MSSQ), to evaluate stress levels and stressors. School and ethical committee clearance were obtained prior to the study. Data were analysed using SPSS version 12. Results: Of the medical students who were administered the questionnaire, 761 (72%) respondents participated in this study. The prevalence of stress among the medical students was 29.6%. The top 10 stressors were academic-related. Prevalence of stress for the first, second, third, fourth and fifth year students was 26.3%, 36.5 %, 31.4%, 35.3% and 21.9%, respectively. Year of study was the only significant factor affecting stress among medical students (P-value < 0.05). Conclusions: The prevalence of stress among medical students in USM is high. Academicrelated problems were the major stressor among medical students. Year of study was the factor most significantly associated with medical students’ stress. There was a bimodal pattern of the stress level throughout the year of study.

Background: Medical training is often regarded as a stressful period. Studies have previously found that 21.6%–50% of medical students experience significant psychological distress. The present study compared the prevalence and levels of psychological distress between 2 cohorts of first-year medical students that underwent different admission selection processes. Methods: A comparative cross-sectional study was conducted by comparing 2 cohorts of first-year medical students; 1 group (cohort 1) was selected based purely on academic merit (2008/2009 cohort) and the other group (cohort 2) was selected based on academic merit, psychometric assessment, and interview performance (2009/2010 cohort). Their distress levels were measured by the General Health Questionnaire, and scores higher than 3 were considered indicative of significant psychological distress. Results: The prevalence (P = 0.003) and levels (P = 0.001) of psychological distress were significantly different between the 2 cohorts. Cohort 1 had 1.2–3.3 times higher risk of developing psychological distress compared to cohort 2 (P = 0.007). Conclusion: Cohort 2 had better psychological health than cohort 1 and was less likely to develop psychological distress. This study provided evidence of a potential benefit of multimodal student selection based on academic merit, psychometric assessment, and interview performance. This selection process might identify medical students who will maintain better psychological health.

Introduction: Fall is a health problem for older persons. This study investigates the potential factors of concern: the nutritional status of older persons and non-communicable disease association with incidence of falls. Methods: This study used data from NHMS 2018, and conducted a cross-sectional design by applying two-stage stratified cluster sampling. Descriptive statistics such as the percentage of each variable were done. Factors associated with falls were determined at both univariate and multivariable levels using simple logistic regression and multiple logistic regression. The data were presented as standard values for each analysis and adjusted odds ratios with 95% CI with p values (<0.05). Results: A total of 3,867 from 3,977 elderly (mean age 68.2+ 6.85) were recruited with the response rate of 97.2%. Factors associated with fall were 70 years old and above (AOR= 1.34, 95% CI: 1.09, 1.64), obesity (AOR=1.55, 95% CI: 1.21, 1.98), undernutrition (AOR=1.59, 95% CI: 1.30, 1.94), persons with 2 NCDs (AOR=1.49, 95% CI: 1.15, 1.92) and persons with 3 NCDs (AOR=1.63, 95% CI: 1.23, 2.16). Conclusions Advanced age, malnutrition, obesity, and having two or more NCDs are associated with falls in the NHMS 2018 study. In conclusion, falls are prevalent among older persons. There is an urgent need for public health strategies and programmes to decrease the incidence of modifiable risk factors and early identification of those at risk. Implementation of fall preventive programs which includes multifactorial interventions at hospitals and homes can also significantly reduce incidence of falls among older persons