title: Are students' symptoms and health complaints associated with perceived stress at university? Perspectives from the United Kingdom and Egypt.
abstract: This cross-sectional survey assessed and compared by country, the levels and correlates of 21 self-reported symptoms/health complaints. We examined the associations between self-reported symptoms and perceived stress. Data was collected from universities in the United Kingdom and Egypt (N = 3706 and 3271 undergraduates, respectively). A self-administered questionnaire assessed a range of self-reported symptoms, perceived stress, sociodemographic (gender, age, marital status, year of study, living arrangements during semester, income sufficiency), lifestyle (tobacco smoking, illicit drug/s use, alcohol consumption frequency), and health variables (subjective health status, health awareness, BMI), along with religiosity, and quality of life. Factor analysis categorized the 21 self-reported symptoms into four components. Correlation analysis and linear regression tested the associations between the self-reported symptoms and stress. Factor analysis of the health symptoms generated four symptom groups for each of the UK and Egypt (psychological; circulatory/breathing; gastrointestinal; and, pains/aches), and factor loadings were quite similar for both countries. Whilst the two samples showed similarities as to the kind of symptoms most frequently reported by students, the Egyptian sample had significantly higher frequency than the UK for every symptom. Frequent complaints (both countries) included difficulties to concentrate, fatigue, headaches, nervousness/anxiety, and back pain (UK) and mood swings (Egypt). Significantly more Egyptian students reported ≥ 4 symptoms over the past year than the UK. For each of the UK and Egypt, across each of the four symptom groups, there was a stepladder appearance whereby the frequency of symptoms increased with increasing quartiles of perceived stress. Not controlling for other variables, for both countries, there were significant positive correlations between each of the four symptom groups and stress; the highest correlation was for psychological symptoms. After controlling for sex, age country, and other symptom groups, stress was highly and significantly associated with psychological symptoms and also with pain & aches symptoms in both countries. UK students were generally less stressed than their counterparts in Egypt. Age and female gender were also associated with stress; the younger the student was the more likely to suffer from stress. Interactions were not significant. Across both countries, the levels of stress among students and the associations between perceived stress and health complaints suggest the need for a multiple approaches in order to understand the sources of stress; how college students experience stress; and, the coping mechanisms that different students employ to mitigate stress. Interventions aimed at both preventing, treating and caring for students' distress, and also preventive strategies to help minimize the impact of stressful situations are required. Strategies that address both physical and psychological complaints may be beneficial for this population.
authors.affiliation: Faculty of Applied Sciences, University of Gloucestershire, Gloucester GL2 9HW, UK. walidansari@glos.ac.uk.
authors.forename: Walid
authors.initials: W
authors.lastname: El Ansari
authors.affiliation: Faculty of Technology, Design and Environment, Oxford Brookes University, Oxford OX33 1 HX, UK. roskrochi@brookes.ac.uk.
authors.forename: Reza
authors.initials: R
authors.lastname: Oskrochi
authors.affiliation: Faculty of Technology, Design and Environment, Oxford Brookes University, Oxford OX33 1 HX, UK. grhaghgoo2004@yahoo.com.
authors.forename: Ghollamreza
authors.initials: G
authors.lastname: Haghgoo
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D010465:Perception; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014495:Universities; D055815:Young Adult