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Such news doesn't surprise those who work with large companies. A study on job satisfaction out this summer from the Conference Board, a non-profit think tank in New York that focuses on management and the marketplace, found "the majority of Americans continue to be unhappy at work. The representative survey of 5, U. Psychologist Ben Palmer is global CEO and founder of Genos International, a consulting firm that focuses on emotional intelligence and employee engagement.

He says the current state of global competition means that Western nations in particular are unsuccessfully trying to compete with cheap labor in countries such as China and India. This may be the result of a combination of high levels of both neuroticism and conscientiousness.

We found that the demands or stress associated with academic studies exert unfavorable effects on private life and wellbeing i. At the same time though mastering medical studies can enhance self-esteem, self-efficacy, and resilience.

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However, non-academic life can also be stressful i. In line with earlier research, our study suggests that the beginning of academic studies may be a particularly stressful new stage of life i. In terms of personal challenges, the failure to achieve previous school performance levels was reported as distressing by our study participants. Among some students, the loss of this important self-defining feature seemed to induce self-doubt and anxiety, which is in agreement with findings from earlier research [ 2 , 35 ].

Academic studies may be associated with chronic and high stress exposure, and prior evidence has shown that such stress is linked to worse performance, poorer satisfaction, intentions to quit, and elevated depression, anxiety, higher risk of suicidal ideation or physical problems [ 25 , 34 , 36 — 39 ]. As a consequence of chronic exposure, several students suffer from poor health and fatigue [ 34 , 37 ], which is in line with our observation. In our study, some participants framed this experience as a paradox, that is, the fact that they study a medical subject with the aim to cure people, but that this study jeopardizes their own health, which is supported by further observations [ 40 ].

Research suggests that the demand for increased time for private life gains relevance among medical students [ 41 , 42 ]. A cross-sectional study from Germany suggested that more than one-third of medical students report not to have time to pursue individual interests [ 3 ]. Our study confirms this overall perception and further adds that many participants may in fact neglect almost all activities except academic studies.

Consequently, medical studies subjectively become the only domain of life. Supporting this notion, a US study found that socializing decreases in medical school [ 23 ]. It has also previously been observed that insufficient time for social demands can enhance perceived stress and may lead to a sense of guilt [ 35 ], which is in line with findings from our study.

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Our study suggests that private life i. These findings are in line with the results of earlier studies showing that social support and regular exercise are associated with lower psychological distress or rather better quality of life among medical students [ 35 , 38 , 45 ].

By contrast, participants from our study expressed that side jobs could be perceived as additional strain as they are time-consuming. Also, whenever side jobs cannot be taken to the required extent to cover expenses, financial worries may emerge. An Australian study confirmed that there is a positive correlation between financial worries and perceived stress [ 38 ]. We found that specific personality traits may affect the perception of academic stress among medical students, such as a high degree of conscientiousness. Studies from Germany have found that many medical students exhibit personality traits i.

This is in line with our observation that a high degree of conscientiousness may contribute to higher stress levels. Positive aspects of a high degree of conscientiousness were also shown by earlier research, which reported that high conscientiousness correlates with better performance [ 49 , 50 ].

As described in the materials and methods section the majority of medical students is chosen by Abitur grades and thus by their academic performance. High levels of conscientiousness are related to better academic performance [ 51 ].

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Consequently, individuals with high conscientiousness may be more likely to be admitted. However, high conscientiousness also predicts stress [ 52 ], which may contribute to poorer health [ 53 , 54 ]. Therefore, the current approach in Germany to the selection of students for i. A potential selection of medical students towards high levels conscientiousness may also translate into a different personality trait later in the medical career: conscientiousness is related to an exaggerated sense of responsibility, which in turn is one aspect of compulsiveness in the personality of physicians [ 55 ].

Some potential methodological limitations deserve mentioning. First, it cannot be ruled out that our approach to participant recruitment is susceptible to selection bias. For instance, very dissatisfied or very satisfied students may have been more likely to participate and this could have limited the scope of opinions that were shared.

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If there were gender differences related to our research question, views of male students could be somewhat under-represented in our study. Second, the first author CB herself was a medical student at the time of data collection and data analysis. This issue was addressed by the fact that transcripts and data analyses were reviewed by and discussed with AL, who is a public health researcher. Further, the focus groups were not facilitated by CB, but by TM a psychologist to reduce potential bias during data collection. Third, group discussions were held until thematic saturation of topics was achieved.

While focus groups are particularly useful to explore issues in depth, anonymity is not given — especially if group members know each other — and therefore sensitive topics were possibly not raised e. Finally, we recruited two subpopulations of medical students who were either in earlier stages of their medical study i. The aim of our study was not to examine whether the interrelatedness of academic stressors and stressors in other domains of life differed by the year of medical studies.

One may speculate though that the reporting or experience of the issues covered by our study is affected by the academic year. For instance, the reporting of students in earlier stages may be affected not only by their current stressors but also by anticipated stressors. By contrast, students in advanced stages are apparently selected towards their ability to have successfully coped with previous stressors.

This sense of mastery may have affected their reporting i. Individual-level preventive action may build on compulsory stress management training, which needs to be a part of the curriculum and thus cannot be skipped due to a sense of time pressure. The literature suggests effective approaches to reduce perceived stress, such as stress management training involving mindfulness-based stress reduction 13, 20, 37 , autogeneous training [ 56 ] or biofeedback [ 57 ].

Some participants express to have a guilty conscience because of the feeling that they do not study hard enough. This could be addressed by providing an inventory detailing academic expectations, for instance, with regard to the topics that should be covered by students e.

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Introduction of new learning technologies including e-learning [ 58 ] and virtual patient simulation [ 59 ] could be opportunities to create a curriculum which caters for the needs of individual students [ 60 ]. Furthermore, some participants reported to be distressed by their failure to achieve top performance levels in terms of grades. This may result in excessive work commitment.

One approach to reduce this stressor would be to avoid grading whenever possible and to only inform students about whether they have passed or not. As mentioned above, we suspect that the selection of students for medical education in Germany favors students with personality traits that are associated with better academic performance, but also with impaired health [ 13 ].

This issue seems to be addressed to some extent as the selection procedures currently need to be revised in Germany to ensure that less emphasis is placed on grades at school [ 61 ]. We found that academic studies may lead to various personal challenges e. Negative effects may be less time for social contacts and leisure activities. Private life can help students to cope with academic stress. Social contact could lead to an additional burden if social requirements cannot be fulfilled by students. Personality traits may modify the perception of and responses to stress.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. We thank Mrs.

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Stefanie Skodda for her contribution to the development of the topic guide, support during data collection and transcription of large segments of our recordings. For her translation of quotes we are grateful to Ms. This may have induced bias which we are not aware of.

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National Center for Biotechnology Information , U. Journal List Med Educ Online v. Med Educ Online. Published online Apr Author information Article notes Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Associated Data Data Availability Statement Data can be obtained from the corresponding author for research purposes upon reasonable request. Introduction The health and well-being of medical students is an issue which has attracted increasing research interest. Materials and methods Research team The research team consisted of two medical students CB and StS, see Acknowledgments , and two researchers with frequent teaching contact to medical students, with experience related to the facilitation of focus groups, and expertise in qualitative research and stress research TM and AL.

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Data collection The research team created a topic guide for the focus groups. Data analysis Content analysis was carried out according to an approach suggested by Mayring [ 27 ] using the MaxQDA 12 software package. Table 1. A1 During the first semester, just mentally , I think we had to take eleven exams. A2 But somehow my whole life is centred around studying.

In my spare time, I hardly do anything but study. A3 And each time I do something else than studying I have a bad conscience because I ought to study. And each time I study I feel terribly stressed because I think I need a break. A4 We even studied during the Christmas break. With a heavy heart, but still. You visit some relatives and take along your flashcards. You sit on the sofa with earplugs in your ears, but at least you stayed with your relatives.