A Comparison of Stress Perception in International and Local First Semester Medical Students Using Psychometric, Psychophysiological, and Humoral Methods
Abstract
:1. Introduction
2. Materials and Methods
- an oral examination;
- a seminar; and
- a relaxing situation that served as the baseline measurement.
3. Results
3.1. Sample Description
3.2. Differences between International and Local Students
3.3. Differences over the Course of the Semester
3.4. Comparison between Current Sample and Norm Values
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Students’ Cultural Background | N | Male | Female | Mage | SDage |
---|---|---|---|---|---|
Local | 20 | 7 | 13 | 19.80 | 2.12 |
International | 17 | 7 | 10 | 20.67 | 3.94 |
All | 37 | 14 | 23 | 20.21 | 3.10 |
International Students’ Origin | |||||
Europe | 6 | ||||
Southeast Asia | 4 | ||||
Latin America | 3 | ||||
Middle East | 2 | ||||
Africa | 1 | ||||
South Asia | 1 |
Psychometric Measure | Nationality | N | MT1 | SDT1 | Mean Rank | Rank-Sum | U | r | MT2 | SDT2 | Mean Rank | Rank-Sum | U | r | MT3 | SDT3 | Mean Rank | Rank-Sum | U | r |
MBI, ‘emotional exhaustion’ | local | 20 | 2.12 | 0.93 | 17.60 | 352.0 | −0.856 | 0.14 | 2.46 | 1.02 | 22.08 | 441.5 | −1.510 | 0.25 | 2.35 | 1.20 | 21.00 | 420.0 | −1.596 | 0.27 |
international | 16 | 2.40 | 1.00 | 20.65 | 351.0 | 1.73 | 1.05 | 16.64 | 299.5 | 1.66 | 1.04 | 15.38 | 246.0 | |||||||
MBI, ‘cynicism’ | local | 20 | 0.41 | 0.73 | 19.13 | 382.5 | −0.087 | 0.01 | 0.64 | 0.95 | 21.00 | 420.0 | −0.930 | 0.16 | 0.69 | 0.89 | 21.60 | 432.0 | −2.140 | 0.36 |
international | 16 | 0.53 | 0.93 | 18.85 | 320.5 | 0.28 | 0.54 | 17.83 | 321.0 | 0.23 | 0.49 | 14.63 | 234.0 | |||||||
MBI, ‘professional efficacy’ | local | 20 | 4.65 | 0.71 | 16.75 | 335.0 | −1.378 | 0.23 | 4.60 | 0.71 | 23.08 | 461.5 | −2.096 | 0.35 | 4.67 | 0.86 | 22.13 | 442.5 | −2.314 | 0.39 |
international | 16 | 4.94 | 0.61 | 21.65 | 368.0 | 3.92 | 1.07 | 15.53 | 279.5 | 3.97 | 0.92 | 13.97 | 223.5 | |||||||
PSQ-20 | local | 20 | 0.42 | 0.08 | 17.43 | 348.5 | −0.962 | 0.16 | 0.42 | 0.72 | 19.95 | 399.0 | −0.582 | 0.10 | 0.43 | 0.13 | 18.85 | 377.0 | −0.224 | 0.04 |
international | 16 | 0.44 | 0.11 | 20.85 | 354.5 | 0.41 | 0.12 | 17.88 | 304.0 | 0.41 | 0.08 | 18.06 | 289.0 | |||||||
JSPE-S | local | 20 | 111.85 | 10.19 | 22.53 | 450.5 | −2.154 | 0.36 | 110.60 | 11.34 | 22.15 | 443.0 | −1.921 | 0.32 | 110.35 | 10.77 | 22.50 | 450.0 | −2.549 | 0.42 |
international | 16 | 101.86 | 14.51 | 14.85 | 252.5 | 99.75 | 15.81 | 15.29 | 260.0 | 100.19 | 15.37 | 13.50 | 216.0 | |||||||
PHQ-9 | local | 20 | 4.65 | 3.54 | 19.90 | 398.0 | −0.553 | 0.09 | 4.60 | 3.17 | 22.88 | 457.5 | −2.385 | 0.40 | 4.45 | 3.20 | 22.63 | 452.5 | −2.665 | 0.44 |
international | 16 | 4.19 | 3.02 | 17.94 | 305.0 | 1.88 | 2.47 | 14.44 | 245.5 | 1.94 | 2.72 | 13.34 | 213.5 | |||||||
GSE | local | 20 | 29.73 | 3.35 | 17.68 | 353.5 | −0.812 | 0.14 | 30.35 | 4.45 | 18.28 | 365.5 | −0.444 | 0.07 | 31.95 | 4.11 | 18.98 | 379.5 | −0.304 | 0.05 |
international | 16 | 30.50 | 3.54 | 20.56 | 349.5 | 30.75 | 3.84 | 19.85 | 337.5 | 32.19 | 4.02 | 17.91 | 286.5 | |||||||
Psychophysiological measure | Nationality | N | Mrest | SDrest | Mean Rank | Rank-Sum | U | r | Mseminar | SDseminar | Mean Rank | Rank-Sum | U | r | Mexam | SDexam | Mean Rank | Rank-Sum | U | r |
SDNN (ms) | local | 20 | 74.56 | 26.24 | 16.20 | 324.0 | −1.707 | 0.28 | 80.13 | 30.86 | 20.70 | 414.0 | −1.036 | 0.17 | 46.58 | 19.94 | 20.25 | 405.0 | −0.762 | 0.13 |
international | 17 | 95.20 | 40.37 | 22.29 | 379.0 | 70.94 | 28.52 | 17.00 | 289.0 | 40.46 | 17.15 | 17.53 | 298.0 | |||||||
RMSSD (ms) | local | 20 | 59.45 | 35.31 | 18.40 | 368.0 | −0.366 | 0.06 | 47.21 | 29.68 | 19.90 | 398.0 | −0.549 | 0.09 | 15.47 | 9.25 | 19.75 | 395.0 | −0.457 | 0.08 |
international | 17 | 60.25 | 29.56 | 19.71 | 335.0 | 38.64 | 17.74 | 17.94 | 305.0 | 13.72 | 7.61 | 18.12 | 308.0 | |||||||
pNN50 (%) | local | 20 | 30.85 | 24.64 | 18.30 | 366.0 | −0.427 | 0.07 | 21.95 | 20.23 | 19.90 | 398.0 | −0.549 | 0.09 | 2.28 | 2.83 | 20.35 | 407.0 | −0.823 | 0.14 |
international | 17 | 31.58 | 19.69 | 19.82 | 337.0 | 16.31 | 12.77 | 17.94 | 305.0 | 1.65 | 2.14 | 17.41 | 296.0 | |||||||
LF (ms²) | local | 20 | 1716 | 1409 | 17.75 | 355.0 | −0.762 | 0.13 | 1784 | 1250 | 19.15 | 383.0 | −0.091 | 0.02 | 840.0 | 660.1 | 20.35 | 407.0 | −0.823 | 0.14 |
international | 17 | 1932 | 1409 | 20.47 | 348.0 | 1782 | 1636 | 18.82 | 320.0 | 654.8 | 644.5 | 17.41 | 296.0 | |||||||
HF (ms²) | local | 20 | 1657 | 1941 | 17.70 | 354.0 | −0.792 | 0.13 | 1163 | 1509 | 18.75 | 375.0 | −0.152 | 0.03 | 165.1 | 193.7 | 19.80 | 396.0 | −0.488 | 0.08 |
international | 17 | 1655 | 1582 | 20.53 | 349.0 | 785 | 866 | 19.29 | 328.0 | 136.3 | 138.6 | 18.06 | 307.0 | |||||||
LF/HF | local | 20 | 2.28 | 1.93 | 19.20 | 384.0 | −0.122 | 0.02 | 3.62 | 2.37 | 20.45 | 409.0 | −0.884 | 0.15 | 7.52 | 5.16 | 19.95 | 399.0 | −0.579 | 0.10 |
international | 17 | 2.04 | 1.64 | 18.76 | 319.0 | 3.02 | 2.14 | 17.29 | 294.0 | 6.21 | 2.84 | 17.88 | 304.0 | |||||||
Humoral measure | Nationality | N | MT1 | SDT1 | Mean Rank | Rank-Sum | U | r | MT2 | SDT2 | Mean Rank | Rank-Sum | U | r | ||||||
Hair cortisol (pg/mg) | local | 20 | 6.98 | 7.53 | 20.50 | 410.0 | −0.585 | 0.10 | 6.47 | 5.12 | 21.25 | 425.0 | −1.371 | 0.23 | ||||||
international | 17 | 4.74 | 2.53 | 18.39 | 331.0 | 4.15 | 2.27 | 16.35 | 278.0 |
Psychometric Measure | Nationality | N | MT1 | SDT1 | Mean Rank | MT2 | SDT2 | Mean Rank | MT3 | SDT3 | Mean Rank | df | Chi2 |
MBI, ‘emotional exhaustion’ | local | 20 | 2.12 | 0.93 | 1.93 | 2.46 | 1.02 | 2.18 | 2.35 | 1.20 | 1.90 | 2 | 0.97 |
international | 16 | 2.40 | 1.00 | 2.59 | 1.73 | 1.05 | 1.75 | 1.66 | 1.04 | 1.66 | 2 | 9.56 | |
MBI, ‘cynicism’ | local | 20 | 0.41 | 0.73 | 1.68 | 0.64 | 0.95 | 2.05 | 0.69 | 0.89 | 2.28 | 2 | 5.65 |
international | 16 | 0.53 | 0.93 | 2.16 | 0.28 | 0.54 | 1.84 | 0.23 | 0.49 | 2.00 | 2 | 1.67 | |
MBI, ‘professional efficacy’ | local | 20 | 4.65 | 0.71 | 2.03 | 4.60 | 0.71 | 1.80 | 4.67 | 0.86 | 2.18 | 2 | 1.54 |
international | 16 | 4.94 | 0.61 | 2.78 | 3.92 | 1.07 | 1.50 | 3.97 | 0.92 | 1.72 | 2 | 16.03 | |
PSQ-20 | local | 20 | 0.42 | 0.08 | 1.95 | 0.42 | 0.12 | 2.03 | 0.43 | 0.13 | 2.03 | 2 | 0.076 |
international | 16 | 0.44 | 0.11 | 2.31 | 0.41 | 0.12 | 1.91 | 0.41 | 0.08 | 1.78 | 2 | 2.59 | |
JSPE-S | local | 20 | 111.85 | 10.19 | 2.00 | 110.60 | 11.34 | 2.08 | 110.35 | 10.77 | 1.93 | 2 | 0.25 |
international | 16 | 101.86 | 14.51 | 2.19 | 99.75 | 15.81 | 1.94 | 100.19 | 15.37 | 1.88 | 2 | 0.90 | |
PHQ-9 | local | 20 | 4.65 | 3.54 | 1.95 | 4.60 | 3.17 | 2.05 | 4.45 | 3.20 | 2.00 | 2 | 0.12 |
international | 16 | 4.19 | 3.02 | 2.72 | 1.88 | 2.47 | 1.69 | 1.94 | 2.72 | 1.59 | 2 | 14.25 | |
GSE | local | 20 | 29.73 | 3.35 | 1.65 | 30.35 | 4.45 | 1.90 | 31.95 | 4.11 | 2.45 | 2 | 8.12 |
international | 16 | 30.50 | 3.54 | 1.63 | 30.75 | 3.84 | 1.81 | 32.19 | 4.02 | 2.56 | 2 | 9.00 | |
Psychophysiological Measure | Nationality | N | Mrest | SDrest | Mean Rank | Mseminar | SDseminar | Mean Rank | Mexam | SDexam | Mean Rank | df | Chi2 |
SDNN (ms) | local | 20 | 74.56 | 26.24 | 2.25 | 80.13 | 30.86 | 2.45 | 46.58 | 19.94 | 1.30 | 2 | 15.10 * |
international | 17 | 95.20 | 40.37 | 2.76 | 70.94 | 28.52 | 2.00 | 40.46 | 17.15 | 1.24 | 2 | 19.88 * | |
RMSSD (ms) | local | 20 | 59.45 | 35.31 | 2.65 | 47.21 | 29.68 | 2.30 | 15.47 | 9.25 | 1.05 | 2 | 28.30 * |
international | 17 | 60.25 | 29.56 | 2.82 | 38.64 | 17.74 | 2.12 | 13.72 | 7.61 | 1.06 | 2 | 26.82 * | |
pNN50 (%) | local | 20 | 30.85 | 24.64 | 2.75 | 21.95 | 20.23 | 2.15 | 2.28 | 2.83 | 1.10 | 2 | 27.90 * |
international | 17 | 31.58 | 19.69 | 2.71 | 16.31 | 12.77 | 2.12 | 1.65 | 2.14 | 1.18 | 2 | 20.24 * | |
LF (ms²) | local | 20 | 1716 | 1409 | 2.35 | 1784 | 1250 | 2.30 | 840.0 | 660.1 | 1.35 | 2 | 12.70 * |
international | 17 | 1932 | 1409 | 2.53 | 1782 | 1636 | 2.24 | 654.8 | 644.5 | 1.24 | 2 | 15.65 * | |
HF (ms²) | local | 20 | 1657 | 1941 | 2.65 | 1163 | 1509 | 2.30 | 165.1 | 193.7 | 1.05 | 2 | 28.30 * |
international | 17 | 1655 | 1582 | 2.76 | 785 | 866 | 2.06 | 136.3 | 138.6 | 1.18 | 2 | 21.53 * | |
LF/HF | local | 20 | 2.28 | 1.93 | 1.30 | 3.62 | 2.37 | 1.90 | 7.52 | 5.16 | 2.80 | 2 | 22.80 * |
international | 17 | 2.04 | 1.64 | 1.24 | 3.02 | 2.14 | 1.82 | 6.21 | 2.84 | 2.94 | 2 | 25.53 * | |
Humoral measure | Nationality | N | MT1 | SDT1 | Mean Rank | MT2 | SDT2 | Mean Rank | df | Chi2 | |||
Hair cortisol (pg/mg) | local | 20 | 6.98 | 7.53 | 1.50 | 6.47 | 5.12 | 1.50 | 1 | 0.00 | |||
international | 17 | 4.74 | 2.53 | 1.59 | 4.15 | 2.27 | 1.41 | 1 | 0.53 |
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Huhn, D.; Schmid, C.; Erschens, R.; Junne, F.; Herrmann-Werner, A.; Möltner, A.; Herzog, W.; Nikendei, C. A Comparison of Stress Perception in International and Local First Semester Medical Students Using Psychometric, Psychophysiological, and Humoral Methods. Int. J. Environ. Res. Public Health 2018, 15, 2820. https://doi.org/10.3390/ijerph15122820
Huhn D, Schmid C, Erschens R, Junne F, Herrmann-Werner A, Möltner A, Herzog W, Nikendei C. A Comparison of Stress Perception in International and Local First Semester Medical Students Using Psychometric, Psychophysiological, and Humoral Methods. International Journal of Environmental Research and Public Health. 2018; 15(12):2820. https://doi.org/10.3390/ijerph15122820
Chicago/Turabian StyleHuhn, Daniel, Carolin Schmid, Rebecca Erschens, Florian Junne, Anne Herrmann-Werner, Andreas Möltner, Wolfgang Herzog, and Christoph Nikendei. 2018. "A Comparison of Stress Perception in International and Local First Semester Medical Students Using Psychometric, Psychophysiological, and Humoral Methods" International Journal of Environmental Research and Public Health 15, no. 12: 2820. https://doi.org/10.3390/ijerph15122820