Academic burnout, self-esteem, coping with stress and gratitude amongPolish medical students – a cross sectional study

Authors

DOI:

https://doi.org/10.2478/cpp-2022-0023

Keywords:

burnout, self-esteem, stress, gratitude, students

Abstract

Introduction: Academic burnout is emerging as an essential obstacle in education process. Students of the most challenging fields of study with high degrees of stress are thought to be at the highest risk. Medical studies are considered one of them. The aim of the study was to measure the levels of academic burnout, stress and gratitude among Polish medical students of Medical University of Lublin, and determine their styles of coping with stress.

Materials and methods: A cross-sectional study was conducted using a questionnaire comprised of the following: Maslach Burnout Inventory – Student Survey (MBI-SS), Rosenberg Self-Esteem Scale (SES), a Coping Inventory for Stressful Situations (CISS) and a Gratitude Questionnaire Six-Item form (GQ-6). The data was obtained from 773 medical students.

Results: Total number of 169 students (21.86%) met criteria for academic burnout. When it comes to 354 participants, they displayed signs of low self-esteem (45.8%). The number of 18 students showed low level of gratitude, while gratitude level of the majority of them – 496 (64.17%) was high. The most common style of coping with stress was emotions-oriented style – 354 students (48.29%), followed by task-oriented style – 345 students (47.07%). Burnout subscales turned out to be associated with age, year of study, self-esteem, gratitude and different styles of coping with stress to the various extent.

Conclusions: The prevalence of academic burnout among Polish medical students is high compared with general population across various occupations. Utilisation of protective characteristics of high self-esteem, gratitude and healthy coping methods can result in development of efficient anti-burnout prevention strategies and intervention tools.

References

1. Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav. 1981 Apr;2(2):99-113.

2. Alkhamees AA, Alaqil NS, Alsoghayer AS, Alharbi BA. Prevalence and determinants of burnout syndrome and depression among medical students at Qassim University, Saudi Arabia. Saudi Med. J. 2020 Dec;41(12):1375-80.

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

4. Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students a systematic review and meta-analysis. Vol. 316, JAMA - Journal of the American Medical Association. American Medical Association; 2016. p. 2214-36.

5. Cushman S, West R. Precursors to College Student Burnout: Developing a Typology of Understanding. Qual Res Rep Commun. 2006 Dec;7(1):23-31.

6. Endler NS, Parker JDA. Coping Inventory for Stressful Stituations (CISS): Manual. Toronto: Multi-Health Systems, Inc.; 1990.

7. Szczepaniak P, Strelau J, Wrześniewski K. Diagnoza stylów radzenia sobie ze stresem za pomocą polskiej wersji kwestionariusza CISS Endlera i Parkera. Przegląd Psychol. 1996;39(1):187-210.

8. Rosenberg M. Society and the adolescent self-image. Prinveton Univ Press; 1965.

9. Dzwonkowska I, Lachowicz-Tabaczek K, Łaguna M. Skala samooceny SES Morrisa Rosenberga - polska daptacja metody. Psychol Społeczna. 2007;(2):164-76.

10. Chirkowska-Smolak T, Kleka P. The Maslach Burnout Inventory–General Survey: validation across different occupational groups in Poland. Pol Psychol Bull. 2011;42(2):86-94.

11. McCullough ME, Emmons RA, Tsang J-A. The grateful disposition: A conceptual and empirical topography. J Pers Soc Psychol. 2002;82(1):112-27.

12. Kossakowska M, Kwiatek P. Polska adaptacja kwestionariusza do badania wdzięczności GQ-6 The Polish adaptation of the Gratitude Questionnaire (GQ-6). Przeglad Psychol. 2015 Jan 1;

13. Maslach C, Jackson S, Leiter M. The Maslach Burnout Inventory Manual. In: Evaluating Stress: A Book of Resources. 1997. p. 191-218.

14. Galán F, Sanmartín A, Polo J, Giner L. Burnout risk in medical students in Spain using the Maslach Burnout Inventory-Student Survey. Int Arch Occup Environ Health. 2011 Apr;84(4):453-9.

15. Erschens R, Loda T, Herrmann-Werner A, et al. Behaviour-based functional and dysfunctional strategies of medical students to cope with burnout. Med Educ Online. 2018 Dec;23(1):1535738.

16. Fitzpatrick O, Biesma R, Conroy RM, McGarvey A. Prevalence and relationship between burnout and depression in our future doctors: a cross-sectional study in a cohort of preclinical and clinical medical students in Ireland. BMJ Open. 2019 May 1;9(4):e023297.

17. Nteveros A, Kyprianou M, Artemiadis A, et al. Burnout among medical students in Cyprus: A cross-sectional study. PloS One. 2020;15(11):e0241335.

18. Liu H, Yansane AI, Zhang Y, Fu H, Hong N, Kalenderian E. Burnout and study engagement among medical students at Sun Yat-sen University, China: A cross-sectional study. Medicine (Baltimore). 2018 Apr;97(15):e0326.

19. Obregon M, Luo J, Shelton J, Blevins T, MacDowell M. Assessment of burnout in medical students using the Maslach Burnout Inventory-Student Survey: a cross-sectional data analysis. BMC Med Educ. 2020 Oct 21;20(1):376.

20. Yu J, Chae S. The mediating effect of resilience on the relationship between the academic burnout and psychological well-being of medical students. Korean J Med Educ. 2020 Mar;32(1):13-21.

21. Thun-Hohenstein L, Höbinger-Ablasser C, Geyerhofer S, Lampert K, Schreuer M, Fritz C. Burnout in medical students. Neuropsychiatr Klin Diagn Ther Rehabil Organ Ges Osterreichischer Nervenarzte Psychiater. 2021 Mar;35(1):17-27.

22. Santen SA, Holt DB, Kemp JD, Hemphill RR. Burnout in medical students: examining the prevalence and associated factors. South Med J. 2010 Aug;103(8):758-63.

23. Lee KP, Yeung N, Wong C, Yip B, Luk LHF, Wong S. Prevalence of medical students’ burnout and its associated demographics and lifestyle factors in Hong Kong. PloS One. 2020;15(7):e0235154.

24. Haile YG, Senkute AL, Alemu BT, Bedane DM, Kebede KB. Prevalence and associated factors of burnout among Debre Berhan University medical students: a cross-sectional study. BMC Med Educ. 2019 Nov 8;19(1):413.

25. Altannir Y, Alnajjar W, Ahmad SO, et al. Assessment of burnout in medical undergraduate students in Riyadh, Saudi Arabia. BMC Med Educ. 2019 Jan 25;19(1):34.

26. Humphris G, Blinkhorn A, Freeman R, et al. Psychological stress in undergraduate dental students: baseline results from seven European dental schools. Eur J Dent Educ Off J Assoc Dent Educ Eur. 2002 Feb;6(1):22-9.

27. Pöhlmann K, Jonas I, Ruf S, Harzer W. Stress, burnout and health in the clinical period of dental education. Eur J Dent Educ Off J Assoc Dent Educ Eur. 2005 May;9(2):78-84.

28. Amin WM, Al-Ali MH, Duaibis RB, Oweis T, Badran DH. Burnout among the clinical dental students in the jordanian universities. J Clin Med Res. 2009 Oct;1(4):207-11.

29. Montero-Marin J, Monticelli F, Casas M, et al. Burnout syndrome among dental students: a short version of the ‘Burnout Clinical Subtype Questionnaire’ adapted for students (BCSQ-12-SS). BMC Med Educ. 2011 Dec 12;11:103.

30. Mafla AC, Villa-Torres L, Polychronopoulou A, et al. Burnout prevalence and correlates amongst Colombian dental students: the STRESSCODE study. Eur J Dent Educ Off J Assoc Dent Educ Eur. 2015 Nov;19(4):242-50.

31. Vasconcelos EM de, Trindade CO, Barbosa LR, Martino MMF de. Predictive factors of burnout syndrome in nursing students at a public university. Rev Esc Enferm U P. 2020;54:e03564.

32. Quina Galdino MJ, Brando Matos de Almeida LP, Ferreira Rigonatti da Silva L, et al. Burnout among nursing students: a mixed method study. Investig Educ En Enfermeria. 2020 Feb;38(1).

33. Lopes AR, Nihei OK. Burnout among nursing students: predictors and association with empathy and self-efficacy. Rev Bras Enferm. 2020;73(1):e20180280.

34. Estrada Araoz EG, Gallegos Ramos NA, Mamani Uchasara HJ. Academic burnout in Peruvian university students. Apunt Univ. 2021 Jun;11(2):48.

35. Aguayo R, Cañadas GR, Assbaa-Kaddouri L, Cañadas-De la Fuente GA, Ramírez-Baena L, Ortega-Campos E. A Risk Profile of Sociodemographic Factors in the Onset of Academic Burnout Syndrome in a Sample of University Students. Int J Environ Res Public Health. 2019 Feb 27;16(5).

36. Worly B, Verbeck N, Walker C, Clinchot DM. Burnout, perceived stress, and empathic concern: differences in female and male Millennial medical students. Psychol Health Med. 2019 Apr;24(4):429-38.

37. Puertas-Neyra K, Galy Mendoza T, Silvana Caceres L, Nestor Falcon P. Burnout syndrome in Veterinary Medicine students. Rev Investig Vet PERU. 2020;31(2).

38. Elkins C, Plante KP, Germain LJ, Morley CP. Burnout and Depression in MS1 and MS3 Years: A Comparison of Cohorts at One Medical School. Fam Med. 2017 Jun;49(6):456-9.

39. Ried LD, Motycka C, Mobley C, Meldrum M. Comparing selfreported burnout of pharmacy students on the founding campus with those at distance campuses. Am J Pharm Educ. 2006 Oct 15;70(5):114.

40. Guthrie E, Black D, Bagalkote H, Shaw C, Campbell M, Creed F. Psychological stress and burnout in medical students: a five-year prospective longitudinal study. J R Soc Med. 1998 May;91(5):237-43.

41. Lee SJ, Choi YJ, Chae H. The effects of personality traits on academic burnout in Korean medical students. Integr Med Res. 2017 Jun;6(2):207-13.

42. Prins DJ, van Vendeloo SN, Brand PLP, et al. The relationship between burnout, personality traits, and medical specialty. A national study among Dutch residents. Med Teach. 2019 May;41(5):584-90.

43. Gold JA, Johnson B, Leydon G, Rohrbaugh RM, Wilkins KM. Mental health self-care in medical students: a comprehensive look at help-seeking. Acad Psychiatry J Am Assoc Dir Psychiatr Resid Train Assoc Acad Psychiatry. 2015 Feb;39(1):37-46.

44. Burr J, Beck Dallaghan GL. The Relationship of Emotions and Burnout to Medical Students’ Academic Performance. Teach Learn Med. 2019 Dec;31(5):479-86.

45. Willcock SM, Daly MG, Tennant CC, Allard BJ. Burnout and psychiatric morbidity in new medical graduates. Med J Aust. 2004 Oct 4;181(7):357-60.

46. Kristanto T, Chen WS, Thoo YY. Academic burnout and eating disorder among students in Monash University Malaysia. Eat Behav. 2016 Aug;22:96-100.

47. Pagnin D, de Queiroz V, Carvalho YTMS, Dutra ASS, Amaral MB, Queiroz TT. The relation between burnout and sleep disorders in medical students. Acad Psychiatry J Am Assoc Dir Psychiatr Resid Train Assoc Acad Psychiatry. 2014 Aug;38(4):438-44.

48. Deeb GR, Braun S, Carrico C, Kinser P, Laskin D, Golob Deeb J. Burnout, depression and suicidal ideation in dental and dental hygiene students. Eur J Dent Educ Off J Assoc Dent Educ Eur. 2018 Feb;22(1):e70-4.

49. Walsh AL, Lehmann S, Zabinski J, et al. Interventions to Prevent and Reduce Burnout Among Undergraduate and Graduate Medical Education Trainees: a Systematic Review. Acad Psychiatry J Am Assoc Dir Psychiatr Resid Train Assoc Acad Psychiatry. 2019 Aug;43(4):386-95.

50. Daya Z, Hearn JH. Mindfulness interventions in medical education: A systematic review of their impact on medical student stress, depression, fatigue and burnout. Med Teach. 2018 Feb;40(2):146-53.

51. Xie C, Zeng Y, Lv Y, Li X, Xiao J, Hu X. Educational intervention versus mindfulness-based intervention for ICU nurses with occupational burnout: A parallel, controlled trial. Complement Ther Med. 2020 Aug;52:102485.

52. Clarkson M, Heads G, Hodgson D, Probst H. Does the intervention of mindfulness reduce levels of burnout and compassion fatigue and increase resilience in pre-registration students? A pilot study. Radiogr Lond Engl 1995. 2019 Feb;25(1):4-9.

53. Raditya M, Sutarina N. Relationship between burnout and physical activity level among pre-clinical medical students. JPMA J Pak Med Assoc. 2021 Feb;71(Suppl 2)(2):S62-8.

54. von Harscher H, Desmarais N, Dollinger R, Grossman S, Aldana S. The impact of empathy on burnout in medical students: new findings. Psychol Health Med. 2018 Mar;23(3):295-303.

55. Cho E, Jeon S. The role of empathy and psychological need satisfaction in pharmacy students’ burnout and well-being. BMC Med Educ. 2019 Feb 4;19(1):43.

56. Moreno-Fernandez J, Ochoa JJ, Lopez-Aliaga I, et al. Lockdown, Emotional Intelligence, Academic Engagement and Burnout in Pharmacy Students during the Quarantine. Pharm Basel Switz. 2020 Oct 22;8(4).

57. Fares J, Saadeddin Z, Al Tabosh H, et al. Extracurricular activities associated with stress and burnout in preclinical medical students. J Epidemiol Glob Health. 2016 Sep;6(3):177-85.

58. Lane J, Lane AM, Kyprianou A. Self-efficacy, self-esteem and their impact on academic performance. Soc Behav Personal. 2004 May 1;32(3):247.

59. Tangney J, Baumeister R, Boone A. High Self‐Control Predicts Good Adjustment, Less Pathology, Better Grades, and Interpersonal Success. J Pers. 2004 May 1;72:271-324.

60. Crego A, Carrillo-Diaz M, Armfield JM, Romero M. Stress and Academic Performance in Dental Students: The Role of Coping Strategies and Examination-Related Self-Efficacy. J Dent Educ. 2016 Feb;80(2):165-72.

61. Sa B, Ojeh N, Majumder MAA, et al. The Relationship Between Self-Esteem, Emotional Intelligence, and Empathy Among Students From Six Health Professional Programs. Teach Learn Med. 2019 Dec;31(5):536-43.

62. Khan MA, Malviya M, English K, et al. Medical Student Personality Traits and Clinical Grades in the Internal Medicine Clerkship. Med Sci Educ. 2021 Apr;31(2):637-45.

63. Kirkpatrick, L.A., Ellis B.J. What is the evolutionary significance of self-esteem? the adaptive functions of self-evaluative psychological mechanisms,” in Self-Esteem Issues and Answers: A Sourcebook of Current Perspectives. M. H. Kernis (Ed.) Self-Esteem: Issues and Answers. New York: Psychology Press; 2006.

64. Edwards D, Burnard P, Bennett K, Hebden U. A longitudinal study of stress and self-esteem in student nurses. Nurse Educ Today. 2010 Jan 1;30(1):78-84.

65. Molero Jurado M del M, Pérez-Fuentes M del C, Gázquez Linares JJ, Barragán Martín AB. Burnout in Health Professionals According to Their Self-Esteem, Social Support and Empathy Profile. Front Psychol [Internet]. 2018 [cited 2021 Jun 22];9. Available from: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00424/full

66. Lees S, Ellis N. The design of a stress-management programme for nursing personnel. J Adv Nurs. 1990;15(8):946-61.

67. Freire, Patrícia Larrosa, Trentin, Jessica Puchalski, de Avila Quevedo, Luciana. Trends in burnout syndrome and emotional factors: an assessment of anesthesiologists in Southern Brazil, 2012. 2016 Jun;21(4):413-23.

68. Kong F, Ding K, Zhao J. The Relationships Among Gratitude, Self-esteem, Social Support and Life Satisfaction Among Undergraduate Students. J Happiness Stud. 2015 Apr 1;16:477-89.

69. Marcysiak M, Dąbrowska O, Marcysiak M. Burnout in a nursing profession versus coping. Vol. 22, Nursing Problems/Problemy Pielęgniarstwa. Termedia; 2014.

70. Nowakowska-Domagala K, Jablkowska-Górecka K, Kostrzanowska-Jarmakowska L, Mortoń M, Stecz P. The Interrelationships of Coping Styles and Professional Burnout Among Physiotherapists: A Cross-Sectional Study. Medicine (Baltimore). 2015 Jun 1;94(24):e906.

71. Di Monte C, Monaco S, Mariani R, Di Trani M. From Resilience to Burnout: Psychological Features of Italian General Practitioners During COVID-19 Emergency. Front Psychol. 2020 Oct 2;11.

72. Banasiewicz J, Zaręba K, Rozenek H, et al. Adaptive capacity of midwives participating in pregnancy termination procedures: Polish experience. Health Psychol Open. 2020;7(2).

73. Michael P Leiter, Arnold B Bakker CM. Burnout at Work: A psychological perspective. Psychology Press; 2014. 182 p.

74. Geng Y. Gratitude mediates the effect of emotional intelligence on subjective well-being: A structural equation modeling analysis. J Health Psychol. 2018 Sep;23(10):1378-86.

75. Jin G, Wang Y. The influence of gratitude on learning engagement among adolescents: The multiple mediating effects of teachers’ emotional support and students’ basic psychological needs. J Adolesc. 2019 Dec;77:21-31.

76. Mofidi T, El-Alayli A, Brown AA. Trait gratitude and grateful coping as they relate to college student persistence, success, and integration in school. J Coll Stud Retent-Res Theory Pract. 2014 Nov;16(3):325-49.

77. Nawa N, Yamagishi N. Enhanced academic motivation in university students following a 2-week online gratitude journal intervention. BMC Psychol. 2021 May 13;9.

78. Kaniuka AR, Kelliher Rabon J, Brooks BD, Sirois F, Kleiman E, Hirsch JK. Gratitude and suicide risk among college students: Substantiating the protective benefits of being thankful. J Am Coll Health J ACH. 2020 Jan 16;1-8.

79. Gabana NT, Steinfeldt J, Wong YJ, Chung YB, Svetina D. Attitude of Gratitude: Exploring the Implementation of a Gratitude Intervention with College Athletes. J Appl SPORT Psychol. 2019 Jul 3;31(3):273-84.

80. Gabana NT, Steinfeldt JA, Wong YJ, Chung YB. Gratitude, Burnout, and Sport Satisfaction Among College Student-Athletes: The Mediating Role of Perceived Social Support. J Clin Sport Psychol. 2017 Mar;11(1):14-33.

81. Chen LH, Chang Y-P. Cross-Lagged Associations between Gratitude and Adolescent Athlete Burnout. Curr Psychol. 2014 Dec;33(4):460-78.

82. Cheng S-T, Tsui PK, Lam JHM. Improving Mental Health in Health Care Practitioners: Randomized Controlled Trial of a Gratitude Intervention. J Consult Clin Psychol. 2015 Feb;83(1):177-86.

83. Kim SR, Park OL, Kim HY, Kim JY. Factors influencing wellbeing in clinical nurses: A path analysis using a multi-mediation model. J Clin Nurs. 2019 Dec;28(23-24):4549-59.

84. Adair KC, Rodriguez-Homs LG, Masoud S, Mosca PJ, Sexton JB. Gratitude at Work: Prospective Cohort Study of a Web-Based, Single-Exposure Well-Being Intervention for Health Care Workers. J Med Internet Res. 2020 May 14;22(5):e15562.

85. Melnyk BM, Kelly SA, Stephens J, et al. Interventions to Improve Mental Health, Well-Being, Physical Health, and Lifestyle Behaviors in Physicians and Nurses: A Systematic Review. Am J Health Promot AJHP. 2020 Nov;34(8):929-41.

86. Ricker M, Maizes V, Brooks AJ, Lindberg C, Cook P, Lebensohn P. A Longitudinal Study of Burnout and Well-being in Family Medicine Resident Physicians. Fam Med. 2020 Nov;52(10):716-23.

87. Victorson D, Sauer C, Horowitz B, Wolf-Beadle J. Development and Implementation of a Brief Healthcare Professional Support Program Based in Gratitude, Mindfulness, Self-compassion, and Empathy. J Nurs Adm. 2021 Apr 1;51(4):212-9.

88. Chan DW. Burnout and life satisfaction: does gratitude intervention make a difference among Chinese school teachers in Hong Kong? Educ Psychol. 2011;31(7):809-23.

89. Lee J-Y, Kim S-Y, Bae K-Y, et al. The association of gratitude with perceived stress and burnout among male firefighters in Korea. Personal Individ Differ. 2018 Mar 1;123:205-8.

Downloads

Published

2022-12-28

How to Cite

Niedobylski, S. ., Michta, K. ., Wachoł, K. ., Niedziałek, K. ., Łopuszańska, U. ., Samardakiewicz, M. ., & Próchnicki, M. . (2022). Academic burnout, self-esteem, coping with stress and gratitude amongPolish medical students – a cross sectional study. Current Problems of Psychiatry, 23(4), 246-257. https://doi.org/10.2478/cpp-2022-0023