Correlation Between Perceived Stress on Mental Health and Coping Strategies by Post Graduate Residents in a Tertiary Care Hospital

M. Saqib Musharaf

doi:10.70302/jpsim.v7i3.2640

Original Research

Correlation Between Perceived Stress on Mental Health and Coping Strategies by Post Graduate Residents in a Tertiary Care Hospital

M. Saqib Musharaf

Al Aleem Medical College, Gulab Devi Hospital, Lahore

✉ Correspondence: M. Saqib Musharaf Email: drmsaqibm@gmail.com

DOI https://doi.org/10.70302/jpsim.v7i3.2640

Volume: 7, Issue 3 Pages: 207–212 Published: 21 Aug 2026

Received: 22 Apr 2026 Revised: 11 Jun 2026 Accepted: 12 Aug 2026 Published Online: 21 Aug 2026

Ethics approval was not required for this study (no human or animal participants directly involved).

Abstract

Objectives

To assess the correlation between perceived stress and mental health outcomes of postgraduate medical residents in a tertiary care hospital, and to find the most common coping strategies employed by them.

Methods

This mixed-method explanatory sequential study was carried out for a period of six months in Gulab Devi Teaching Hospital, Lahore. 46 postgraduate trainees were quota sampled to have equal representation of first- and final-year trainees. Quantitative data were gathered using a structured questionnaire containing the Perceived Stress Scale (PSS-10) and the General Health Questionnaire (GHQ-12). Coping strategies data were collected through interviews from residents until saturation. Quantitative data were analyzed in SPSS 27 using descriptive statistics, chi-square and t-tests, and thematic analysis for qualitative data.

Results

Mean age was 31.65 ± 4.51 years with mean working hours per week of 77.89 ± 6.01. Perceived- high stress among residents was experienced by 63.0%, while 71.7% were GHQ case screen-positive. Family support (30.4%) was the most frequent coping strategy, followed by exercise (21.7%), peer support (19.6%), religion/prayer (17.4%), and time management (10.9%). Strong correlations were found between stress and year of residency, specialty, and satisfaction with pay. Those with higher stress and poor mental health were significantly older and worked longer hours (p < 0.05).

Conclusion

Postgraduate residents were found to have poor mental health and high levels of stress, which were especially affected by working hours, specialty, age, and job satisfaction. Coping depended extensively on family and social support.

Keywords

Psychological Mental Health Coping Skills Internship and Residency.

How to Cite This Article

Musharaf MS. Correlation Between Perceived Stress on Mental Health and Coping Strategies by Post Graduate Residents in a Tertiary Care Hospital. J Pak Soc Intern Med. 2026;7(3):207–212. doi:10.70302/jpsim.v7i3.2640

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Conflict of Interest

The authors declare no conflict of interest.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

This research received no specific grant from any funding agency.

Funder information follows the Crossref Funder Registry standard.

Ethics Statement

not_applicable

Conducted in accordance with the Declaration of Helsinki.

References

da Nóbrega Lucena Pinho R, Costa TF, Silva NM, Barros-Areal AF, de Mattos Salles A, Oliveira AP, et al. Mental Health and Burnout Syndrome Among Postgraduate Students in Medical and Multidisciplinary Residencies During the COVID-19 Pandemic in Brazil: Protocol for a Prospective Cohort Study. JMIR Res Protoc. 2021;10(1):e24298.
Rabha AP, Das UB, Deka U. Assessment of level of stress among post-graduate trainees working in tertiary care hospital in a district of Assam. Int J Community Med Public Health. 2024;11(2):885-92.
Youssef D, Youssef J, Abou-Abbas L, Kawtharani M, Hassan H. Prevalence and correlates of burnout among physicians in a developing country facing multi-layered crises: a cross-sectional study. Sci Rep. 2022;12(1):16095.
Vm AE, Arunkumar M, Thozhanenjan I, Bhandari A, Aishwarya PM, Prasanth K, et al. The Mental Health Challenges of Medical Postgraduates in Chengalpattu District, Tamil Nadu: Are they being Educated or Exploited? Cureus. 2025;17(1):e77157.
Bosun A, Kalinovic R, Munteanu C, Pascariu AC, Vlad G, Enatescu VR, et al. Factors influencing Family Medicine Residents attitudes toward mental illness. Eur Psychiatry. 2023;66(Suppl 1):S894-5.
Manzoor S, Sajjad M, Anwar I, Rafi A. Coping strategies adopted by medical residents in dealing with work-related stress: a mixed-methods study. BMC Med Educ. 2022;22(1):449.
Alam L, Khan J, Alam M, Faraid V, Ajmal F, Bahadur L. Residents’ perspective on the quality of postgraduate training programs in Pakistan – the good, the bad and the ugly. Pak J Med Sci. 2021;37(7):1803-8.
Chew QH, Chia FLA, Ng WK, Lee WCI, Tan PLL, Wong CS, et al. Perceived Stress, Stigma, Traumatic Stress Levels and Coping Responses amongst Residents in Training across Multiple Specialties during COVID-19 Pandemic-A Longitudinal Study. Int J Environ Res Public Health. 2020;17(18):6683.
Zhang Q, Dong G, Meng W, Chen Z, Cao Y, Zhang M. Perceived Stress and Psychological Impact Among Healthcare Workers at a Tertiaty Hospital in China During the COVID-19 Outbreak: The Moderating Role of Resilience and Social Support. Front Psychiatry. 2022;12:570971.
Nagasaki K, Nishizaki Y, Shinozaki T, Shimizu T, Yamamoto Y, Shikino K, et al. Association between mental health and duty hours of postgraduate residents in Japan: a nationwide cross-sectional study. Sci Rep. 2022;12(1):10626.
Wijeratne C, Johnco C, Draper B, Earl JK. Older Physicians’ Reporting of Psychological Distress, Alcohol Use, Burnout and Workplace Stressors. Am J Geriatr Psychiatry. 2021;29(5):478-87.
Labrague LJ. Specific coping styles and its relationship with psychological distress, anxiety, mental health, and psychological well-being among student nurses during the second wave of the COVID-19 pandemic. Perspect Psychiatr Care. 2022;58(4):2707-14.
Ghafoor H, Nordbeck P, Ritter O, Pauli P, Schulz SM. Can Religiosity and Social Support Explain Effects of Trait Emotional Intelligence on Health-Related Quality of Life: A Cross-Cultural Study. J Relig Health. 2022;61(1):158-74.
Matavelli RD, de Jesus SN, Pinto P, Viseu J. Does coping mediate the effect of financial threat on life satisfaction? A multigroup analysis. Análise Psicológica. 2021;39(1):65-76.
Rojas R, Hickmann M, Wolf S, Kolassa IT, Behnke A. Coping in the Emergency Medical Services: Associations With the Personnel’s Stress, Self-Efficacy, Job Satisfaction, and Health. Clin Psychol Eur. 2022;4(1):1-25.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2026 Journal of Pakistan Society of Internal Medicine.

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[1] da Nóbrega Lucena Pinho R, Costa TF, Silva NM, Barros-Areal AF, de Mattos Salles A, Oliveira AP, et al. Mental Health and Burnout Syndrome Among Postgraduate Students in Medical and Multidisciplinary Residencies During the COVID-19 Pandemic in Brazil: Protocol for a Prospective Cohort Study. JMIR Res Protoc. 2021;10(1):e24298.

[2] Rabha AP, Das UB, Deka U. Assessment of level of stress among post-graduate trainees working in tertiary care hospital in a district of Assam. Int J Community Med Public Health. 2024;11(2):885-92.

[3] Youssef D, Youssef J, Abou-Abbas L, Kawtharani M, Hassan H. Prevalence and correlates of burnout among physicians in a developing country facing multi-layered crises: a cross-sectional study. Sci Rep. 2022;12(1):16095.

[4] Vm AE, Arunkumar M, Thozhanenjan I, Bhandari A, Aishwarya PM, Prasanth K, et al. The Mental Health Challenges of Medical Postgraduates in Chengalpattu District, Tamil Nadu: Are they being Educated or Exploited? Cureus. 2025;17(1):e77157.

[5] Bosun A, Kalinovic R, Munteanu C, Pascariu AC, Vlad G, Enatescu VR, et al. Factors influencing Family Medicine Residents attitudes toward mental illness. Eur Psychiatry. 2023;66(Suppl 1):S894-5.

[6] Manzoor S, Sajjad M, Anwar I, Rafi A. Coping strategies adopted by medical residents in dealing with work-related stress: a mixed-methods study. BMC Med Educ. 2022;22(1):449.

[7] Alam L, Khan J, Alam M, Faraid V, Ajmal F, Bahadur L. Residents’ perspective on the quality of postgraduate training programs in Pakistan – the good, the bad and the ugly. Pak J Med Sci. 2021;37(7):1803-8.

[8] Chew QH, Chia FLA, Ng WK, Lee WCI, Tan PLL, Wong CS, et al. Perceived Stress, Stigma, Traumatic Stress Levels and Coping Responses amongst Residents in Training across Multiple Specialties during COVID-19 Pandemic-A Longitudinal Study. Int J Environ Res Public Health. 2020;17(18):6683.

[9] Zhang Q, Dong G, Meng W, Chen Z, Cao Y, Zhang M. Perceived Stress and Psychological Impact Among Healthcare Workers at a Tertiaty Hospital in China During the COVID-19 Outbreak: The Moderating Role of Resilience and Social Support. Front Psychiatry. 2022;12:570971.

[10] Nagasaki K, Nishizaki Y, Shinozaki T, Shimizu T, Yamamoto Y, Shikino K, et al. Association between mental health and duty hours of postgraduate residents in Japan: a nationwide cross-sectional study. Sci Rep. 2022;12(1):10626.

[11] Wijeratne C, Johnco C, Draper B, Earl JK. Older Physicians’ Reporting of Psychological Distress, Alcohol Use, Burnout and Workplace Stressors. Am J Geriatr Psychiatry. 2021;29(5):478-87.

[12] Labrague LJ. Specific coping styles and its relationship with psychological distress, anxiety, mental health, and psychological well-being among student nurses during the second wave of the COVID-19 pandemic. Perspect Psychiatr Care. 2022;58(4):2707-14.

[13] Ghafoor H, Nordbeck P, Ritter O, Pauli P, Schulz SM. Can Religiosity and Social Support Explain Effects of Trait Emotional Intelligence on Health-Related Quality of Life: A Cross-Cultural Study. J Relig Health. 2022;61(1):158-74.

[14] Matavelli RD, de Jesus SN, Pinto P, Viseu J. Does coping mediate the effect of financial threat on life satisfaction? A multigroup analysis. Análise Psicológica. 2021;39(1):65-76.

[15] Rojas R, Hickmann M, Wolf S, Kolassa IT, Behnke A. Coping in the Emergency Medical Services: Associations With the Personnel’s Stress, Self-Efficacy, Job Satisfaction, and Health. Clin Psychol Eur. 2022;4(1):1-25.