Cross-sectional Study about Stress and Health Recognition in Korean Medicine Student by Gender

Ho-Yeon Go; Hyun-Kyung Sung; Minjeong Kim; Han Chae; Soojin Lee; Go, Ho-Yeon; Sung, Hyun-Kyung; Kim, Minjeong; Chae, Han; Lee, Soojin

doi:10.13048/jkm.18017

JKM > Volume 39(2); 2018 > Article

Go, Sung, Kim, Chae, and Lee: Cross-sectional Study about Stress and Health Recognition in Korean Medicine Student by Gender

Original Article

The Journal of Korean Medicine 2018; 39(2): 80-91.

Published online: June 30, 2018

DOI: https://doi.org/10.13048/jkm.18017

Cross-sectional Study about Stress and Health Recognition in Korean Medicine Student by Gender

Ho-Yeon Go¹

, Hyun-Kyung Sung²

, Minjeong Kim³

, Han Chae⁴

, Soojin Lee⁵^{, *}

¹Dept. of Internal Medicine, College of Korean Medicine, Semyung University

²Dept. of Pediatrics, College of Korean Medicine, Semyung University

³Dept. of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Sangji University

⁴Division of Longevity and Biofunctional Medicine, School of Korean Medicine, Pusan National University

⁵Department of Physiology, College of Korean Medicine, Sangji University

Correspondence to: 이수진(Soojin Lee), College of Korean Medicine, 83 Sangjidae-gil Wonju-si Gangwon-do, 220-702, Republic of Korea, Tel: +82-33-730-0673, Fax: +82-33-730-0653, E-mail: jinlee@sangji.ac.kr

Received May 28, 2018 Revised June 19, 2018 Accepted June 19, 2018

Abstract

Objectives

The purpose of this study was to investigate stress and health recognition in Korean medical student by gender.

Methods

393 Korean medical student participated in this study. They were surveyed demographic characteristics(gender, age, drinking, morning diet, health recognition and etc), medical stress scale, Maslachh burnout inventory, Korea acceptance and action, and Ego Resilience Scale. For statistical analysis, chi-square test, Student t-test, correlation analysis, and simple regression analysis has been used.

Results

In Medical stress scale and ego resilience, it is not significant difference by gender. Female students were significantly higher than male students in Maslach burnout inventory(P=0.015). Male students were significantly higher than female students in Korea Acceptance and Action(P=0.002). Health recognition have negative correlation between medical stress and academic exhaustion, and positive correlation between psychological flexibility and ego resilience.

Conclusions

Through these results, we need to further study and develop strategies to reduce stress according to gender in Korean medical college.

Keywords: Korean medicine, Stress, Health recognition, Gender, Cross-sectional study

Table 1

Demographic Characteristics in Participants

		Male	Female	P-Value
School Years	1^stgrade	40(15.6)	26(19.1)	0.690
	2^ndgrade	46(17.9)	17(12.5)
	3^rdgrade	48(18.7)	22(16.2)
	4^thgrade	37(14.4)	23(16.9)
	5^thgrade	33(12.8)	18(13.2)
	6^thgrade	53(20.6)	30(22.1)
Martial Status	Single	170(66.1)	67(49.3)	0.006
	Single - courting	84(32.7)	67(49.3)
	Married	3( 1.2)	1( 0.7)
	Separated	0( 0.0)	1( 0.7)
Diet	Regular	152(59.1)	84(61.8)	0.614
Diet	Irregular	105(40.9)	52(38.2)
Diet frequency	Etc	1(0.4)	2(1.5)	0.378
	1 time	6(2.3)	3(2.2)
	2 time	155(60.3)	74(54.4)
	3 time	89(34.6)	56(41.2)
	4 time	6(2.3)	1(0.7)
		2.36±0.59	2.38±0.62	0.837
Morning Diet	Eating	64(24.9)	51(37.5)	0.006
	Uneating	108(42.0)	37(27.2)
	Irregular	85(33.1)	48(35.3)
Nosh	0 time	82(31.9)	26(19.1)	0.003
	1 time	149(58.0)	80(58.8)
	2 time	20( 7.8)	23(16.9)
	3 time	6( 2.3)	7( 5.1)
		0.81±0.67	1.08±0.75	0.000
BMI	Low weight	6(2.3)	37(23.2)	0.000
	WTN	131(51.0)	91(66.9)
	Overweight	113(44.0)	7(5.1)
	Obesity	7(2.7)	1(0.7)
Smoke	No smoking	197(76.7)	134(98.5)	0.000
	Stop smoking	34(13.2)	1(0.7)
	Smoking	26(10.1)	1(0.7)
Drinking frequency/weeks		1.43±1.30	1.10±1.19	0.011
Health recognition		62.35±23.90	61.71±23.84	0.800

BMI: body mass index kg/m2ValuesareN(%)ormean±standarddeviations.

P-value calculated by Chi-square.

Table 2

Medical Stress Scale by Gender in Participants

	Total	Male	Female	P-value
1. Medical school fosters a sense of anonymity and feelings of isolation among students. 한의대는 나에게 고립되어 있다거나 존재감이 없다는 느낌을 갖게 한다.	2.65±1.15	2.59±1.13	2.76±1.18	0.174
2. I am concerned that I will not be able to endure the long hours and responsibilities associated with clinical training and practice. 나는 긴 시간의 교육과 실습이 주는 부담을 견뎌내지 못할까봐 걱정된다.	2.69±1.18	2.57±1.14	2.91±1.22	0.005
3. I do not know what the faculty/administration expect. of me. 나는 학교와 교수님들이 나에게 무엇을 기대하는지 모르겠다.	2.86±1.02	2.90±1.04	2.78±0.99	0.271
4. Medical training controls my life and leaves too little time for other activities. 한의대에서의 강의, 과제, 시험 등이 나의 생활을 좌우하고 있어서, 다른 일들을 할수 있는 시간이 거의 없다.	2.95±1.29	2.83±1.27	3.18±1.31	0.009
5. I amconcerned that 1 will be unable to master the entire pool of medical knowledge. 나는 모든 의학 지식들을 제대로 익힐 수 없을 것 같아서 걱정이 된다.	3.30±1.16	3.21±1.16	3.48±1.14	0.029
6. This medical school is fostering a physician role at the expense of one’s personality and interests. 한의대는 개인의 관심사나 인품을 무시하고 한의사로서의 기술만을 교육한다.	2.55±1.09	2.53±1.04	2.60±1.18	0.567
7. Medical school is more competítíve than I expected. 한의과대학 생활은 내가 예상했던 것 보다 더 경쟁적이다.	2.76±1.16	2.72±1.16	2.83±1.17	0.351
8. The attitude of too many of the faculty is that students should be subjected to “baptism by fire” 많은 교수님들은 학생들이 텍스트보다는 실제 임상현장을 통해 배워야한다고 생각한다.	2.98±0.95	2.90±0.96	3.12±0.91	0.032
9. The majority of students feel that success in medical school is in spite of the administration rather than because of it. 대부분의 학생들은 대학이 성공적인 한의대 생활에 도움을 주지 못하고 있다고 느낀다.	3.30±1.11	3.29±1.11	3.31±1.11	0.885
의학 교육과정 및 환경 Medical school environment	26.03±6.05	25.54±6.09	26.97±5.89	0.025
10. Medical school is cold, impersonal,and needlessly bureaucratized. 한의과대학은 비인간적이고, 냉정하며, 이유 없이 관료주의적이다.	2.62±1.13	2.70±1.15	2.47±1.10	0.060
11.Decisions regarding electives and clerkships are made on the basis of information obtained from fellow students and not from the faculty. 선택과목과 선택실습의 결정은, 교수보다는 학생들로부터 얻는 정보를 토대로 이루어진다.	2.99±1.17	2.93±1.14	3.10±1.07	0.135
12. Medical school is more of a threat than a challenge. 한의과대학 생활은 도전할 대상이라기보다는 나를 위협하는 것으로 느껴진다.	2.41±1.00	2.46±1.01	2.32±0.99	0.180
개인적 유능감 및 인내심 Endurance and expectations	8.02±2.25	8.08±2.29	7.89±2.16	0.421
13. Personal fïnances are a source of concern to me. 나에게 있어서 돈과 관련된 문제는 매우 중요하다.	2.41±1.00	2.45±1.01	2.32±0.99	0.180
Total	37.92±37.92	37.48±8.05	38.75±7.60	0.131

Values are mean±standard deviations.

P-value calculated by Student t-test.

Table 3

Medical Stress Scale by Gender in Participants

	Total	Male	Female	P-value
1. I feel emotionally drained from my work 나는 공부 때문에 정서적으로 고갈된 느낌이다.	3.65±1.75	3.53±1.74	3.88±1.76	0.060
2. I feel used up at the end of a day at university. 나는 학교 수업이 끝나고 집에 돌아오면 완전히 지친다.	4.32±1.75	4.01±1.71	4.91±1.67	0.000
3. I feel tired when I get up in the morning and I have to face another day at the university. 나는 아침에 일어나면 학교에 가서 다시 공부를 해야 하는 것 때문에 힘들다.	4.23±1.71	4.06±±1.67	4.54±1.75	0.008
4. Studying or attending a class is really a strain for me. 나는 공부를 하거나 수업에 참여하는 것 때문에 스트레스를 많이 받는다.	3.97±1.68	3.88±1.67	4.15±1.69	0.118
5. I feel burned out from my studies. 나는 공부로 인해 소진되었다고 느낀다.	3.96±1.78	3.84±1.74	4.19±1.85	0.061
정서적 고갈 Exhaustion	20.13±7.29	19.30±7.32	21.68±6.70	0.002
6. I have become less interested in my studies since my enrollment at the university. 나는 학교에 입학한 이후로 공부에 대한 흥미를 덜 느끼게 되었다.	4.10±1.81	4.17±1.83	3.96±1.77	0.288
7. I have become less enthusiastic about my studies. 나는 공부에 대한 열정이 식는 것 같다.	4.00±1.76	4.07±1.74	3.88±1.81	0.325
8. I have become less enthusiastic about my studies 나는 공부가 미래에 도움이 될 지 회의적이다.	3.44±1.83	3.58±1.80	3.17±1.86	0.034
9. I doubt the significance of my studies 나는 공부의 중요성이 의심스럽다.	2.95±1.69	3.06±1.72	2.75±1.60	0.081
냉담 Cynicism	14.49±5.85	14.88±5.75	13.76±5.98	0.073
10. I can effectively solve the problems that arise in my studies. 나는 공부하면서 생기는 문제를 효과적으로 해결할 수 있다.	4.35±1.32	4.35±1.29	4.35±1.37	0.952
11. I belive that I make an effective contribution to the classes that I attend. 나는 학교 수업에 활발하게 참여한다고 생각한다.	3.89±1.45	3.82±1.46	4.03±1.43	0.176
12. In my opinion, I am a good student. 내 생각에 나는 훌륭한 학생이다.	4.02±1.51	3.87±1.53	4.30±1.43	0.007
13. I feel stimulated when I achieve my study goals. 나는 학업 목표를 성취할 때 활력이 생긴다.	4.73±1.50	4.44±1.57	5.28±1.18	0.000
14. I have learned many interesting things during the course of my studies. 나는 공부를 통해 흥미있는 내용을 많이 배웠다.	4.59±1.32	4.46±1.30	4.85±1.33	0.005
15. During class I feel confident that I am effective in getting things done. 나는 수업 중에 수행을 효과적으로 잘 했다고 확신한다.	4.21±1.32	4.12±1.34	4.39±1,27	0.055
전문적인 효능감 Professional efficiency	25.80±6.30	25.06±6.55	27.19±5.57	0.001
Total	65.76±11.88	64.40±11.76	68.31±11.72	0.002

Values are mean±standard deviations.

P-value calculated by Student t-test.

Table 4

Korea Acceptance and Action by Gender in Participants

	Total	Male	Female	P-value
1. It’s OK if I remember something unpleasant. 나는 불쾌한 기억을 떠올리더라도 괜찮다.	3.86±1.28	3.88±1.22	3.83±1.39	0.721
2. My painful experiences and memories make it difficult for me to live a life that I would value.* 고통스러운 경험과 기억으로 인해 나는 내가 가치 있게 여기는 삶을 살기가 어렵다.	5.17±1.39	5.20±1.36	5.10±1.44	0.517
3. I’m afraid of my feelings.* 나는 내 감정을 느끼는것이 두렵다.	5.19±1.48	5.25±1.39	5.06±1.55	0.206
4. I worry about not being able to control my worries and feelings.* 나는 내 걱정과 느낌을 통제하지 못하는 것에 대해 염려한다.	4.88±1.54	5.07±1.49	4.50±1.56	0.000
5. My painful memories prevent me from having a fulfilling life.* 내 고통스러운 기억들은 내가 만족스러운 삶을 살지 못하게 한다.	5.16±1.44	5.23±1.43	5.02±1.44	0.182
6. I am in control of my life. 나는 내 삶을 잘 관리하고 있다.	4.45±1.15	4.40±1.20	4.52±1.06	0.337
7. Emotions cause problems in my life.* 감정은 내 일상생활에서 문제를 일으킨다.	4.70±1.37	4.88±1.33	4.35±1.39	0.000
8. It seems like most people are handling their lives better than I am.* 대부분의 사람들은 나보다 자신의 삶을 잘 꾸려나가고 있는 것 같다.	4.25±1.37	4.33±1.38	4.09±1.33	0.095
9. Worries get in the way of my success.* 걱정은 내가 성공하는데 걸림돌이 된다.	4.43±1.34	4.62±1.29	4.07±1.36	0.000
10. My thoughts and feelings do not get in the way of how I want to live my life. 내 생각과 감정은 내가 살고 싶은 방식대로 살아가는 데 방해되지 않는다.	4.05±1.35	4.09±1.43	3.98±1.23	0.457
Total	46.11±9.38	46.95±9.26	44.53±9.45	0.015

* Item reversed for scoring purposes.

Values are mean±standard deviations. P-value calculated by Student t-test.

Table 5

Ego Resilience Scale by Gender by Participants

	Total	Male	Female	P-value
1 나는 친구들에게 너그럽다. I am generous with my friends.	2.84±0.73	2.85±0.71	2.84±0.78	0.898
2 나는 당황하게 되더라도 빨리 안정을 찾는다. I quickly get over and recover from being startled.	2.50±0.84	2.56±0.80	2.40±0.90	0.073
3 나는 새롭고 낯선 상황을 다루는 것이 즐겁다. I enjoy dealing with new and unusual situations.	2.02±0.90	2.05±0.89	1.96±0.91	0.301
4 나는 보통 다른 사람들에게 호감 가는 인상을 심어준다. I usually succeed in making a favorable impression on people.	2.57±0.85	2.55±0.84	2.61±0.87	0.494
5 나는 이전에 먹어 본적 없는 음식을 먹는 것을 즐긴다. I enjoy trying new foods I have never tasted before.	2.39±1.03	2.39±1.03	2.41±1.04	0.809
6 나는 매우 에너지가 넘치는 사람으로 비춰진다. I am regarded as a very energetic person.	2.14±0.90	2.14±0.85	2.13±0.99	0.903
7 나는 친숙한 곳이라도, 다른 길로 가는 것을 좋아한다. I like to take different paths to familiar places.	2.03±0.97	2.09±0.96	1.93±0.99	0.113
8 나는 대부분의 사람들보다 호기심이 더 많다. I am more curious than most people.	2.32±0.90	2.35±0.85	2.25±0.99	0.295
9 내가 만나는 대부분의 사람들에게 호감을 가진다. Most of the people I meet are likable.	2.46±0.86	2.41±0.85	2.54±0.89	0.150
10 나는 보통 행동하기 전에 신중하게 생각한다. I usually think carefully about something before acting.	2.66±0.85	2.67±0.85	2.66±0.86	0.968
11 나는 지금까지 해보지 않은 새로운 무언가를 하기 좋아한다. I like to do new and different things.	2.32±0.90	2.32±0.85	2.32±0.93	0.995
12 나의 일상생활은 흥미로운 것들로 가득 차있다. My daily life is full of things that keep me interested.	2.09±0.84	2.09±0.81	2.10±0.90	0.946
13 나는 내가 꽤 강인한 성격을 지닌 사람이라고 말할 수 있다. I would be willing to describe myself as a pretty “strong” personality.	2.44±0.92	2.52±0.92	2.29±0.91	0.022
14 나는 누군가에게 화가 나도 꽤 빨리 풀린다. I get over my anger at someone reasonably quickly.	2.50±1.03	2.52±1.00	2.47±1.08	0.641
Total	33.30±7.13	33.51±6.82	32.91±7.69	0.433

Values are mean±standard deviations. P-value calculated by Student t-test.

Table 6

Correlations between Stress and Perceived Health Status

Value	Pearson correlation value	P-value
Medical Stress Scale - Medical school environment	−0.308	0.000
Medical Stress Scale - Endurance and expectations	−0.181	0.000
Medical Stress Scale - Finance	−0.243	0.000
Medical Stress Scale Sum Score	−0.301	0.000
Maslach Burnout Inventory - Exhaustion	−0.297	0.000
Maslach Burnout Inventory - Cynicism	−0.219	0.000
Maslach Burnout Inventory – Professional Efficiency	0.236	0.000
Maslach Burnout Inventory Sum Score	−0.223	0.000
Acceptance and Action Score	0.317	0.000
Ego Resilience Scale Score	0.325	0.000

* Pearson correlation value

Table 7

Simple Regression between Stress and Perceived Health Status

Value	β*	P-value
Constant	38.509
Medical Stress Scale - Medical school environment	0.332	0.799
Medical Stress Scale - Endurance and expectations	0.802	0.583
Medical Stress Scale - Finance	−0.571	0.763
Medical Stress Scale Sum Score	−0.470	0.695
Maslach Burnout Inventory - Exhaustion	1.205	0.218
Maslach Burnout Inventory - Cynicism	1.399	0.155
Maslach Burnout Inventory – Professional Efficiency	1.652	0.080
Maslach Burnout Inventory Sum Score	−1.485	0.113
Acceptance and Action Score	0.334	0.015
Ego Resilience Scale Score	0.687	<0.001

* Simple regression value

참고문헌

1. Hope, V, & Henderson, M. Medical student depression, anxiety and distress outside North America: a systematic review. Med Educ, (2014). 48(10), 963-79.

2. Dyrbye, LN, West, CP, Satele, D, Boone, S, Tan, L, & Sloan, J, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med, (2014). 89(3), 443-51.

3. Ishak, W, Nikravesh, R, Lederer, S, Perry, R, Ogunyemi, D, & Bernstein, C. Burnout in medical students: a systematic review. Clin Teach, (2013). 10(4), 242-5.

4. Alsulami, S, Al Omar, Z, Binnwejim, MS, Alhamdan, F, Aldrees, A, & Al-Bawardi, A, et al. Perception of academic stress among Health Science Preparatory Program students in two Saudi universities. Adv Med Educ Pract, (2018). 9, 159-64.

5. Al Rasheed, F, Naqvi, AA, Ahmad, R, & Ahmad, N. Academic Stress and Prevalence of Stress-Related Self-Medication among Undergraduate Female Students of Health and Non-Health Cluster Colleges of a Public Sector University in Dammam, Saudi Arabia. J Pharm Bioallied Sci, (2017). 9(4), 251-8.

6. Assaf, AM, Al-Abbassi, R, & Al-Binni, M. Academic stress-induced changes in Th1- and Th2-cytokine response. Saudi Pharm J, (2017). 25(8), 1237-47.

7. Kim, YK. The influence of stress on alcohol addiction, internet addiction and problem gambling: spiritual well-being as mediator. Korean J Counselling, (2013). 14(1), 97-114.

8. Hong, SY. Relation amang Stress, Ego-Resilience, Self-Efficacy, Clinical performance in graduate medical student. J Korea Academia-Industrial Coopreation Soc, (2011). 12(12), 5797-804.

9. Kim, SH, Han, SY, Kim, JD, Choi, SM, Lee, SJ, & Lim, JH, et al. Study on stress and burnout in medical education at the school of Korean medicine. J of Oriental Neuropsychiatry, (2015). 26(2), 103-16.

10. Chang, JY, Kim, KS, & Kim, BS. Study of on academic stress responses according to Sasang constitutions of oriental medicine college students. J of Oriental Neuropsychiatry, (2012). 23(3), 77-88.

11. Yang, DH, Oh, YJ, Cheun, YH, Cho, YS, Oh, KM, & Kim, BK. Test anxiety investigation of students in oriental medicine college by using Korea’s version-test anxiety inventory, state-trait anxiety inventory, symptom check list90-revision. J of Oriental Neuropsychiatry, (2008). 19(1), 55-70.

12. Vitaliano, PP, Russo, J, Carr, JE, & Heerwagen, JH. Medical school pressures and their relationship to anxiety. J Nerv Ment Dis, (1984). 172(12), 730-6.

13. Bond, FW, Hayes, SC, Baer, RA, Carpenter, KM, Guenole, N, & Orcutt, HK, et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther, (2011). 42(4), 676-88.

14. Heo, JH, Choi, MS, & Jin, HJ. Study on the reliability and validity of Korean translated acceptance-action questionnaire-II. Korean J Counseling and Psychotherapy, (2009). 21(4), 861-78.

15. Block, J, & Kremen, AM. IQ and ego-resiliency: conceptual and empirical connections and separateness. J Pers Soc Psychol, (1996). 70(2), 349-61.

16. Cha JH. The Effect of Relationships among the Search for and Presence of Meaning in Life, Psychological Flexibility, Ego-Resiliency on Life Satisfaction. Gyeongsang national university;Master Thesis. 2015.

17. Kim, JM, & Son, CN. Effects of acceptance and commitment therapy(ACT) on social avoidance and self-focused attention or college student with speech anxiety. KJHP, (2013). 18(2), 267-83.

18. Kim, GE, & Yang, NM. The Relations between Ego-Resilience and Post-Traumatic Growth on University students:Mediating Effects of Meaning in life and Active Stress Coping Method. Korean Journal of Counseling and Psychotherapy, (2016). 28(1), 127-45.