Abstract
BACKGROUND: Self-perceived stress is a common problem among university participants with relatively high-stress levels. This study aimed to determine perceived stress levels and associated factors among preclinical participants at a medical college in Central Nepal. METHODS: This study employed an analytical cross-sectional design. The participants were first- and second-year MBBS students studying in the second, third, and fourth semesters at the preclinical science premises of Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal. The Perceived Stress Scale was used to assess perceived stress levels. A medical participant stress questionnaire was used to identify the different sources of stressors. The associations between sociodemographic profiles and perceived stress and stressors were tested. RESULTS: The mean age of the 247 undergraduate medical participants was 20.61 years (SD ± 1.47), with the majority being male (70.9%) and Hindu (92.3%). Significant gender differences in stress levels were observed, with males reporting higher levels of low (24.6%) and moderate stress (69.1%) than females did (p-value = 0.009). The second-semester participants experienced the highest levels of moderate (74.1%) and high stress (14.1%), with significant semester-related differences (p-value = 0.027). Participants with a history of anxiety or depression had significantly higher stress levels (p-value < 0.001). The key stressors were academic-related, including lack of time for review and examinations, with gender (OR = 2.85, 95% CI: 1.15-7.02), semester (OR = 0.32, 95% CI: 0.13-0.76) and history of anxiety (OR = 5.29, 95% CI: 1.54-18.07) being significant predictors of stress. CONCLUSIONS: High levels of stress among undergraduate medical students in Nepal are driven primarily by academic pressure, with second-semester participants and those with a history of anxiety or depression being the most affected. Compared with male participants, female participants experienced higher stress levels. These findings highlight the need for targeted stress management and mental health support for medical students.