Effect of Brief Behavioral Intervention Program in Managing Stress in Medical Students from Two Southern California Universities

Abstract

The study aims to assess 1) the prevalence of stress among a group of third and fourth year medical students (MS) from two Southern California universities and 2) the effect of a brief behavioral intervention program (BBIP) on stress management among the students instructed on stress intervention techniques. The stress level was determined by using the General Well Being Scale (GWBS), a self-report questionnaire designed by the National Center for Health Statistics.1 The stress testing was done prior to the psycho-educational lecture on stress. The prevalence of stress and the variation of stress based on gender, academic year (third vs. fourth year) and time of testing (beginning vs. end of rotation) was measured in 104 medical students. To assess the effect of the psycho-educational lectures on stress, the last 32 students who rotated in our service had the pre-test and the lecture at the beginning of the rotation and the post-test at the end of the rotation. Among the medical students studied, 53/104 (51%) reported stress; among this group, 20/53 (37.7%) reported severe stress or distress. The prevalence of stress in this group of students was not significantly different if the stress level was measured at the beginning (46.9%) vs. the end of the rotation (52.8%, p = 0.57). The total stress score was lower (suggesting higher stress) in the fourth vs. third year MS (69.7+/-16.3 vs. 73.2+/-12.7, p=0.2), and in female students vs. male students (69.9+/-14.5 vs. 73.7+/-13.8, p=0.17). Female students, when compared to their male counterparts, had a lower anxiety score (12.2+/-4.4 vs. 15.4+/-4.3, p p0.005), consistent with higher anxiety level, since the polarity for the anxiety questions is reversed. Among the students who had both a pre and post-test (N=32) after the BBIP (deep diaphragmatic breathing, self-control relaxation, walking meditation), the reported stress decreased from 46.9 % (15/32) to 21.9% (7/25) (p 0.05). In addition, scores indicated that the brief behavioral intervention program significantly decreased the anxiety level and improved the positive well-being. Our study showed that stress is very prevalent among the medical students tested, affecting 51% of the students. Among those who reported stress, 37.7% reported distress. Female students reported a higher level of anxiety compared to their male colleagues. Following the implementation of a brief behavioral program, the prevalence of stress in this group of students decreased by 46.7 %. This was associated with a decrease in the reported anxiety and an increase in the positive well-being. Since stress is very prevalent among medical students, increased awareness of stress and early intervention may prevent burnout, improve job satisfaction and ultimately improve health care delivery.