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

Table 4. Bivariate regression results for students’ well-being during teaching period predicting wellbeing during semester examination period

being during the semester evaluation period by well-being during the teaching period. Regression analysis showed that psychological well-being during the semester evaluation period( T4) is poorly predicted by the psychological well-being at the beginning of the first academic semester( T1). Even so, psychological well-being( i. e. both the positive psychological well-being assessed by the WHO-5 scores and the severity of depression symptoms assessed by the MDI score) during the semester evaluation period( T4) seems to be more accurately predicted by their well-being during similar periods with respect to the quality of the stressors, i. e. written examination( T2), or at the end of the teaching period( T3). Also, the psychological well-being in terms of severity of depression symptoms seems an aspect that is more predictable than subjective the positive psychological well-being.( Table 4).

4. Discussion

The level of psychological well-being in dental and medical students was previously reported by several studies to be reduced compared to the population norms, being most probably related to the identified high level of stress, reported as present in about one in three dental students. 4, 8 This study results suggest reduced levels of positive psychological well-being in dental students, compared to the general population( i. e., of approximately 70, when measured by WHO- 5), 9, 10 especially during the semester evaluation period. Two cross-sectional studies evaluating well-being using WHO-5 on samples formed by dental students from Europe were identified, i. e. one from Munich, Germany, reporting WHO- 5 scores of about 55, 11 and one from Budapest, Hungary, reporting scores of WHO-5 of 58. 12 Both found the WHO-5 scores for dental students below 70, but it is difficult to compare the results of those studies to those of the current study considering the exact moment for data collection, with regard to the academic year progress, as it was not clearly specified in the two prior studies. Regarding the variation in the students’ MDI scores, it was noticed that at the beginning of the academic semester the frequency of depression was rather similar compared to the general population in Europe, i. e. of approximately 8.56 %. 13 Even so, over the academic semester the frequency of depression increased, reaching its highest level during the semester evaluation period( 24 %), to a level closer to the one reported by Ibrahim et al. for university students( 30.6 %). 14 According to current knowledge, the association between stress and examinations is predictable, as they are believed to act as an acute stressor, and to have a cumulative effect. 15, 16 This aspect is supported by our study especially for the written examinations, which are associated to a higher decrease in the students’ level of wellbeing. Other prospective research, on dental students, suggests that there can be an increase in the stress perceived over the academic year, that is suspected to have detrimental effects on performance and health. 17-19 Stressors perceived by students’ and their effects most probably are different among dental schools, being related to a mix of factors, including individual and institutional parameters, but also geographic and socio-demographic patterns, Romanian dental students being previously identified as experiencing a high perceived stress level. 20-23 The decrease in the level of well-being should be counted considering several aspects: subjective well-being predicts objective mental health, may impact on the learning performance, may bias the student’ s evaluation and have negative long-term effects, e. g., emotional problems such as depression, may limit and impact the future professional practice. 9, 10, 24 As concerns were raised with respect to the decreased wellbeing of the dental students, the inherent distress that exists and its negative effect at a personal and learning level, recommendations were made to help students to cultivate their skills to sustain their well-being, through formal and informal offerings within medical school. 25-27 According to this study’ s results, students at high risk of reduced levels of well-being during the semester evaluation period may be initially identified during other periods over the semester with written examinations, and interventions for coping with examination stress at the most demanding times of the academic year may be planned accordingly. Also, positive and negative psychological states are generally seen as related, but independent constructs of well-being. Our results suggest that negative wellbeing is a more predictable state that positive well-being, therefore better knowledge of the impact of academic stressors and their longterm effect on each of them, separately, may be necessary to be understood, in order to have a clearer idea on this phenomenon. Regarding the instruments used for data collection, for positive and negative psychological states, some details