Tgp chi Y Dugc hgc - Tru&ng Oqi hgc Y Dugc Hui- Tdp 6, so 3 - thdng 7/2016
STRESS VA CAC YEU TO LIEN QUAN d S I N H VIEN KHOA Y TE CONG CONG, TRUOIMG DAI HOC Y D U O t HUE
Dodn Vucmg Diim Khdnh'^, Li Binh Duvng'^, Phqm Tiiyen', Tran Binh Thang', Biii Thj Phucmg Anh', Nguyin Thj Trd My', Nguyin Thj Yin', Biii D&c Ha', Nguyin HOu Himg', Nguyin Van KteV (l)Khoa Y te Cbng cgng, Trubng Dgi hgc Y Dugc Hue (2)Viin Nghien c&u S&c khoe Cgng dong, Trudng Dgi hgc Y Dugc Hue Tdm tat
Ogt van de: CCing vdi vife gia tang cae yeu td nguy ca qua trinh phat t r i l n kinh t l , do thj hda va hpi nhgp qudc te, stress ngiy cing phd bien dgc bift la trong mdi trudng giao dye dgi hpe, dio tao Y khoa thi stress eang eao. Nghien edu niy duyc thyc hifn nham muc tifu 1) Md ta tinh trgng stress d sinh vifn nam thd nhat khoa Y t l cdng cfing, trudng Dgi hpc Y Duye Hue; (2)Tlm hieu mfit so yeu to lifn quan den tinh trgng stress trfn ddi tuyng nay. Odi tuyng va phyyng phap nghien cdu: Nghien cdu sd dung thiet ke nghifn cdu md ta cat ngang thue hifn tren 209 sinh vien nim thd nhat Khoa YTCC, Trudng Ogi hpc Y Duyc Hue. 5d lifu duye thu thap bang bp cdng cy t y dien gdm 5 phan: thfing tin chung; dge diem mdi quan hf c i nhin vdl gia dinh, bgn be, xa hfii; cae yeu td ve thdi quen ciia sinh vifn; cae y l u td ve hpc tgp ciia sinh vifn; tinh trang stress eua sinh vifn. Oo ludng tinh trgng stress cua sinh vifn bang Thang do PSS-14 (perceived stress scale-14 items) vdi diem cat P55 > 30 de xae djnh ngudng stress cao. Phin tich sfi lifu bang phan mem SPSS 18.0, md hinh hoi quy logistic da bien duycsd dyng xae djnh cie ylu td lifn quan vdi stress eiia sinh vifn vdi dd tin cgy 95%. Ket qui: Ty if sinh vifn bj stress eao ehiem 24,9%; sinh vifn nd cao gip dfii so vdi sinh vifn nam OR=2,3 (KTC:1,10 - 4,83); sinh vifn tinh khae eao gap 2,8 lan so vdi sinh vifn trong tinh OR=2,83 (KTC:1,19 - 6,73). Cac yeu td cd lifn quan vdi tinh trang stress cao d sinh vifn bao gdm: (1) cic mdi quan he xa hfii ciia sinh vien: ed hay khfing cd bgn than, khd khan trong quan hf vdi bgn be, khd khan trong cic boat dpng xa hfii. (2) cac yfu to lifn quan din qui trinh hpc tap: ap lye hpe tgp, ed nguyen vpng thi Igi Ogi hpc, khd khan trong tim kiem tai lifu; khd khin trong tilp cgn eic phuang phap giang dgy, hpc tgp mdi. Kit lugn; Stress l i mfit tinh trgng pho biln trong sinh vifn nam thd nhat Khoa Y te Cdng Cong. Cae yeu td ve quan hf xa hpi va cic y l u td lifn quan d i n qui trinh hoc tgp cd lifn quan den tinh trgng mac stress eao d sinh vien.
rd khda: stress, sinh viin Khoa Y tiCbng cbng, Oqi hqc Y Ou&c Hue Abstract
PERCEIVED STRESS AND ASSOCIATED FACTORS AMONG UNDERGRADUATE STUDENTS OF FACULTY OF PUBLIC HEALTH,
HUE UNIVERSITY OF MEDICINE AND PHARMACY
Doan Vuong Diem Khanh H Le Dinh Duong'-', Pham Tuyen', Tron Binh Thang^, Bui Thi Phuong Anh', Nguyen Thl Tra My', Nguyen Tbi Yen', Bui Due Ha', Nguyen Huu Hung', Nguyen Van Kieu'
(l)Faculty of Public Health, Hue University of Medicine and Pharmacy (2)lnstitute far Community Health Research, Hue University of Medicine and Pharmacy Background: With the development of risk factors in modernizing the education system in Vietnam, stress among students is gradually increasing. Especially, among medical students there has been a high demonstration of stress. The main aim of this study was to identify associated factors of stress among first year undergraduate students of the Faculty of Public Health of Hue UMP. Methods: A cross-sectional survey
»/as conducted with a total sample of 209 first year undergraduate students of the Faculty of Public Health, Hue UMP. Data collection was undertaken using self-admistrative structured-questionnaire, which included five main parts: demographic characteristics, personal relationships; factors related to hobbies and studies;
^ ^ ^ ^ ^ ^ ^ hi: Bodn Vuvng diemkhanhl972&gmail.c^^K^^^M ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ H 'di-^:M/l^^lSNgiyaSngyaing:22/5/29m:Ngiiyia^pi^^^^^^'^'^^/^^^^^^^^^^^
\66 JOUHNALOF MEDICINEAND PHARMACY
Tgp chl Y Dugc bgc - Tru&ng Bgi hge Y Dugc Hui- Tgp 6, so 3- thdng 7/2016 fectors related to the study environment; and stress situation of students. Stress situation was measured using the perceived stress scale (P55-14 items). The cut off point of 30 and above was used to identify the situati'on of high stress among the students. Chi-square test with 95% Cl and mutiple logistic regression were implemented to examine factors related to high stress situation. Results: The percentage of high stress among students was 24.9%. The proportion of high stress offemale students was 2 times higher than male students {0R= 2.3; 95%C1:1.10 - 4 83). Students who lived in other provinces had a 2.8 times higher prevalence of high stress compared to those from Thua Thien province (OR=2.83; 95%CI: 1.19 - 6.73). Related factors of high stress status included: (1) personal relationships (having close friends or not, difficulty in relationships with friends, difficulty in social activities) and (2) factors related to study envininement (academic stress; aspiration of retaking the enrollment examination of entering university, difficulty in finding reference documents for study, difficulty of approaching new learning methods). Conclusion: High stress situation was common among first year undergraduate. Personal relationship and factors related to study environement were significantly associated with high stress situation among the students.
Key words: Stress, Public Health, undergraduate first year student. Hue UMP
i.oArv^Nol
stress l i tinh trang rat phd biln trong mfii trudng xa hpi hifn nay, stress co the gay ra cic hgu qui vf mat tam ly va sinh iy nhu khd t i p trung ehii y, khd ghi nhd, cing thang, khdng hang hai ti'ch cyc trong hoat dfing. Stress inh hudng din CO the theo nhieu cich, cd the tang nguy co bj eae bfnh t | t co t h l , ciJng ed the l i nguyfn nhin tryc tilp gay bfnh, hogc cung cd t h l lam cho kha nang phye hdi cy t h l lim giam kha nang dyyng dau vdl stress trong tuong lai.
Sinh vien chju sy t i c ddng eiia cic quy lugt phat triln t i m sinh ly Ida tudi, mol trudng sdng x l hfii.
Vifc nghifn edu nh&ng khd khan trong cupc sdng eiia hpe smh v i sinh vien da du&c quan t i m t d rat liu tgi cic nudc ed nfn giao dye phat trien nhu b Ddc, d Lien bang Nga ...Nghifn cdu d Thil Lan cho thay cang thing d sinh vifn chiem 61.4% (Saipanish, 2003). Tgi Vift Nam, Theo nghifn edu eiia Lf Thu Huyen (2010) b sinh vifn khoa Y t l Cfing Cpng, trudng OHYD Tp.Hd Chi Minh eho thay ty If sinh vifn bj stress bfnh 1^ ehiem ty If kha cap 24,2% [2].
Sinh vien nim thd nhat l i nhdm dgc bift han, la ddi tuyng phii chuyin tilp t d mdi trudng hpc tgp Phd thdng sang Oai hpe vdi nhieu khae bift v l kiln thdc, hinh thdc v i phuang phap giing dgy cung nhu hpc tgp, nhdng moi quan hf vdi bgn be, thay cd..., ddng thdi sy khic bift ve hoin eanh sdng, dieu kifn kinh t l cua moi gia dinh bupc sinh vien phai tgo cho minh cich sdng t y lap..."rat ca nhdng khic bift dd da gay khdng it khd khan tam ly, cd inh hudng den sde khde t i m t h i n va kit qui hpe tgp ciia sinh vifn.
Nghien cdu niy nham mye ti'eu md ta tinh trgng
stress va mpt sd yeu td lifn quan vdl stress dsinh vien nam thd nhit khoa Y t f edng epng trudng Ogi hpc Y Duye Hue nam hye 2014-2015.
2. o d l Tirt^lMG vA PHirCNG PHAP N G H I I N Cl>U 2.1 Odi tuyng: Chpn mau toan bp sinh vifn nam thd nhit Khoa YTCC Trudng Dai hqc Y Duye Hue. Ty If tham gia nghifn edu la 97,7% (209/214 sinh vien) trong thdi gian t d thing 9/2014 d i n 12/2014.
2.2 Phutfng phip nghien cdu: Nghifn cdu sd dung thiet ke md ta eat ngang bang phUOng phip djnh luyng sd dgng bp eau hdi thiet ke san.
Thang do PSS-14 (perceived stress seale-14 items) duye sd dyng de dinh gia tinh trgng stress.
Thang do niy bao gom 14 myc hdi duyc danh gii theo thang do Likert 5 mdc t d khdng bao gid den rat thudng xuyfn va duye cho diem t d 0-4 dilm.
Tdng diem giao ddng t d 0 - 56 dilm, diem eat PSS > 30 d l danh gia tinh trang mac stress cao d sinh vifn. Thdng tin dyyc thu thgp bang bfi eau hdi t d dien.
Sd lifu duye nhgp bang phan mfm Epidata 3.1 va xd 1^ bang phin mem SPSS 18.0. Kilm djnh Chi- square test vdi dp tin cgy 95% duye sd dyng de xae dinh eic yfu td lien quan vdi tinh trgng stress cOa sinh vifn. Sd dyng md hinh hdi quy logistic da biln d l xie djnh cic yeu td hen quan.
2.3. Ogo ddc nghien cdu
Nghien cdu tien hanh trfn eo sd tham gia t y nguyfn ciia sinh vifn, tdn trpng va dam bio b( mgt eae thfing tin c i nhin. Sinh vien du&c giii thich day du myc dich va y nghTa ciia nghifn edu.
lOUKNAL OP MEDICINE Al
Tqp chi Y Duvc hoc- Tru&ng Bgi hqc Y Duvc Hui- Tqp 6, so 3- thang 7/2016 3. K i t QUA NGHIEN CU'U
3.1. Die diem chung ciia m l u nghien cdu
Nghifn cdu duyc thye hifn tren 209 sinh vifn nim thd nhat khoa YTCC vdi dfi tuoi trung binh ta 18,3 (18-23).
Bang 1. Oge diem mlu nghifn cdu D^c diem
Gidi tinh - Nam - ND- Din t$c
Kinh - Thieu so Ton giao
- Co Khong QuS quin
Thira Thien Hue Noi khac Ntfi it hien tai
- Nha trg, KTX - Khac Ntfi song
Thanh thj - Nong thon Kinh te
- Kh^gia Trung binh - Ngheo Hon nhan bd m^
- Song cung nhau - ithac Nginh hpc
ncc
- YHDP
I3n so (n) 71 138 203 6 26 183
55 154
170 39 56 153 50 137 22
195 14
44 165
Tyle%
34,0 66,0 97,1 2,9 12,4 87,6
26,3 73,7
81,3 18,7 26,8 73,2 23,9 65,6 10,5
93,3 6,7
21,1 78,9 5inh vifn n& chiem da sfi trong khdi sinh vifn
nam thd nhat khoa YTCC. Ty If sinh vifn dan tfie thilu sd chl chiem 2,9%.
3.2. Md ta tinh trgng stress cCia sinh vien Bilu dd 1. Phan bd tinh trgng stress sinh vien Dilm trung binh ehung theo thang do PPS 14 cua sinh vifn Khoa YTCC la 27,45 dilm. T^ If sinh vifn duyc
I 6 8 JOUBN*L OF MEDICINE AI
dinh gii ed stress eao (PP5>30) chiem diem PPS > 30 chiem 24,9%; 73,7% cd stress ed diem PPS dao dfing td 16 - 30 dilm, 1,4% sinh vifn khdng bj stress. (PPS<16).
3.3. Mdt sd cac y l u t d lien quan den tinh trgng stress ciia sinh vien
3.3.1. Liin quan gida cdc dqc diim chung cia sinh viin v&i tinh trqng stress
Tgp chi YDugc bgc • Tru&ng Dgi hgc YDugc Hui- Tgp 6, si3 - tbdng 7/2016 Bing 2. Lien quan giu'a
D|c di^m Chung
Tuoi Gio'i*
Ncri song Que quin*
No'i o' hi^n nay
K i n h t l gia dinh
<18
>18 Nam NO' Thanh thi Nong thfin Thifa thien - Hue
Khac Nha tro, <TX
Khac Giau, l(ha Trung blnh
Ngheo
cac dac digm chung cua sinh vign vdi tinh trang stress
TSng
149 60 71 138 56 153 55 154 170 40 50 137 22
Tinh trang stress cao Co
(PSS score > 30) n 36 16 11 41 9 43 7 45 47 5 12 32 8
24,2
%
26,7 15,5 29,7 16,1 28,1 12,7 29,2 27,6 12,8 24,0 23,4 36,4
Khdng (PSS score < 30) n 113
44 60 97 47 110 48 109 123 35 38 105 14
75,8
%
73,3 84,5 70,3 83,9 71,9 87,3 70,8 72,4 87,2 76,0 75,6 63,6
P
0,71 0,02 0,08 0,02 0,064
0,43
* sy khde bift cb y nghTa thdng ki vdip<0,05
Nhgn xit: Co mdi lien quan gi&a tinh trang stress eao ciia sinh vifn vdl cic ylu td ve gidi ti'nh, noi sdng v i quf quin ciia sinh vifn vdi dp tin ciy 95%.
3.3.2 Lien quan giSTa cdc mdi quan hf v&i gia dinh, bgn be, xa hqi cda sinh viin v&i tinh trqng stress Bang 3. Lifn quan gida cic mdi quan hf vdi gia dinh, bgn be, xa hfii cua smh vifn vdi tinh trgng stress
iVldi quan h# ca nhan
Co ban than*
Gap kho khan trong mdi quan he vdi ngu'cri than Kho khan trong quan h#
vdi ban be**
Kho khan tham gia cac hoatd$ngxahOi**
Khd khan trong tinh yeu Gap cac bien co trong gia dinh
S^r ky vong tir gia dinh Cd Khong
Co Khdng
Cd Khdng
Co Khdng
Cd Khdng
Cd Khdng
Cd Khdng
Tdng
185 24 25 184 53 156 104 105 36 173 34 175 88 121
Tinh trang stress cao Cd (PPS >30) n 42 10 9 43 22 30 38 14 8 44 9 43 24 28
%
22,7 41,7 36,0 23,4 41,5 19,2 36,5 13,3 22,2 25,4 26,5 24,6 27,3 23,1
Khdng( PPS <30) n 143
14 16 141 31 126 66 91 28 129 25 132 64 93
%
77,3 58,3 64,0 76,6 58,5 80,8 63,5 86,7 77,8 74,6 73,5 75,4 72,7 76,9
P
0,04
0,17
0,001
0,00
0,68
0,85
0,49
* s& khde biqt c6 •^ nghTa vdip<0,0S
**s& khde biqt cd y nghTa vdip<0,01
Tlllp chiYDugc bgc - Tru&ng Bqi bqc Y Dugc Hue- Tgp 6, so 3 - thdng 7/2016
Nhqn xet: Trong eie y l u td v l mfii quan hf ciia hogt dpng xa hpi ciia sinh vifn l i 3 yfu tfi ed lifn sinh vifn thi tinh trgng ed ban than; ggp rac rdi quan d i n tinh trang stress cao cOa sinh vifn khoa trong quan hf vdi bgn be v i kho khan trong eie YTCC.
3.3.3. Lien guan giita vdn di hgc tap vd tinh trqng stress vd cda sinh vien Bang 4. Mdi lien quan gida van df hpc tgp vdi tinh trgng stress ciia sinh vifn
D|c diem ve hgc tip
"rang ^p lu'c hoc tap*
Khd khan trong tim kidm giao trinh, tdi lieu*
Nguyen vong thi lai Khd khan trong viec tiep can phuong phap giang day va hoc tap mdi**
Thdi khda bieu hgfp ly
Cd Khdng
Cd Khdng
Cd Khdng
Cd Khdng
Cd Khdng
n
174 35 162 47 26 183 165 44 152 57
Tinh ti^ng stress cao Cd
(PPS >30) n 48 4 46 6 10 42 48 4 37 15
27,6
%
11,4 28,4 12,8 38,5 23,0 29,1 9,1 24,3 26,3
Khdng (PPS<30) n 126
31 116 41 16 141 117 40 115 42
72,4
%
88,6 71,6 87,2 61,5 77,0 70,9 90,9 75,7 73,7
P
0,04 0,02 0,08 0,006
0,76
* s& khde biit CO ji nghTa v&i p<0,05
** s& khde biit cb "y nghTa v&i p<0,01
NhbnixtiTang ip lyc hpc tgp, khd khin trong tim kilm giiotrlnh/tii lifu, cd nguyfn vong thi Ial; khd khan trong tilp egn phuong phip giang dgy/hpc tgp mdi la nh&ng ylu to cd lifn quan vdi tinh trang stress cao cia smh vifn.
3.3.4. Xdc dinh cdc yiu tdliin quan vdi stress cda sinh viin bdng mb hinh hbi quy logisti'e da biin.
Bing 5. Md hinh logistic da biln
Gidi tinh
Nam Nif Hd khau thu&ng trii
Thira Thien Hue Tinh khac Ban t h i n
Cd Khdng Khd khan trong quan he vdl ban be
Cd Khdng Khd khin khi tham gia cic hoat d$ng xa h$i
Cd Khdng Tang ap iu'c trong hgc tap
Cd Khdng
iVld hinh A P
0,04
0,45 0,07
0,17
0,03
0,67 OR
1 2,3
1 1,404
1 2,48
1 0,60
1 0,412
1 0,77
KTC 95%
(1,10-4,83);
(0,58 - 3,41)
(0,92-6,68)
(0,28-1,26)
(0,19-0,89)
(0,23-2,60)
iVId hinh B P
0,03
0,04
0,00 OR
1 2,28
1 2,76
1 0,27
iac 95%
(1,055-4,92)
(1,06-7,16)
(0,13-0,54)
ITO lOURNALOF MEDICINE AND PHARMACY
Tqp ch! YBUVC hqc - Tru&ng Bgi hgc Y Dugc Hui- Tgp 6, si3 - thdng 7/2016
Khd khan trong vife tim kilm giio trinh, tai lifu hoc t i p
Cd Khdng Khd khan trong vife ti'ep cgn phyong phap giang dgy v i hpc t i p mdi
Cd Khdng
0,69
0,18 1 0,813
1 0,44
(0,29-2,31)
(0,14-1,46) (Mb hinh A: Mb hinb day dd, Mb hinh fi: md hinh
4. BAN lU^H
Md t i tinh trang stress ciia sinh vifn nam t h d nhit Khoa Y tICong c§ng. Oilm trung binh chung stress theo thang do PSS-14 la 27,45 diem (50=
4,85); ty If stress theo cae mde dfi nhe (td 18 - 30 dilm) v i nang (>30 diem) lln lyyt l i 73% va 24%.
Kit qua niy khi tu'ong ddng vdi myt vdi mpt nghien cdu trfn sinh vien YTCC, Tru'dng DHYD Tp.Hd Chi Minh nim 2010 v f stress sd dyng thang do P55 eho thay ty If sinh vien bi stress bfnh ly chilm ty' If khi cao 24,2% va mlu nghien edu eung khi tu'ong ddng vdi nghifn cdu cua ehung tdi (ty If sinh vlfn n&
chllm gap ddi nam gidi (68,1%), nhi trp/ky tdc xa chiem trfn 50%) [2]. Nhy vgy ed t h l nhin thay t f If stress ndi chung la rat phd bien trong sinh vifn..
Nghien edu khac ve stress ciia sinh vlfn Ogi hpc Oi Nang cho thay ty If sinh vifn bj stress nang la 7,6%
v i t^ If cd stress la khoang 70% . Bilu hifn roi logn lo au theo thang do Beck ciia sinh vien trong nghifn cdu nay la 0,7% ngng, 9,0% mdc trung binh, 43,8%
nhe va 46,5% khdng cd bieu hifn rdi loan. [3]
Tinh trgng stress cua cin bfi va giang vifn tru'dng DHYTCC Hi Nfii qua nghifn cdu cua t i e gia Nguyin Thai Quynh Chi cho thay 17,1% bj stress d mde dd nhe, 7,3% mdc dp vda, 3,2% stress mdc dfi ngng va rat ngng. Difu nay cho thiy stress khfing chl pho biln trong sinh vifn ma cdn d dfii tu'yng can bp giing vien Kit qua nay thip han so vdi nghifn cdu cua chiing tdi. Tuy vgy sy khic bift ed t h l bi anh hydng do each do ludng v i va nhdm ddi tu'yng nghifn cdu khae nhau [1, 2].
Mpt nghien cdu khac khi tyyng ddng vdi nghifn cdu ciia chung tdi thyc hifn tgi Pakistan d ddi tyyng sinh vifn Y Khoa va sd dgng bfi edng ey dinh gia stress PSS-14[6]. Bfi cdng cy t y diln thift ke san thyc hifn tren 200 smh vifn Y khoa nam thd 1 va nam thd2 vaty If nam: ndla 1:2 cho thay diem sotrung binh ve stress theo thang PSS 14 la 30,84(50=7,01);
eao han cd y nghTa (p<0,01) so vdi dilm trung binh stress trong nghifn cdu ciia chiing tdi. Sy khac bift
rut gqn)
niy cd t h l do nhifu y l u td trong do cd sy khic nhau ve mdi tru'dng hye tgp; xa hpi va ehimg tpc; dp tudi trung binh trong nghien edu nay eao hon so vdi nghien edu ciia chOng tdi (20,35±1,09), v i cae sinh vifn trong miu nghifn cdu c^a tic gii den t d nhieu qudc gia khic nhau nhu Saudi Arabia, M?, Bahrain, Oman, Canada, Kuwait.
Ket qua ve tinh trgng stress trong vdi mpt nghien cdu trfn sinh vifn Y khoa tgi Iran sd dyng thang do Kessler-10 cho ty If stress cao la 20,8%; stress trung binh la 22,5%; stress mdc dfi nh? la 18,0% va khdng cd stress l i 38,7%. Sy khic bift nay cd the la do thang do sd dyng di do \&bng stress khae nhau bfn canh do la mpt sd dgc dilm ve ty If gidi ti'nh (nghifn cdu nay gan nhu" 1:1) hay nh&ng dgc dilm vf chiing tpc, mfii tru'dng xa hfii, giao dye v i tinh trgng hfin nhan [5]. Trong cie nghifn edu ve tinh trgng stress hifn nay trfn t h l gidi cOng nhu' tai Vift Nam cd khi nhieu thang do d l dinh gii die bift la thang do PSS ma chu yeu la PSS 10 v i PSS 14. Phan ti'eh 2 thang do nay ve dfi nhgy, dp dge hifu cung nhu' ti'nh gia trj de do lu-dng tinh trgng stress la kha tyong ddng nhau du'yc t h l hifn trong nghifn cdu ciia Doris YP Leung v i cfing sy. [4]
Phin tfch myt sdyeu t d lifn quan: 5lnh vien nd bj stress eao gap 2,3 lan so vdi nhdm sinh vifn nam (0R=
2,3; 95%CI: 1,06 - 4,92). Nguyen nhin sinh ra stress ed t h l xult phat t d ylu td mfii tru'dng ben ngoii hay yeu td npi tgi bfn trong eon ngu'di. Ciing mpt sy kifn tie dpng den nhOng con ngu'di khac nhau cd the gay ra mdc dfi stress khae nhau do nhgn thdc va phin iing ciia moi ngydi trudc eae t i c nhin gay stress la khae nhau. Nhieu nghifn cdu nhu' nghifn cdu tai Pakistan eho thiy sinh vifn nd bj stress eao gap 2,25 (95% Cl: 1,07-4,76) so vdi sinh vien nam, nghifn cdu trfn sinh vien tgi Phip diem trung binh PPS-10 eung cao hon cd y nghTa d sinh vifn n&.{6]
Noi sdng, quf quin la yeu tfi cd lifn quan vdi tinh trang stress trong nghifn cdu nay, Nh&ng i p lye cufic sfing khi sdng xa gia dinh, thay ddi dieu
JOURNAL OF MEDICINE AND PHABMACY 7 1 1
Tgp ch! Y DUVC hgc - Tru&ng Dgi hgc Y Dugc Hue- Tgp 6, so 3- thing 7/2016 kifn nha dcd t i e dyng d i n stress ciia sinh vifn. Sinh vifn t d eic vung nfing thfin ehuyen ve thanh pho sdng, hpc tgp chju stress cao gip 2 lan so vdi sinh vien sfing tgl vung thanh thj (OR = 2,04; 95%C1:1,02- 4,52). Difu niy cung tu'ong ddng khi so sanh vdi nhdm smh vien trong tinh Thda Thifn Huf va sinh vien tinh khic, kha nang sinh vien tinh khic bj stress cao gip 2,83 lan {OR=2,83; 95%CI: 1,19 - 6,73) so vdl sinh Vlfn trong tinh. Thay dfii mfii tru'dng sdng die bift la d cac viing ndng thdn, kmh t l khd khin lam tang ap lye cho sinh vien trong thieh nghi vdi mdi tru'dng song, hpc tap mdi nhat la doi vdi sinh vifn nam thd nhat nhu'trong nghifn cdu eua ehiing tfii. Tuy nhifn nh&ng yfu td niy trong mfi hinh phan ti'ch da biln thi chu'a thiy co sy lifn quan vdi stress cao cOa sinh vifn.
Stress ed lifn quan mgt thiet vdi eic mdi quan he ban than, xa hpi ciia sinh vien: y l u td ve bgn than, hogt dpng xa hyi la cac yeu td du'yc phat hifn cd lifn quan cd y nghTa thdng kf vdl tinh trgng stress trong nghien edu nay. Nhdm sinh vifn khdng cd ban t h i n bj stress cao gap 2,76 lan so vdi nhdm cd ban t h i n . Sinh vifn khdng gap khd khin trong trong hogt ddng xa hfii mac stress thap hon 70%
so vdi nhdm ggp khd khan trong eae hogt dfing xa hpi. Ket qua nay eung du'yc \y giai them trong ket qua nghifn cdu ciia Lf Thu Huyen va Huynh Ho Ngpc Quynh [2], t i If sinh vlfn bj stress bfnh ly cd ti'nh cich hu'dng ndi bang 2,6 lln ti If sinh vifn bj stress bfnh ly cd ti'nh cich hydng ngoai. Oieu niy the hien kha nang thich dng vdi mdi trydng mdi ciia cac sinh vien.
Stress cd lien quan iru'c tifp vdi vifc hpc t i p , nghifn cdu cua sinh vifn. Vif c thay ddi phyong phip hpc tgp, cich giing dgy ciia giang vien, mdi trydng hpc tgp khac so vdi cac tru'dng hpc phd thdng trung
hoc la cae yeu to anh hu'dng d l gay stress cho cae bgn sinh vifn nim thd nhat. Trong phan ti'ch don bien ehiing tdi nhfn thay nh&ng sinh vien cam thay tang ap lye hpe tgp, khd khan trong tim kiem tai lifu, giio trinh, ggp khd khan trong tifp can phuang phip giang dgy, hpc tgp mdi cd ty' If bj stress cao hon cd y nghTa thong ke so vdi nhdm cdn lgi. Tuy nhifn chua tim thiy khae bift trong md hinh da bien. Sinh vifn YTCC, BS.YHDP l i nhdng sinh vifn duac dao tgo theo hf thdng ti'n chi ciia Nha tru'dng, sy thay ddi phu'ang phap dao tgo din den thay ddi ve sfi gid hpc, phuang phap hpc ddi hdi sinh vifn kha nangty hpe, sinh vifn lam vifc dpc lap, lam vife nhdm nhieu hon. Ngoii cic y l u to v l hoe t|p ciia sinh vien cd le ty If sinh vien bj stress se cao hon nlu chiing tdi thuc hifn df tai nay trong ky thi kit thiic hpe phan khi sinh vifn danh nhieu thdi gian hon, chju nhieu i p luc hon cho vifc hoe tgp so vdi thdi diem chung tdi thye hifn de t i i nay.
5. KET LUAN
Stress la mfit tinh trgng phd bien trong sinh vien nam thd nhit Khoa Yte Cfing Cfing, ty If sinh vifn bj stress cao chilm 24,9%.
Cie y l u td ed lien quan vdi tinh trgng stress cao bao gdm gidi ti'nh; bgn than, khd khan trong cic hoat dfing xa hdi.
KlfN NGH!
1. Tgo ra cic sin choi, ciu Igc bfi giup cic sinh vien nam thd nhat tham gia cac hogt dfing xa hfii, ngogi khda,
2. Hfi try t u van tam 1'^ cho cic sinh vlfn bj stress cao die bift l i cic sinh vifn n&, sinh vifn ngheo khd khan, sinh vien t d cie tinh khac.
3. Hudng din, t u van eho sinh vifn ve giao trinh, tai lifu va phuang phip hpc t|p thfch hyp.
TAI LlEu THAM KHAO 1. Nguyin Thai Quynh Chi, Truong Quang Tien (2014),
"Tinh trgng stress ciia can bd va giang vien trucmg Ogi hpc Y te Cong Cpng va mpt sd ylu to lien quan". Tgp chl Y te Cong Cpng, 9, 26-31.
2. Le Thu Huyen, Hu^nh Ho Ngoc Qu^nh (2010) "Tinh trgng stress ciia smh vifn y te Cfing Cpng Ogi hpc Y Duyc thinh phd Ho Chi Minh va cac yeu tfi lien quan nam 2010".
Tgp chi Y hpc Tp.Ho Chf Minh, 15 (1), 87 - 92 3. Bill Van Van, Nguyin Thi My Anh (2009) "Bieu hifn stress ciia sinh vien Dai hpc Oa Ning". Tgp chi Khoa hpc va cdng nghf, Ogi hpc Oa Nang, 6,126 -132.
4. DorisYPLeung, Tai-hingLam, ophlaSCChan (2010)
I 7 2 JOURNAL OF MEDICINE Al
"Three versions of Perceived Stress 5cale:validation in a sample of Chinese cardiac patients who smoke", BMC Public Health 201010
5. G.M.Koochaki, A.Charkazi, AHasanzadeh, M.
Saedani, M. Qorbani, A. Marjani (2011) "Prevalence of stress among Iranian medical students: a questionnairesunrey", EasternMediterraneanHealthJournal, 17 (7), 593 -598.
6. MohsinShah, ShahidHasan, SaminaMallk, ChandrashekharTSreeramareddy (2010) "Perceived Stress, Sources and Severity of Stress among medical undergraduates in a Pakistani Medical School".. BMC Medical Education, 10
