Perceptions of Stress Among Dental Students Living in a War-Affected Zone.

The aims of this study were to assess the perceived levels and sources of stress for Libyan dental students living in a war zone and to compare the results of those students with students living in conflict-free areas in the same country. Eight hundred randomly selected students from three Libyan dental schools in conflict-active and conflict-free regions were invited to participate in a survey in 2016. The survey instrument was the validated Dental Environment Stress (DES) questionnaire translated into Arabic. Responses to the 41 items were on a five-point scale from 0=not stressful at all to 4=very stressful. The response rate was 84.4% (675/800). The results showed that the respondents' overall mean score of stress perception was 2.5 (SD 0.6). There was a statistically significant difference in overall perceived stress between the two groups (p<0.001), with a significantly higher level of stress on five of the six domains for students in the conflict-free zones. For the combined groups, the workload and faculty administration domains had the highest stress scores: mean 3.1 (SD 0.7) and 2.8 (0.7), respectively. Overall, living in conflict-free areas for these students was associated with higher perceived dental school stress than for the students living in a war zone. Stresses of dental school in the conflict-active zone were likely perceived to be relatively less important against the backdrop of stressors imposed by the conflict outside school. Although the overall score of stress perception for these Libyan dental students was comparable to that found in other countries, the perceived stress among students in conflict-active regions was generally lower but varied by domain.