JCDR - Register at Journal of Clinical and Diagnostic Research
Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X
Dentistry Section DOI : 10.7860/JCDR/2017/25358.10371
Year : 2017 | Month : Aug | Volume : 11 | Issue : 8 Full Version Page : ZC33 - ZC38

An Insight into Spiritual Health and Coping Tactics among Dental Students; A Gain or Blight: A Cross-sectional Study

Kuldeep Dhama1, Ritu Gupta2, Ashish Singla3, Basavaraj Patthi4, Irfan Ali5, LAV Kumar Niraj6, Jishnu Krishna Kumar7, Monika Prasad8

1 Tutor, Department of Public Health Dentistry, Divya Jyoti College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India.
2 Senior Lecturer, Department of Public Health Dentistry, Divya Jyoti College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India.
3 Reader, Department of Public Health Dentistry, Divya Jyoti College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India.
4 Professor and Head, Department of Public Health Dentistry, Divya Jyoti College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India.
5 Tutor, Department of Public Health Dentistry, Divya Jyoti College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India.
6 Tutor, Department of Public Health Dentistry, Divya Jyoti College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India.
7 Tutor, Department of Public Health Dentistry, Divya Jyoti College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India.
8 Tutor, Department of Public Health Dentistry, Divya Jyoti College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India.


NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR: Dr. Kuldeep Dhama, Tutor, Department of Public Health Dentistry, Divya Jyoti College of Dental Sciences and Research, Niwari Road, Modinagar-201204, Ghaziabad, Uttar Pradesh, India.
E-mail: dhama.viccky50@gmail.com
Abstract

Introduction

Spiritual health is the youngest dimension of health which affects the coping skills of the individual and may help the dental students who are the caregivers of the future, to overcome crisis situation with time.

Aim

To measure the association between spiritual health and coping skills among the dental students of private dental college.

Materials and Methods

A questionnaire based cross-divtional study was conducted to assess the spiritual health status using Spiritual Health Assessment Scale (SHAS) and coping skills using Adolescent Coping Orientation for Problem Experiences (ACOPE) scale among the 389 dental students of different academic years in a private dental college. The data obtained was subjected to descriptive statistics and means were compared using independent t-test and one-way ANOVA.

Results

The mean age of the study participants was 22.8±3.17 years. Majority of the students had fair spiritual health score (74.55%). Of the coping strategies dimension, highest mean score was observed in seeking diversions (3.60±1.40) and the least mean score was observed in engaging in demanding activities (2.67±1.41). Statistically significant association was seen between dimension of coping behaviour and spiritual health (p≤ 0.05).

Conclusion

The present study highlights that spiritual health plays a central role and influences the coping strategies in human health. The spiritual health can continuously compensate with other health like mental, physical and social well-being.

Keywords

Introduction

Modern medicine is often accused for it’s engrossment with the study of disease and neglect of the study of health. Spirituality is something everyone can experience, assists us to see meaning and purpose in the things we value, can bring hope and healing in times of suffering and loss and encourages us to seek the best relationship with ourselves, others and what rests beyond [1].

Spiritual health has been considered the fourth dimension of health. It contributes to the recognition of one’s full potential, meaning and use of life and fulfilment from within. Such a state of being is attainable through self evolution, self actualisation and transcendence [2]. Spiritual health has been regarded as a vital component and fourth dimension of health as perceived by World Health Organisation. WHO Executive Board (1998) projected that the preamble of the constitution should be improved as follows: “Health is a dynamic state of complete physical, mental, spiritual and social well being and not merely the absence of disease or infirmity” [3].

Existing literature reveals that spirituality broadly focuses on being deeply involved in day to day activities of the universe, at the same time being detached, where there is a continuous endeavour for developing universality of love, compassion and calm to replace anger, jealousy, ego and hate, resulting in usage of one’s abilities to the fullest and even transcending beyond that. It opens the process of ‘becoming’ to ‘being’ and extending ‘beyond’ to attain fullest positive health [2].

Dental education is very meticulous and requires competitive training to develop skills to treat patients. Thus, dental students face myriad stresses from getting into dental college, to clinical training, to dealing with emotions inherent in doctor-patient relationship, to increased workload which can lead to poor health, burnout and development of adverse habits like alcoholism, smoking and substance abuse. It is therefore important for dental students to cope with their stress.

Coping has been defined as the “cognitive and behavioural efforts to control, subjugate, or endure the inner and/or external demands that are created by the stressful transaction” [4]. Spirituality can act as an important coping resource, as development of spiritual health will facilitate holistic learning and improve the overall physical and psychological wellbeing and also improve the quality of life [5,6]. Sen S et al., found spiritual health was significantly related to adaptive coping among medical student [5].

Dental student are prone to academic stress especially the fresher’s due to transitional nature of college life as they feel homesick and are required to take responsibilities on their own. Studies have found stress among nursing and dental students. A study by Kumar R and Nancy among nursing students found moderate and severe level of stress among 34% and 33% of the students resecptevely [7]. Similarly, a study conducted among first year student of a dental school in Califonia by Burk DT and Bender DJ found the most commonly perceived problem by dental students were of an emotional nature relating acadmic performance. Adjusting to rigorous academic expectations may lead to increased stress [8]. Thus, the present study was conducted to the measure the spiritual health status, coping skills and association between the two among the dental student of private dental college in Modinagar, Uttar Pradesh, India.

Materials and Methods

A questionnaire based cross-sectional study was conducted among undergraduate and postgraduate students of a private dental college in Modinagar, Uttar Pradesh, India. A total 450 students were approached to be part of the study from April 2016 to June 2016. Ethical approval was received from the Institutional review board of Divya Jyoti College of Dental Sciences and Research, Modinagar. The purpose of the study was explained and informed written consent was obtained from all the study participants. Participation in the study was voluntary and confidentiality of data was maintained. Data was collected using a pretested, predesigned, structured questionnaire. Questionnaire comprised of two parts. The first part consisted of demographic data such as name, age, sex, education, living arrangements, religion, parent’s education, type of family, type of residence and adverse habits. The second part measured the Spiritual Health of Individual using Spiritual Health Assessment Scale (SHAS) [9] and coping strategies of individuals using Adolescent Coping Orientation for Problem Experiences (ACOPE) Scale [10].

The SHAS scale contains three domains of spiritual health v.i.z. self development, self actualization and self realization. Each of the domains has seven items in as shown in [Table/Fig-1].

spiritual health assessment scale domain and items [9].

DomainItem
Self developmenta. Prudence i.e., wisdom of discrimination.b. Gratitude i.e., respect others.c. Generosity i.e., feeling of equity.d. Charity i.e., helping people.e. Patience i.e., calm in adverse.f. Self control i.e., able to control emotions.g. Moral Actions i.e., act according to moral values.
Self actualizationa. Introspection: How much you thought about your own self.b. Purpose of life: How much you know about purpose of your life.d. Way of life: How much you know about the way you want to live your life.e. Strengths: How much you know about your own strength.f. Weaknesses: How much you know about your own weaknesses.g. Solutions: How much you know about solutions to deal with your weaknesses.h. End of life: How much you thought about end of your life.
Self realizationa. Thoughtlessness: Zero state of mind.b. Yoga: Feeling one with yourself.c. Satisfaction: Feeling self-satisfaction i.e., completeness.d. Freedom: Feeling of eternal freedom.e. Nigum facts: Eternal facts understanding.f. Bliss: Feeling of pleasure without outside objects.g. Sixth Sense: Intrusions and inspirations from one’s inner self.

Each item is scored on 5 point Likert scale from score ‘1’ for ‘never’ to score ‘5’ for ‘always’. Each domain score ranges from ‘7’ to ‘35’ and the overall spiritual health score ranges from ‘21’ to ‘105’. Interpretation of spiritual health scale is shown in [Table/Fig-2].

Interpretation of spiritual scale.

Level of spiritual healthScoring between
Poor spiritual health21 to 49
Fair spiritual health50 to 77
Good spiritual health78 to 105

Coping was assessed using a scale developed by Patterson and Mc-Cubbin (1987) [10]. It is a 5-point likert scale varying from 1=never, 2=hardly, 3=sometimes, 4=often to 5=most of the time. It contains total 54 items under 12 domains.

The questionnaire was pretested by conducting a pilot study on 45 of the study participants and they were not included in the main study. Reliability of the questionnaire was analyzed by using test-retest, and the values of measured Kappa (k) and weighted Kappa (k) was 0.85 and 0.92 respectively. Internal consistency of the questionnaire was estimated by applying chronbach’s-alpha (α) and the value of α = 0.86 was obtained.

Statistical Analysis

The questionnaires which were submitted were coded and analysis was performed using Statistical Package for Social Sciences (SPSS) 16.0 (SPSS Inc., Chicago, IL, USA) and descriptive test including mean and standard deviation were applied. ANOVA was applied to know association between spiritual health and coping dimensions. The level of significance was set at p-value<0.05.

Results

The questionnaire based study was carried out among the 450 dental students to assess their spiritual health and coping stratigeses. A total of 389 student responded to the questionnaire, generating the response rate of 86.4%.

[Table/Fig-3] shows the sociodemographic characteristics of study participants. The dental students were aged between 18 years to 32 years with the mean age of 22.8 (3.17) years. Majority, 57.06% of the respondents were females. A total of 75.84% students were undergraduates and 24.16% were postgraduates. Majority, 95.37%were unmarried and 53.21% students lived in joint families. Of all the respondents, fathers of 55.01% and mothers of 39.85% were graduates while fathers of 44.99% and mothers of 60.15% were postgraduates.

Sociodemographic data of study subjects.

VariablesNumberPercentage
GenderMale16742.94
Female22257.06
Level of educationGraduate29575.84
Postgraduate9424.16
Living arrangementSingle37195.37
Married184.63
Father’s educationPostgraduate17544.99
Graduate21455.01
Mother’s esducationPostgraduate23460.15
Graduate15539.85
Type of familyJoint20753.21
Nuclear18246.79
Type of residenceHosteller24462.72
Day scholar14537.28
Adverse habitsPresent10326.48
Absent28673.52

[Table/Fig-4] shows the responses and mean scores for each item of various dimensions of spiritual health i.e., self development, self actualization and self realization. Highest mean score was observed for Self development (3.54±1.31) dimension.

Dimension of spiritual health score.

VariablesNever N(%)Hardly N(%)Sometimes N(%)Often N(%)Most of time N(%)MEAN±SD
Self development3.54±1.31
Prudence62 (15.9)49 (12.6)66 (17)100 (25.7)112 (28.8)3.39±1.42
Gratitude15 (3.9)31 (8)80 (20.6)91 (23.4)172 (44.2)3.96±1.14
Generosity50 (12.9)30 (7.7)75 (19.3)129 (33.2)105 (27)3.54±1.31
Charity40 (10.3)39 (10)47 (12.1)182 (46.8)81 (20.8)3.58±1.21
Patience37 (9.5)54 (13.90)46 (11.8)128 (32.9)124 (31.9)3.64±1.31
Self control31 (8)99 (25.4)37 (9.5)137 (35.2)85 (21.9)3.38±1.29
Moral action61 (15.7)54 (13.9)59 (15.2)110 (28.3)105 (27)3.37±1.41
Self actualization3.08±1.36
Introspection75 (19.3)60 (15.4)91 (23.4)81 (20.8)82 (21.1)3.09±1.40
Purpose of life75 (19.3)65 (16.7)87 (22.4)86 (21.1)76 (19.5)3.06±1.39
Way of life37 (9.5)99 (25.4)91 (23.4)85 (21.9)77 (19.8)3.17±1.27
Strength89 (22.9)58 (14.9)54 (13.9)97 (24.9)91 (23.4)3.11±1.49
Weakness103 (26.5)50 (12.9)49 (12.6)100 (25.7)87 (22.4)3.05±1.53
Solution55 (14.1)88 (22.6)89 (22.9)127 (32.6)30 (7.7)2.97±1.19
End of life45 (11.6)76 (19.5)134 (34.4)79 (20.3)55 (14.1)3.06±1.19
Self realization3.10±1.33
Thoughtlessness44 (11.3)92 (23.7)96 (24.7)91 (23.4)66 (17)3.11±1.26
Yoga76 (19.5)58 (14.9)59 (15.2)140 (36)56 (14.4)3.11±1.36
Satisfaction94 (24.2)57 (14.7)65 (16.7)95 (24.4)78 (20.1)3.02±1.47
Freedom83 (21.3)61 (15.7)72 (18.5)102 (26.2)71 (18.3)3.04±1.41
Nigum facts39 (10)136 (35)58 (14.9)101 (26)55 (14.1)2.99±1.25
Bliss43 (11.1)79 (20.3)87 (22.4)127 (32.6)53 (13.6)3.17±1.22
Sixth sense33 (8.5)86 (22.1)71 (18.3)103 (26.5)96 (24.7)3.37±1.29

[Table/Fig-5] shows 4.12% of the respondents had poor spiritual health with a mean score of 48.44±0.81, 74.55 % of the respondents had fair spiritual health with a mean score of 65.36±8.65 and 21.33% had good spiritual health with a mean score of 81.52±3.23.

Spiritual health score according to grading.

Level of Spiritual HealthN(%)Mean
Poor spiritual health16 (4.12)48.44±0.81
Fair spiritual health290 (74.55)65.36±8.65
Good spiritual health83 (21.33)81.52±3.23

[Table/Fig-6] shows the responses and mean scores for various domains of coping strategies. Seeking diversions (3.60±1.40) was the most commonly used coping strategy whereas engaging in demanding activites (2.67±1.41) was the least commonly used coping strategy.

Coping strategies used by dental students.

Coping StrategiesNever N(%)Hardly N(%)Sometimes N(%)Often N(%)Most of time N(%)MEAN±SD
Ventilating feelings3.18±1.23
Say mean things to people be sarcastic45(11.6)52(13.4)132(33.9)106(27.2)54(13.9)3.19±1.18
Swear19(4.9)87(22.4)89(22.9)117(30.1)77(19.8)3.38±1.17
Let off stream by complaining to your friends47(12.1)39(10)117(30.1)105(27)81(20.8)3.34±1.25
Get angry and yell at people39(10)91(23.4)104(26.7)116(29.8)39(10)3.06±1.15
Let off stream by complaining to family members50(12.9)54(13.9)74(19)156(40.1)55(14.1)3.29±1.24
Cry65(16.7)85(21.9)77(19.8)84(21.6)78(20.1)3.06±1.38
Seeking diversions3.60±1.40
Go to movie37(9.5)31(8)111(28.5)79(20.3)131(33.7)3.61±1.28
Play video games60(15.4)83(21.3)70(18)52(13.4)124(31.9)3.25±1.47
Use drugs166(42.7)62(15.9)42(10.8)68(17.5)51(13.1)2.42±1.49
Listen to music, stereo or radio49(12.6)60(15.4)68(17.5)61(15.7)151(38.8)3.53±1.44
Read48(12.3)42(10.8)65(16.7)119(30.6)115(29.6)3.54±1.34
Go shopping, buy things you like42(10.8)35(9)78(20.1)102(26.2)132(33.9)3.63±1.32
Watch T.V45(11.6)45(11.6)109(28)99(25.4)91(23.4)3.38±1.27
Sleep32(8.2)40(10.3)65(16.7)180(46.3)72(18.5)3.57±1.14
Relaxing3.54±1.30
Work on a hobby41(8.2)53(13.6)79(20.3)84(21.6)132(33.9)3.55±1.35
Eat food33(8.5)54(13.9)42(10.8)126(32.4)134(34.4)3.70±1.29
Day dream40(10.3)63(16.2)91(23.4)91(23.4)104(26.7)3.40±1.31
Ride around in the car32(8.2)78(20.1)115(29.6)96(24.7)68(17.5)3.23±1.19
Self reliance3.05±1.39
Get a job or a work harder82(21.1)60(15.4)64(16.5)118(30.3)65(16.7)3.06±1.40
Try to think of good things66(17)49(12.6)49(12.6)101(26)112(28.8)3.37±1.44
Try to make your own decisions79(20.3)46(11.8)59(15.2)89(22.9)116(29.8)3.30±1.50
Organize your life that what you have to do93(23.9)44(11.3)40(10.3)134(34.4)78(20.1)3.15±1.48
Get more involved in activities in school22(5.7)100(25.7)71(18.3)106(27.2)90(23.1)3.37±1.24
Tell yourself that problem(s) is not important43(11.1)44(11.3)87(22.4)130(33.4)85(21.9)3.44±1.25
Developing social support3.29±1.44
Blame others for what’s going on61(15.7)58(14.9)73(18.8)97(24.9)100(25.7)3.30±1.40
Apologize to people48(12.3)43(11.1)82(21.1)130(33.4)86(22.1)3.42±1.28
Try to help other people solve their problems79(20.3)32(8.2)62(15.9)105(27)111(28.5)3.35±1.47
Try to keep up friendships or make new friends89(22.9)45(11.6)49(12.6)102(26.2)104(26.7)3.22±1.52
Say nice things to others89(22.9)59(15.2)51(13.1)99(25.4)91(23.4)3.11±1.50
Talk to friends about how you feel72(18.5)66(17)55(14.1)104(26.7)92(23.7)3.20±1.44
Solving family problems3.22±1.30
Talk to your father about what bothers you66(17)65(16.7)85(21.9)60(15.4)113(29)3.23±1.45
Try to reason with parents and talk things out, compromise37(9.5)45(11.6)105(27)139(35.7)63(16.2)3.38±1.16
Go along with parents request30(7.7)54(13.9)116(29.8)147(37.8)42(10.8)3.30±1.08
Do things with your family59(15.2)70(18)74(19)95(24.4)91(23.4)3.23±1.38
Talk to a brother or sister about how you feel31(8)62(15.9)52(13.4)81(20.8)163(41.9)3.73±1.35
Talk to your mother about what bothers you25(6.4)86(22.1)71(18.3)99(25.4)108(27.8)3.46±1.27
Avoiding2.68±1.46
Smoke135(34.7)46(11.80)77(19.8)68(17.5)63(16.2)2.69±1.49
Use drugs prescribe by doctors37(9.5)52(13.4)97(24.9)123(31.6)80(20.6)3.40±1.22
Try to stay away from home as much as possible81(20.8)56(14.4)75(19.3)105(27)72(18.5)3.08±1.40
Try to see the good things60(15.4)59(15.2)44(11.3)123(31.6)103(26.5)3.39±1.41
Drink beer, wine, liquor121(31.1)40(10.3)38(9.8)71(18.3)119(30.6)3.07±1.66
Seeking spiritual support3.01±1.45
Talk to minister, priest or rabbi107(27.5)52(13.4)64(16.5)57(14.7)109(28)3.02±1.58
Go to church/temple/mashed58(14.9)95(24.4)88(22.6)75(19.3)73(18.8)3.03±1.33
Pray69(17.7)37(9.5)63(16.2)125(32.1)95(24.4)3.36±1.40
Investing in close friends3.48±1.51
Be close with someone you care about59(15.2)53(13.6)42(10.8)110(28.3)125(32.1)3.49±1.44
Be with a boyfriend or girlfriend113(29)36(9.3)60(15.4)95(24.4)85(21.9)3.01±1.54
Seeking professional support3.17±1.32
Get professional counseling45(11.6)81(20.8)99(25.4)89(22.9)75(19.3)3.17±1.28
Talk to counselor at school about what bothers you55(14.1)74(19)71(18.3)99(25.4)90(23.1)3.24±1.37
Engaging in demanding activities2.67±1.41
Do a strenuous physical activity (jogging, biking etc)126(32.4)74(19)49(12.6)79(20.3)61(15.7)2.68±1.49
Try, on your own, to figure out how to deal with your problems and tensions70(18)59(15.2)70(18)142(36.5)48(12.3)3.10±1.31
Try to improve yourself (get body in shape, get better grades, etc.)75(19.3)50(12.9)80(20.6)96(24.7)88(22.6)3.19±1.42
Work hard on school work or school projects86(22.1)64(16.5)78(20.1)104(26.7)57(14.7)2.95±1.38
Being humorous3.11±1.26
Joke and keep a sense of humor42(10.8)99(25.4)85(21.9)95(24.4)68(17.5)3.12±1.27
Try to be funny and make it light of it all40(10.3)79(20.3)73(18.8)126(32.4)71(18.3)3.28±1.26

[Table/Fig-7] shows married individuals had significantly higher mean spiritual health score and also father’s and mother’s education was significantly associated with the spiritual health of the students (p<0.05).

Association between demographic data and spiritual health.

VariablesNMean±SDt-valuep-value
GenderMale16767.38±12.011.2210.223
Female22268.74±9.93
Level of educationGraduate29567.71±11.061.1570.147
Postgraduate9469.54±10.21
Living arrangementSingle37167.97±10.992.0780.050*
Married1871.88±7.60
Father ‘s educationPostgraduate17569.58±10.582.3460.019*
Graduate21466.99±11.00
Mother’s educationPostgraduate23469.35±10.322.6060.010*
Graduate15566.42±11.40
Type of familyJoint20768.11±11.130.0950.925
Nuclear18268.22±10.70

[Table/Fig-8] shows association between spiritual health and coping dimensions. All the dimension of coping skills were found to be significantly associated with spiritual health (p≤0.05) except the dimensions; avoiding and seeking professional support.

Association between spiritual health and coping dimensions.

CopingSpiritual healthf-valueSig.
FairPoorGood
Ventilating feelings3.05±.563.12±.773.59±.7412.722<0.001*
Seeking diversions4.06±.483.28±.723.53±.6312.285<0.001*
Relaxing4.17±.703.35±.893.72±.8811.438<0.001*
Selfreliance2.40±.983.17±.853.80±.7527.273<0.001*
Developing social support2.73±.783.16±.803.73±.7920.058<0.001*
Solving family problems3.14±.553.30±.703.72±.9510.766<0.001*
Avoiding2.91±.393.09±713.26±.712.7150.067
Seeking spiritual support2.70±.773.08±.893.39±.975.5360.004*
Investing in close friends2.00±1.293.30±1.243.30±.999.079<0.001*
Seeking professional support3.40±.843.16±1.083.31±.98.8890.412
Engaging in demanding activities1.67±1.012.96±.993.28±.6819.894<0.001*
Being humorous2.31±1.073.13±1.083.61±1.0911.903<0.001*

Significant (ANOVA was applied)


Discussion

The present study measures the spiritual health and coping behaviours among dental students in crisis situation. Due to paucity of data on spiritual health of health professionals, our findings could not be extensively compared with the existing reported literature.

Social determinants like married life, education of the father and education of mother were influencing the growth of spiritual health and augmenting the self actualization domain. Respondents with only the former criterion specifically focus on a holistic approach to life and internal locus of command. These important aspects build the personality of dental students that may aid in the nurture of ailing patients. The spiritual health of the dental students were greatly influenced by the education of their fathers and mothers. The higher the education status of the head of the family, better may be the personality and spiritual health of an individual as they might have better control of the internal locus and more holistic approach towards life. Similarly a study conducted by Sen S et al., among the third semester medical students in government medical colleges of Kolkata, West Bengal, India found the respondents who had more educated fathers and mothers had better spiritual health [5].

In the present study, only 21.33% had good spiritual health while majority i.e., 74.55% had fair spiritual health and only 4.12 % had poor spiritual health whereas a study done by Gaur KL et al., on individuals aged 20-60 years in Dausa city of Rajasthan, India, found majority (72.19%) of the study participants had poor spiritual health [9]. The difference could be due to the sociodemographic characteristics as our study participants are dentist living in healthy environment and their parents having good education [9].

When the domains of spiritual health were studied it was found that self development was having high mean score (3.54) followed by self realization (3.10) and self actualization (3.08), as self–development is the basic principle of spirituality which includes the basic instincts of gratitude, generosity, charity and patience.

In the present study, the mean spiritual health score of the females students was significantly higher than males students which was in agreement with the study conducted by Sen S et al., [5].

In the present study, coping was assessed using ACOPE scale. Dental students face lot of stress due to rigorous training. A study conducted by Burk DT and Bender DJ found personal disappointment with performance was perceived as the most severe problem followed by stress among first year dental student in Califonia [8].

The present study showed the most commonly used coping strategy by dental student was seeking diversion as watching movies, TV shows or sleeping may provide an escape from every day life. Dentist are traning at highest level to learn and acquiers skills to treat patients. Listening to music stereo or radio followed by going to movies can provide a break from their routine work. Majority of the students reported to have never used drugs but 13.1% of the students reported using anti-anxiety drugs most of the time during exams to reduce their anxiety. The findings of this study are in agreement with the study conducted by Kumar R and Nancy where seeking diversion was the most commonly used coping strategy [7]. In a similar study done by Ickes MJ et al., for graduate and postgraduate students which is in agreement with our study where Sleep (69.6%), exercise (66.1%), and food (56.8%) were the most common coping strategies [11].

Our study showed a significant association between spiritual health and coping strategies among dentists. As coping is a dynamic and on going process. Spiritiualty might help dentist to balance and help better adjust to stressful situation. Additional studies involving larger population are needed to support the results of the present study.

Recommendation: It is important for a dental students to not to ignore stress in day to day life and cope with their stress by:

By meditating which helps control stress, decrease anxiety, improve cardiovascular health, and achieve a greater capacity for relaxation.

By exercising regularly which helps relieve some symptoms of depression and stress, and help us to maintain our health.

By staying positive as positive thinking is better coping skills during hardships and times of stress.

By developing a common support system and sharing your feelings and experiences by speaking to friends, family, a teacher or a counselor.

By seeking diversions during your busy day like listening to good music, watching TV etc.

Limitation

The main limitation of this research was the cross-sectional design, use of one college setting, the small sample size. The longitudinal studies should be further conducted to know about the various coping strategies used by the college students based on their stress levels. This study used a self-report questionnaire to collect data, which may have caused possible response bias from each responder, for example, respondents may give socially acceptable answers. Results may not be generalized to all college students.

Conclusion

The coping strategies influence the human health, and spiritual health play a central role. The spiritual health continuously compensate with other heath like mental, physical and social well-being. The spiritual health of the dental students were influenced by the education of their parients. Higher the education status of the father, better may be the coping strategies. Relaxation of mind to increase the concentration in work can be achieved with healthy spiritual practices like meditation. Furthermore, a spiritually healthy person establishes his/her ideas and works well. The belief that spiritual awakening originates in a later stage of life is not so true as it is everlasting throughout the life and it influences us to deal with difficult situations. The development of spiritual health with adaptive coping skills in adolescents is beneficial for reducing the risk of getting into depression and general anxiety disorder. Further research is required to include this in the National Mental Health Program. Thus, being spiritually healthy can earn social support as well as distress the mind.

*Significant (ANOVA was applied)

References

[1]Keawpimon P, Kritchareon S, Chunuan S, Nayai U, Development of the buddhist based spiritual health of Thai university students instrument Sociology Study 2014 4:708-13.  [Google Scholar]

[2]Dhar N, Chaturvedi SK, Nandan D, Spiritual health, the fourth dimension: a public health perspective Southeast Asian J Trop Med Public Health 2013 2(1):03-05.  [Google Scholar]

[3]World Health Organization, “The World Health Report 1998 Life in the 21st century A vision for all, chapter 1 1998 Geneva, SwitzerlandWHO Press:21  [Google Scholar]

[4]Lazarus R, Folkman S, Stress, appraisal and coping 1984 1st editionNew YorkThe Springer Publishing Copmany:1483  [Google Scholar]

[5]Sen S, Pal D, Hazra S, Pandey GK, Spiritual health of students in government medical colleges of Kolkata and their coping skills in a crisis situation Indian J Public Health 2015 59:196-203.  [Google Scholar]

[6]MacLean CD, Susi B, Phifer N, Bynum D, Franco MK, Monroe M, Patient preference for physician discussion and practice of spirituality. Results from a multicenter patient survey J Ge Intern Med 2003 18(1):38-43.  [Google Scholar]

[7]Kumar R. Nancy, Stress and Coping Strategies among Nursing Students Int J Nurs Midwifery 2011 7(4):141-51.  [Google Scholar]

[8]Burk DT, Bender DJ, Use and perceived effectiveness of student support services in a first-year dental student population J Dent Educ 2005 69(10):1148-60.  [Google Scholar]

[9]Gaur KL, Sharma M, Measuring spiritual health: spiritual health assessment scale (SHAS) Int J Innov Res Dev 2014 3(3):63-67.  [Google Scholar]

[10]Patterson JM, Mccubbin HI, Adolescent coping style and behaviors conceptualization and measurement J Adolesc 1987 10(2):163-86.  [Google Scholar]

[11]Ickes MJ, Brown J, Reeves B, Martin PD, Differences between undergraduate and graduate students in stress and coping strategies Calif J Health Promot 2005 13(1):13-25.  [Google Scholar]