1.Effects of A Brief Stress Reduction Intervention On Medical Students' Depression, Anxiety And Stress Level During Stressful Period
ASEAN Journal of Psychiatry 2011;12(1):1-14
Objective: The objective of this study was to evaluate whether students exposed to a brief stress reduction intervention would have lesser stress, anxiety and depression levels compared to their non-exposed classmates during stressful events. Methods: The Ex Post Facto design was applied in this study. Students who were exposed and not exposed to a brief stress reduction intervention were surveyed during a continuous examination and during the final examination. The Depression Anxiety Stress Scales (DASS) was used to examine effects on anxiety, stress, and depression levels. Results: The exposed students statistically had lower anxiety and depression scores than the non-exposed students during the stressful period. Reduction of stress, anxiety and depression scores was sustained during the stressful period. Conclusion: The significant reduction of anxiety and depression scores suggested that brief intervention was effective in the enhancement of the psychological wellbeing of exposed medical students during stressful period.
2.Stability of Usmeq-I In Measuring Emotional Intelligence In Medical Students
ASEAN Journal of Psychiatry 2012;13(1):1-6
Objective: Emotional Intelligence (EI) is described as the ability to perceive, express, understand, motivate, control and regulate emotion. The USM Emotional Quotient
Inventory (USMEQ-i) was designed to measure EI and it was found to be a reliable and valid tool in a sample of prospective medical students. The objective of this
study is to determine stability of the USMEQ-i to measure EI at different time and occasions. Methods: A prospective cohort study was done on 196 first year medical
students. It was administered to the medical students at four different intervals. The Cronbach’s alpha and intra-class correlation analysis were applied to measure the
internal consistency and agreement level across the intervals. The analysis was done using Statistical Package for Social Sciences (SPSS) version 18. Results: A total of
196 first year medical students participated in this study. Its overall Cronbach’s alpha value across intervals ranged between 0.94 and 0.97. The Cronbach’s alpha
values of emotional control, emotional maturity, emotional conscientiousness, emotional awareness, emotional commitment, emotional fortitude, and emotional
expression scale ranged between 0.59 and 0.91. The Cronbach’s alpha value for the faking index scale ranged from 0.76 to 0.89. The ICC coefficient values for EI total
score was 0.83, EI domain score ranged between 0.62 and 0.76 and the faking index score was 0.76. Conclusion: The USMEQ-i has demonstrated a good level of stability
and internal consistency to measure EI at different time and occasions. It is a promising psychometric instrument that can be used to measure EI
3.The validity of two malay versions of the general health questionnaire (GHQ) in detecting distressed medical students
ASEAN Journal of Psychiatry 2010;11(2):135-142
Objective: To compare the sensitivity, specificity and reliability between the Malay GHQ-30 and the Malay GHQ-12 in detecting distressed medical
students. This study determined which version is more sensitive, specific and reliable in detecting distressed medical students. Methods: Three validated
instruments, the Malay version GHQ-30, the Malay version GHQ-12 and the Malay version Beck Depression Inventory-II (BDI-II), were administered to a total of 187 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 both GHQs by testing against the BDI-II. Reliability analysis (Cronbach’s alpha) was applied to test internal
consistency of the GHQ. The analysis was done using SPSS version 12. Results: 141 (75.4%) medical students participated in this study. The GHQ-30 sensitivity and specificity at cut-off point of 6 was 87.5% and 80.6%
respectively with positive predictive value (PPV) of 70% as well as area under ROC curve was 0.93. The GHQ-12 sensitivity and specificity at cut-off
point of 4 was 81.3% and 75.3% respectively with PPV of 62.9% as well as area under ROC curve was 0.82 The Cronbach’s alpha value of the GHQ-30 and GHQ-12 was 0.93 and 0.85 respectively. The Kappa value for the GHQ-
12 and GHQ-30 was 0.65 (p < 0.001). Conclusion: This study showed the Malay GHQ-30 had better ability to discriminate between distressed and non-distressed medical students compared to the Malay GHQ-12. The shorter version was found to be as reliable as the long version GHQ-30 in
detecting distressed medical students. The optimum threshold score for the GHQ-30 and GHQ-12 to detect distressed medical students were 6 and 4 respectively. The GHQ-12 and GHQ-30 showed a good level of agreement in
detecting distressed medical students.
4.Stress, stressors and coping strategies among secondary school students in a Malaysian government secondary school: initial findings
ASEAN Journal of Psychiatry 2010;11(2):143-157
Objective: In the process of growing, adolescents experience stress either good or bad depending on how they cope. School training further adds to this
stressful situation. It is noteworthy that persistent over stress will impair students’ academic achievement, personal and professional development.
This preliminary study is meant to obtain initial data on the stress prevalence, stressors, and coping strategies among secondary school children in Malaysia. Data gained from this preliminary study provides valuable data
for subsequence research in the future. Methods: This is a cross-sectional study involving 100 secondary school students from a Malaysian government
secondary school. The validated Malay version 12-item General Health Questionnaire (GHQ-12), Soalselidik Stressor Sekolah Menengah (SSSM) and Malay version of Brief COPE were used to identify stress level, stressors,
and coping strategies. Results: A number of 90 (90%) students participated in this study. The prevalence of stress among secondary school students was
26.1%. It was found that the main stressors were related to academic. The top five coping strategies were religion, positive reinterpretation, active coping, planning, and use of instrumental support. Conclusion: The
prevalence of stress among secondary school students in a Malaysian stressor among the students. The most frequent coping strategies being used by the students were positive coping strategies.
5.Big Sib Students’ Perceptions of the Educational Environment at the School of Medical Sciences, Universiti Sains Malaysia, using Dundee Ready Educational Environment Measure (DREEM) Inventory
Hafiza Arzuman ; Muhamad Saiful Bahri Yusoff ; Som Phong Chit
Malaysian Journal of Medical Sciences 2010;17(3):40-47
Background: A cross-sectional descriptive study was conducted among Big Sib students to
explore their perceptions of the educational environment at the School of Medical Sciences, Universiti
Sains Malaysia (USM) and its weak areas using the Dundee Ready Educational Environment
Measure (DREEM) inventory. The DREEM inventory is a validated global instrument for measuring
educational environments in undergraduate medical and health professional education.
Method: The English version of the DREEM inventory was administered to all Year 2 Big Sib
students (n = 67) at a regular Big Sib session. The purpose of the study as well as confidentiality and
ethical issues were explained to the students before the questionnaire was administered.
Results: The response rate was 62.7% (42 out of 67 students). The overall DREEM score
was 117.9/200 (SD 14.6). The DREEM indicated that the Big Sib students’ perception of educational
environment of the medical school was more positive than negative. Nevertheless, the study also
revealed some problem areas within the educational environment.
Conclusion: This pilot study revealed that Big Sib students perceived a positive learning
environment at the School of Medical Sciences, USM. It also identified some low-scored areas that
require further exploration to pinpoint the exact problems. The relatively small study population
selected from a particular group of students was the major limitation of the study. This small sample
size also means that the study findings cannot be generalised.
6.Stress, Stressors And Coping Strategies Among House Officers In A Malaysian Hospital
Muhamad Saiful Bahri Yusoff ; Tan Ying Jie ; Ab Rahman Esa
ASEAN Journal of Psychiatry 2011;12(1):1-10
highly stressful environment to doctors. This article described findings on stress, stressors and coping strategies among house officers in a Malaysian hospital. Methods: A cross-sectional study was conducted on house officers in a Malaysian hospital. The 12 items General Health Questionnaire (GHQ-12), General Stressors Questionnaire (GSQ) and Brief COPE inventory were administered to measure perceived stress, sources of stress and coping strategies among house officers respectively. Data was analysed using SPSS version 12. Results: Forty two house officers participated in this study. This study found that approximately 31% of the house officers were in distress. The top five stressors were fears of making mistakes that can lead to serious consequences, work overload, working with uncooperative colleagues, doing work that mentally straining and feeling of being underpaid. The most frequent coping strategies used by house officers were religion, acceptance and self-distraction. Conclusion: This study found that there was a high percentage of distressed house officers. It also found that major stressors were related to performance pressure. The main coping strategy used by house officer was emotion-focused copin
7.Impact of medical student well-being workshop on the medical students' stress level: A preliminary study
Muhamad Saiful Bahri Yusoff ; Ahmad Fuad Abdul Rahim
ASEAN Journal of Psychiatry 2010;11(1):56-63
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.
8.Prevalence and sources of stress among postgraduate medical trainees: initial findings
Muhamad Saiful Bahri Yusoff and Ahmad Fuad Abdul Rahim
ASEAN Journal of Psychiatry 2010;11(2):180-189
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
9.Prevalence and Sources of Stress among Universiti Sains Malaysia Medical Students
Muhamad Saiful Bahri Yusoff ; Ahmad Fuad Abdul Rahim ; Mohd Jamil Yaacob
Malaysian Journal of Medical Sciences 2010;17(1):30-37
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.
10.The development and validity of the medical student stressor questionnaire (MSSQ)
Muhamad Saiful Bahri Yusoff ; Ahmad Fuad Abdul Rahim ; Mohd Jamil Yaacob
ASEAN Journal of Psychiatry 2010;11(1):13-24
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.