Psychological counseling needs and associated factors among fourth-year students at Hanoi medical university, academic year 2023-2024

I. Introduction

In today’s fast-paced society, medical students face increasingly demanding schedules and rigorous academic expectations. With substantial study pressures, stringent training requirements, and the anticipation of a challenging career, medical students often encounter numerous difficulties and psychological stressors.

Despite growing awareness and knowledge in the field of psychology, many students still struggle to address their psychological issues effectively. Feelings of anxiety, stress, and even depression are common and can negatively impact academic performance, personal development, mental well-being, and overall health. A 2016 systematic review reported that up to 27% of medical students surveyed experienced depression, leading to various consequences, including decreased academic capability, lower quality of life, diminished interest in the profession, and, in severe cases, suicidal ideation.

In this context, psychological counseling has become an increasingly important resource for medical students. Research by Claudia Finkelstein et al. indicates that timely psychological support can reduce the proportion of students experiencing stress from 65% to 48% over a six-month period [3, p. 32-38]. Nevertheless, significant challenges remain in adequately meeting this need. Limited awareness and acceptance of psychological counseling among students often prevent many from seeking necessary support.

This is especially relevant for fourth-year students at Hanoi Medical University, who are adjusting to intensive clinical schedules. Additional factors, such as exam pressure, evolving training programs, professional ethics, and the complexities of interacting with patients and their families, contribute to a high-stress environment for these students.

Recognizing the importance of accurately identifying and addressing the psychological counseling needs of medical students, this study was conducted with two primary objectives:

1. To survey the psychological counseling needs of fourth-year students at Hanoi Medical University.
2. To evaluate the correlation between psychological counseling needs and related factors.

II. Subjects and Methods

1. Research Participants

The study involved fourth-year students at Hanoi Medical University during the 2023-2024 academic year. Participants were those without an acute phase of a chronic disease or any acute illness, no history of physical brain damage (such as neurological disease or nerve trauma), and no previous diagnosis or treatment for mental disorders.

2. Research Methods

Study Design: Cross-sectional descriptive study.

Research Period: January 2024.

Sample Size: Calculated using the formula for estimating sample size for a population proportion.

After incorporating a 5% margin of error, the target sample size was determined to be 204 students. However, during data processing, 8 invalid responses were excluded, resulting in a final sample size of 196 for analysis.

Sampling Method: Random sampling was conducted based on the list of fourth-year students from each major.

3. Research Tools and Procedures

Research Tools:

• A psychological counseling needs questionnaire, originally developed by the research team at the Institute of Preventive Medicine and Public Health, Hanoi Medical University, in 2019, with updates and modifications.
• The DASS21 questionnaire, standardized in Vietnamese version by the Institute of Mental Health, Bach Mai Hospital.

Research Procedure: Participants were informed about the study, provided written consent for voluntary participation, and completed the two questionnaires in a designated research room. The collected responses were coded, entered, and prepared for analysis.

4. Data Analysis and Processing

Data were entered, cleaned, and analyzed using STATA 15 software.

5. Research Ethics

Participants were thoroughly informed about the study and participated voluntarily. Personal information was kept confidential, and results were used solely for research purposes.

III. Results

1. General characteristics of the research subjects:

The study collected 196 research subjects including 126 medical students and 70 bachelor's students. The proportion of women in the study was higher than that of men (35.7% men, 64.29% women). Students with normal BMI accounted for 60.71%; 24.49% of students were underweight and 4.59% were obese. Currently, 47.45% of students choose to stay in rented accommodation, 31.12% in dormitories, and the rest live with family or acquaintances 21.43%. The students' academic results at the levels of Excellent, Fair, Average, and Poor were 6.63%, 38.27%, 50.59%, and 0.51%, respectively.

2. Psychological counseling needs among fourth-year students at Hanoi medical university

Among fourth-year students, 67.7% indicated a need for psychological counseling. Of these, 18.37% reported experiencing psychological challenges and expressed a desire for counseling support. The remaining 81.63% of students, though not currently experiencing psychological difficulties, were open to counseling as a means to develop knowledge and coping skills for potential future challenges. Details of these counseling needs are illustrated in figure 1 and figure 2.

Fig. 1. The need for psychological counseling on life problems

Figure 1 indicates that the need for career orientation counseling is the most prevalent (23.98%), followed by academic counseling (19.9%). In comparison, the need for life skills development (11.73%) and specialized support (1.02%) are less common.

Fig. 2. Desired form of psychological consultation

Figure 2 shows that the most preferred form of psychological counseling among fourth-year students is individual, face-to-face counseling (53.57%). When surveyed about their preferred counselor, 67.35% of students indicated a preference for a school psychologist, followed by lecturers with relevant teaching experience (61.22%) and senior students who had completed training courses (45.92%).

Table 1

Characteristics of psychological counseling needs for students (n=196)

Table 1 shows that the majority of students prefer psychological counseling to be available at any time (67.86%) and favor a private room designated for counseling sessions (62.76%). Hanoi Medical University has established a student information and counseling center, known as the “Soul Recharging Station.” Among surveyed students, 87.24% expressed support for establishing a dedicated psychological counseling room on campus, and 69.9% reported they would consider using this resource when experiencing psychological difficulties. However, 30.1% of students were not inclined to visit the counseling room for various reasons.

3. Correlation Between Psychological Counseling Needs and Related Factors

No statistically significant correlation was found between the need for psychological counseling and factors such as field of study, gender, or whether students experienced academic challenges.

Table 2

Correlation between psychological consultation needs and cumulative scores

Table 2 indicates that students with Good to Excellent cumulative scores are approximately 2.186 times more likely to seek psychological counseling for career orientation compared to students with Average to Poor cumulative scores.

Table 3

Correlation between need for psychological consultation and level of disorder (based on DASS21 results)

Table 3 demonstrates that students with at least one severe psychological disorder (stress, anxiety, or depression) are 3.24 times more likely to seek psychological counseling for life skills development compared to students without psychological disorders.

Table 4

Correlation between need for psychological consultation and DASS21-Depression results

Table 4 indicates that students with depressive disorders have a 2.4 times higher need for psychological counseling focused on personal life skills development compared to students without such disorders.

IV. Discussion

1. Psychological Counseling Needs of Students

A significant majority of students (67.7%) expressed a need for psychological counseling, and 87.24% viewed the establishment of an on-campus counseling room as essential. This reflects strong student support for psychological counseling services at Hanoi Medical University. Notably, students showed particular interest in counseling related to academics and career orientation (23.98%), a finding consistent with results from a 2019 study by Nguyen Thi Thu Thuy and Dang Thuy Duong on the counseling needs of first-year students at Hanoi Medical University [4, p. 216-224]. This similarity may stem from shared factors within the learning environment, such as academic pressure, concerns about future career prospects, and the need for self-development, despite the studies focusing on different student cohorts.

A considerable proportion of students expressed a preference for support from a school psychologist (67.35%), with counseling available at any time of need (67.86%) and conducted in a dedicated, private counseling room on campus (67.76%). The most preferred format for counseling was direct, one-on-one sessions (53.57%), suggesting a strong desire among students for private, face-to-face interaction with counselors. Email was also a popular option (40.31%), likely due to its convenience in the digital age. In contrast, a study on students at the University of Forestry by Bui Thi Ngoc Thoa [5] found that most students favored indirect forms of consultation.

The findings indicate that 69.9% of students are willing to visit the Student Information and Counseling Center, known as the "Soul Charging Station" at Hanoi Medical University. However, 30.1% of students remain reluctant to seek help even when facing psychological challenges, possibly due to limited understanding of available services, reluctance to share personal issues, or concerns about confidentiality.

2. Correlation Between the Need for Psychological Counseling and Related Factors

The research results indicate that students with cumulative scores in the Good to Excellent range have a significantly higher need for career orientation counseling, approximately 2.186 times greater than students with Average to Poor scores. Additionally, students with higher academic performance tend to view their psychological challenges more constructively and actively seek professional support to address these issues. This may suggest that high-achieving students are more focused on future career development opportunities.

Students experiencing severe psychological disorders or depressive symptoms demonstrated a greater need for counseling focused on life skills development, with this need being 3.24 times and 2.4 times higher, respectively, compared to students without such disorders. Providing timely psychological counseling could thus support students in overcoming challenges and fostering positive personal growth.

Overall, our study, along with prior research, consistently highlights the demand for psychological counseling among students, underscoring the importance of offering and enhancing high-quality counseling services within the university setting.

V. Conclusion & Recommendations

1. Conclusion:

Among fourth-year students at Hanoi Medical University, 67.7% expressed a need for psychological counseling, with 53.57% prioritizing direct individual counseling, 67.35% preferring support from school psychologists, and 67.76% favoring a designated counseling room. Students with Good to Excellent cumulative scores exhibited a 2.186 times higher need for career orientation counseling compared to other groups. Additionally, students with severe or depressive scores on the DASS21 scale showed a need for life skills counseling 2.4 and 3.4 times higher, respectively, than students without such conditions.

2. Recommendations:

The university should promote mental health awareness and encourage recognition of psychological counseling needs among students. Expanding dedicated counseling facilities, increasing professional resources, and providing varied, flexible counseling services would help meet these needs.

Regular assessment of counseling service effectiveness, along with actively gathering student feedback, is essential to continually refine and enhance counseling programs and activities.

VI. Acknowledgement

The authors would like to express our gratitude to Dr Pham Tung Son, HMU students: Vo Trung Hieu, Hoang Bao An, Tran Hong Thai for data collection, data analysis and technical assistance. Their extraordinary contributions have greatly improved the quality of this paper.