Association between the level of stress and severity of pain, and factors associated with stress, and perceived knowledge on stress management among university students in Phnom Penh, Cambodia among University Students in Phnom Penh, Cambodia
DOI:
https://doi.org/10.62992/d978bp11Keywords:
Stress, Severity of pain, Factor association, Perceived knowledge, Stress and pain managementAbstract
Background: Stress negatively impacts mental and physical health, often leading to anxiety and hypertension. By identifying key factors, we can better understand the challenges faced by university students in Cambodia and develop targeted solutions to support their mental health and well-being.
Objectives: This study seeks to determine the prevalence of stress and pain among university students in Phnom Penh, and also investigating associated factors with stress levels, determining stress-pain association, and gathering insights into pain management strategies.
Methods: A cross-sectional study was conducted at five universities in Phnom Penh, Cambodia, from September to November 2023. A total of 320 students were selected through simple random sampling, and data was collected using a structured questionnaire administered via face-to-face interviews. Descriptive data were analysed using Excel and SPSS. Univariate analysis was conducted to screen for potential factors associated with high stress, using a chi-squared test. The final multiple logistic regression model retained only factors that are significantly associated with stress (P<0.05).
Results: Findings revealed that stress levels were significantly higher in female students (63.6%) compared to males (42.7%), and gender was strongly associated with high stress levels (P<0.001). Students who said something negatively to themselves were 3.51 times more likely to experience high stress (95% CI: 2.14-5.75, P<0.001) and students with insufficient sleep had a 2.82 times higher risk of high stress (95% CI: 1.78-4.45, P<0.001). Acute pain was the most prevalence among participants, and we found that all type of pain were associated with high stress (P<0.05).
Conclusion: This study demonstrates significant stress levels among university students in Phnom Penh, driven by both internal and external factors. Universities should implement comprehensive support programs to mitigate stress and pain management to improve student well-being. Also, the impact of pain management by self-medication with analgesic.
References
Kranner I, Minibayeva FV, Beckett RP, Seal CE. What is stress? Concepts, definitions and applications in seed science. The New phytologist. 2010;188(3):655-73.
Fuad M, Nasir B, Qader M, Bakar M, Elnajeh M, Abdullah M. Prevalence and Risk Factors of Stress, Anxiety and Depression among Medical Students of a Private Medical University in Malaysia. Education in Medicine. 2015;7:52.
Suchday S, Ewart C, Friedberg J. Urban Stress and Health in Developing Countries: Development and Validation of a Neighborhood Stress Index for India. Behavioral medicine (Washington, DC). 2006;32:77-86.
Al-Qahtani MF, Alsubaie ASR. Investigating Stress and Sources of Stress Among Female Health Profession Students in a Saudi University. Journal of multidisciplinary healthcare. 2020;13:477-84.
Cong X, Wu J, Vittner D, Xu W, Hussain N, Galvin S, et al. The impact of cumulative pain/stress on neurobehavioral development of preterm infants in the NICU. Early human development. 2017;108:9-16.
Bernier Carney KM, Young EE, Guite JW, Starkweather AR. A Systematic Review of Biological Mechanisms and Chronic Pain Outcomes During Stress Reduction Interventions. Biological research for nursing. 2020;22(2):205-16.
White RS, Jiang J, Hall CB, Katz MJ, Zimmerman ME, Sliwinski M, Lipton RB. Higher Perceived Stress Scale Scores Are Associated with Higher Pain Intensity and Pain Interference Levels in Older Adults. Journal of the American Geriatrics Society. 2014;62(12):2350-6.
Panigrahi A, Behera BK, Sarma NN. Prevalence, pattern, and associated psychosocial factors of headache among undergraduate students of health profession. Clinical Epidemiology and Global Health. 2020;8(2):365-70.
Srirug P, Jongjit K, Muansri O, Somton Y, Kongbankhong N, Sengsoon P. Prevalence and factor associated work-related musculoskeletal disorders of students in virtual classroom. Heliyon. 2023;9(8):e18461.
Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-82.
Stress Management - Symptoms, Causes & Management: SingHealth; [cited 2024 Sep 3]. Available from: https://www.singhealth.com.sg/patient-care/conditions-treatments/stress-management.
Stress Management Parkview Health; [cited 2024 Sep 3]. Available from: https://www.parkview.com/blog/stress-management?blogId=425dc420-7592-4e26-86b8-22b30ef9fd31.
Bouchoucha M, Devroede G, Deutsch D, Airinei G, Sabate JM, Benamouzig R. Self-Perceived Stress Is Associated With Chest Pain and Personality in Patients With Refractory Functional Gastrointestinal Disorders. The Journal of nervous and mental disease. 2022;210(5):342-7.
Hamaideh SH. Stressors and reactions to stressors among university students. The International journal of social psychiatry. 2011;57(1):69-80.
The Need to Promote Mental Health Awareness among Cambodian University Students – Cambodian Education Forum; [cited 2024 Sep 3]. Available from: https://cefcambodia.com/2021/05/01/the-need-to-promote-mental-health-awareness-among-cambodian-university-students/.
Goal 3: Good health and well-being - The Global Goals: The Global Goals; [cited 2024 Sep 3]. Available from: https://www.globalgoals.org/goals/3-good-health-and-well-being/.
Naing L, Nordin RB, Abdul Rahman H, Naing YT. Sample size calculation for prevalence studies using Scalex and ScalaR calculators. BMC Medical Research Methodology. 2022;22:209.
7.5 Calculating the Sample Size for a Confidence Interval – Introduction to Statistics [cited 2024 Sep 3]. Available from: https://ecampusontario.pressbooks.pub/introstats/chapter/7-5-calculating-the-sample-size-for-a-confidence-interval/.
Perceived Stress Scale [cited 2024 Sep 3]. Available from: https://www.das.nh.gov/wellness/docs/percieved%20stress%20scale.pdf.
Faces Pain Scale Physiopedia; [cited 2024 Sep 3]. Available from: https://www.physio-pedia.com/Faces_Pain_Scale.
Möckel L, Gerhard A, Mohr M, Armbrust CI, Möckel C. Prevalence of pain, analgesic self-medication and mental health in German pre-hospital emergency medical service personnel: a nationwide survey pilot-study. International archives of occupational and environmental health. 2021;94(8):1975-82.
Stress: World Health Organization; [cited 2024 Sep 3]. Available from: https://www.who.int/news-room/questions-and-answers/item/stress.
Alahmed SK, Mohyeldin AM, Alshammari A, Alshammari ZF, Alhamdi RA, Alghaslan SA, et al. Knowledge and Awareness Regarding Osteoarthritis and Its Factors in Hail Region, Saudi Arabia. Cureus. 2023;15(3):e36557.
Laranjeira CA. The effects of perceived stress and ways of coping in a sample of Portuguese health workers. J Clin Nurs. 2012;21(11-12):1755-62.
Alosaimi FD, Kazim SN, Almufleh AS, Aladwani BS, Alsubaie AS. Prevalence of stress and its determinants among residents in Saudi Arabia. Saudi medical journal. 2015;36(5):605-12.
Mirza AA, Milaat WA, Ramadan IK, Baig M, Elmorsy SA, Beyari GM, et al. Depression, anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study. Neurosciences (Riyadh, Saudi Arabia). 2021;26(2):141-51.
Jia Yuin F, Yee T. Prevalence and Determinants of Perceived Stress among Undergraduate Students in A Malaysian University. Journal of the University of Malaya Medical Centre. 2018;21:1-5.
Aboalshamat K, Jawhari A, Alotibi S, Alzahrani K, Al-Mohimeed H, Alzahrani M, Rashedi H. Relationship of self-esteem with depression, anxiety, and stress among dental and medical students in Jeddah, Saudi Arabia. Journal of International Medicine and Dentistry. 2017;4:61-8.
Mofatteh M. Risk factors associated with stress, anxiety, and depression among university undergraduate students. AIMS Public Health. 2021;8(1):36-65.
Timmers I, Quaedflieg C, Hsu C, Heathcote LC, Rovnaghi CR, Simons LE. The interaction between stress and chronic pain through the lens of threat learning. Neuroscience and biobehavioral reviews. 2019;107:641-55.
Wyns A, Hendrix J, Lahousse A, De Bruyne E, Nijs J, Godderis L, Polli A. The Biology of Stress Intolerance in Patients with Chronic Pain-State of the Art and Future Directions. J Clin Med. 2023;12(6).
Tesarz J, Baumeister D, Andersen TE, Vaegter HB. Pain perception and processing in individuals with posttraumatic stress disorder: a systematic review with meta-analysis. Pain reports. 2020;5(5):e849.
Sahranavard S, Esmaeili A, Salehiniya H, Behdani S. The effectiveness of group training of cognitive behavioral therapy-based stress management on anxiety, hardiness and self-efficacy in female medical students. J Educ Health Promot. 2019;8:49.
J. AB. Holistic Approaches to Stress Management: Understanding, Prevention, and Coping Strategies. Research invention journal of current research in humanities and social sciences 2024;3(1):83-7.
Tse MYM, Tang A, Budnick A, Ng SMS, Yeung SSY. Pain and Pain Management among University Students: Online Survey and Web-Based Education. Cyberpsychology, Behavior, and Social Networking. 2017;20(5):305-13.
Kim HJ, Boo S, Meeker TJ. Pain Prevalence, Management and Interference Among University Students in South Korea: An Exploratory Cross-Sectional Study. Journal of pain research. 2021;14:2423-31.
Samorek W, Przylepa J, Urbaniak J, Rogala A, Pilimon A, Błochowiak K, Błochowiak K. Assessment of Preferences in Taking Painkillers among Students of Medicine, Dentistry, and Pharmacy: A Pilot Study. Healthcare (Basel, Switzerland). 2024;12(2).
Downloads
Published
License
Copyright (c) 2025 International Journal of Public Health Asia Pacific
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
International Journal of Public Health Asia Pacific (IJPHAP) is licensed under a Creative Commons Attribution-Non-Commercial-No Derivatives 4.0 international (CC BY-NC-ND 4.0) license, unless otherwise stated. Please read our Policies page for more information on Open Access, copyright, and permissions.
