A qualitative study of stresses faced by Ghanaian medical students

•212• Chapter 17 A qualitative study of stresses faced by Ghanaian medical students Angela Ofori-Atta, Olive Okraku, Seraphim Mork, Abena Sarfo, E. Ghanney, A. Sefa- Dedeh and Sammy Ohene Introduction Medical students experience much stress throughout their period of study. The stressors include but are not limited to difﬁculties of clinical years, stressors associated with continuous assessments, economic constraints,relationshipproblems,personalityproblems,mentalhealth problems, substance abuse training and inadequate social support (Sani M, Mahfouz MS, Bani I et al., 2012; Sreeramareddy, Shankar, Binu et al., 2007; Chandrashekhar, Sreeramareddy, Suri et al.,2010; Super, 1998). Although these stresses may be considered as part of the daily hassles which all students face, the stresses faced by medical students seem to be magniﬁed by the large amount of academic workload they face, the limited amount of time they have and the excellence expected of them. The prevalence of depressive symptoms among medical students was 12.9%, signiﬁcantly higher than in the general population according to a study conducted in Sweden by Dahlin, Joneborg & Runeson (2005), and in Saudi Arabia, the sense of belittlement felt by students from both students and peers contributed signiﬁcantly to stress (Shoukat, Anis, Kella et al., 2010). According to a study conducted in Nigeria, medical students cited as stressors overcrowded accommodation, congested classrooms, prolonged and frequent strikes and lack of holidays (Omigbodun, Odukogbe, Omigbodun et al., 2006). Gunderson (2001) quotes from a director of medical humanities and medical research at Dalhousie University in Halifax: “We want people who are driven, who are competitive, who can excel at everything that they do.” This is a tall order indeed because this high expectation comes at a price; most medical students are so concerned with dealing with •213• A qualitative study of stresses faced by Ghanaian medical students the workload at school that they forget to take care of their physical, emotional, social and spiritual needs and this leads them to experience stress. “Self-care is not a part of the physician’s professional training and typically is low on a physician’s list of priorities” according to Gunderson (also Tait, Shanafelt, Bradley, et al., 2002); Dyrbye, Thomas, and Massie (2008). In addition to neglecting their own health, Werner and Korsch (1976) report L.L. Stephen’s words; “the encounter with morbidity and mortality heightens the student’s feelings of vulnerability. If he over-identiﬁes with patients, he may suffer more and be unable to provide rational medical care. If he protects himself by dehumanizing patients, humane treatment suffers.” Clearly, the medical student is caught between a rock and a hard place. In spite of this, a study from Norway concluded that the mental health of medical students in Norway did not differ signiﬁcantly from that of the general public. However, the students recorded lower levels of general self-esteem than those of the general public. Additionally, male students reported less general self-esteem and more nervous symptoms than female students (Bramness, Fixdal, & Vaglum; 1991). In Ghana, practical steps are yet to be taken to identify the stresses that are experienced by Ghanaian medical students and the methods that can be used to prevent and alleviate them in order to prevent students from dropping-out. Participants and methods Selection of participants After seeking permission from the University’s administration, the class lists for medical students in Level 200, Level 300, the ﬁrst clinical year and second clinical year were obtained. Every tenth student on the class list was selected to ensure random sampling from each class, after which the class presidents were added. They then participated in focus group discussions. •214• Chapter 17 Procedure The selected students were invited to the Department of Psychiatry at a time that was convenient for both the students and the staff at the department. Before focus group discussions began, the students were informed of the aims of the focus group discussion and their consent was sought. The students were assured conﬁdentiality. A facilitator initiated the discussions by posing open-ended questions inquiring about stressors typically faced by medical students. This led to further discussions on topics including academic workload, food, accommodation and hostel facilities, relationship problems, ﬁnancial problems, entertainment, religion and social support. Participants proposed possible solutions. These discussions were recorded with student permission by a simple digital voice recorder. Analysis of data The recordings of the focus group discussions were transcribed and emerging common themes on various stresses were identiﬁed. Similarly, solutions suggested by participants were noted...

Source: UG