The Effect of a Problem-focused Coping Stress Management Program on Self-efficacy, Psychological Distress, and Salivary Cortisol among First-year Medical Students of Udayana University

  • Susy Purnawati Physiology Department Medical Faculty of Udayana University
  • Putu Gede Adiatmika Physiology Department Medical Faculty, Udayana University, Indonesia
  • Cokorda Bagus Jaya Lesmana Udayana University and the Suryani Institute of Mental Health, Indonesia
Keywords: cortisol, psychological distress, self-efficacy, coping skill


Objective. Current evidence has shown academic stress to be associated with student maladaptive behavior. This study aimed to investigate the effect of a problem-focused coping stress management program on first-year medical students’ self-efficacy, psychological distress and find its effect on salivary cortisol.

Method. Forty students who scored high on academic stress and external locus of control were randomly selected as the intervention (n = 26) and control group (n = 14). An intervention in the form of a problem-focused coping stress management program was organized. The intervention was a 1½-hour training class conducted once a week for four weeks.

Results. There was a significant difference in self-efficacy between the intervention and control groups (p-value = 0.029). The self-efficacy score was significantly higher after the intervention (19.31 ± 2.396 vs 21.27 ± 2.677, p = 0.005). Likewise, a significant difference in the psychological distress between the two groups was found after the intervention (control group = 40.14 ± 3.860; intervention group = 37.12 ± 4.537, p < 0.05). We also found a significant decrease in salivary cortisol after the intervention among this group (0.68262 μg/dl ± 0.367 to 0.43304 μg/dl ± 0.231, p < 0.05), but there was no significant difference in cortisol between intervention and control group after the intervention (0.49479 μg/dl ± 0.264 and 0.43304 μg/dl ± 0.231, p = 0.448).

Conclusion. The problem-focused coping stress management program improved self-efficacy and decreased the psychological distress and salivary cortisol of first-year medical students in this research.