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Reidar Tyssen

Publications and source records attributed to Reidar Tyssen.

13 recordsLinked to original sources

Life satisfaction and resilience in medical school--a six-year longitudinal, nationwide and comparative study.

BACKGROUND: This study examined the relationship between life satisfaction among medical students and a basic model of personality, stress and coping. Previous studies have shown relatively high levels of distress, such as symptoms of depression and suicidal thoughts in medical undergraduates. However despite the increased focus on positive psychological health and well-being during the past decades, only a few studies have focused on life satisfaction and coping in medical students. This is the first longitudinal study which has identified predictors of sustained high levels of life satisfaction among medical students. METHODS: This longitudinal, nationwide questionnaire study examined the course of life satisfaction during medical school, compared the level of satisfaction of medical students with that of other university students, and identified resilience factors. T-tests were used to compare means of life satisfaction between and within the population groups. K-means cluster analyses were applied to identify subgroups among the medical students. Analysis of Variance (ANOVA) and logistic regression analyses were used to compare the subgroups. RESULTS: Life satisfaction decreased during medical school. Medical students were as satisfied as other students in the first year of study, but reported less satisfaction in their graduation year. Medical students who sustained high levels of life satisfaction perceived medical school as interfering less with their social and personal life, and were less likely to use emotion focused coping, such as wishful thinking, than their peers. CONCLUSION: Medical schools should encourage students to spend adequate time on their social and personal lives and emphasise the importance of health-promoting coping strategies.

Adaptation, Psychological↗

Self-prescribing among young Norwegian doctors: a nine-year follow-up study of a nationwide sample.

BACKGROUND: Self-prescribing among doctors is common, but no longitudinal studies have documented this issue. We studied the self-prescribing behaviour among young Norwegian physicians and the predictors of self-prescribing. METHODS: We conducted a nationwide, prospective and longitudinal study following young Norwegian physicians from internship through the subsequent nine years using three postal questionnaires. Chi-square tests and logistic regression models were applied. RESULTS: About 54% of the physicians in their fourth and ninth postgraduate years had self-prescribed medication at least once during the previous year. Among those who had used prescription medication during the previous year, about 90% had self-prescribed. Self-prescribing behaviour did not differ significantly between men and women, or according to the type of work at any time. The most frequently self-prescribed medications were antibiotics (71%-81%), contraceptives (24%-25%), analgesics (18%-21%), and hypnotics (9%-12%). Those who had needed treatment for mental problems had self-prescribed hypnotics and sedatives to a greater extent than the others. Being male, having self-prescribed during internship, somatic complaints, mental distress, subjective health complaints, and not having sought help from a general practitioner, were significant adjusted predictors of self-prescribing in the ninth postgraduate year. CONCLUSION: The level of self-prescribing among young Norwegian physicians is relatively high, and this behaviour is established early in their professional lives. Although self-prescribing is acceptable in some situations, physicians should seek professional help for illness. Efforts to inculcate more rational help-seeking behaviour should probably start in medical schools.

Analgesics↗

Which young physicians are satisfied with their work? A prospective nationwide study in Norway.

BACKGROUND: Few studies have investigated personality and medical school variables in regard to job satisfaction after graduation. It is of great importance to investigate these factors because this information may be used in the recruitment/admittance process to medical schools, and possibly to improve medical education. METHODS: We conducted a nationwide prospective 10-year follow-up study of medical students at all medical schools in Norway. They were approached three times during their medical training: at very beginning (T1), in the middle (T2), in the last year of medical school (T3), and then four years after graduation (T4). There were 210 participants who responded on all four occasions. Job satisfaction was measured with the Job Satisfaction Scale, which was used as the outcome variable. In addition to conducting multiple regression analysis for the total sample, we also conducted similar analyses separately for men and women. RESULTS: Among the demographic and personality variables, 'having a father who is a physician' and 'interpersonal functioning (being withdrawn)' were significantly associated with job satisfaction at T4. Among the medical school variables, 'well-being with peers', 'identification with the doctor's role at the end of curriculum', 'perceived medical school stress', and 'perceived clinical skills' were significantly associated with job satisfaction. In the multiple regression analysis only 'father as a physician' and 'perceived clinical skills' yielded an independent influence on the outcome variable in separate analyses within sub-groups of male and female students, 'perceived clinical skills' differentiated among woman only, while 'well-being with peers' differentiated only among men. CONCLUSION: The main finding of this study is that the young physicians who are the most satisfied in their work are those whose fathers are physicians and those who have a high level of perceived clinical skills at the end of medical school. There are also differences in regard to predictors of job satisfaction among men and women. These findings indicate that medical schools should invest substantial effort in clinical skills training, and this seems to be especially important among female students.

Adult↗

Suicide rates according to education with a particular focus on physicians in Norway 1960-2000.

BACKGROUND: Suicide rates are higher in certain educational groups. The highest rates are generally found in the medical and allied professions, but the empirical evidence for high suicide rates may be questionable. This study compares the rate of suicide among trained physicians, dentists, nurses, police officers and theologians with the rate among other university graduates and the general population according to sex, age and time period. METHOD: Census data from 1960, 1970, 1980 and 1990 relating to education were linked to suicide as cause of death data from Statistics Norway, and followed up for the period 1960-2000, comprising 46 and 49 million person-years among men and women respectively. RESULTS: Physicians still have a higher rate compared with other graduates and the general population, both among males [43.0, 95% confidence interval (CI) 35.3-52.5] and females (26.1, 95% CI 15.1-44.9). Suicide rates increased steeply by age among physicians and other graduates, whereas for non-graduates the rate was highest in the 40-60 years age group. The suicide rate among female nurses was also elevated, whereas police officers seemed to have an intermediate suicide risk. The rate among theologians was low (7.0, 95% CI 2.9-16.9). The suicide rates in the 1990s were significantly lower than in the 1980s. CONCLUSIONS: The high suicide rates among physicians and elderly graduates are of concern. The reasons why graduates are more vulnerable than others when getting older and the low rate among theologians warrant further study.

Adult↗

Does change from a traditional to a new medical curriculum reduce negative attitudes among students? A quasi-experimental study.

The authors investigated whether a new type of medical school curriculum-with problem-based learning, integrated preclinical and clinical phases, and increased levels of contact between students, patients and teachers--is associated with lower levels of students' negative attitudes towards medical training than is a traditional medical school curriculum. This association was found, and was confirmed by a comparison between students in a university that had changed from a traditional curriculum to a new curriculum. Curriculum design may explain differences in students' attitudes towards medical school.

Adult↗

The relative importance of individual and organizational factors for the prevention of job stress during internship: a nationwide and prospective study.

This study aimed to investigate the relative and sequential importance of individual and organizational predictors of job stress associated with medical internship work. All medical students who graduated in Norway over 2 years (n = 631) were surveyed and followed up 1 year later at the end of the hospital internship year. The outcome was job stress as a house officer; predictor variables included individual factors at medical school and work-related factors during internship. A total of 371 (58%) responded at both time points. Adjusted predictors of job stress were: vulnerability (neuroticism) personality trait (beta 1.7 [95% CI, 0.94 to 2.5]); perceived recording skills (beta -0.43 [-0.78 to -0.08]); number of hours of sleep when on call (beta -2.3 [-3.6 to -1.0]); and learning environment on the hospital wards (beta -0.56 [-0.82 to -0.30]) (see table 2). The vulnerability trait was especially important among the female interns. The predictors explained 29% of the total variance in the model; personality contributed 16% of the variance, perceived recording skills 4% and the organizational factors measured in the internship year explained 9%. In terms of prevention, both individual factors (personality trait and perceived skills) and organizational work-related factors (sleep deprivation and learning environment on the wards) should be considered.

Adult↗

Identification with the role of doctor at the end of medical school: a nationwide longitudinal study.

OBJECTIVE: Given the sparse literature on the topic, there is a need to know more about student identification with the role of doctor, particularly with respect to the possible impact of pre-existing and medical school factors. DESIGN AND PARTICIPANTS: Medical students at all 4 Norwegian universities (n = 421) were mailed questionnaires on entry to their medical course (T1). Respondents were surveyed again halfway through (T2) and at the end (T3) of their 6-year courses. The study sample comprised the 236 students who responded on all 3 occasions. RESULTS: No significant variation occurred between medical schools in the level of student identification with the role of doctor, except for a significant gender difference at 1 university. Among pre-existing factors, interpersonal problems and confidence in one's own knowledge had independent impact on role identification controlled for gender, age, parental relationships, personality and mental health. This impact was mediated through perceived stress and perceived recording skills, while confidence in knowledge also maintained impact in the final model. Women had a lower level of role identification, with the strongest impact coming from pre-existing factors like interpersonal problems, fear of encountering demanding work, and confidence in own knowledge. For men, change in perceived medical school stress from T2 to T3 and perceived recording/clinical skills had significant impact on the level of role identification. CONCLUSION: Pre-existing factors, partly mediated through skill acquisition and stressful medical school experiences, influenced role identification. In women, pre-existing factors had a significant impact upon role identification, contrasting with men, whose role identification was more influenced by medical school factors.

Adult↗

Help-seeking for mental health problems among young physicians: is it the most ill that seeks help? - A longitudinal and nationwide study.

OBJECTIVES: The aims of this study were to assess the prevalence of self-reported mental health problems and help-seeking among young physicians, and identify predictors of seeking help. METHODS: A prospective cohort sample of Norwegian medical students (N = 631) were assessed in their final semester (T1), and in the first (T2) and fourth (T3) postgraduate year. The average observation period was 3.6 years. RESULTS: The prevalence of mental health problems that needed treatment over the preceding year was observed to have increased from 11% at T2 to 17% at T3. There was no increase in help-seeking. Longitudinally, 34% reported that they needed treatment on one or several occasions. Adjusted predictors of help-seeking were perceived level of mental health problems and a reality weakness personality trait. CONCLUSION: Those who sought help had higher levels of emotional distress than those who did not. However, higher reality weakness scores predicted lower help-seeking and, therefore, may be a risk factor for avoiding necessary care.

Adult↗

The process of suicidal planning among medical doctors: predictors in a longitudinal Norwegian sample.

BACKGROUND: The suicidal process is a common underlying perspective on suicidal behaviour, but the process has hardly been empirically studied. This study investigates the process from suicidal thoughts to suicidal planning among physicians; an occupational group with a raised risk of suicide. The process is studied in two ways: First, predictors at medical school of postgraduate suicidal planning are identified. Second, the transition from suicidal thoughts to planning over three to four years is explored. METHODS: A nationwide cohort of Norwegian medical students (N=631) were approached initially in their final semester (T1), and then again in the first (T2) and fourth (T3) postgraduate years. The average observation time was 3.6 years. RESULTS: Twenty-eight participants (6%) reported suicidal planning in the postgraduate years. Adjusted predictors at T1 were vulnerability trait (neuroticism), severe depressive symptoms, and negative life events. Among those with previous suicidal thoughts at T1, 13 (8%) reported suicidal planning at T2 or T3. Adjusted predictors of transition from thoughts to planning were reality weakness trait, severe depressive symptoms, and a low level of perceived medical school stress. A minority of the postgraduate planners had sought professional care. LIMITATIONS: The effect of severe depressive symptoms may be overestimated, and the sample size is relatively small. CONCLUSIONS: Common predictors for both postgraduate suicidal planning and transition from thoughts to planning were depressive symptoms and personality traits. Reality weakness was the most decisive trait for aggravation in suicidal ideation, and this personality trait needs further study in suicidal research and clinical awareness.

Adult↗

Personality traits and drinking to cope as predictors of hazardous drinking among medical students.

OBJECTIVE: The purpose of this study was to describe the prevalence and development of drinking to cope and hazardous drinking among medical students and to examine whether various personality traits and drinking to cope predict hazardous drinking. METHOD: In a 6-year prospective study of a nationwide sample of medical students (N = 421) assessments were made by questionnaire at the beginning (T1) and at the end (T2) of each participant's tenure at medical school. A cohort of 272 medical students (56% women) from all medical schools in Norway participated at both T1 and T2. The questionnaires encompassed measures of personality characteristics (Basic Characteristic Inventory) and alcohol-use (hazardous drinking and drinking to cope). RESULTS: The levels of drinking to cope and hazardous drinking were not significantly different between T1 and T2, rising from 9.2% to 11.8% and from 17.7% to 19.2%, respectively. Hazardous drinking at T1 (odds ratio [OR] = 7.0; 95% confidence interval [CI]: 3.2-15.4) and level of control (personality trait) at T1 (OR = 0.7; 95% CI: 0.6-0.9) predicted hazardous drinking at T2 among all the students. Hazardous drinking (OR = 3.5; 95% CI: 1.4-9.0), control (OR = 0.7; 95% CI: 0.6-0.9) and drinking to cope at T1 (OR = 5.0; 95% CI: 1.0-24.1) independently predicted hazardous drinking at T2 among the men, whereas the only predictor among the women was hazardous drinking at T1 (OR = 42.1; 95% CI: 8.1-218.2). CONCLUSIONS: Drinking to cope should be targeted for preventive measures against hazardous drinking, particularly among men. The effects of personality and drinking to cope differ by gender and should be studied further.

Adaptation, Psychological↗

Mental health problems among young doctors: an updated review of prospective studies.

Previous studies have shown the medical community to exhibit a relatively high level of certain mental health problems, particularly depression, which may lead to drug abuse and suicide. We reviewed prospective studies published over the past 20 years to investigate the prevalence and predictors of mental health problems in doctors during their first postgraduate years. We selected clinically relevant mental health problems as the outcome measure. We found nine cohort studies that met our selection criteria. Each of them had limitations, notably low response rate at follow-up, small sample size, and/or short observation period. Most studies showed that symptoms of mental health problems, particularly of depression, were highest during the first postgraduate year. They found that individual factors, such as family background, personality traits (neuroticism and self-criticism), and coping by wishful thinking, as well as contextual factors including perceived medical-school stress, perceived overwork, emotional pressure, working in an intensive-care setting, and stress outside of work, were often predictive of mental health problems. The studies revealed somewhat discrepant findings with respect to gender. The implications of these findings are discussed.

Adaptation, Psychological↗