Physical therapy students can experience elevated levels of stress due to the pressure to be successful, changes in the environment, personal concerns, the lack of spare time, increased work, or financial burdens. The purpose of this study was to examine the perceived stress and coping strategies of Doctor of Physical Therapy (DPT) students enrolled in a hybrid-learning curriculum during the COVID-19 pademic. A total of 73 students enrolled in the DPT hybrid-learning curriculum responded to a survey which consisted of socio-demographics, the 10-item Perceived Stress Scale (PSS), and the 28-item Brief COPE. A general question regarding stress relating to COVID-19 was presented as a sliding percentage. Data analysis included a Spearman correlation, a Kruskal-Wallis test, and a linear regression to evaluate coping mechanisms against PSS scores. The mean (± SD) score on the PSS was 22.65 (± 10.21) and the Brief COPE was 59.18 (± 10.61). A non-significant negative correlation was found between the PSS and Brief COPE (r = -0.024). A third of the variation in the perceived stress score could be accounted for by students utilizing coping mechanisms regardless of other factors (R2 = 0.35). No significant differences were found when comparing PSS and Brief Cope to age, hours worked per week and term. Perceived stress was higher in females compared to males, but the results were not significant. Stress related to COVID-19 mean percentage reported by DPT students was 49.03%. During a global pandemic, DPT students enrolled in a hybrid-learning curriculum reported elevated levels of stress but reported higher adaptive versus maladaptive coping strategies. It can be beneficial that universities evaluate the stress and coping methods of students to potentially avoid the negative impacts of stress.
References
[1]
Wang, C., Horby, P.W., Hayden, F.G. and Gao, G.F. (2020) A Novel Coronavirus Outbreak of Global Health Concern. Lancet, 395, 470-473. https://doi.org/10.1016/S0140-6736(20)30185-9
[2]
Gagnon, K., Young, B., Bachman, T., Longbottom, T., Severin, R. and Walker, M.J. (2020) Doctor of Physical Therapy Education in a Hybrid Learning Environment: Reimagining the Possibilities and Navigating a “New Normal”. Physical Therapy, 100, 1268-1277. https://doi.org/10.1093/ptj/pzaa096
[3]
Lazarus, S. and Folman, R.S. (1984) Stress, Appraisal and Coping. Springer Publishing Company, New York.
[4]
May, W.W., Morgan, B.J., Lemke, J.C., Karst, G.M. and Stone, H.L. (1995) Model for Ability-Based Assessment in Physical Therapy Education. Journal of Physical Therapy Education, 9, 3-6. https://doi.org/10.1097/00001416-199501000-00002
[5]
Hirsch, J.D., Nemlekar, P., Phuong, P., Hollenbach, K.A., Lee, K.C., Adler, D.S., et al. (2020) Patterns of Stress, Coping and Health-Related Quality of Life in Doctor of Pharmacy Students. American Journal of Pharmaceutical Education, 84, Article 7547. https://doi.org/10.5688/ajpe7547
[6]
Garber, M.C. (2017) Exercise as a Stress Coping Mechanism in a Pharmacy Student Population. American Journal of Pharmaceutical Education, 81, Article No. 20. https://doi.org/10.5688/ajpe81350
[7]
Carver, C.S. (1997) You Want to Measure Coping but Your Protocol’s Too Long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, Article No. 92. https://doi.org/10.1207/s15327558ijbm0401_6
[8]
Van Veld, R., Slaven, E.J., Reynolds, B., Shupe, P. and Woolery, C. (2018) First-Year Doctor of Physical Therapy Students Demonstrate Change in Coping with Stress. Journal of Physical Therapy Education, 32, 138-144. https://doi.org/10.1097/JTE.0000000000000037
[9]
Ellison, J., Mitchell, K., Bogardus, J., Hammerle, K., Manara, C. and Gleeson, P. (2020) Mental and Physical Health Behaviors of Doctor of Physical Therapy Students. Journal of Physical Therapy Education, 34, 227-233. https://doi.org/10.1097/JTE.0000000000000141
[10]
Anuradha, R., Dutta, R., Raja, J.D., Sivaprakasam, P. and Patil, A.B. (2017) Stress and Stressors among Medical Undergraduate Students: A Cross-Sectional Study in a Private Medical College in Tamil Nadu. Indian Journal of Community Medicine, 42, 222-225. https://doi.org/10.4103/ijcm.IJCM_287_16
[11]
Sreeramareddy, C.T., Shankar, P.R., Binu, V.S., Mukhopadhyay, C., Ray, B. and Menezes, R.G. (2007) Psychological Morbidity, Sources of Stress and Coping Strategies among Undergraduate Medical Students of Nepal. BMC Medical Education, 7, Article No. 26. https://doi.org/10.1186/1472-6920-7-26
[12]
Madhyastha, S., Latha, K.S. and Kamath, A. (2014) Stress, Coping and Gender Differences in Third Year Medical Students. Journal of Health Management, 16, 315-326. https://doi.org/10.1177/0972063414526124
[13]
Shah, M., Hasan, S., Malik, S. and Sreeramareddy, C.T. (2010) Perceived Stress, Sources and Severity of Stress among Medical Undergraduates in a Pakistani Medical School. BMC Medical Education, 10, Article No. 2. https://doi.org/10.1186/1472-6920-10-2
[14]
Al-Dubai, S.A.R., Al-Naggar, R.A., Alshagga, M.A. and Rampal, K.G. (2011) Stress and Coping Strategies of Students in a Medical Faculty in Malaysia. Malaysian Journal of Medical Sciences, 18, 57-64.
[15]
Kafeel, T., Shoaib, R., Sohail, F., Yamin, F., Ahmed, I. and Paracha, H. (2018) Level of Stress among Doctor of Physical Therapy Students in Karachi, Pakistan. The Indian Journal of Physiotherapy & Occupational Therapy, 12, 112.
[16]
Walsh, J.M., Feeney, C., Hussey, J. and Donnellan, C. (2010) Sources of Stress and Psychological Morbidity among Undergraduate Physiotherapy Students. Physiotherapy, 96, 206-212. https://doi.org/10.1016/j.physio.2010.01.005
[17]
Syed, A., Ali, S.S. and Khan, M. (2018) Frequency of Depression, Anxiety and Stress among the Undergraduate Physiotherapy Students. Pakistan Journal of Medical Sciences, 34, 468-471. https://doi.org/10.12669/pjms.342.12298
[18]
Hodselmans, A.-P.P., Hemdal, E., Lundberg, S., Bjarnegård, A., Hobbelen, H. and Svantesson, U. (2018) Physiotherapy Students’ Perceived Stress, Stressors, and Reactions to Stressors: A Comparative Study between Sweden and the Netherlands. Physiotherapy Theory and Practice, 34, 293-300. https://doi.org/10.1080/09593985.2017.1390805
[19]
Janse Van Vuuren, E.C., Bodenstein, K. and Nel, M. (2018) Stressors and Coping Strategies among Physiotherapy Students: Towards an Integrated Support Structure. Health SA Gesondheid, 23, Article No. a1091. https://doi.org/10.4102/hsag.v23i0.1091
[20]
Jacob, T., Gummesson, C., Nordmark, E., El-Ansary, D., Remedios, L. and Webb, G. (2012) Perceived Stress and Sources of Stress among Physiotherapy Students from 3 Countries. Journal of Physical Therapy Education, 26, 57-65. https://doi.org/10.1097/00001416-201207000-00008
[21]
Higuchi, D. and Echigo, A. (2016) Characteristics of Coping Strategies and the Relationships between Coping Strategies and Stress Reactions in Physical Therapy Students during Clinical Practice. Journal of Physical Therapy Science, 28, 2867-2870. https://doi.org/10.1589/jpts.28.2867
[22]
Bíró, é., Veres-Balajti, I. and Kósa, K. (2016) Social Support Contributes to Resilience among Physiotherapy Students: A Cross Sectional Survey and Focus Group Study. Physiotherapy, 102, 189-195. https://doi.org/10.1016/j.physio.2015.05.002
[23]
Frank, L.M. and Cassady, S.L. (2005) Health and Wellness in Entry-Level Physical Therapy Students: Are Measures of Stress, Anxiety, and Academic Performance Related? Cardiopulmonary Physical Therapy Journal, 16, 5-13. https://doi.org/10.1097/01823246-200516040-00002
[24]
Al Ateeq, D.A., Aljhani, S. and Al Eesa, D. (2020) Perceived Stress among Students in Virtual Classrooms during the COVID-19 Outbreak in KSA. Journal of Taibah University Medical Sciences, 15, 398-403. https://doi.org/10.1016/j.jtumed.2020.07.004
[25]
Pedrozo-Pupo, J.C., Pedrozo-Cortés, M.J. and Campo-Arias, A. (2020) Perceived Stress Associated with COVID-19 Epidemic in Colombia: An Online Survey. Cadernos de Saúde Pública, 36, e00090520. https://doi.org/10.1590/0102-311x00090520
[26]
Sheroun, D., Wankhar, D.D., Devrani, A., Lissamma, P.V. and Chatterjee, K. (2020) A Study to Assess the Perceived Stress and Coping Strategies among B. Sc. Nursing Students of Selected Colleges in Pune during COVID-19 Pandemic Lockdown. International Journal of Science and Healthcare Research, 5, 280-288.
[27]
Richardson, M.V., Miller, H., Papa, E. and Santurri, L. (2022) Perfectionism, Stress, and the Entry-Level Doctor of Physical Therapy Student: A Cross-Sectional, Observational Study. Journal of Physical Therapy Education, 36, 9-16. https://doi.org/10.1097/JTE.0000000000000213
[28]
Mazurek Melnyk, B., Slevin, C., Militello, L., Hoying, J., Teall, A. and Mcgovern, C. (2016) Physical Health, Lifestyle Beliefs and Behaviors, and Mental Health of Entering Graduate Health Professional Students: Evidence to Support Screening and Early Intervention. Journal of the American Association of Nurse Practitioners, 28, 204-211. https://doi.org/10.1002/2327-6924.12350
[29]
Deutskens, E., De Ruyter, K., Wetzels, M. and Oosterveld, P. (2004) Response Rate and Response Quality of Internet-Based Surveys: An Experimental Study. Marketing Letters, 15, 21-36. https://doi.org/10.1023/B:MARK.0000021968.86465.00
[30]
Cohen, S., Kamarck, T. and Mermelstein, R. (1983) A Global Measure of Perceived Stress. Journal of Health and Social Behavior, 24, 385-396. https://doi.org/10.2307/2136404
[31]
Cohen, S. and Janicki-Deverts, D. (2012) Who’s Stressed? Distributions of Psychological Stress in the United States in Probability Samples from 1983, 2006, and 2009. Journal of Applied Social Psychology, 42, 1320-1334. https://doi.org/10.1111/j.1559-1816.2012.00900.x
[32]
Lee, E.H. (2012) Review of the Psychometric Evidence of the Perceived Stress Scale. Asian Nursing Research (Korean Society of Nursing Science), 6, 121-127. https://doi.org/10.1016/j.anr.2012.08.004
[33]
Taylor, J.M. (2015) Psychometric Analysis of the Ten-Item Perceived Stress Scale. Psychological Assessment, 27, 90-101. https://doi.org/10.1037/a0038100
[34]
Cohen, S. (1988) Perceived Stress in a Probability Sample of the United States. In: Spacapan, S. and Oskamp, S., Eds., The Social Psychology of Health. Sage Publications, Inc., Thousand Oaks, 31-67.
[35]
Folkman, S. and Moskowitz, J.T. (2004) Coping: Pitfalls and Promise. Annual Review of Psychology, 55, 745-774. https://doi.org/10.1146/annurev.psych.55.090902.141456
[36]
Jacob, T., Ben Itzchak, E. and Raz, O. (2013) Stress among Healthcare Students-A Cross Disciplinary Perspective. Physiotherapy Theory and Practice, 29, 401-412. https://doi.org/10.3109/09593985.2012.734011
[37]
Jacob, T., Einstein, O. and Bio Tamar Jacob, A. (2016) Stress among Bachelor Physical Therapy Students in Israel during Clinical Practice and Its Association with Academic Achievements—Results of a Longitudinal Study. The Internet Journal of Allied Health Sciences and Practice, 14, Article No. 9. https://doi.org/10.46743/1540-580X/2016.1563 Https://nsuworks.nova.edu/ijahsp/vol14/iss1/9
[38]
Bogardus, J.M., Blackinton, M., Litwin, B., Nelson, T.M. and Mitchell, K. (2021) Depression, Anxiety, and Stress in Doctor of Physical Therapy Students: Analysis of Incidence and Lived Experiences. Journal of Physical Therapy Education, 35, 251-257. https://doi.org/10.1097/JTE.0000000000000185
[39]
Anderson, C.E.P. and Dutton, L.L. (2022) Physical Therapy Student Stress during the COVID-19 Pandemic: A Qualitative Study. Journal of Physical Therapy Education, 36, 1-7. https://doi.org/10.1097/JTE.0000000000000218
