{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T14:41:25Z","timestamp":1793457685424,"version":"4.5.0"},"update-to":[{"DOI":"10.12688\/f1000research.75879.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000}},{"DOI":"10.12688\/f1000research.75879.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000}}],"reference-count":29,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"None"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    <ns3:bold>Background:<\/ns3:bold>\n                    Medical students are subjected to various stressors throughout their training, which has a considerable impact on their physical and mental health. Some students have positive ways of coping, while others take to maladaptive coping measures. This study aims to assess severity, sources of stress, and coping strategies among medical students of a non-Western low-income country from South Asia.\n                    <ns3:bold>Methods:<\/ns3:bold>\n                    A self-administered questionnaire-based cross-sectional study was carried out. Demographic variables were collected and stress level was assessed using PSS 14 (Perceived Stress Scale 14). The sources of stress were assessed using MSSQ (Medical Student Stressor Questionnaire) and coping strategies were evaluated using the Brief-Coping Orientation to Problems Experienced 28.\n                    <ns3:bold>Results:<\/ns3:bold>\n                    The response rate was 95%. The mean PSS score was 27.85. Overall, 55% of students were stressed (male 52%, female 60%), the difference among gender was not significant. Basic science students perceived higher levels of stress than clinical clerkship students. Academic related stressors caused higher stress, whereas other variables caused moderate stress. The major stressors were examinations, inadequate time to study, poor marks, extensive amount of learning content, and the need to performing well in the exam. The five most common coping strategies used were active coping, acceptance, planning, self-distraction, and instrumental support. The least common coping mechanism was substance use. All MSSQ domains positively correlated with the total PSS score. Students with higher PSS scores were likely to use behavioral disengagement, venting, and self-blame as the primary coping strategies.\n                    <ns3:bold>Conclusions:<\/ns3:bold>\n                    Stress level among the medical students is high and mainly in relation to academia. Inadequate guidance from teachers contributed significantly. Stressed students were likely to use maladaptive coping strategies. Strategies to enhance teacher-student communication and adaptive coping measures should be implemented. Further studies should be done to evaluate the effects of stress on the academic outcomes of students.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.75879.3","type":"journal-article","created":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T07:00:07Z","timestamp":1704265207000},"page":"167","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Perceived stress, sources of stress and coping strategies among undergraduate medical students of Nepal: a cross-sectional study"],"prefix":"10.12688","volume":"11","author":[{"given":"Ujjawal","family":"Paudel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anima","family":"Parajuli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivanee","family":"Kumari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9957-9160","authenticated-orcid":false,"given":"Saroj","family":"Adhikari Yadav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kedar","family":"Marahatta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2024,1,3]]},"reference":[{"key":"ref1","article-title":"Oxford Dictionary Online.","year":"n.d."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"354-373","DOI":"10.1097\/00001888-200604000-00009","article-title":"Systematic Review of Depression, Anxiety, and Other Indicators of Psychological Distress Among U.S. and Canadian Medical Students.","volume":"81","author":"L Dyrbye","year":"2006","journal-title":"Acad. 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The Social Psychology of Health: Claremont Symposium on Applied Social Psychology Newbury Park, CA: Sage Spacapam S, Oskamp S.","author":"S Cohen","year":"1988"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.6084\/m9.figshare.c.5757833.v1","article-title":"Underlying data of \u201cPerceived Stress, Sources of Stress and Coping Strategies among Undergraduate Medical Students of Nepal\u201d.","author":"S Adhikari Yadav","year":"2021"}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/11-167\/v3\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-167\/v3\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-167\/v3\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T23:25:19Z","timestamp":1725837919000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/11-167\/v3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,3]]},"references-count":29,"URL":"https:\/\/doi.org\/10.12688\/f1000research.75879.3","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.75879.2","asserted-by":"subject"},{"id-type":"doi","id":"10.12688\/f1000research.75879.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.156923.r277561","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.156923.r277561","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,3]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/11-167\/v3#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.155814.r206200, Bijit Biswas, Department of Community and Family Medicine, All India Institute of Medical Sciences, Deoghar, Jharkhand, 26 Sep 2023, version 2, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/11-167\/v2#referee-response-206200","order":0,"name":"referee-response-206200","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.155814.r206199, Alicia Fournier, Universite de Bourgogne, Dijon, Bourgogne-Franche-Comt\u00e9, 29 Sep 2023, version 2, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/11-167\/v2#referee-response-206199","order":1,"name":"referee-response-206199","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Saroj Adhikari Yadav<\/b>; \n<i>Posted: 02 Oct 2023<\/i>; Dear Reviewer,  We would like to express our gratitude for your thoughtful and comprehensive review of our manuscript. Your feedback has been invaluable in improving the quality and clarity of our work. We have addressed each of your concerns and also incorporated other reviewers' and study mentors' feedback in the revised version of the manuscript.  In the abstract: The number of participants included in the analyses has been mentioned. The reference group in the results section has been clarified. Statements in the conclusion now align with the corresponding results.  In the Method section: Information on the categorization of the MSSQ scores has been done in a standard manner, and relevant references have been included. The manuscript now accurately reflects the statistical tests we performed, and the results of these analyses have been appropriately presented in the results section.  In the results section: The Brief-COPE section has been revised to provide a clearer explanation of our goals, and the Table 6 explanation has been rewritten for better clarity. The wording has been adjusted and rephrased for clarity. References to statistical significance have been corrected. We have compared stressed and unstressed students on the MSSQ stress factors and reported the findings as relevant. We have clarified our use of the terms &quot;maladaptive&quot; and &quot;adaptive&quot; strategies and reviewed the concept as suggested.  In the discussion section: Statistical results have been kept only in necessary sentences of the discussion for clarity of the readers. Differences are only mentioned when statistical significance is found or is required to be mentioned due to statistically significant differences in other studies but not ours (like stressed based on gender). The mentioned result and its presence in the results section have been reviewed.  We can see your review has significantly improved the manuscript's overall quality and accuracy. Your detailed and meticulous feedback has been instrumental in this process, and we genuinely appreciate your time and effort in reviewing our work. Thank you for your help and support.  Sincerely, Dr Adhikari Yadav, MD.","URL":"https:\/\/f1000research.com\/articles\/11-167\/v3#referee-comment-10324","order":2,"name":"referee-comment-10324","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.156923.r277561, Prakash Banjade, Manipal College of Medical Sciences, Pokhara, 09 Sep 2024, version 3, indexed","URL":"https:\/\/f1000research.com\/articles\/11-167\/v3#referee-response-277561","order":3,"name":"referee-response-277561","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}