Medical education online · 2026
Stress, coping, and other determinants of poor sleep quality among healthcare students in a conflict region: a cross-sectional study.
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El Hajal Carl, Sejaan AlAchkar Melanie, Sakr Fouad, Habre Maha, Akiki Zeina
Аннотация
BACKGROUND: Healthcare students face substantial academic demands that may impair sleep, increase stress, and shape coping behaviors. This study evaluated sleep quality, perceived stress, and coping strategies via the PSQI, PSS-10, and Brief-COPE and examined sleep quality predictors (demographic, stress-related, and coping factors) among healthcare students in a conflict-affected context.
METHODS: This cross-sectional study surveyed Lebanese healthcare students (premedical, medical, nursing, pharmacy, and other health disciplines) via an online, self-administered questionnaire distributed through snowball sampling. Validated scales were used, and bivariate and multivariable analyses were conducted with the PSQI score as the dependent outcome.
RESULTS: Among 452 healthcare students, 77.2% reported poor sleep quality, 50% avoidant coping as their dominant strategy, and 92% reported moderate to high perceived stress. Being a nursing student (adjusted beta (95% CI) = 1.77 (0.19; 3.36)), a pharmacy student (1.08 (0.004; 2.17)), experiencing mental health problems (1.15 (0.42; 1.87)), social isolation (1.07 (0.17; 1.96)), having an avoidant-coping strategy (0.90 (0.19; 1.61)), or experiencing high perceived stress (1.14 (0.06; 2.76)) were positively and significantly associated with poorer sleep quality. However, exercising 3 times per week or more was positively associated with better sleep quality.
CONCLUSION: Poor sleep quality is widespread among healthcare students and is associated with increased stress, mental health issues, and avoidant coping. Supporting mental health, promoting adaptive coping, and encouraging regular physical activity may improve well-being in conflict settings to strengthen student health, academic performance, and the future healthcare workforce.
METHODS: This cross-sectional study surveyed Lebanese healthcare students (premedical, medical, nursing, pharmacy, and other health disciplines) via an online, self-administered questionnaire distributed through snowball sampling. Validated scales were used, and bivariate and multivariable analyses were conducted with the PSQI score as the dependent outcome.
RESULTS: Among 452 healthcare students, 77.2% reported poor sleep quality, 50% avoidant coping as their dominant strategy, and 92% reported moderate to high perceived stress. Being a nursing student (adjusted beta (95% CI) = 1.77 (0.19; 3.36)), a pharmacy student (1.08 (0.004; 2.17)), experiencing mental health problems (1.15 (0.42; 1.87)), social isolation (1.07 (0.17; 1.96)), having an avoidant-coping strategy (0.90 (0.19; 1.61)), or experiencing high perceived stress (1.14 (0.06; 2.76)) were positively and significantly associated with poorer sleep quality. However, exercising 3 times per week or more was positively associated with better sleep quality.
CONCLUSION: Poor sleep quality is widespread among healthcare students and is associated with increased stress, mental health issues, and avoidant coping. Supporting mental health, promoting adaptive coping, and encouraging regular physical activity may improve well-being in conflict settings to strengthen student health, academic performance, and the future healthcare workforce.