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PREDICTING THE PSYCHOLOGICAL WELL-BEING OF DENTAL STUDENTS DURING THE SEMESTER EVALUATION PERIOD: A PROSPECTIVE STUDY

Table 1. Student’ s positive well-being, assessed by WHO-5 scores, over the first semester of the academic year

Time Students WHO-5 score( mean) p

T1

T2

T3

T4

All( T1: T2): 0.038 * All( T2: T3): 0.136 All( T3: T4): 0.009 * All( T1: T4): 0.014 * Male: Female( T1): 0.523 Male: Female( T2): 0.103 Male: Female( T3): 0.805 Male: Female( T4): 0.084 From Bucharest: Other( T1): 0.203 From Bucharest: Other( T2): 0.667 From Bucharest: Other( T3): 0.249 From Bucharest: Other( T4): 0.529

2. Materials and Methods

This study was approved by the Ethics Committee for Scientific Research at the“ Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania( PO-35-F-03, No. 55).

2.1 Study design and settings A prospective study was designed and implemented on a cohort of second year dental students from the Faculty of Dental Medicine,“ Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania. Data were collected during the first semester of the 2014-2015 academic year( from October 1 st 2014 to February 15 th 2015), three consecutive times during the teaching period and one time during the semester exam period.

2.2 Subjects One series of second year dental students who attended the above-mentioned university was enrolled in this study. Enrolment was done considering all eligible subjects, who voluntarily agree to participate in this study. Repeaters and transferred students were excluded, because their courses are partially different from those of regular students, having usually less or more subjects to attend. All participants were informed upon the main characteristics of this study and a written informed consent was granted, in the beginning, and also in the follow-up appointments.

2.3 Variables The main study outcome was the subjective psychological well-being, assessed using the WHO-Five Well-being Index( WHO-5) and the Major Depression Inventory( MDI). The Romanian language version of both questionnaires was used. The Romanian language version of WHO-5 that was used was the one available on the website dedicate to this index, that of the Psychiatric Research Unit( Mental Health Centre North Zealand, Hillerod, Denmark). The index has been previously tested and demonstrated to have good psychometric properties as a well-being scale and as a screening instrument for depression. 7 The Romanian language version of MDI that was used was the one available in the Romanian guide for adult depression for general practitioners. Other study variables were demographics( age, sex) and origin( from Bucharest or other). The latter was chosen on the idea that students from Bucharest experience less life changes, usually preserving their living accommodation and the relations with their family and friends.

2.4 Data collection Data were collected by administering a written questionnaire before or after classes, its timing being related to the academic activities, as favouring different levels of stress, as follows: T1- 2 nd week of the teaching period, corresponding to the beginning of the first academic semester; T2- 7 th week of the teaching period, corresponding to its middle, during which half-semester theoretical examinations are scheduled for some of the courses taken; the questionnaire was filled just after a written examination; T3- 13 th week of the teaching period, that was just after the Christmas and New Year break, corresponding to the end of the teaching period, when students have practical examinations for the seminars activities of most of the courses taken; the questionnaire was filled just after a practical examination; T4- 4 th week( last week) of the semester exam period; the questionnaire was administered just after a written examination.

2.5 Statistical methods Missing data, caused by not fully filling the questionnaire all four times, were managed by excluding the subject from the analysis. Data analysis included frequency distributions, Wilcoxon test, paired t-test, Mann-Whitney test and unpaired t-test. Change in well-being was assessed by change of WHO-5 score and MDI score. The difference of WHO-5 scores of at least 10, considered as a clinically significant change