A total of 186 graduate students from two medical research institutions in Shanghai, Ruijin Hospital and Renji Hospital, expressed interest in the study. Of these, 152 were from Ruijin Hospital and 34 were from Renji Hospital. Participants were at different stages of their academic journey at the time of the survey: some were at the beginning of their research studies, while others were nearing the end of their degree programs.
Given the comprehensive nature of the study, the participants had diverse backgrounds, varying in factors such as gender, age, marital status, educational level, prior work experience, and average family income. Table 1 summarizes the demographic information of the participants.
Findings on the experience of stress and its management during the graduate study were categorized into three main areas: sources of stress, implications of stress, and coping strategies.
Influence of Demographic Factors:
Stress Sources and Levels
Research Workload: The mean stress score was 3.74 (SD=1.15), indicating a moderately high level of stress from academic demands.
Publishing Pressure: This emerged as the highest stressor, with a mean score of 3.92 (SD=1.28), revealing substantial stress related to publishing among students.
Future Career Uncertainty: Significant stress was also found regarding career planning, with a mean score of 3.81 (SD=1.14).
Personal Life Stressors: These were rated moderately stressful, with a mean score of 3.21 (SD=1.24).
Correlations with Academic Performance
A significant negative correlation between overall stress score and academic performance (r=-0.372, p=0.006) indicated that higher stress was associated with poorer academic performance.
Gender Differences
Females reported higher work-life balance stress (t=2.15, p=0.034) and publishing stress (t=1.98, p=0.025) than males.
While both genders identified academic workload and pressure to publish as significant stressors, females reported higher levels of stress related to work-life balance and interpersonal relationships within their lab environment.
Educational Level
One-way ANOVA showed significant differences in publishing stress scores between educational levels (F=3.92, p=0.011); doctoral students exhibited substantially higher publishing stress than master's students.
A higher educational level, corresponding to increased stress related to job market uncertainties and pressure to publish, was especially notable for doctoral students nearing graduation. These students, however, reported higher confidence in their research capabilities.
Marital Status
Unmarried students reported higher stress related to future uncertainties, while married students or those with families indicated more stress linked to achieving a work-life balance (t=2.46, p=0.015).
Work Experience and Economic Factors
Students with prior work experience displayed higher resilience to academic workload stress.
Students from lower-income families had greater financial stress (r=-0.428, p=0.001).
Predictive Factors for Overall Stress
Multiple regression analysis showed that gender (β=0.192, p=0.046), education level (β=0.174, p=0.032), and marital status (β=0.221, p=0.018) significantly predicted overall stress levels in graduate students.
The statistical analysis results of various sources of stress among graduate students are presented in Table 2.
Implications of Stress:
The impact of stress manifested differently across our sample. Female students reported a higher incidence of physical symptoms such as headaches, sleep disturbances, and diminished appetite. They also conveyed a more pronounced impact of stress on their personal relationships and self-perception.
Older and married students or those with families were more likely to report that stress negatively impacted their ability to maintain a harmonious work-life balance, leading to dissatisfaction and increased feelings of guilt associated with not being able to fulfill familial and personal commitments effectively.
Financial stress was significant. Students from lower-income families were more likely to report heightened anxiety about their financial future, potentially distracting them from their academic pursuits and adding to the overall stress.
Higher stress levels corresponded to a decrease in academic performance, particularly in concentration, creativity and problem-solving skills, and motivation to pursue challenging research tasks.
Coping Strategies:
Stress management strategies varied considerably. Male and younger students tended to rely on physical activities such as sports and exercise or hobbies like listening to music or gaming as stress relievers. They were less likely to seek professional psychological help, indicating a potential stigma or lack of awareness about the benefits of such resources.
In contrast, female, older, or married students showed a higher inclination towards seeking professional help such as counseling or therapy when encountering significant stress. These students also reported a higher reliance on social support networks, including friends, family, and peers.
Students with prior work experience or from higher-income families were more likely to employ problem-focused coping strategies, such as seeking advice from mentors or peers, organizing their workload more effectively, and using relaxation techniques such as mindfulness or meditation.
In conclusion, these findings suggest that a one-size-fits-all approach may not be effective in addressing the stress experienced by medical research graduate students. Institutions should consider a range of demographic factors when designing interventions and provide a variety of coping mechanisms to cater to diverse student needs.