Perceived stress, sources of stress and coping strategies among undergraduate medical students of Nepal: a cross-sectional study

Abstract

Background: Medical students are subjected to significant stressors impacting their physical and mental health. While some students employ positive coping mechanism, others resort to maladaptive coping measures. This study aims to assess prevalence, severity, and sources of stress, as well as coping strategies among medical students of a non-Western low-income country from South Asia. Methods: A self-administered questionnaire-based cross-sectional study was carried out. Demographic variables were collected and stress level was assessed using PSS 14 (Perceived Stress Scale 14). The sources of stress were assessed using MSSQ (Medical Student Stressor Questionnaire) and coping strategies were evaluated using the Brief-Coping Orientation to Problems Experienced. Results: A remarkable response rate of 95% was achieved. Overall, 55% of students were stressed (male 52%, female 60%), the difference among gender was not significant. Initial basic science years students perceived higher levels of stress than later clinical clerkship students. Academic related stressors emerged as leading cause of stress, whereas other variables caused moderate stress. The major stressors were examinations, inadequate time to study, poor marks, extensive amount of learning content, and the need to performing well in the exam. Regarding coping strategies, the study revealed five predominant coping strategies:  active coping, acceptance, planning, self-distraction, and instrumental support. Conversely, the least common coping mechanism was substance use. Conclusions: This study reveals a high prevalence of stress level among the medical students, mainly driven by academic pressure. Stressed students were likely to use maladaptive coping strategies. First year medical students require focused support, and promoting healthier coping measures among all medical students is crucial.. Further studies can be done to evaluate the effects of stress on the academic outcomes of students.