Research Article

Stress among Dental Students in Saudi Dental Colleges: Part I: Coping Strategies

by Abdulrahman Al-Thobaiti1, Alhanouf Al-Shamrani2, Ali BinAjian3, Mohammed Al-Dhubaiban4, Ahmed Alabed5, Thakib Al-Shalan6*

1Endodontist Dentistry Graduate Student, Royal Colleges of Surgeons of Edinburgh, United Kingdom

2Pediatric Dentistry Graduate Students, College of Dentistry, Alexandria University, Egypt.

3Graduate Student, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia

4Assistant Professor at the Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.

5Computer Engineer, King Saud University Medical City

6Professor at the Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia

*Corresponding author: Thakib Al-Shalan, Professor at the Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia

Received Date: 26 November, 2024

Accepted Date: 03 December, 2024

Published Date: 06 December, 2024

Citation: Al-Thobaiti A, Al-Shamrani A, BinAjian A, Al-Dhubaiban M, Alabed A, et al. (2024) Stress among Dental Students in Saudi Dental Colleges: Part I: Coping Strategies. J Community Med Public Health 8: 483. https://doi.org/10.29011/2577-2228.100483

Abstract

Aim: The aim of the study is to investigate coping strategies used by dental students in Saudi dental colleges. Materials and Methods: A total of 509 dental students and interns from Saudi dental colleges participated in the study by answering a questionnaire sent to them by web link survey conducted through Survey Monkey. Statistical Analysis: All data was transferred to Statistical Package for the Social Sciences statistical software (SPSS version 16.0). Descriptive statistics are presented. Results: Dental interns and students highest coping method (52.8%) is by “find comfort in my religion”. The method of “get emotional support and / or academic advice from others” is chosen by 30.1% and 29.5% as “I have not done this at all” and ““I have been doing this slightly” respectively. Conclusion: Interns and students in Saudi dental colleges chose “to find my comfort in my religion” to cope with stress they face in the dental college. It is important that dental colleges incorporate stress-coping programs in their academic activities.

Introduction

It has been reported that dental professionals are subject to different stress-related physical and emotional stress [1,2]. This might be attributed to the stress accumulated since there previous experience in dental colleges. In Saudi Arabia, students enter dental colleges directly from high school. To be admitted to a dental college, they go in strong competition that requires top high school grades and strong performance on examinations and interviews. This causes stress on then which will continue throughout their education in the dental college, where high achievement is expected [3]. PiazzaWaggoner, et al. have reported that undergraduate education experiences in dental colleges are stressful [4]. Furthermore, other studies have reported similar finding and reported that this stressful experience can have implications on students’ emotional, physical, social, and future professional well-being [5-7]. In addition, stress also adversely affects the academic performances of students [8]. The prevalence of stress and depression among dental students ranged from 100% to 54% [3,9-11].

As the standard baccalaureate dental program is a very demanding 4-to-6-year college education, therefore, it is important that dental students should cope with the stress. Coping is defined as a cognitive and behavioural effort taken by individuals to try to either alleviate or appreciate the requirements creating the disparity between the person and the coexisting environment [12,13].

Previously, we found that over 95% of students in Saudi dental colleges suffer from stress [11]. The purpose of this study is to investigate the stress- coping strategies used by dental students in Saudi dental colleges. Findings may be used by dental colleges in Saudi Arabia to address the coping strategies and program to reduce stress among their students. In addition, knowing the coping factors will help dental colleges and faculties to make evidencebased strategies to their students to reduce and cope with stress.

Materials and Methods

The study was approved by King Saud Medical City Institutional Review Board (No. E-22-6866) and registered in King Saud University College of Dentistry Research Center (No. FR 0642). The materials and methods were described previously [11]. In brief, a self-administered questionnaire was used. It consists of 2 parts. Part 1 consists of demographic characteristics of the participants. Part II consists of questions related to the presence or absence of stress and factors that are perceived by participants to cause the stress and the coping methods. The coping methods were of four levels: level 1= I have not done this at all, level 2= I have been doing this slightly, level 3= I have been doing this moderately, level 4= I have been doing this a lot of time.

Subjects included all dental students and interns from the 25 dental Colleges in Saudi Arabia. The questionnaire was distributed using a web link survey conducted through SurveyMonkey during the period of June to September 2022.

Statistical Analysis

Data were analyzed in SPSS (Statistical Package for the Social Sciences) software (version 26.0.; SPSS, Inc., Chicago, Illinois, USA). Descriptive statistics were produced using numbers and percentages are presented.

Results

A total of 509 dental students and interns participated in the study. The demographic characteristics of the participants are shown in Table 1.

Characteristic

N

%

Gender

Male

296

58.2

Female

213

41.8

Academic Level in the College?

1st Year in the Dental College, (3rd and/or 4th Semesters)

44

8.6

2nd Year in the Dental College, (5th and/or 6th Semesters)

35

6.9

3rd Year in the Dental College, (7th and/or 8th Semesters)

69

13.6

4th Year in the Dental College, (9th and/or 10th Semesters)

107

21.0

5th Year in the Dental College, (11th and/or 12th Semesters)

121

23.8

Intern

133

26.1

Cumulative Grade Point Average (GPA) out of 5

Less than 2.75

20

3.9

2.75 and less than 3.75

135

26.5

3.75 and less than 4.25

161

31.6

More than 4.25

193

37.9

Table 1: Demographic Characteristics of participants (N=509) [11].

Table 2 shows coping methods and usage’s level used by participants. The “find comfort in my religion” coping method is chosen by 52.8% of the participants as “I have been doing this a lot of time”. The coping method of “get emotional support and / or academic advice from others” is chosen by 30.1% and 29.5% as “I have not done this at all” and ““I have been doing this slightly” respectively. Other coping methods which are used by participants a lot of time are “to take an action to make the stress-situation better, 31%”, “looking for something good about what is happening good in my life, 29.5%”, “accept that I cannot control everything around me. 26.1%”, and “blame myself for things that happened, 28.3%”.

Coping Methods

Participants’ level of action: Number (%)*

1

2

3

4

Find comfort in my religion (praying or mediating) to cope with stress.

23 (4.5)

84 (16.5)

133 (26.1)

269 (52.8)

Take an action to make the stress-situation better (like sleeping, resting, eating).

40 (7.9)

120 (23.6)

191 (37.5)

158 (31.0)

Looking for something good about what is happening in my life.

59 (11.6)

130 (25.5)

170 (33.4)

150 (29.5)

Blame myself for things that happened and caused me stressed.

85 (16.7)

153 (30.1)

127 (25.0)

144 (28.3)

Accept that I cannot control everything around me.

88 (17.3)

144 (28.3)

144 (28.3)

133 (26.1)

Make jokes and fun of the stress-situation.

63 (12.4)

174 (34.2)

155 (30.5)

117 (23.0)

Do work or other activities (e.g. sport, watch movies) to think less about the stress.

62 (12.2)

160 (31.4)

174 (34.2)

113 (22.2)

Express my negative feeling to let my unpleasant stress-feeling escape.

149 (29.3)

147 (28.9)

124 (24.4)

89 (17.5)

Get emotional support and / or academic advice from other(s) to reduce my stress.

153 (30.1)

150 (29.5)

127 (25.0)

79 (15.5)

*1= I have not done this at all, 2= I have been doing this slightly, 3= I have been doing this moderately, 4= I have been doing this a lot of time.

Table 2: Stress’s coping methods and level of action used by participants (N=509).

When 2 levels were combined (levels 1 & 2, and level 3 & 4), results showed that “find comfort in my religion” coping method is chosen by 79 % of the participants (Table 3). Again, the “get emotional support and / or academic advice from others” coping method is used by 59.5% (level 1= I have not done this at all, level 2= I have been doing this slightly).

Coping method

A*: N (%)

B*: N (%)

Find comfort in my religion (praying or mediating) to cope with stress

107 (21)

402 (79)

Take an action to make the stress-situation better (like sleeping, resting, eating)

160 (31.4)

349 (68.6)

Looking for something good about what is happening in my life

189 (37.1)

320 (62.9)

Do work or other activities (e.g. sport, watch movies) to think less about the stress

222 (43.6)

287 (56.4)

Accept that you cannot control everything around you

232 (45.6)

277 (54.4)

Make jokes and fun of the stress-situation

237 (46.6)

272 (53.4)

Blame myself for things that happened and caused me stressed

238 (46.8)

271 (53.2)

Express my negative feeling to let my unpleasant stress-feeling escape

296 (58.2)

213 (41.8)

Get emotional support and / or academic advice from other(s) to reduce my stress

303 (59.5)

206 (40.5)

*A= (I have not done this at all) and (I have been doing this slightly). B= (I have been doing this moderately) and (I have been doing this a lot of time).

Table 3: Stress’s coping methods used by participants when 2 low levels (A) and 2 high levels (B) combined* (N=509).

Discussion

Stress among undergraduate students is not uncommon. Our previous publication has shown that over 95% of dental students and interns in Saudi dental colleges reported that they have stress [11]. This finding is consistent with findings in a literature review [14].

The objective of this study was to find coping strategies used by dental interns and undergraduate students to cope with stress they face in dental education. As the study used a questionnaire to collect the students and interns from dental colleges in Saudi Arabia via media, limitations exist such as students’ responses might be affected by the emotional status when filling the questionnaire. Future studies might be done by site visiting the dental colleges and meeting students to explain the purpose of the study before distributing the questionnaire.

Results showed variations in interns and students’ strategies to cope with stress they face in the dental colleges. The highest coping method used by participants is “Find comfort in my religion (praying or mediating) to cope with stress”. This is in agreements with previous study [15]. This may indicate that the strong faith they have. The second method which is used by participants most of the times is “Take an action to make the stress-situation better”. In addition, it may indicate that there is no well-structured program to help students when they have stress. This is supported by low percentage of participants who choose the method of “Get emotional support and / or academic advice from other(s) to reduce my stress”. This result is consistent with previous studies which reported that less than 15% of dental students sought professional counselling [16,17]. Furthermore, this result was found as shown in a systemic review by Al-zahem et al. [18]. In this review, the coping strategies by dental students in Saudi Arabia include several components, such as reducing fear of failure and workload pressure due to examinations and requirements, coping techniques, such as deep breathing exercises.

Limited number of publications that study the effectiveness of stress coping methods for dental students exist. Previous study reported the deficiency in stress management research and programs to help dental students in their studies [17]. In health colleges, it has been reported that nursing students utilized problem focused (dealing with the problem), emotion focused (regulating the emotion), and dysfunctional (venting the emotions) stress coping mechanisms to alleviate their stress [19].

The effect of stress on dental students shows the importance of establishing stress management programs in dental education. This might be done by incorporating courses in the undergraduate dental curriculum which is taught by clinical psychologist. Furthermore, it can be recommended that Saudi dental colleges investigate and understand stressors that affect their students and what coping strategies are utilized by them. This will enable dental colleges (administrators and academicians) to evaluate and utilize evidence-based interventions and supporting programs to their students.

Conclusion

More than half of the students in Saudi dental colleges choose “find comfort in my religion” as the most coping method. The method of “get emotional support and / or academic advice from others” is used by approximately one third of the 509 participants.

References

  1. Lang-Runtz H (1984) Stress in dentistry: it can kill you. J Can Dent Assoc 50: 539-541.
  2. Wilson RF, Coward PY, Capewell J, Laidler TL, Rigby AC, et al. (1998) Perceived sources of occupational stress in general dental practitioners. Br Dent J 184: 499-502.
  3. Basudan S, Binanzan N, Alhassan A (2017) Depression, anxiety and stress in dental students. Int J Med Educ 8: 179-186.
  4. Piazza-Waggoner CA, Cohen LL, Kohli K, Taylor BK (2003) Stress management for dental students performing their first pediatric restorative procedure. J Dent Educ 67: 542-548.
  5. Goldstein MB (1980) Interpersonal support and coping among firstyear dental students. J Dent Educ 44: 202-205.
  6. Humphris G, Blinkhorn A, Freeman R, Gorter R, Hoad-Reddick G, et al. (2002) Psychological stress in undergraduate dental students: baseline results from seven European dental schools. Eur J Dent Educ 6: 22-29.
  7. Pöhlmann K, Jonas I, Ruf S, Harzer W (2005) Stress, burnout, and health in the clinical period of dental education. Eur J Dent Educ 9: 78-84.
  8. Crego A, Carrillo-Diaz M, Armfield JM, Romero M (2016) Stress and academic performance in dental students: the role of coping strategies and examination-related self-efficacy. J Dent Educ 80: 165-172.
  9. Ahmad MS, Md Yusoff MM, Abdul Razak I (2012) Stress and its relief among undergraduate dental students in Malaysia. Southeast Asian J Trop Med Public Health 42: 996-1004.
  10. Dewan H, Loka SR, Mandal NB, Mogla S, Lenin KR, et al. (2022) Prevalence of Stress and Coping Disorders among Dental Students: An Original Research. J Pharm Bioallied Sci 14: S277-S279.
  11. Al-Dhubaiban M, BinAjian A, Al-Shumrani A, Al-Thobaiti A, Al-Shalan T (2023) Stress among Dental Students in Saudi Dental Colleges: Cross-Sectional Study. J Community Med Public Health 7: 387.
  12. Folkman S, Lazarus RS (1980) An analysis of coping in a middle-aged community sample. J Health Soc Behav 21: 219-239.
  13. Firth J (1986) Levels and sources of stress in medical students. Br Med J (Clin Res Ed) 292: 1177-1180.
  14. Khanagar SB, Al-Ehaideb A, Jamleh A, Ababneh K, Maganur PC, et al. (2021) Psychological Distress among Undergraduate Dental Students in Saudi Arabia and Its Coping Strategies-A Systematic Review. Healthcare (Basel) 7: 429.
  15. Alomar SAA, Khair AB, Shantakumari N, Abdelmagied M, Hadi KMH (2020) Perceived Sources of Stress and Stress Coping Strategies among Junior Dental Students at Ajman University. J Int Dent Med Res 13: 306-314.
  16. Harris RC, Millichamp CJ, Thomson WM (2015) Stress and coping in fourth-year medical and dental students. N Z Dent J 111: 102-108.
  17. Tisdelle DA, Hansen DJ, St Lawrence JS, Brown JC (2022) Stress management training for dental students. J Dent Educ 48: 196-202.
  18. Alzahem AM, Van der Molen HT, Alaujan AH, De Boer BJ (2014) Stress management in dental students: a systematic review. Adv Med Educ Pract 28: 167-176.
  19. Chaabane S, Chaabna K, Bhagat S, Abraham A, Doraiswamy S, et al. (2021) Perceived stress, stressors, and coping strategies among nursing students in the Middle East and North Africa: an overview of systematic reviews. Syst Rev 5: 136.

© by the Authors & Gavin Publishers. This is an Open Access Journal Article Published Under Attribution-Share Alike CC BY-SA: Creative Commons Attribution-Share Alike 4.0 International License. With this license, readers can share, distribute, download, even commercially, as long as the original source is properly cited. Read More About Open Access Policy.

Journal of Community Medicine & Public Health

Update cookies preferences