Role of Stress in Burnout among Students of Medicine and Dentistry – A Study in Ljubljana, Slovenia, Faculty of Medicine

Medical education is challenging, but for some students it can be very stressful. Studies suggest that stress during medical education can have a negative impact on students’ mental health and that burnout is frequent among medical school students. The aim of this study was to measure burnout among students of medicine/dentistry (M/D) at the Faculty of Medicine, University of Ljubljana, Slovenia, in relation to their perception of stress, so as to enable planning preventative activities for students at risk. The data were collected in a cross-sectional study, carried out in spring 2008 among the total population of M/D students of 1st, 3rd, 4th and 6th year, using a self-administered online questionnaire. Oldenburg Burnout Inventory (OLBI) instrument was used. Separate burnout scores were calculated for the exhaustion and disengagement dimensions of burnout, and related to students’ perception of stress. Multiple linear regression method was carried out to adjust the association estimates for several potential confounders (gender, study program, relationship status, and grade). The overall response rate was 47.2%, and a total of 476 students participated. Students scored higher on exhaustion than on disengagement dimension - the mean value of burnout scores on the exhaustion dimension scale was -1.68, while it was -4.58 on the disengagement dimension scale. The results showed a statistically significant difference between high and low risk-for-stress groups of students in both burnout dimensions (average value of burnout scores on the exhaustion scale: high risk-for-stress group -3.69, low risk-for-stress group 0.19, p<0.001; average value of burnout scores on the disengagement scale: high risk-for-stress group -5.57, low risk-for-stress group -3.65, p<0.001). After adjustment for potential confounders differences on both burnout subscales remained almost unchanged. Results confirmed our hypothesis that M/D students of Ljubljana Faculty of Medicine who frequently experience stress (especially those with poor coping mechanisms), exhibit higher degree of burnout

Long-term Abstinence and Well-being of Alcohol-dependent Patients after Intensive Treatment and Aftercare Telephone Contacts

Aim To identify whether intensive treatment and aftercare telephone contacts influence long-term abstinence and well-being of patients with alcohol dependency. Methods Six hundred and twenty two patients were evaluated at the beginning and end of intensive in-patient treatment. At the end of the treatment, the patients were divided into two recruitment cohorts – telephone contact group (n = 347), in whom basic outcome criteria (abstinence, marital and employment status, self-evaluation of well-being) were evaluated 3, 6, 12, and 24 months after intensive treatment and no contact group (n = 275) in whom the basic outcome criteria were checked only at 24 months after the intensive treatment. At 24 months, response rate was 33.4% in telephone contact group (n = 116) and 30.5% (n = 84) in no contact group. Results Positive indicators of therapy success (abstinence or decrease in drinking, stabile social relations, and more positive self-evaluation of well-being) were found in 53.0% of patients at 3 months, 44.3% at 6 months, and 30.6% at 12 months in telephone contact group. Overall abstinence 24 months after the end of intensive treatment was reported in 25.7% of all patients, including non-respondents. Both groups achieved significant improvement in subjective well-being during intensive treatment. At 24 months, 3 attributes of subjective well-being (subjective psychological health, evaluation of financial status, general quality of life) were significantly higher in telephone contact group. However, groups did not significantly differ in the abstinence level (telephone contact group = 27.7%, no contact group = 24.4%). Conclusion Significant differences in well-being variables between telephone contact group and no contact group at 24 months after the end of intensive treatment are at least partially due to phone contact/informative checking 3, 6, and 12 months after the end of intensive therapy. Telephone or any short and easy accessible communication checking is a promising as supportive and research tool in aftercare alcohol addiction treatment, especially because of its cost-benefit advantages

Adolescent substance dependency in relation to parental substance (ab)use

Problem: Stanje odvisnosti pri mladostnikih, ki smo ga določili na nominalni ravni ter opredelili kot neodvisno spremenljivko, smo ugotavljali v zvezi z naslednjimi odvisnimi spremenljivkami: mladostnikova raven samospoštovanja, depresivnosti in ocena družinskega vzdušja ter starševska izraženost kazalcev zlorabe psihotropnih snovi. Metoda: Vključeno je bilo 197 družin (oče, mati, mladostnik - povprečna starost 17,2 let). Uporabljeni so bili naslednji kazalci: Rosenbergova lestvica samospoštovanja, semantični diferencial za oceno družinskega vzdušja, Zungova lestvica depresivnosti in (Substance Abuse Subtle Screening Inventory) vprašalnik za ugotavljanje izraženosti odvisnosti od psihotropnih snovi SASSI-3. Hipoteze smo preverjali z univariatnimi in multivariatnimi pristopi ob upoštevanju dveh kovariat (ocene izraženosti odvisnosti mater in očetov). Rezultati: Pri odvisnih mladostnikih je bila ugotovljena pomembno višja raven depresivnosti, raven samospoštovanja in ocena družinske klime pa sta bili pomembno nižji. Očetje ne-odvisnih mladostnikov in matere odvisnih mladostnikov so se izkazali kot bolj ranljivi na področju kazalcev odvisnosti. Stanje odvisnosti pri mladostnikih je pogosteje razločevalo subskore SASSI-3 pri očetih kot pri materah. Zaključek: Rezultati kažejo, da so v skupini z odvisnimi mladostniki na vprašalnik odgovarjali bolj angažirani očetje. Poudarjena je potreba po večji podpori materam in večji vključenosti očetov v zdravljenje odvisnih mladostnikov.Problem: Relations between adolescents\u27 substance dependency status (yes-no) as independent and adolescent self and family evaluations and parental indicators of substance dependency as dependent variables were studied. Methods: All together 197 families were included (father, mother, adolescent -mean age of adolescent was 17.2 years). Rosenberg self - esteem scale, originally constructed semantic differential perceived family climate, Zung depression scale and SASSI-3 (Substance Abuse Subtle Screening Inventory) instrument were applied. Multivariate and univariate approach were applied to verify hypotheses about differences in dependent variables regarding the independent one also with estimated mothers\u27 and fathers\u27 dependency as two covariates. Results: Level of depression was significantly higher, but level of self-esteem and family climate evaluation were significantly lower in dependent adolescents. Fathers of non-dependent adolescents and mothers of dependent adolescents were found more substance dependency vulnerable. Adolescent dependence status differed more frequently in fathers\u27 than in mothers\u27 SASSI-3 sub scores. Conclusions: Results indicate that in group of substance dependent adolescent families with healthier and more engaged fathers participated in the study. Support for mothers\u27 vulnerability and need for fathers\u27 involvement in treatment of dependent adolescent is underlined