Psychological and Physical injuries among medical students in Wayanad district Kerala - A cross sectional study

 

Sudarshan B P

 

Abstract               The main objective of the study is to observe the injuries in medical students. This cross sectional study was carried out at DM WIMS, Wayanad, Kerala from October 2017 to December 2017. A pilot study was done initially comprising 40 students to find out the feasibility and also to validate the questionnaire following which the main study was conducted and statistical analysis was done. Among 685 medical students 68% were females. 32.41% of the total population was injured and 40.5% of this was during the first year MBBS. 83.33% of the injuries occurred within the campus and 51.35% were sports injuries. Most common cause that provoked injury was fall (26.57%) and football (22.52%). Lower limb was most commonly affected (49.09%) followed by upper limb (19.36%). Among all Injuries 36.03% were sprains, 20.27% were simple wounds and 9.45% were fractures. Out of the total injuries 59% needed hospitalization in which 25% was treated IP. Apart from this, 17% of the total population had psychological injuries of which love failure (32.47%) holds the major share. Injuries were most common among first years (57.26%) with major causes being love failure (32.47%) and home sickness (24.78%).

Key words: Medical students, Physical injury, psychological injury.

 

INTRODUCTION

Injuries among medical students are of at most importance. Injuries may be physical or psychological. Sports are one of the most common and widespread recreational activity and a common cultural element of modern society.

Sports play a significant role in education, socialization, community spirit, health and wellbeing. Sports and exercise contributes both to the physical and mental health of an individual. But like no rose is without thorns, participation in sports also entails risk of injury for athlete’s right from professional level down to amateurs. Also medical field related injuries and accidents accounts major part of physical injuries. Sport injury may be regarded as an inseparable part of sport activities. Sports or similar physical activities promote physical fitness and cognition. ^1-5

We are living in a world of competitions and like adding fuel to flame academic matters like exams and grading contributes further stress to students. We are social beings and are liable to family values and emotions. So anything related to our kith and kin affect our life and psychologically harm us. Our study is typically focused on physical and psychological injuries among our students.

 

MATERIALS AND METHODS

Study setting

The present study was carried out among the undergraduate medical students [N=685] (first year to final year) of DM WIMS medical college, Meppadi, Wayanad, Kerala, India.

Study design: Cross sectional study

Study period: October-December 2017

Sample size: Universal sampling (All the students who gave consent for study, N=685)

Inclusion criteria: All the students who participated in the study with consent

 

Exclusion criteria: Those students who are not willing /absent

METHOD OF DATA COLLECTION

The study was conducted by administering the questionnaire during theory class hours not disturbing the regular classes. Students who were not present on that day were met personally and administered the questionnaire. A pilot study was done prior to the study among 40 participants to find out the feasibility and validate the questionnaire.

Data regarding gender, year of study, presence of any injury after joining MBBS whether it was within the campus or not, site of injury, type of injury, requirement of hospitalization and psychological injury has been collected

STATISTICAL ANALYSIS

Data was entered into Microsoft excel data sheet and was analyzed using SPSS 22 version software. Categorical data was represented in the form of Frequencies and proportions.

 

RESULTS

Total 685 students participated in our study. Majority of population who participated in the study were females. Out of 685 students 465 (67.8%) student were female and 220 (32.2%) were male.

 

Table 1: Prevalence of Physical Injury

32% of the population was found to have some form of physical injury.

 

Table 2: Prevalence of Psychological injury

17% of the population was found to have some form of psychological injury.

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Table 3: Frequency Distribution of subjects according to Number of times the physical injury occurred

Majority of the subjects 59.9% had physical injury once followed by 15.76% of the subjects had physical injury twice, 15.16% of the subjects had physical injury more than 3 times. 83% of them were injured within the campus followed by 13.51% outside the campus and 3.15% in both.

 

Table 4: Distribution of cause of physical injury among the students

 Majority of the population 26.57% had injury by fall, followed by 22.52% had injury by football, 23.87% had injury by others include Kho-Kho, Throw ball, Fighting, needle stick injuries and a combination of football and fighting. 59% among the injured student required hospitalization.

 

Table 5: Distribution of subjects according to Type of physical Injury

Majority of the population was found to have had a sprain (36%). Others include a combination of simple wound, sprain and simple wound, sprain, contusion

Table 6: Distribution of subjects according to Reason for psychological injury

Reason	Frequency	Percentage
Home sickness	29	24.78
Ragging	6	5.12
Love failure	38	32.47
Depression	17	14.52
Others	27	23.07
Total	117	100

Majority of the subjects 32.47% had love failure as a reason for psychological injury, followed by 24.78% had home sickness as a reason for psychological injury, 14.52% had depression as a reason for psychological injury, 5% had ragging as a reason for psychological injury.

Majority of the psychological injuries occurred in the first year, of which most common is homesickness (20%). In second year it was financial issues etc. In third and fourth years, depression seems to be the major cause of psychological injury.

 

DISCUSSION

Our study shows that physical injuries accounted for (67.59%) from which sports injury was common among medical students (51.35%). Similar findings were seen in a study undertaken at a medical college in Nepal (1). Among all the injuries, most common cause for injury was fall which accounts for 26.57% followed by football (22.52%) which is less compared to the study in medical college Nepal 36.1%⁶.

In sports injuries, most common cause was football (22.52%), followed by cricket (4.05%), volleyball (3.6%). Apart from sports, causes for injuries according to the study are travel (5.8%), dance (4.95%). Other injuries involved are Kho-Kho, Throw ball and needle stick injuries which accounts for 23.87%. Various studies across the globe also suggested that contact games like football, basketball has the highest chances of causing injuries. Lower limb was commonly affected in 49.09%. A study done in Nepal Medical College ⁶ also has reported that the lower limbs are commonly affected by sports. Sprain was the commonest form of injury followed by simple wound and fracture. In about half of the cases (59%) hospitalization was required. This study is unlike the study done in Nepal Medical College, where about one fourth of the cases required hospitalization. Most of the students got admitted in orthopedics department.

This study also includes psychological injuries, which reveals that only 17.08% of the participants suffered from psychological injuries. This study was unlike the cross-sectional study from Syria, where majority of students had psychological injuries ⁷. Among this 17.08% of the students who had psychological injuries, more than half of the students were from first year. Most common cause of psychological injuries was due to love failure which accounts for 32.47% followed by home sickness(24.78%).Prevalence of depression was only 14.52% which is very less compared to the study from Syria ⁷ where prevalence of depression was very high which accounts for 60.6%.Around 23% suffered from Other causes like family issues ,financial and management problems The study showed that the major cause for psychological injuries in first year MBBS was love failure which accounts for 31.34% followed by homesickness (30%).In second year the major cause was due to family issues, financial problems and management issues(which was included in others) which accounts for 35%, followed by homesickness (30.43%).

 

CONCLUSION

From our study, physical injuries account for the maximum number of injuries among medical students. Among physical injuries fall is the leading cause, followed by sports injuries. Descriptive Statistics and injury rates show that football is the leading cause for sport injuries. Majority among those injured sustained injuries in their lower limb; the type of injury being mostly sprain. Awareness regarding the risk of sports injury and knowledge about its prevention should be promoted. Preventive measures like insoles, external joint supports and specific training programs may help reduce the risk of injuries. Our study also shows incidence of psychological injuries among which, love failures was the leading cause followed by homesickness and that too maximum in the first year. Counseling in this regard can help reduce this problem to a large extent

 

RECOMMENDATIONS

 It is important to keep injuries to a minimum especially those avoidable which occur due to extreme carelessness of students.

To prevent this it is essential to educate students about the various safety precautions (like protective gear), avoid indulging in contact sports in the presence of a preexisting injury etc.

Proper coaching about the rules of the game is required as knowing the dos and don’ts of the game can prepare you in anticipating the injury.

Early recognition of injury and prompt treatment. A composed mind is needed to take quick and necessary decisions so that complications can be prevented. Meditation, motivation, counseling can help reduce psychological injuries to an extent. A sound mind and a sound body are inevitable for a healthy life.

 

ACKNOWLEDGEMENTS

Authors would like to acknowledge all the subjects participated in the study. Everyone who contributed in the completion of the study including the technical staff

 

REFERENCES

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