Level of hopelessness and related factors in upcoming medical work force

Ahmet Ergin, Ali İhsan Bozkurt, Süleyman Utku Uzun



Background and purpose: Students in medical schools are under the great personal distress during their education. Likewise, medical or surgical residency can be a stressful and overwhelming period during which residents work long hours.  The aim of the study was to determine the level of hopelessness in the medical students and residents and to examine its relations with socio-demographic features and working conditions.

Methods: A cross-sectional survey was conducted among 203 medical students and 132 medical residents in Pamukkale University, Turkey. Beck Hopelessness Scale (BHS) was used to measure the level of hopelessness.

Results: Women constituted 49.3% of the participants. 20.3% of the participants were younger than 20. 35.2% of the participants were in the lowest SES. The mean BHS score was 5.76±4.5. The score in medical residents (7.29±5.1) was higher than in the 1st (4.48±3.6), 3rd (4.13±3.4) and 6th grade medical students (5.4±4.1), (p<0.001). SES did not change the score. The score in the residents who worked  ‘≤40 hours’ weekly was 5.18±3.5; ‘between >40-≤60 hours’, 6.1±4.4; ‘between >60-≤100 hours’, 7.97±5.6; and ‘over 100 hours’, 9.67±5.6, (p=0.028). Multivariate analysis showed that weekly working hours of the residents was the most important factor affecting the score (p<0.001).

Conclusions: The hopelessness level of the medical residents was the highest and weekly working hours was the main factor affecting the hopelessness levels in the medical residents.

Keywords: medical education; hopelessness; depression; students; residents.


medical education; hopelessness; depression; students; residents.

Full Text:




Rideout E, Montemuro M. Hope, morale and adaptation in patient with chronic heart failure. J Adv Nurs. 1986;11:429-38.

Melges FT. Types of hopelessness in psychological process. Arch Gen Psychiatry. 1969;20:669-90.

Kashani JH, Reid JC, Rosenberg TK. Levels of hopelessness in children and adolescents: a developmental perspective. J Consult Clin Psychol. 1989;57:5-7.

Birol L. Nursing process. A systematic approach to nursing care. Izmir: Impact Printing. 1997;116-42.

Beck AT. Thinking a depression. Arch Gen Psychiatry. 1963;9:324-33.

Beck AT, Steer RA, Kovacs M, Gamion B. Hopelessness and eventual suicide: a 10 year prospective study of patients hospitalized with suicidal intention. Am J Psychiatry. 1985;142:559-63.

Sreeramareddy CT, Shankar PR, Binu VS, Mukhopadhyay C, Ray B, Menezes RG. Psychological morbidity, sources of stress and coping strategies among undergraduate medical students of Nepal. BMC Med Educ. 2007;7:26.

Jadoon NA, Yaqoob R, Raza A, Shehzad AM, Choudhry ZS. Anxiety and depression among medical students: A cross-sectional study. JPMA. 2010;60:699.

Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Acad Med. 2006;81:354-73.

Association of American Medical Colleges. Educating doctors to provide high quality medical care. A vision for medical education in the United States. Report of the Ad Hoc Committee of Deans. Washington, DC: AAMC; 2004.

Geurts S, Rutte C, Peeters M. Antecedents and consequences of work-home interference among medical residents. Soc Sci Med. 1999;48:1135-48.

Thomas NK. Resident Burnout. JAMA. 2004;292:2880-8.

Akbulut Y, Sarp N, Ugurluoglu E. Reform of the health care system in Turkey: a review of universal health insurance. World Hosp Health Serv. 2007;43:13-6.

Currie CE, Elton RA, Todd J, Platt S. Indicators of socioeconomic status for adolescents: the WHO health behavior in school-aged children survey. Health Educ Res. 1997;12:385-97.

Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: The hopelessness scale. J Consult Clin Psychol. 1974;42:861-65.

Seber G, Dilbaz N, Kaptanoğlu C, Tekin D. Hopelessness scale: validity and reliability. J Crisis. 1993;3:134-38.

Ozmen D, Dundar PE, Çetinkaya AC, Taskin O, Ozmen E. The level of hopelessness and affecting factors in high school students. Anatolian Journal of Psychiatry. 2008;9:8-15.

Sahin A. A study on the level of hopelessness in students at the Faculty of Theology. Selcuk University Faculty of Theology Journal. 2002;13:143-57.

Bostanci M, Ozdel O, Oguzhanoğlu NK et al. Depressive symptomatology among university students in Denizli, Turkey: Prevalence and

sociodemographic correlates. Croat Med J. 2005;46:96-100.

Aktekin M, Karaman T, Senol YY, Erdem S, Erengin H, Akaydin M. Anxiety depression and stressful life events among medical students: a prospective study in Antalya, Turkey. Med Educ. 2001;35:12-7.

Guthrie EA, Black D, Shaw CM, Hamilton J, Creed FH, Tomenson B. Embarking upon a medical career: psychological morbidity in first year medical students. Med Educ. 1995;29:337-41.

Guthrie E, Black D, Bagalkote H, Shaw C, Campbell M, Creed F. Psychological stress and burnout in medical students: a five-year prospective longitudinal study. J R Soc Med. 1998;91:237-43.

Moffat KJ, McConnachie A, Ross S, Morrison JM. First-year medical student stress and coping in a problem-based learning medical curriculum. Med Educ. 2004;38:482-91.

Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Med Educ. 2005;39:594-604.

Tyssen R, Vaglum P, Gronvold NT, Ekeberg O. Factors in medical school that predict postgraduate mental health problems in need of treatment. A nationwide and longitudinal study. Med Educ. 2001;35:110-20.

Biaggi P, Peter S, Ulich E. Stressors, emotional exhaustion and aversion to patients in residents and chief residents-what can be done? Swiss Med Wkly. 2003;133:339-46.

Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal residency program. Ann Intern Med. 2002;136:358-67.

Fletcher KE, Underwood W 3rd, Davis SQ, Mangrulkar RS, McMahon LF Jr., Saint S. Effects of work hour reduction on residents' lives: a systematic review. JAMA. 2005;294:1088-100.

Mansukhani MP, Kolla BP, Surani S, Varon J, Ramar K. Sleep deprivation in resident physicians, work hour limitations, and related outcomes: a systematic review of the literature. Postgrad Med. 2012;124:241-9.

Desai SV, Feldman L, Brown L et al. Effect of the 2011 vs 2003 Duty hour regulation-compliant models on sleep duration, trainee education and continuity of patient care among internal medicine house staff: A randomized trial. JAMA Intern Med. 2013;173:649-55.

DOI: https://doi.org/10.22037/jme.v15i1.10155

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.