gms | German Medical Science

Background: The changing life-worlds university students face after the beginning of their studies constitute various challenges in students’ lives. They need to cope with changing living situations, such as changing physical and social environments and challenging administrational and study requirements. The period from adolescence to young adulthood is a crucial transitional phase which may cause high stress levels in students, particularly in case of deficient coping with these demands [1]. Chinese students additionally face extreme peer competition before and during their studies accompanied by many economic and psychosocial demands that may increase their stress level [2]. This study investigated the prevalence and factors associated with perceived stress among students from two Chinese universities.

Methods: Standardised interviews were conducted among university students at Peking University, Beijing and Sun Yat-sen University, Guangzhou, China in 2010 and 2011. Descriptive and bivariable analyses were applied to describe the stress level of the students and to characterize subgroup differences. Adjusted binary logistic regression models were applied to estimate the strength of association (odds ratio) of factors associated with perceived stress (Cohen’s perceived stress scale).

Results: The sample of 1,856 students was almost gender-balanced with 52.1% males and 47.9% females. The proportion of stressed students was substantial (38.5%). Adjusted for age, sex, income situation, birth place (rural vs. urban), partnership, only-child status, religion, and parents’ educational level, we found that social support (high vs. low level: OR=0.3), self-efficacy (high vs. low level: OR=0.1), sense of coherence (high vs. low level OR=0.04), self-rated health status (poor vs. good OR=1.8), satisfaction with health status (unsatisfied vs. satisfied OR=2.1), satisfaction with weight (unsatisfied vs. satisfied OR=1.3), satisfaction with study performance (unsatisfied vs. satisfied OR=1.6), and having concrete plans after studies (no vs. yes OR=1,5) were significantly (p<0.001) associated with the level of perceived stress.

Discussion: The results clearly show that the examined students suffer from high level of perceived stress. Personal traits like self-efficacy and sense of coherence have strong influence on perceived stress. This should motivate universities to create a study environment that increases these resources, for example through establishing comprehensible curricula, providing transparent grading criteria and improving the study-ability of academic courses. Additionally, universities should open perspectives to students for future job plans after studies, for instance by conducting job fairs. In order to strengthen students’ perceived social support, universities are called upon to enable students to continue their existing social ties with friends and families and to enable students to establish stable and reliable social interaction with peers and teaching staff at universities, e.g. by arranging sport or cultural events. Besides these contextual factors, physical health was also related to perceived stress. This emphasizes the association between somatic and mental health and constitutes great potential for stress reducing measures in the university setting.