DEPRESSIVE SYMPTOMS AND RELATED FACTORS OF THE GENERAL MEDICAL STUDENT AT HAI PHONG UNIVERSITY OF MEDICINE AND PHARMACY IN 2016

`MINISTRY OF HEALTH MINISTRY OF EDUCATION AND TRAINING HAI PHONG UNIERSITY OF MEDICINE AND PHARMACY NGUYEN THI MO DEPRESSIVE SYMPTOMS AND RELATED FACTORS OF THE GENERAL MEDICAL STUDENT AT HAI PHONG UNIVERSITY OF MEDICINE AND PHARMACY IN 2016 GRADUATE THESIS OF PREVENTIVE MEDICINE DOCTOR HAI PHONG 6/2016 `MINISTRY OF HEALTH MINISTRY OF EDUCATION AND TRAINING HAI PHONG UNIERSITY OF MEDICINE AND PHARMACY NGUYEN THI MO DEPRESSIVE SYMPTOMS AND RELATED FACTORS OF THE GENERAL MEDICAL STUDENT AT HAI PHONG UNIVERSITY OF MEDICINE AND PHARMACY IN 2016 Majors: Preventive Medicine Doctor Code : GRADUATE THESIS OF PREVENTIVE MEDICINE DORTOR Thesis Advisors: Master Nguyen Thi Minh Ngoc Master Nguyen Thi Thu Thao HAI PHONG 6/2016 DECLARATION I am sure that this graduate thesis is my own study; all investigated data and researching results which are actually honest and logical, have never been published in other research projects NGUYEN THI MO ACKNOWLEDGMENT I would like to express my sincere gratitude: The Rector Board and Department of Undergraduate Education, Hai Phong University of Medicine and Pharmacy The Chairmen Board and lecturers of the Department of Public Health at Hai Phong University of Medicine and Pharmacy dedicatedly instructed me to study and complete my thesis Meanwhile, the training University department assists me to collect accurate and reliable data particularly I would like to express my faithful thanks to Master Nguyen Thi Minh Ngoc and Nguyen Thi Thu Thao, who spent a lot of their time on instructing me for my thesis I sincerely thank Mr Ha Van Truong, the lecturer at the Ha Truong English center guided, instructed and prompted me in English language My family and friends always encourage and support me to study and complete my thesis Hai Phong, 25/5/2016 Author Nguyen Thi Mo ABBREVIATIONS CES-D C.I WHO The center for epidemiologic studies depression scale Confidence interval The World Health Organization CONTENT INTRODUCTION .1 CHAPTER .3 Literature review .3 1.1 Concepts of depression .3 1.3 Risk factors and consequences of depression in medical students 11 1.4 Depression measurement 14 CHAPTER .17 METHODOLOGY .17 2.1 Study subjects 17 2.2 Study location 17 2.3 Study time 17 2.4 Methodology .17 2.5 Data processing and analysis 21 2.6 Ethical study .22 CHAPTER .23 RESULT 23 3.1 Description of general characteristics 23 3.2 Students have depressive symptoms based on the CES-D scale 26 3.3 Depressive symptoms and related factors 29 DISCUSSION 38 4.1 The general characteristics and depressive symptom of the study subjects 38 4.2 Related factors to depressive symptoms of general medical students at Hai Phong University of Medicine and Pharmacy, 2015 – 2016 .42 CONCLUSION 53 RECOMMENDATION 55 REFERENCES QUESTIONNAIRE Part C: Stressful life events 10 LIST OF TABLE Table 2.1: Distribution of the sample size in grade Table 2.2: Variables and index measurement Table 3.1: Distribution of subject by religion and year in course Table 3.2: Distribution of subject by parents’ education Table 3.3: Distribution of subject by current residence Table 3.4: Positive signs according to the CES-D Table 3.5: Difficulty in communication signs based on the CES-D Table 3.6: Depressed signs based on the CES-D Table 3.7: Active selves signs according to the CES-D Table 3.8: The relationship between depressive symptom and grade Table 3.9: The relationship between depressive symptom and gender Table 3.10: The relationship between depressive symptom and religion Table 3.11: The relationship between depressive symptom and current 19 20 25 27 28 29 29 30 31 33 34 34 35 residence Table 3.12: The relationship between depressive symptom and parents’ 36 marital status Table 3.13: The relationship between depressive symptom and family 38 residence Table 3.14: The relationship between friends, society and depressive 38 symptom Table 3.15: The relationship between the family factors and depressive 40 symptom Table 3.16: The relationship between depressive symptom and 41 interpersonal sources Table 3.17: The relationship between the study- related factors and 42 depressive symptom LIST OF FIGURES Figure 1.1: Proposed model of causes and consequences of student 15 distress Figure 3.1: Distribution of subject by gender Figure 3.2: Distribution of subject by ethnicity and course Figure 3.3: Distribution of subject by family residence Figure 3.4: Percentage of depressive symptom among the students 25 26 27 32 INTRODUCTION Depression is now becoming one of the most serious mental health issues and social problems in many countries and trending to increase in the next 20 years [31] Depressive symptoms are widely distributed in the population and disrupt people’s normal life According to World Health Organization (2012), depression is a significant contributor to the global burden of disease with an estimated 350 million people in all communities across the world affected [37] Moreover, every year, approximately 5% of the world population have depression [36] WHO predicts that by 2020 depression will be the second cause of loss of working second in the world [37] Depression results from a complex interaction of social psychological and biological factors Especially, when long-lasting and with moderate or severe intensity, depression can lead to lead to more stress and dysfunction, worsen the affected person’s life situation At its worst, depression can lead to suicide Within about million cases die per year in the world, the suicide is the second leading cause of death in the 15-29 age-group [37] However, in Vietnam, a scientific awareness about depression is still limited "Feeling sad" has been seen as a normal shape of mood, not to be considered as criteria for evaluating early signs of depression The early evaluation of depressive signs is an extremely important thing to prevent the occurrence as well as to have effective treatment process for depression So far there have been few types of research on depressive symptoms in Vietnamese people as well as students, especially on medical students Students have to experience numerous challenges including exploring or developing their identity, navigating the transition from a state of 55 RECOMMENDATION According to the obtained research results, we propose a number of recommendations designed in order to limit the depressive symptom in students at the university as followings: - A range of discussion activities on experience and scientific learning methods to help student avoid stress and fatigue should be increasingly held throughout joining to studying club such as English clubs, French clubs , participating in extracurricular activities such as sports, dance sports club, guitar club Besides, chatting with friends and relatives is required for keeping psychological state balanced in stressful learning process - The extracurricular activities, psychological seminar are of necessity for the guidance on preventing depression from students, especially for freshmen enrolling at the university - Psychological counseling room in the school is critical to help students have difficulties in learn and in their personal life - In order to detect early depressive symptom in the student, it is necessary to carry on regular psychological tests - More research on each student form specialized in the particular problems should be taken place to find out solution of students' depression REFERENCES Vietnamese Nguyễn Thị Thiên Ân (2009), Biểu bệnh trầm cảm bệnh nhân độ tuổi từ 18-45 điều trị Bệnh viện tâm thần Đà Nẵng từ tháng 10/08-3/09, Khoá luận tốt nghiệp ngành Tâm lý học, Đại học sư phạm - Đại học Đà Nẵng Bộ Y tế, Đại học Y Dược Hải Phịng (2014), Thơng báo tuyển sinh đại học, http://hpmu.edu.vn/hpmu/news/Dai-Hoc-32/Thong-bao-tuyen-sinh-Daihoc-421/, truy cập ngày 24/5/2015 Bộ Y tế, Tổng cục thống kê, UNICEF, WHO (2009), “Điều tra quốc gia Vị thành niên niên Việt Nam Lần thứ 2” Nguyễn Thanh Cao (2011), Thực trạng trầm cảm 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QUESTIONNAIRE Dear students, being a student in 6th form, we conduct a study to measure prevalence of depressive symptom and related factors in the learning environment Your information will be managed confidentially, only for research purpose and contributed to improve quality of the academic environment and your well-being as well Fill this box □ with your suitable choice Part A: you and yours’ family A1 A2 A3 A4 A5 A6 Gender Birth year Ages Ethnic Religion Year in course Male Ages Kinh Nung Tay Dao Hoa H’Mong Kmer Other Non-religion Christian Buddhist Other Freshman Fourth form Second form Fifth form Third form Rural area Sixth form A7 A8 A9 Family’s residence Current residence Parents’ marital status Female Urban area Dormitory Room/house rent Living with parents/ relation Other Live together Separated Divorce Parental loss Always A10 Often How often you excises? Sometime Seldom A11 Grade point average Never < 5,5 5,5-6,4 6,5-7,4 7,5-8,4