Maladaptive coping strategies in health professional students dealing with stress

Button, Pamela (2014) Maladaptive coping strategies in health professional students dealing with stress. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

This thesis is comprised of two manuscripts exploring health professional student stress, coping, and help-seeking behaviours in an Atlantic Canadian university, using a sequential mixed methods design. The first manuscript examines students’ self-reported levels of stress and use of coping strategies to manage their stress. In this study, 120 students (82 females, 38 males) enrolled in the second year of medical, nursing, and pharmacy programs completed measures including the How I Deal With Stress survey, Perceived Stress Scale, and the SCOFF. Students reported high levels of stress, with those in nursing reporting significantly higher levels of stress than those in medicine, though neither group differed significantly from those in pharmacy. Gender was also found to be a significant contributor to student’s own reports of stress, with females reporting higher levels of stress and a multiple regression analysis revealed that gender accounts for more of the variance than any other factor on both measures of stress. On the HIDS, 2.5% of students reported engaging in NSSI, below rates found in other research, while 85% endorsed using eating as a coping strategy and 44% coped by trying to control their weight. On the SCOFF, 17.5% of students were found to be at risk of having a diagnosable eating disorder. An examination of other coping strategies revealed that 66% of students have used alcohol as a means of coping with stress. The second manuscript is a qualitative analysis of interviews conducted with ten students in which I explored the students lived experiences of stress, coping, and views on help-seeking behaviours. Thematic content analysis revealed that students identified their academic program as their greatest source of stress, although financial concerns, personal relationships, health, a lack of balance, professional socialization and living situations were also listed as stressors. Students indicated that they often sought social support, used exercise, staying on top of work, prioritizing, and decreasing and setting realistic expectations as coping strategies that worked for them. Other strategies discussed included eating pathology such as restriction and emotionally driven eating, use of alcohol, lack of sleep, a history of selfinjurious behaviours, smoking, and pushing beyond productivity. Students had varied levels of awareness of the mental health services available on campus, and students cited concerns around stigma, confidentiality, and conflict of interest as reasons for not seeking help from the appropriate services provided. The role of a hidden curriculum and the culture of health professional training programs are noted throughout the student interviews providing interesting insight into what impacts student functioning and identifying an important topic to be explored in future research.

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