Grade
Table 3.8 shows that the percentage of depressive symptoms in students and their grade is not seen having difference (p> 0,05). The percentage of depressive signs of the 4th grade is the highest (40,4%), lower in the 6th grade, the 3rd grade, the1st grade (38,7%, 36,8%, 36,6%) and finally students of the 5th, the 2nd (34,7%, 34%). In the study of Nieme, the depressive symptoms commonly see at the time of graduation than at start clinical (36% vs 17%) [30]. The percentage of students showing depressive symptom of the grades in the results of our research is similar to that in which of J. Caleb Othieno on university students in Kenya [14], and the percentage of students the 1st, the 2nd, the 3rd, the 5th having depressive symptom in our study is lower than the results research of Mr. Hamza Abdulghani Mohammad of student Medical University in Saudi Arabia [21].
Gender
Table 3.9 shows, the difference between the precentage of male and female who have depressive symptoms is no significant difference with p>
0,05. 39,4% are the depressive signs percentage of male students, on the other hand, that in female students is 35,8%. The percentage of male and female students showing depressive signs in our study are higher than the results of Mr. Nguyen Dinh Quyen's research (male: 36,8%, female: 34,5%) [31] and the study of Mr. Reyes-Rodriguez Maelynn on students of Puerto Rica university (male: 19%, female: 28%) [27]. The majority of studies show that the percentage of experiencing depressive signs of female is higher than men [17]. A study in the US is performed on adolescent, young and female ratio having depressive symptom is twice times greater than men (12% and 6,6%) [32]. Because almost female are not as strong-willed as male are, so
they are often psychologically affected and think more when they have trouble. However in our study, the percentages of men students are more than women. Our study does not output specific characteristics by gender affecting signs of depression due to the time and cost limitations. Perhaps, it leads to the inaccurate result.
Religion
Table 3.10 shows that, 37,5% students having the depressive symptom is in irreligious groups, 1,36 (95% CI:0.65- 2.84) times higher than those in religious group (30,6%), but this difference is no significant, with p-value
>0,05. The results of our study do not indicate an association between religion and depressive symptom in students.
Current residence
Table 3.11 shows, the depressive sign is not different in current residence (p> 0,05). The percentage of students living with their parents/
relatives have the highest signs of depression (39,6%), followed by students living in campus’s hostel (37,5%) and the lowest is in the group of students living in renting a room (36,6%). This can be explained that living at the hostel offers them more own space, not under the supervision of the family, and doing everything themselves so that students feel more comfortable than living with parents and living dormitories. Living with parents/relatives is usually under controlled, putting on study pressure that will affect the psychology, as a result, students feel unfreedom, stress which is the reason having signs of depression. The proportion of students living with their parents, dormitory and hostels with depressive symptom of our study is compatible with the findings of Mr. J. Caleb Othieno on university students in Kenya (40%, 35%,36%) [14].
Parents' marital status
Table 3.12 shows, the percentage of depressive sign in students having parents separated, divorced is the highest 46,7%. The result of our study
shows that percentage of the depressive signs of students whose parents separated, divorced are higher than the research results of Mr. Reyes- Rodriguez Maelynn of college students in Puerto Rica [27] and lower the results Mr. Nguyen Dinh Quyen's research [31]. Parents usually take care of and spend their whole love on their children. The separated and divorced parents are major influence on the psychology of children. However, in our study, the difference between parents’ marital status and the depressive symptom is no statistic significant, with p> 0,05. Maybe in our study, the amount of students having divorced or separated parents is small, just 15, so it cannot show entirely.
Factors related to friends, society
Depressive signs of the students are higher when they have some difficulties, such as finding new friends, making social activities, getting conflicts with roommates, witnessing the death of a friend or finished the relationship with love.
The difference between depressive symptom and troubles in finding new friends is found highly significant with p <0,01 (table 3.14). The percentage of depressive symptom in students having troubles in finding new friends is 55,2%, 3,343 times higher than those without this problem. This can be explained by the lack of interest, sharing with friends while experiencing difficulties their life. On the other hand, it shows the students’ poor ability to connect, which can lead to the depressive symptom. The percentage of students getting trouble in finding new friends in our study is higher than the findings of Ms. Nguyen Thi Bich Lien (42,2%) [6] and Mr. Do Dinh Quyen (52,7%) [31].
To the table 3.14, the difference between depressive symptom and troubles in making social activities is highly significant. This may explain that the flexibility of the students can be expressed clearly when they take part in
social activities. However, to participate in the social activities, students should also be sociable and need to have a solution for suitable work, or they will easily fall into a state of aloneness, disappointment, and negative thoughts. Many factors may affect participation social activities of students. It is possible that students are not confident enough, not active enough, so often working alone or playing with a best friend, but disregarding the team's activities, such as participation in the arts, participation in volunteer, join the club... also possibly, students actively participate in these activities, but they do not organize and distribute a suitable time, as the consequence it has adversely impacted on the learning, working, and creates boredom for students. In our study, the percentage depressive symptom of students with troubles in making social activities is 46,1%. Our results are consistent with the findings of Ms. Nguyen Thi Bich Lien [6] and higher than the findings of Mr. Do Dinh Quyen (40,6%) [31].
It is considered that the sharing room may also have conflicts with roommates . And when it comes to occurs, students will become tired, tense and uncomfortable. Conflicts for a long time without solution can lead to depression. The result of our study shows that the students making an argument with their roommate have depressive signs 3,59 times higher than those without an argument, but the difference is statistical significance , at p
<0,05.
In our study, the percentage of depressive symptom in students whose a close friend died accounts for 52%, the group has no close friends died is 36,2%. The result of our research is compatible with the findings by Mr. Do Dinh Quyen [31]. The percentage of depressive symptom in the group with the death of a friend of our research is higher than the results of the Mr.
Reyes-Rodriguez Maelynn, of university students in Puerto Rica (27%) [27]. We believe that a good friend died impacts significantly on
psychological object. Students who are under the circumstance not only get grief, but also lose one who can share feelings, it easily leads to depression.
However, the difference between the depressive symptom and a close friend died sign is not statistically significant , at p> 0,05 like the other studies, possibly due to the number of students in the case in our study is only 25 people, it is not large enough to express at all.
Result table 3.14 also shows that, the students who just have finished the relationship with their love takes up the high percentage of depressive signs, which is 55,3%, 2,42 times higher than those without this problem, with p <0,01. After that, it makes them often feel sad and regretful, depressed about the current, upset about many things in their daily life, all of which can lead to the signs of depression. The percentage of depressive symptom among students with finished the relationship with their love of our study is higher than the findings of the Mr. Reyes-Rodriguez Maelynn of college students in Puerto Rica (42%) [27].
In addition, the financial and accommodation difficulties are also one of the effects coming with the great depressive sign. 68,4% of students with financial difficulties has the signs of depression, difficulties in accommodation groups is 64,7% (table 3.14). We believe the more lack of financial source, the more they worry, hesitate to do expenses, therefore, they have the greater signs of depression. Not only that, medical students have been doing a vast of studying workload, so, it is necessary for them to entertain in order to relieve mentality, whether it could be or not, the financial is a determinant. The students’ lack of finance tends to stay at home, however, they cannot help being sad, jealous of one who are going out. Some students have to work at part-time to earn extra money for paying and learning. These things affect badly these students than others having good economic conditions, comfortably spend on what they want. Problems about
accommodation are of the catastrophic effect making student to have higher depressive signs because students mostly come from the small town, so finding a safe place with reasonable prices in response to the learning needs and basic needs is essential. For the students who live in a place has security is not good, a lot of theft, or which are too far away from schools or markets, or find suitable accommodation but the price is too high, in such a case, the students are always anxious, uncertain, and it adversely affects students. Depressive symptom rate with financial and accommodated difficulties students of our study is higher than the study by Ms. Tran Quynh Anh (8,1%, 16%) [35].
Factors belonging to the family
Result table 3.15 shows that the percentage of depressive symptom in the group of students who have member family died is higher than (43,8%) among those without (36,0%), but the difference is not statistically significant, with p> 0,05. The result shows that the percentage of depression signs among students whose having member family died in our research is:
lower than the results of Mr. Do Dinh Quyen (51,9%) [31] and Ms. Nguyen Thi Bich Lien (55,6%) [6], higher than the research Mr. Reyes-Rodriguez Maelynn of college students in Puerto Rica (28,2%) [27]. We think that the level of bond between them and another member of their family influences differently sadness, regret when one of them dies. The pass away from parents, grandparents, brothers and sisters often makes the subject a lot more painful than other relatives, from there, signs of depression will be also different. In this study, we do not divide clearly the degree of close to the members of their family, perhaps this is the reason resulting in an imprecision.
Trouble with parents is another factor closely related to the depressive symptom in students. The percentage of depressive sign in students getting
troubles with parents is 52,9%, 2,28 times higher than those without this troubles, with p <0,01. The percentage of depressive symptom among students having trouble between them and their parents of our research are suitable for the findings of Ms. Nguyen Thi Bich Lien [6], is higher than the findings of Mr. Do Dinh Quyen (38,7%) [31], Tran Quynh Anh (29,1%) [35], and higher than the results of the author Mr. Lu Chen, Lin Way done on college students in China (47%) [26]. Explaining, parents who are subject always are respected, but because of different generations and different thoughts, they are different from both attitude and opinion, therefore, creating pressure is difficult to relieve, easily lead to depressive signs.
The personal source factors
The change in sleeping and eating habits is also an influential factor in depressive symptom. The percentage of students having change in sleeping habits getting depressive signs is 41,9%, 1,63 times higher than those without changing in their sleeping habits with p<0,05, the group changed their eating habits is 45,1%, 1,95 times higher than those without these changes, with p
<0,05 (table 3.16) so, this change relates closely the signs of depression. It could be explained that the arranging time is hard to fit into the timetable of school and schedules at the hospital, students can hardly give a reasonable timetable thereby it leads to the change in dining and relaxing. Changing these habits are also changing the biological rhythm, causing the body often fall into a state of fatigue, depression, irritability, this also leads to increased depressive symptom. The rate of depressive symptom in students with changes in sleeping and eating habits of our study is lower than the results of Ms. Nguyen Thi Bich Lien (70,7%, 65,6%) [6] and the findings of Mr. Do Dinh Quyen (42%, 40,7%) [31].
Regular sport, exercise is a beneficial healthy behavior. Based on research, we find that the percentage of depressive signs in seldom practicing
an exercise (53,4%), is 3,3 times higher than the students doing regular exercises, with p <0,001 (table 3.16). We believe that the sport, exercise not only brings benefits in terms of physical health, but also relieves the daily psychological pressure. That makes students more active, more confident, happier, and limits the signs of depression. Medical students usually study for 6 years, longer than other fields, so many cases, students are engaged, married while still in school. Results table 3.16 shows, the percentage of students engaged / married to the depressive symptom (70%) is higher than those without (36,3%), with p <0,05. Our result shows that the percentage of depressive symptom of students married, engaged is higher than the findings of Mr. Do Dinh Quyen (60%) [31] and Ms. Nguyen Thi Bich Lien (61,5%) [6]. It is understandable that in addition to living life as a normal student, students engaged / married has to worry more about family life, wife/husband /children, so easily draws on more effective depression.
Not only the students within economic difficulty, but many other students still have a part-time job to train yourself. The result of the study, the percentage of students working part-time getting depressive symptom is 37,1%, higher than the student without having a part-time job, and the difference is not statistically significant, with p> 0,05 (table 3.16). The results of our study, the percentage of students getting depressive signs with extra jobs is suitable for the findings of Mr. Do Dinh Quyen [31], lower than the results of Ms. Nguyen Thi Bich Lien (55,8%) [6]. Working part-time may have more impact on the students, some of them are the increasing impact of experience, the ability to organize time and creation life skills, but others are bad such as creating a negative, nervous pressure, however, the relationship between having a part-time job and the depressive symptom are more difficult to express clearly with the cross-sectional descriptive study.
Results table 3.16 shows that the percentage of depressive signs of the severe injuries student group accounts for 48,4%, 1,65 times higher than the group without injury, this difference is not statistically significant, p>
0,05. Our research shows that the rate of depression signs of trauma students is higher than the findings of Ms. Nguyen Thi Bich Lien (8%) [6] and the results of the Mr. Reyes-Rodriguez of college students in Puerto Rica (28,2%) [27]. We believe that the student injuries will be affected by many sides, from suffering from the pain to reducing health, from having difficulty in movement and doing activities to costing of treatment, or disturbing study...
these effects can lead to signs of depression.
Study-related factors
These students at the Haiphong University of Medicine and Pharmacy, especially general Medical Department, students always set high academic goals, so not reached their goal, students will feel disappointed themselves, shy with their friends, which become boredom, if no having suitable solution to reach their goal, students are prone to depression. In our study, percentage of the students with a low academic grade point average getting depressive symptom accounts for 39,5%, 1,54 times higher compared to those having a high score, the difference is statistically significant with p <0,05 (table 3.17). The percentage of students with a low academic grade point average getting depressive sign of our study is lower than the results of Ms. Nguyen Thi Bich Lien (86,4%) [6], Mr. Do Dinh Quyen (58,1%) [31], and higher the research results of Ms. Tran Quynh Anh (17,8%) [35].
Academic scores are very important for students, especially medical students as it comes to ability and attempt in learning, helps students find a job after graduation, so the satisfaction of study is also great influence on the psychology of students. In our study, the group dissatisfied with their studying results having a depressive symptom percentage is 41,9%, higher
than 1,85 times the satisfaction of study group. The percentage of students getting depressive symptom with dissatisfied about study of our study is lower than the results of Ms. Tran Quynh Anh (56,5%) [35].
Result table 3.17 shows that the percentage of depressive symptom in students arguing with teachers is 56,5%, higher than the group without (36,1%), with p>0,05. Our result shows that the percentage of students with arguing with their instructors having depressive symptom is higher than the research results of Ms. Nguyen Thi Bich Lien (53,8%) [6]. For some reasons, misunderstandings between teachers and students can lead to conflicts, make them lose interest in the course, teachers, if last long, it leads to signs of depression. But if it happens, it requires a process, while our study is only descriptive cross-sectional study so it cannot fully express the exact relationship between these factors and depression.
The breaking university regulation is also a factor to be associated closely with the signs of depression. Results table 3.17 shows that the proportion of depressive symptom students breaking university regulation is 2,46 times higher than the without group, with p < 0,05. The result of our study shows the percentage of students who have committing rule of university with depressive symptom is higher than the results of Ms. Tran Quynh Anh (7,1%) [35]. We believe that the students who have breaking university regulation, for example, give up lessons, cheat in exams... do not understand what they have learned at university, cannot update their knowledge, so students will have not a good result in the exam, do not achieve the purpose of learning and that can arise a sense shy, keep away from people, give up more lessons.
To finish the course, during their studying, they have to take a test, and failing in exam is a problem that most students facing. In our study, the results showed that the percentage of students getting depressive symptom
with failing in exam is 39,3%, higher than the students do not (34,7%), but the this difference is not statistically significant, with p> 0,05. The percentage of failing in exam students with the depressive sign of our study is higher than the results of Ms. Tran Quynh Anh (31,8%) [35].