The impact of student life stress on health related quality of life among doctor of pharmacy students

College Student Journal, June, 2004 by Gireesh V. Gupchup, Matthew E. Borrego, Niranjan Konduri

The purpose of this study was to examine the association between student-life stress and health related quality of life (HRQOL) among Doctor of Pharmacy (Pharm.D.) students. Data were collected for 166 students in the first three years of a Pharm.D. curriculum. Student-Life Stress Inventory scores were significantly negatively correlated to mental component SF-12 HRQOL scores (p<0.004) for the overall sample (r = -0.58), gender (rfemale = -0.56, rmale = -0.56) and within each professional year (rfirst-year = -0.50, rsecond-year = -0.49, rthird-year = -0.68). However, z-tests indicated that the magnitude of the correlations did not vary significantly by gender or year in the curriculum. Strategies are needed to reduce Student-Life Stress and improve the mental component of HRQOL.

Introduction

The intensity of the Doctor of Pharmacy (Pharm.D.) curriculum requires enormous commitment and hard work by students. The intense curriculum may produce stress on the pharmacy student's life. The Pharm.D. curriculum typically involves two years of pre-pharmacy coursework after high school, followed by four years in the professional pharmacy curriculum. The transition from the pre-pharmacy curriculum, which is similar to an undergraduate program, to the professional Pharm.D. curriculum involves significant change. Morevover, the curriculum requirements vary significantly during the four years of matriculation in the Pharm.D. program. The transition from an undergraduate program to a professional program has been reported to result in increased stress levels for students (Beck, Hackett, Srivastava, McKim, & Rockwell, 1997). In the hope of preparing students for their future roles as pharmacists, it is important to identify stressful factors that may affect their successful development. This is especially true since student stress has been associated with a variety of negative outcomes, including effects on general and health-related quality of life (Hudd, Dumplao, Erdmann-Sager, Murray, Phan, Soukas, & Yokozuka, 2000; Damush, Hays, & DiMatteo, 1997).

Lazarus and Folkman (1984) describe stress as a specific stimulus-response transaction, which threatens an individual. One study identified the major academic stressors among college students to be tests, grade competition, time demands, professors and classroom environment, and career and future success (Murphy & Archer, 1996). Another study reported that stress may be associated with the type of institution the student attends (e.g., public, private, undergraduate, professional or graduate) (Hudd et al., 2000). Misra, McKean, West, and Russo (2000) found that academic stress among college students varies across year in school and gender. Specifically, freshmen and sophomores had higher academic stress levels than juniors and seniors, and females reported higher academic stress than males. Interestingly, this study found that the levels of academic stress perceived by students and their faculty varied. Faculty members' perceptions of student academic stress and reactions to stressors were higher than students' self-perceptions. Because faculty members most often observe students during class time, the results of this observation could imply that students experience their largest amount of stress during class hours (Misra, et al., 2000).

The literature is replete with evidence that students in health professional programs also suffer from stress. Most of these studies have been performed in medical, dental and nursing students (Beck, & Srivastava, 1991 ; Coburn, & Jovaisas, 1975; Davis, Tedesco, & Meier, 1989; Hamill, 1995; Helmers, Danoff, Steinert, Leyton, & Young, 1997; Vitaliano, Maiuuro, Mitchell, & Russo, 1989). Surprisingly, only two studies have been reported that measured stress levels among pharmacy students in United States. The first study focused on perceived stress levels among students in a Bachelor of Science pharmacy program and found that stress levels were not related to any of the demographic variables, including age, gender and involvement in professional student organizations (Ortmeier, Wolfgang, & Martin, 1991). The second study, which measured stress among students in Pharm.D. programs found that financial burdens, unsupportive faculty, absence of a counseling service, excessive study load, English not being the first language and not being a minority student were significant predictors of stress (Dutta, 2001). Both of these studies have measured stress among pharmacy students during one specific academic year in the curriculum.

The limitation of the published literature related to student-life stress in pharmacy students is that no research has been reported pertaining to student-life stress and its effect on health-related quality of life (HRQOL) among pharmacy students. Additionally, the relationship between student-life stress and HRQOL across different years in the Pharm.D. curriculum has not been reported. Answers to these questions would help pharmacy educators develop first, an understanding or awareness of the impact of student-life stress on students HRQOL, and second, programs to alleviate student-life stress as pharmacy students progress though the curriculum.