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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