Occurrence of Medical Student Syndrome and Associated Factors Among AAUP Nursing students in Palestine

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Shayeb, Salam nuhad ali, Qutayba Z. Ayaseh, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8065122/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background Medical Students Syndrome (MSS) is defined that medical students show health related anxiety and irrational fear during studying a specific disease related to the fact that they falsely related their symptoms to the disease that is being studied. So, this intense and irrational fear and anxiety can cause many physical symptoms that affect the students' quality of life. Purpose This study aimed to assess the occurrence of medical student syndrome and associated factors among AAUP nursing students in Palestine. Methods Quantitative descriptive cross-sectional study design conducted at large university in Palestine. The sampling method was convenience sampling. Data collected by self-administered questionnaire and analyzed by using SPSS 27. Results The prevalence of MSS was 43.35%, indicating a moderate response level of stress among nursing students at AAUP. For the factors that are associated with this syndrome, and despite the presence of variation in mean score between independent variable, but there were no any significant relationship between them at (p − 0.05). Conclusion It's important to raise awareness among nursing students about stress caused by MSS. Also, it's important to share this issue with other health care providers to determine the appropriate methods to deal with this stress. medical student syndrome medical students' disease students Palestine MSS Figures Figure 1 Introduction Background Medical Students Syndrome (MSS) is characterized by health-related anxiety in medical students when they study a particular disease, often due to their tendency to misinterpret their own symptoms as indicative of that disease. It is also referred to as second year syndrome, intern's syndrome, nosophobia, and medical studentitis [ 1 ]. Nosophobia refers to a continual, irrational fear that a student has of developing a chronic and potentially fatal illness, such as cancer or CAD [ 2 ]. Nevertheless, Nosophobia is distinct from hypochondria, an illness anxiety disorder that causes individuals to fret about various illnesses, encompassing broader concerns regarding health [ 3 ]. Thus, this overwhelming and illogical fear and anxiety can lead to physical symptoms such as: quickened breathing, difficulty sleeping, elevated heart rate, perspiration, lightheadedness, and nausea. Multiple elements may play a role in MSS, yet a definitive cause remains unclear. These factors encompass: being around someone with a severe illness, experiencing a disease outbreak such as the COVID-19 pandemic, and with contemporary living, the availability of health information on the Internet or various resources has become more accessible, enabling individuals to find comprehensive lists of symptoms and complications linked to almost any disease online; furthermore, a family history significantly influences this [ 4 ] . It is believed that many medical students often experience symptoms of illness and fears concerning the diseases they are learning about over time, a phenomenon known as ‘medical student syndrome’ [ 1 ]. Numerous studies have shown that attending medical school places significant psychological pressure on students due to the workload involved, the stress from classes and exams, the anxiety from new clinical experiences, and the competitive atmosphere among peers [ 5 ], [ 6 ]. This stress will influence symptoms that amplify physical sensations through autonomic activation, increasing individuals' awareness of their bodily condition, especially regarding pain perception. Medical students are also exposed to medical knowledge through intensive clinical and preclinical experiences. This knowledge influences symptom perception through the schemata (illness beliefs and expectations) that develop from it, resulting in heightened attention to particular bodily sensations and regions [ 7 ]. The distinction between nosophobia and hypochondria is that nosophobia refers to an intense and irrational fear of acquiring or experiencing a particular illness. However, the term "hypochondria" pertains to Hypochondriasis, which is a psychiatric condition characterized by an obsession with the fear of possessing, or believing one already has, a severe illness connected to the misinterpretation of physical symptoms despite adequate medical assessment and reassurance [ 8 ]. Recently, the COVID-19 pandemic has become an important element to consider as it has heightened overall public awareness and fear concerning illness and even death [ 9 ]. Additionally, earlier studies highlighted that, in general, quarantine could lead to mental health issues in individuals who had no prior problems, suggesting that the pandemic situation might have also played a role in the rise of nosophobia and hypochondria symptoms [ 10 ]. Nosophobia occurs when an individual experiences an intense or unreasonable fear of acquiring or developing a particular illness, also referred to as disease phobia. Sometimes referred to as medical students' disease, nosophobia is believed to impact medical students more than others, as they are immersed in information regarding various illnesses [ 10 ]. The key distinction between nosophobia and hypochondria is that nosophobia pertains to the fear of acquiring a particular disease, whereas hypochondria deals with broader concerns regarding health. In other terms, nosophobia refers to the fear of diseases, whereas hypochondria is known as illness anxiety disorder or the fear of being ill [ 11 ]. It is thought that a number of medical students experience anxieties and signs of illness associated with the diseases they are continuously studying, a phenomenon referred to as 'medical student syndrome' [ 12 ]. Numerous studies have shown that medical schools impose considerable psychological pressure on students due to the extensive workload, the stress of exams, the anxiety related to new clinical experiences, and the competitive atmosphere. Numerous studies have documented visits to doctors stemming from mandatory health examinations before starting medical school, as well as enrolling with a new General Practitioner near the university, particularly among first-year students who experience higher stress and anxiety levels compared to their peers [ 2 ], [ 9 ]. A prior study indicated that after learning about a new disease, medical students tend to think of symptoms from that specific condition they previously studied, leading them to believe they are experiencing these symptoms, which can trigger anxiety and stress known as disease phobia [ 4 ]. The patient consistently looks for a medical diagnosis in instances of hypochondria, whereas in the case of MSS, there is no rise in the frequency of medical consultations [ 13 ]. Thus, students diagnosed with MSS are less likely to seek medical assistance, but they believe or fear that they might have a disease. This form of hypochondria is distinct and can result in numerous health-related anxiety crises; it occurs in medical students who are intensely focused during their training [ 14 ]. Problem Statement MSS is regarded as a psychologically important condition, yet there is insufficient awareness of it among students, particularly in Palestine. This syndrome generates irrational fears and anxiety with no identifiable reasons, impacting students' lives and lowering their academic performance. Numerous studies have shown that attending medical school subjects students to significant psychological stress due to the workload, exam pressures, anxiety from new clinical experiences, and the competitive atmosphere among peers [ 9 ]. Up to the range of search in this study, there's no published study that conducted to assess the occurrence of medical student syndrome among nursing worldwide, and specificely among nursing students in Palestine. Aim of the study The aim of this study is to assess the prevalence of Medical Student Syndrome (MSS) and its associated factors among nursing students at the Arab American University Palestine (AAUP). Specifically, the study seeks to compare the prevalence of MSS between female and male students, examine differences in MSS prevalence between first-year students and those in more advanced years of study, and evaluate the relationship between students’ educational level and the likelihood of experiencing MSS within the AAUP nursing population. Significance of the Study Medical student's syndrome causes an irrational fear and anxiety without known causes [ 7 ]. It's affected students' academic performence and whole life. So it’s important to study the this syndrome among students [ 1 ]. Also students in medicals colleges suffer from higher level of stress related to theortical and clinical courses [ 4 ]. The absence of published studies that targeted this syndrome especially in Palestine, make this study very important, because the results of this study could provide further baselines for future researches about this topic. Also, the results could support the eveidence-based practice because as mentioned by study [ 10 ]. unspecialized health care worker have poor knowledge about this syndrom and how to deal with it. So, this study will support both knowledge and practice about this syndrome. Methods This chapter will present all methodology elements that used to guide this study including study design, inclusion and exclusion criteria, sample and sampling procedure, site and setting, data collection procedures, data analysis, ethical considerations, measurements, pilot study, proposed budget and timetable of study. Study Design The study was conducted using analytical cross-sectional quantitative design. It was suitable for the study aims, as it helped in investigating multiple independent variables, and it is time- and cost-efficient. Moreover, it helped in investigating the correlation between independent and dependent variables to test the hypotheses. Site and Setting The study was conducted at AAUP, in faculty of nursing. Sample and Sampling The target population for this study consisted of all nursing students enrolled at the intended university, regardless of age, gender, or educational level. A convenience sampling technique was employed due to the practical difficulty of systematically tracking students across different time periods, even when a complete list of names was available. Students were approached and recruited progressively, one after another, until the desired sample size was achieved. Inclusion criteria required participants to be registered nursing students at the university and to provide fully completed questionnaires. Students from other universities or from majors outside nursing, as well as those with incomplete data, were excluded from the study. The sample size was determined using G*Power software (Windows version), applying an independent-samples t-test with a two-tailed approach and a 95% confidence level. Based on these parameters, the required sample size was calculated to be 120 nursing students. Study Instruments A self-administered questionnaire taken from [ 11 ] was used for data collection, which include two sections: Section one: include eight questions about Sociodemographic data of the participents. Section two: Include 22 questions about MSS (1: Strongly disagree, 2: Disagree, 3: Neutral, 4: Agree, and 5: Strongly agree). For validity, content validity was assessed by making sure the questions cover all relevant aspects of the topic by asking three experts from the researchers' faculty and their opinions were taken into consideration before data collection process. The reliability and internal consistency was checked by using cronbach Alpha test in SPSS and it was 0.92. As the existing validated tools did not consider the COVID-19 pandemic, we decided to design our own tool. As we expected timely responses reflecting the current pandemic situation, the questionnaire did not go through the standard validation process. However, our questionnaire was based on DSM-5 criteria as well as on the analysis of existing literature. Period of the study This study was conducted from March to June 2025, during students fourth year. Pilot study A pilot study was conducted prior to data collection among 10% of the sample from the population. The pilot study aimed to explore any obstacles or problems that may face the data collection process. Also, it helped in assessing the readability, clarity, suitability and flexibility among the participant. Pilot study also aimed to identify unclear or ambiguous items in the questionnaire, and it gave important information about concerns that needed to be solved. The pilot study also helped to identify any concerns and adjust them. Moreover, it showed the efficiency of the instrument that is used in larger population. Data Collection Procedure Data collection done by distribution of the questionnaire on nursing groups at facebook website, and in the private groups for nursing faculties. Each student asked to give consent form for participation in the study. After that the students asked to answere the questionnaire completely. Ethical Considerations Prior to initiating data collection, the study was conducted in accordance with the nursing faculty guidelines at AAUP, and ethical approval was obtained from the Institutional Review Board (IRB) at the Arab American University Palestine (IRB Approval No. R-2025/A/4/N). Written informed consent was obtained from each participant after clearly explaining the purpose of the study, assuring them of their anonymity, confidentiality, and their right to withdraw at any stage without any consequences. Participants were also informed that they could request access to the study results upon completion. All ethical procedures followed the principles outlined in the Declaration of Helsinki for research involving human subjects [ 15 ]. Data Analysis Data Analysis was performed using SPSS v.27. Frequency and percentage were obtained for each categorical data. Normality was checked before performing inferential statistics by using the Kolmogorov-Smirnov test. The Non-parametric Man-Whitney U and Kruskal- Wallis H tests used to investigate the relationship between dependent variables and independent variables. Also, the reliability and internal consistency of medical student syndrome scale was checked by using cronpach alpha, it was 0.92. Results Statistical analysis Data Analysis was performed using SPSS v.27. Frequency and percentage were obtained for each categorical data. Normality was checked before performing inferential statistics by using the Kolmogorov-Smirnov test. The Non-parametric Man-Whitney U and Kruskal- Wallis H tests used to investigate the relationship between dependent variables and independent variables. Also, the reliability and internal consistency of medical student syndrome scale was checked by using cronpach alpha, it was 0.92. Sociodemographic characteristics of study sample The study included 120 participants. The majority of participants were aged 20 or older (90.8%), while those under 20 did not exceed 9.2%. Regarding marital status, most participants were single (86.7%), followed by married (9.2%) and divorced (4.2%). In terms of educational level, fourth-year students constituted the largest percentage (59.2%), followed by second-year students (24.2%) and third-year students (16.7%). Regarding place of residence, 55.8% of participants lived in cities, 41.7% in villages, and only 2.5% in refugee camps. When asked about the motivations for choosing their major, the majority cited personal desire (58.3%), followed by family encouragement (32.5%), and financial reasons (9.2%). Other relevant data shown in Table 1 . Table 1 Sociodemographic characteristics of study sample Item Frequency Percentage (%) Age Group < 20 11 9.2 ≥ 20 109 90.8 Marital Status Single 104 86.7 Married 11 9.2 Divorced 5 4.2 Educational Level 2nd year 29 24.2 3rd year 20 16.7 4th year 71 59.2 Living Location City 67 55.8 Village 50 41.7 Camp 3 2.5 Motivation for Choosing Major Personal desire 70 58.3 Family encouragement 39 32.5 Financial reasons 11 9.2 Most Feared Diseases Reported by Participants Table 2 shows the distribution of the most feared diseases among participants. Cancer was the most common disease, reported by nearly half of the participants (45.0%, n = 54). This was followed by diabetes (11.7%), heart attacks (10.8%), and infectious diseases (10.8%), which also accounted for a significant proportion of fears. Less common fears included skin diseases (10.0%), heart disease (7.5%), and high blood pressure (4.2%). Other relevant data shown in Table 2 . Table 2 Most Feared Diseases Reported by Participants Item Frequency Percentage (%) Heart attack 13 10.8 Cardiac disease 9 7.5 Hypertension (HTN) 5 4.2 Diabetes Mellitus (DM) 14 11.7 Infectious disease 13 10.8 Cancer 54 45.0 Skin disease 12 10.0 Descriptive Statistics of Medical Students' Syndrome Table 3 presents descriptive statistics for the 22 items measuring the dimensions of medical student syndrome among a sample of 120 participants. The mean scores for each individual item ranged from 1.84 (Item 13: "I think I have a serious illness") to 2.51 (Item 4: "I wash my hands excessively for fear of microorganisms"). The corresponding percentages, calculated as a percentage of the maximum score (5-point scale), ranged from 36.84% to 50.16%, with the highest score recorded for compulsive handwashing behavior. The overall mean score on the scale was 47.68 (standard deviation = 18.48) out of a possible maximum of 110, yielding a total percentage of 43.35%, indicating a moderate response level for all items. Other details shown in Table 3 . Table 3 Descriptive Statistics of Medical Students' Syndrome Item No. Item Description Mean Std. Deviation Percentage 1 I am afraid of getting sick 2.367 1.4606 47.34% 2 I am afraid of the microorganisms in my surroundings 2.258 1.3811 45.16% 3 During studying topics related to infection, I feel afraid of the microorganisms in my environment 2.333 1.4857 46.66% 4 I wash my hands excessively for fear of microorganism 2.508 1.5174 50.16% 5 I often notice symptoms of a given disease after completing classes on them 2.292 1.5416 45.84% 6 I wash all my foods excessively for fear of microbes on them 2.192 1.3553 43.84% 7 I pay more attention to symptoms after clinical course 2.192 1.5410 43.84% 8 Suspecting disturbing symptoms causes me fear 2.275 1.4199 45.50% 9 I underestimate disturbing disease symptoms 2.275 1.2962 45.50% 10 Fear of illness keeps me awake at night 2.125 1.2739 42.50% 11 I have panic attacks related to fear for my health 2.017 1.2434 40.34% 12 Fear of illness makes it hard to function socially 2.167 1.3368 43.34% 13 I believe I have a serious illness 1.842 1.1227 36.84% 14 I think of symptoms indicating a suspected illness 1.992 1.2735 39.84% 15 I take steps to diagnose suspected disease 2.008 1.2996 40.16% 16 I trust my doctor when they deny my suspicion 2.217 1.4212 44.34% 17 I seek opinions from many specialists 2.058 1.2655 41.16% 18 I confide in friends about health concerns 2.125 1.2540 42.50% 19 I hide my problem due to study demands 2.067 1.3140 41.34% 20 I sought psychiatric/psychotherapeutic counseling 2.175 1.4003 43.50% 21 I used therapy due to fear of illness 2.083 1.3130 41.66% 22 I use the Internet to diagnose or monitor symptoms 2.117 1.3913 42.34% Total Score Medical Students' Syndrome Total Score 47.68 18.48 43.35% Correlation The Kolmogorov-Smirnov test was conducted to determine if the data was normally distributed, revealed that the data was not normally distributed (p < 0.001 ), as illustrated in Fig. 1 . Therefore, nonparametric analyses, such as the Mann-Whitney and Kruskal-Wallis tests were used to investigate the correlations between independent and dependent variables. Comparison of Medical Student Syndrome Scores by Demographic Variables Comparison of Medical Student Syndrome (MSS) scores across demographic variables revealed some differences; however, none of these differences were statistically significant. Female participants reported higher mean MSS scores (50.34 ± 21.32) than males (43.55 ± 11.96), but this difference did not reach significance (p = 0.167). Similarly, participants aged 20 years and older showed higher mean scores (48.34 ± 18.75) than those under 20 years of age (41.18 ± 14.66), although this was also not statistically significant (p = 0.203). Regarding marital status, divorced participants had the highest mean MSS scores (67.40 ± 33.10), followed by married participants (54.27 ± 24.20) and single participants (46.04 ± 16.40); however, these differences were not statistically significant (p = 0.253). Educational level and residential location also showed some differences in MSS test scores. Third-year students had the highest mean scores (51.75 ± 21.54), while participants residing in camps had significantly higher mean scores (70.67 ± 28.38) compared to those living in cities or villages. However, the differences between these groups were not statistically significant (p = 0.254 for residential location). Motivation for major choice did not significantly affect MSS test scores, with similar averages observed between groups motivated by personal desire, family encouragement, or financial reasons (p = 0.956). Other data demonestrated in Table 4 . Table 4 Comparison of Medical Student Syndrome Scores by Demographic Variables Variable Group N Mean ± SD p-value Gender Male 47 43.55 ± 11.96 0.167 Female 73 50.34 ± 21.32 Total 120 47.68 ± 18.48 Age Group < 20 11 41.18 ± 14.66 0.203 ≥ 20 109 48.34 ± 18.75 Total 120 47.68 ± 18.48 Marital Status Single 104 46.04 ± 16.40 0.253 Married 11 54.27 ± 24.20 Divorced 5 67.40 ± 33.10 Total 120 47.68 ± 18.48 0.534 Educational Level 2nd year 29 45.59 ± 12.66 3rd year 20 51.75 ± 21.54 4th year 71 47.39 ± 19.59 Total 120 47.68 ± 18.48 Living Location City 67 47.63 ± 17.44 0.254 Village 50 46.38 ± 18.78 Camp 3 70.67 ± 28.38 Total 120 47.68 ± 18.48 Motivation for Choosing Major Personal desire 70 47.87 ± 18.78 0.956 Family encouragement 39 46.90 ± 18.51 Financial reasons 11 49.27 ± 17.94 Total 120 47.68 ± 18.48 Medical Student Syndrome Scores by Most Feared Disease Analysis of MSS scores by participants' most feared disease as shown in Table 5 revealed variation, with fear of high blood pressure associated with the highest mean score (M = 64.60, SD = 27.91), followed by infectious diseases (M = 51.15, SD = 18.08), and diabetes (M = 49.07, SD = 25.90). Participants who feared heart attacks had the lowest mean score (M = 43.31, SD = 10.98). However, differences in MSS scores across disease categories were not statistically significant (F(6,113) = –, p = 0.665). Table 5 Medical Student Syndrome Scores by Most Feared Disease Most Feared Disease N Mean ± SD p-value Heart attack 13 43.31 ± 10.98 Cardiac disease 9 45.78 ± 17.04 Hypertension (HTN) 5 64.60 ± 27.91 Diabetes Mellitus (DM) 14 49.07 ± 25.90 Infectious disease 13 51.15 ± 18.08 Cancer 54 46.00 ± 18.37 Skin disease 12 49.00 ± 10.24 Total 120 47.68 ± 18.48 0.665 Discussion This chapter will compare the results of the studies that conducted on the same topic, also will include study' recommendations, limitations and conclusion. Also, the sample included representative participants that reflected the general population, and covered alot of factors such as sociodemographic characteristics of the participents including age, gender, various years of study and other factors that reflect the characteristics of entire population. In regard to the study’s sample and sampling method, the sample size considered enough for this study, as it helped in collecting enough information, this will facilitate the generalization process of our findings. Also the data collection of the research was also strong, as manifested by the very low percentage of missing data. Comparison between the results of this study and previous studies The prevelance of MSS in study [ 16 ] was 78.2%. The factors that associated with this syndrome were gender in which male medical students have a higher rate of MSS (65.6%) compared to female medical students. In contrast our study showed that the overall prevelance of MSS was 43.35%, indicating a moderate level of MSS. And the age wasn't associated with the prevelance of MSS. On other hand two studies [ 17 ], [ 9 ] showed that age was associated with higher levels of MSS (for students under 22 years old). The results of two studies [ 1 ], [ 12 ] showed that medical students tended to encounter MSS more frequently as their education advanced. But study by [ 7 ] showed that the advancment in years of study lead to lower score of MSS. On other hand our study and previous research [ 6 ] showed absence of relationship with nurses' year of study and the prevelance of MSS, but third-year students had the highest mean scores (51.75 ± 21.54). The results of our study [ 3 ] showed that regarding marital status, divorced participants had the highest mean MSS scores (67.40 ± 33.10), followed by married participants (54.27 ± 24.20) and single participants (46.04 ± 16.40); however, these differences were not statistically significant (p = 0.253). But study by showed that marital status plays a crucial role in the occurrence of MSS; being married considerably raises MSS rates among medical students (53.8% compared to 21.3%, P = 0.018). The results of study [ 13 ] by showed that the medical students were noted to have a greater fear of diabetes, hypertension, headaches, and cancer respectively. On other hand our study showed that fear of high blood pressure associated with the highest mean score (M = 64.60, SD = 27.91), followed by infectious diseases (M = 51.15, SD = 18.08), and diabetes (M = 49.07, SD = 25.90). Our results indicated that 43.35% of students suffered from MSS indicating moderate severity. These findings agreed with study [ 14 ] that indicated to the presence of moderate stress caused by MSS. But this study indicated that the degree of stress is associated with gender; female students experience a higher level of stress compared to male. These findings contraindicated with our study and study conducted by [ 12 ] in which botg studies showed that female participants reported higher mean MSS scores than males, but this difference did not reach significance (p = 0.167). Previous study conducted by and showed that the occurrence of MSS was 62.2%, and it's linked with being in the middle years of study. On other hand, our results showed that 43.35% of students suffered from MSS indicating moderate severity. And according to years of study, the results showed that third-year students had the highest mean scores (51.75 ± 21.54), but it did not reach significant level (p-value 0.534). These deffirences may be related to the use of various sampling methods between both studies (convenience in our study, and simple random sampling by [ 4 ]. Conclusion This study examined the prevalence of Medical Student Syndrome (MSS) and its associated factors among nursing students at the Arab American University Palestine. The findings revealed a moderate overall level of MSS, with no statistically significant differences across gender, age group, academic year, or other sociodemographic variables. Although MSS was present among students, its distribution appeared relatively uniform across subgroups. These results highlight the importance of recognizing illness-related anxiety among nursing students and underscore the need for targeted awareness and support strategies within academic institutions. Further multi-center and longitudinal research is recommended to deepen understanding of MSS, explore its underlying determinants, and develop effective interventions that promote psychological well-being and academic success among future healthcare professionals. Recommendations Based on the findings of this study, several recommendations are proposed. First, future research should include multi-center studies across universities in the West Bank to obtain a larger and more representative sample, allowing for a clearer understanding of how different demographic and academic variables may influence the prevalence of Medical Student Syndrome (MSS). Second, it is recommended to expand the target population in upcoming studies to include healthcare providers in hospitals as well as individuals from the general community in order to better assess the broader prevalence and characteristics of MSS. Finally, raising awareness among nursing students, university staff, and healthcare professionals about MSS its symptoms, contributing factors, and effective coping strategies is essential to supporting early recognition and promoting healthier psychological and academic well-being. Limitations This study has several limitations that should be acknowledged. First, political circumstances in Palestine posed challenges in obtaining participants’ responses from multiple universities, which limited the ability to conduct a broader multi-center investigation. Second, the use of a cross-sectional design restricts the ability to establish causal relationships, and other research designs particularly interventional or longitudinal studies may yield stronger evidence to inform practice. Finally, time constraints restricted data collection to nursing students only, preventing the inclusion of students from other faculties who may also experience Medical Student Syndrome. These limitations should be considered when interpreting the findings and planning future research. Abbreviations AAUP Arab American University Palestine IRB Institutional Review Board MSS Medical Student Syndrome SD Standard Deviation SPSS Statistical Package for the Social Sciences K-S Test Kolmogorov–Smirnov Test. Declarations Ethics approval and consent to participate Prior to initiating data collection, the study was conducted in accordance with the nursing faculty guidelines at AAUP, and ethical approval was obtained from the Institutional Review Board (IRB) at the Arab American University Palestine (IRB Approval No. R-2025/A/4/N). Written informed consent was obtained from each participant after clearly explaining the purpose of the study, assuring them of their anonymity, confidentiality, and their right to withdraw at any stage without any consequences. Participants were also informed that they could request access to the study results upon completion. All ethical procedures followed the principles outlined in the Declaration of Helsinki for research involving human subjects [ 15 ]. Consent for publication Not applicable Competing interests The authors declare that they have no competing interests. Funding None Author Contribution ENZ conceptualized the study, designed the methodology, supervised the research process, contributed to data analysis, and critically revised the manuscript. BFS contributed to conceptualization, coordinated data collection, performed data entry and statistical analysis, drafted major sections of the manuscript, and participated in revision. SNA assisted in tool adaptation, data collection, and preliminary data processing, and contributed to writing the results and discussion. QZA contributed to the literature review, reference organization, data verification, and drafting of the introduction. MEA participated in data collection, supported statistical analysis, and assisted in preparing tables and figures. MHD provided methodological supervision, contributed to interpretation of findings, and reviewed the final manuscript. All authors read and approved the final manuscript. Acknowledgment Not applicable. Availability of data and materials The data sets supporting the current research results are available from the corresponding authors upon request. References Abdullah SH, Ahmed AE, Algebail HGE, Fatooh A, Ismail LNA, Radwan NK, Sakan NB, Barqawi HJ. Medical Students' Syndrome among Medical Students in the University of Sharjah, UAE. Avicenna J Med. 2023;13(2):77–81. Eslami Shahrbabaki M, Ahmadipour Farsangi H, Bagheri F. Medical Students’ Syndrome: A Cross Sectional Study from South East of Iran. Shiraz E-Medical Journal 2018, In Press. Bin Abdulrahman K, Bahmaid R, Alrajhi D, Alturki B, Alhazani F, Alayed F. Medical students’ syndrome among medical students in Riyadh, Saudi Arabia. World Family Med J /Middle East J Family Med 2023, 21. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8065122","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":556550185,"identity":"70d1445c-0d24-408e-b838-414e453005f6","order_by":0,"name":"Emad Naser Zaid","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyUlEQVRIiWNgGAWjYLCCBDYbIHmADUgwE60ljVQtDGyHwSRxWvgZ2B9+eFB2Po+/8fCzBwwV1okNhLRINjAkSyScu10sceCYuQHDmXTCWgwOMByQSGy7ndhw4ICZBGPbYcJa7A8wNv9IbDuXOP/A8W8SjP+I0GLAwMwGtOVA4oYDZ4C2NBChReIwG5tFwrnkxI0HzpRJJBxLNyaohb+9/fHNH2V2ifNuHN8m8aHGWpagFkRESBwAxilB5aj2ETZ+FIyCUTAKRigAAB0DQpLz9F10AAAAAElFTkSuQmCC","orcid":"","institution":"An-Najah National University","correspondingAuthor":true,"prefix":"","firstName":"Emad","middleName":"Naser","lastName":"Zaid","suffix":""},{"id":556550186,"identity":"e203b463-66da-443d-8a73-424231103605","order_by":1,"name":"Baraa F. Shayeb","email":"","orcid":"","institution":"An-Najah National University","correspondingAuthor":false,"prefix":"","firstName":"Baraa","middleName":"F.","lastName":"Shayeb","suffix":""},{"id":556550187,"identity":"84d0cfc3-facf-4d37-996b-b09e11a2ed2e","order_by":2,"name":"Salam nuhad ali","email":"","orcid":"","institution":"Arab American University","correspondingAuthor":false,"prefix":"","firstName":"Salam","middleName":"nuhad","lastName":"ali","suffix":""},{"id":556550188,"identity":"a2248adf-48b0-4454-b703-3fa06f418ec9","order_by":3,"name":"Qutayba Z. Ayaseh","email":"","orcid":"","institution":"An-Najah National University","correspondingAuthor":false,"prefix":"","firstName":"Qutayba","middleName":"Z.","lastName":"Ayaseh","suffix":""},{"id":556550189,"identity":"44bb88c1-f017-4619-a943-e50a1f5ced78","order_by":4,"name":"Mohammad Emad Abuayyash","email":"","orcid":"","institution":"An-Najah National University","correspondingAuthor":false,"prefix":"","firstName":"Mohammad","middleName":"Emad","lastName":"Abuayyash","suffix":""},{"id":556550190,"identity":"30e7e052-7e5d-4596-9bc1-ac1ca7312aa8","order_by":5,"name":"Mohammad Hasan. Dwikat","email":"","orcid":"","institution":"An-Najah National University","correspondingAuthor":false,"prefix":"","firstName":"Mohammad","middleName":"Hasan.","lastName":"Dwikat","suffix":""}],"badges":[],"createdAt":"2025-11-08 16:08:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8065122/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8065122/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":97707992,"identity":"ff39f559-a9fd-469c-9449-65abfabf56b8","added_by":"auto","created_at":"2025-12-08 13:09:55","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":76298,"visible":true,"origin":"","legend":"","description":"","filename":"EmadBMCMedicalStudent1.docx","url":"https://assets-eu.researchsquare.com/files/rs-8065122/v1/eeafe7ed7bc156984b378262.docx"},{"id":97895225,"identity":"8d6ccdb4-b41f-46ac-8c96-3b9febc200ee","added_by":"auto","created_at":"2025-12-10 15:33:50","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":7729,"visible":true,"origin":"","legend":"","description":"","filename":"a7a7dc58eeab49df868ec99d903f7b90.json","url":"https://assets-eu.researchsquare.com/files/rs-8065122/v1/c1b6e84e2abb739a6fec51f4.json"},{"id":97707994,"identity":"33ea7912-ce1b-484d-8c17-6355714e517f","added_by":"auto","created_at":"2025-12-08 13:09:55","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":100615,"visible":true,"origin":"","legend":"","description":"","filename":"a7a7dc58eeab49df868ec99d903f7b901enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-8065122/v1/8330fb679719dff58cb328fa.xml"},{"id":97707989,"identity":"92f2571f-e77b-4321-a5d4-6319bc1ca8f5","added_by":"auto","created_at":"2025-12-08 13:09:55","extension":"png","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10035,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8065122/v1/222f6094c42a2fcf1588ea43.png"},{"id":97895251,"identity":"1f17aeb8-f911-46ff-949e-d6eec5d34ac9","added_by":"auto","created_at":"2025-12-10 15:33:52","extension":"xml","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":99133,"visible":true,"origin":"","legend":"","description":"","filename":"a7a7dc58eeab49df868ec99d903f7b901structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8065122/v1/a67b6a0f57ec0726f20e5d2d.xml"},{"id":97707990,"identity":"cc09febf-40b6-4a44-82b8-0b231f82ba9a","added_by":"auto","created_at":"2025-12-08 13:09:55","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":106289,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8065122/v1/4efe2ae48e6f17350c7b3029.html"},{"id":97707988,"identity":"eecfe39d-b500-4472-a4b5-8a5d7f0defbe","added_by":"auto","created_at":"2025-12-08 13:09:55","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":16088,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eNormal Q-Q Plot of medical student syndrome\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8065122/v1/4d378d160b46362dd9adbba9.png"},{"id":97902513,"identity":"28f4aaf5-afc8-4a09-8a25-b0a7594806a3","added_by":"auto","created_at":"2025-12-10 15:52:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1251524,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8065122/v1/e10b1036-569a-40f7-8829-17214e11b98c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Occurrence of Medical Student Syndrome and Associated Factors Among AAUP Nursing students in Palestine","fulltext":[{"header":"Introduction","content":"\u003ch3\u003eBackground\u003c/h3\u003e\n\u003cp\u003eMedical Students Syndrome (MSS) is characterized by health-related anxiety in medical students when they study a particular disease, often due to their tendency to misinterpret their own symptoms as indicative of that disease. It is also referred to as second year syndrome, intern's syndrome, nosophobia, and medical studentitis [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eNosophobia refers to a continual, irrational fear that a student has of developing a chronic and potentially fatal illness, such as cancer or CAD [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Nevertheless, Nosophobia is distinct from hypochondria, an illness anxiety disorder that causes individuals to fret about various illnesses, encompassing broader concerns regarding health [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThus, this overwhelming and illogical fear and anxiety can lead to physical symptoms such as: quickened breathing, difficulty sleeping, elevated heart rate, perspiration, lightheadedness, and nausea. Multiple elements may play a role in MSS, yet a definitive cause remains unclear. These factors encompass: being around someone with a severe illness, experiencing a disease outbreak such as the COVID-19 pandemic, and with contemporary living, the availability of health information on the Internet or various resources has become more accessible, enabling individuals to find comprehensive lists of symptoms and complications linked to almost any disease online; furthermore, a family history significantly influences this [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] .\u003c/p\u003e\u003cp\u003eIt is believed that many medical students often experience symptoms of illness and fears concerning the diseases they are learning about over time, a phenomenon known as \u0026lsquo;medical student syndrome\u0026rsquo; [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Numerous studies have shown that attending medical school places significant psychological pressure on students due to the workload involved, the stress from classes and exams, the anxiety from new clinical experiences, and the competitive atmosphere among peers [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThis stress will influence symptoms that amplify physical sensations through autonomic activation, increasing individuals' awareness of their bodily condition, especially regarding pain perception. Medical students are also exposed to medical knowledge through intensive clinical and preclinical experiences. This knowledge influences symptom perception through the schemata (illness beliefs and expectations) that develop from it, resulting in heightened attention to particular bodily sensations and regions [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe distinction between nosophobia and hypochondria is that nosophobia refers to an intense and irrational fear of acquiring or experiencing a particular illness. However, the term \"hypochondria\" pertains to Hypochondriasis, which is a psychiatric condition characterized by an obsession with the fear of possessing, or believing one already has, a severe illness connected to the misinterpretation of physical symptoms despite adequate medical assessment and reassurance [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Recently, the COVID-19 pandemic has become an important element to consider as it has heightened overall public awareness and fear concerning illness and even death [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAdditionally, earlier studies highlighted that, in general, quarantine could lead to mental health issues in individuals who had no prior problems, suggesting that the pandemic situation might have also played a role in the rise of nosophobia and hypochondria symptoms [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eNosophobia occurs when an individual experiences an intense or unreasonable fear of acquiring or developing a particular illness, also referred to as disease phobia. Sometimes referred to as medical students' disease, nosophobia is believed to impact medical students more than others, as they are immersed in information regarding various illnesses [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The key distinction between nosophobia and hypochondria is that nosophobia pertains to the fear of acquiring a particular disease, whereas hypochondria deals with broader concerns regarding health. In other terms, nosophobia refers to the fear of diseases, whereas hypochondria is known as illness anxiety disorder or the fear of being ill [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIt is thought that a number of medical students experience anxieties and signs of illness associated with the diseases they are continuously studying, a phenomenon referred to as 'medical student syndrome' [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Numerous studies have shown that medical schools impose considerable psychological pressure on students due to the extensive workload, the stress of exams, the anxiety related to new clinical experiences, and the competitive atmosphere. Numerous studies have documented visits to doctors stemming from mandatory health examinations before starting medical school, as well as enrolling with a new General Practitioner near the university, particularly among first-year students who experience higher stress and anxiety levels compared to their peers [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eA prior study indicated that after learning about a new disease, medical students tend to think of symptoms from that specific condition they previously studied, leading them to believe they are experiencing these symptoms, which can trigger anxiety and stress known as disease phobia [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe patient consistently looks for a medical diagnosis in instances of hypochondria, whereas in the case of MSS, there is no rise in the frequency of medical consultations [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Thus, students diagnosed with MSS are less likely to seek medical assistance, but they believe or fear that they might have a disease. This form of hypochondria is distinct and can result in numerous health-related anxiety crises; it occurs in medical students who are intensely focused during their training [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eProblem Statement\u003c/h3\u003e\n\u003cp\u003eMSS is regarded as a psychologically important condition, yet there is insufficient awareness of it among students, particularly in Palestine. This syndrome generates irrational fears and anxiety with no identifiable reasons, impacting students' lives and lowering their academic performance. Numerous studies have shown that attending medical school subjects students to significant psychological stress due to the workload, exam pressures, anxiety from new clinical experiences, and the competitive atmosphere among peers [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eUp to the range of search in this study, there's no published study that conducted to assess the occurrence of medical student syndrome among nursing worldwide, and specificely among nursing students in Palestine.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eAim of the study\u003c/h2\u003e\u003cp\u003eThe aim of this study is to assess the prevalence of Medical Student Syndrome (MSS) and its associated factors among nursing students at the Arab American University Palestine (AAUP). Specifically, the study seeks to compare the prevalence of MSS between female and male students, examine differences in MSS prevalence between first-year students and those in more advanced years of study, and evaluate the relationship between students\u0026rsquo; educational level and the likelihood of experiencing MSS within the AAUP nursing population.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eSignificance of the Study\u003c/h3\u003e\n\u003cp\u003eMedical student's syndrome causes an irrational fear and anxiety without known causes [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. It's affected students' academic performence and whole life. So it\u0026rsquo;s important to study the this syndrome among students [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAlso students in medicals colleges suffer from higher level of stress related to theortical and clinical courses [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe absence of published studies that targeted this syndrome especially in Palestine, make this study very important, because the results of this study could provide further baselines for future researches about this topic.\u003c/p\u003e\u003cp\u003eAlso, the results could support the eveidence-based practice because as mentioned by study [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. unspecialized health care worker have poor knowledge about this syndrom and how to deal with it. So, this study will support both knowledge and practice about this syndrome.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis chapter will present all methodology elements that used to guide this study including study design, inclusion and exclusion criteria, sample and sampling procedure, site and setting, data collection procedures, data analysis, ethical considerations, measurements, pilot study, proposed budget and timetable of study.\u003c/p\u003e\n\u003ch3\u003eStudy Design\u003c/h3\u003e\n\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe study was conducted using analytical cross-sectional quantitative design. It was suitable for the study aims, as it helped in investigating multiple independent variables, and it is time- and cost-efficient. Moreover, it helped in investigating the correlation between independent and dependent variables to test the hypotheses.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003eSite and Setting\u003c/h3\u003e\n\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe study was conducted at AAUP, in faculty of nursing.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eSample and Sampling\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe target population for this study consisted of all nursing students enrolled at the intended university, regardless of age, gender, or educational level. A convenience sampling technique was employed due to the practical difficulty of systematically tracking students across different time periods, even when a complete list of names was available. Students were approached and recruited progressively, one after another, until the desired sample size was achieved. Inclusion criteria required participants to be registered nursing students at the university and to provide fully completed questionnaires. Students from other universities or from majors outside nursing, as well as those with incomplete data, were excluded from the study. The sample size was determined using G*Power software (Windows version), applying an independent-samples t-test with a two-tailed approach and a 95% confidence level. Based on these parameters, the required sample size was calculated to be 120 nursing students.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eStudy Instruments\u003c/h3\u003e\n\u003cp\u003eA self-administered questionnaire taken from [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] was used for data collection, which include two sections: Section one: include eight questions about Sociodemographic data of the participents. Section two: Include 22 questions about MSS (1: Strongly disagree, 2: Disagree, 3: Neutral, 4: Agree, and 5: Strongly agree). For validity, content validity was assessed by making sure the questions cover all relevant aspects of the topic by asking three experts from the researchers' faculty and their opinions were taken into consideration before data collection process. The reliability and internal consistency was checked by using cronbach Alpha test in SPSS and it was 0.92.\u003c/p\u003e\u003cp\u003eAs the existing validated tools did not consider the COVID-19 pandemic, we decided to design our own tool. As we expected timely responses reflecting the current pandemic situation, the questionnaire did not go through the standard validation process. However, our questionnaire was based on DSM-5 criteria as well as on the analysis of existing literature.\u003c/p\u003e\n\u003ch3\u003ePeriod of the study\u003c/h3\u003e\n\u003cp\u003eThis study was conducted from March to June 2025, during students fourth year.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003ePilot study\u003c/h2\u003e\u003cp\u003eA pilot study was conducted prior to data collection among 10% of the sample from the population. The pilot study aimed to explore any obstacles or problems that may face the data collection process. Also, it helped in assessing the readability, clarity, suitability and flexibility among the participant. Pilot study also aimed to identify unclear or ambiguous items in the questionnaire, and it gave important information about concerns that needed to be solved. The pilot study also helped to identify any concerns and adjust them. Moreover, it showed the efficiency of the instrument that is used in larger population.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eData Collection Procedure\u003c/h2\u003e\u003cp\u003eData collection done by distribution of the questionnaire on nursing groups at facebook website, and in the private groups for nursing faculties. Each student asked to give consent form for participation in the study. After that the students asked to answere the questionnaire completely.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eEthical Considerations\u003c/h2\u003e\u003cp\u003e Prior to initiating data collection, the study was conducted in accordance with the nursing faculty guidelines at AAUP, and ethical approval was obtained from the Institutional Review Board (IRB) at the Arab American University Palestine (IRB Approval No. R-2025/A/4/N). Written informed consent was obtained from each participant after clearly explaining the purpose of the study, assuring them of their anonymity, confidentiality, and their right to withdraw at any stage without any consequences. Participants were also informed that they could request access to the study results upon completion. All ethical procedures followed the principles outlined in the Declaration of Helsinki for research involving human subjects [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eData Analysis was performed using SPSS v.27. Frequency and percentage were obtained for each categorical data. Normality was checked before performing inferential statistics by using the Kolmogorov-Smirnov test. The Non-parametric Man-Whitney U and Kruskal- Wallis H tests used to investigate the relationship between dependent variables and independent variables. Also, the reliability and internal consistency of medical student syndrome scale was checked by using cronpach alpha, it was 0.92.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eData Analysis was performed using SPSS v.27. Frequency and percentage were obtained for each categorical data. Normality was checked before performing inferential statistics by using the Kolmogorov-Smirnov test. The Non-parametric Man-Whitney U and Kruskal- Wallis H tests used to investigate the relationship between dependent variables and independent variables. Also, the reliability and internal consistency of medical student syndrome scale was checked by using cronpach alpha, it was 0.92.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003eSociodemographic characteristics of study sample\u003c/h2\u003e\u003cp\u003eThe study included 120 participants. The majority of participants were aged 20 or older (90.8%), while those under 20 did not exceed 9.2%. Regarding marital status, most participants were single (86.7%), followed by married (9.2%) and divorced (4.2%). In terms of educational level, fourth-year students constituted the largest percentage (59.2%), followed by second-year students (24.2%) and third-year students (16.7%). Regarding place of residence, 55.8% of participants lived in cities, 41.7% in villages, and only 2.5% in refugee camps. When asked about the motivations for choosing their major, the majority cited personal desire (58.3%), followed by family encouragement (32.5%), and financial reasons (9.2%). Other relevant data shown in Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSociodemographic characteristics of study sample\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eItem\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge Group\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e109\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e90.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e104\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e86.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducational Level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2nd year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3rd year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4th year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e59.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLiving Location\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e55.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVillage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e41.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCamp\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMotivation for Choosing Major\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePersonal desire\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e58.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamily encouragement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFinancial reasons\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003eMost Feared Diseases Reported by Participants\u003c/h2\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the distribution of the most feared diseases among participants. Cancer was the most common disease, reported by nearly half of the participants (45.0%, n\u0026thinsp;=\u0026thinsp;54). This was followed by diabetes (11.7%), heart attacks (10.8%), and infectious diseases (10.8%), which also accounted for a significant proportion of fears. Less common fears included skin diseases (10.0%), heart disease (7.5%), and high blood pressure (4.2%). Other relevant data shown in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eMost Feared Diseases Reported by Participants\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eItem\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeart attack\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCardiac disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypertension (HTN)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiabetes Mellitus (DM)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInfectious disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCancer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e45.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSkin disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\u003ch2\u003eDescriptive Statistics of Medical Students' Syndrome\u003c/h2\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents descriptive statistics for the 22 items measuring the dimensions of medical student syndrome among a sample of 120 participants. The mean scores for each individual item ranged from 1.84 (Item 13: \"I think I have a serious illness\") to 2.51 (Item 4: \"I wash my hands excessively for fear of microorganisms\"). The corresponding percentages, calculated as a percentage of the maximum score (5-point scale), ranged from 36.84% to 50.16%, with the highest score recorded for compulsive handwashing behavior. The overall mean score on the scale was 47.68 (standard deviation\u0026thinsp;=\u0026thinsp;18.48) out of a possible maximum of 110, yielding a total percentage of 43.35%, indicating a moderate response level for all items. Other details shown in Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDescriptive Statistics of Medical Students' Syndrome\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eItem No.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eItem Description\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStd. Deviation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI am afraid of getting sick\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.367\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.4606\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e47.34%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI am afraid of the microorganisms in my surroundings\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.258\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.3811\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e45.16%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDuring studying topics related to infection, I feel afraid of the microorganisms in my environment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.333\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.4857\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e46.66%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI wash my hands excessively for fear of microorganism\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.508\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.5174\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e50.16%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI often notice symptoms of a given disease after completing classes on them\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.292\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.5416\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e45.84%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI wash all my foods excessively for fear of microbes on them\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.192\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.3553\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e43.84%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI pay more attention to symptoms after clinical course\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.192\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.5410\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e43.84%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSuspecting disturbing symptoms causes me fear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.275\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.4199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e45.50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI underestimate disturbing disease symptoms\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.275\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.2962\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e45.50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFear of illness keeps me awake at night\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.2739\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e42.50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI have panic attacks related to fear for my health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.017\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.2434\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e40.34%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFear of illness makes it hard to function socially\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.167\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.3368\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e43.34%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI believe I have a serious illness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.842\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.1227\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e36.84%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI think of symptoms indicating a suspected illness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.992\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.2735\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e39.84%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI take steps to diagnose suspected disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.008\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.2996\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e40.16%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI trust my doctor when they deny my suspicion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.217\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.4212\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e44.34%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI seek opinions from many specialists\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.058\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.2655\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e41.16%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI confide in friends about health concerns\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.2540\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e42.50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI hide my problem due to study demands\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.067\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.3140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e41.34%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI sought psychiatric/psychotherapeutic counseling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.175\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.4003\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e43.50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI used therapy due to fear of illness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.083\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.3130\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e41.66%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eI use the Internet to diagnose or monitor symptoms\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.117\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.3913\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e42.34%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal Score\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMedical Students' Syndrome Total Score\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e47.68\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e18.48\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e43.35%\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\u003ch2\u003eCorrelation\u003c/h2\u003e\u003cp\u003eThe Kolmogorov-Smirnov test was conducted to determine if the data was normally distributed, revealed that the data was not normally distributed \u003cem\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), as illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Therefore, nonparametric analyses, such as the Mann-Whitney and Kruskal-Wallis tests were used to investigate the correlations between independent and dependent variables.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\u003ch2\u003eComparison of Medical Student Syndrome Scores by Demographic Variables\u003c/h2\u003e\u003cp\u003eComparison of Medical Student Syndrome (MSS) scores across demographic variables revealed some differences; however, none of these differences were statistically significant. Female participants reported higher mean MSS scores (50.34\u0026thinsp;\u0026plusmn;\u0026thinsp;21.32) than males (43.55\u0026thinsp;\u0026plusmn;\u0026thinsp;11.96), but this difference did not reach significance (p\u0026thinsp;=\u0026thinsp;0.167).\u003c/p\u003e\u003cp\u003eSimilarly, participants aged 20 years and older showed higher mean scores (48.34\u0026thinsp;\u0026plusmn;\u0026thinsp;18.75) than those under 20 years of age (41.18\u0026thinsp;\u0026plusmn;\u0026thinsp;14.66), although this was also not statistically significant (p\u0026thinsp;=\u0026thinsp;0.203). Regarding marital status, divorced participants had the highest mean MSS scores (67.40\u0026thinsp;\u0026plusmn;\u0026thinsp;33.10), followed by married participants (54.27\u0026thinsp;\u0026plusmn;\u0026thinsp;24.20) and single participants (46.04\u0026thinsp;\u0026plusmn;\u0026thinsp;16.40); however, these differences were not statistically significant (p\u0026thinsp;=\u0026thinsp;0.253).\u003c/p\u003e\u003cp\u003eEducational level and residential location also showed some differences in MSS test scores. Third-year students had the highest mean scores (51.75\u0026thinsp;\u0026plusmn;\u0026thinsp;21.54), while participants residing in camps had significantly higher mean scores (70.67\u0026thinsp;\u0026plusmn;\u0026thinsp;28.38) compared to those living in cities or villages. However, the differences between these groups were not statistically significant (p\u0026thinsp;=\u0026thinsp;0.254 for residential location).\u003c/p\u003e\u003cp\u003eMotivation for major choice did not significantly affect MSS test scores, with similar averages observed between groups motivated by personal desire, family encouragement, or financial reasons (p\u0026thinsp;=\u0026thinsp;0.956). Other data demonestrated in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Medical Student Syndrome Scores by Demographic Variables\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroup\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e43.55\u0026thinsp;\u0026plusmn;\u0026thinsp;11.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.167\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e50.34\u0026thinsp;\u0026plusmn;\u0026thinsp;21.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.68\u0026thinsp;\u0026plusmn;\u0026thinsp;18.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge Group\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e41.18\u0026thinsp;\u0026plusmn;\u0026thinsp;14.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.203\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e109\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e48.34\u0026thinsp;\u0026plusmn;\u0026thinsp;18.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.68\u0026thinsp;\u0026plusmn;\u0026thinsp;18.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e104\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e46.04\u0026thinsp;\u0026plusmn;\u0026thinsp;16.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.253\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e54.27\u0026thinsp;\u0026plusmn;\u0026thinsp;24.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDivorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e67.40\u0026thinsp;\u0026plusmn;\u0026thinsp;33.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.68\u0026thinsp;\u0026plusmn;\u0026thinsp;18.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.534\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducational Level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2nd year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e45.59\u0026thinsp;\u0026plusmn;\u0026thinsp;12.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3rd year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e51.75\u0026thinsp;\u0026plusmn;\u0026thinsp;21.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4th year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.39\u0026thinsp;\u0026plusmn;\u0026thinsp;19.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.68\u0026thinsp;\u0026plusmn;\u0026thinsp;18.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLiving Location\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.63\u0026thinsp;\u0026plusmn;\u0026thinsp;17.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.254\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVillage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e46.38\u0026thinsp;\u0026plusmn;\u0026thinsp;18.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCamp\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e70.67\u0026thinsp;\u0026plusmn;\u0026thinsp;28.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.68\u0026thinsp;\u0026plusmn;\u0026thinsp;18.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMotivation for Choosing Major\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePersonal desire\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.87\u0026thinsp;\u0026plusmn;\u0026thinsp;18.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.956\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFamily encouragement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e46.90\u0026thinsp;\u0026plusmn;\u0026thinsp;18.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFinancial reasons\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e49.27\u0026thinsp;\u0026plusmn;\u0026thinsp;17.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.68\u0026thinsp;\u0026plusmn;\u0026thinsp;18.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\u003ch2\u003eMedical Student Syndrome Scores by Most Feared Disease\u003c/h2\u003e\u003cp\u003eAnalysis of MSS scores by participants' most feared disease as shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e revealed variation, with fear of high blood pressure associated with the highest mean score (M\u0026thinsp;=\u0026thinsp;64.60, SD\u0026thinsp;=\u0026thinsp;27.91), followed by infectious diseases (M\u0026thinsp;=\u0026thinsp;51.15, SD\u0026thinsp;=\u0026thinsp;18.08), and diabetes (M\u0026thinsp;=\u0026thinsp;49.07, SD\u0026thinsp;=\u0026thinsp;25.90). Participants who feared heart attacks had the lowest mean score (M\u0026thinsp;=\u0026thinsp;43.31, SD\u0026thinsp;=\u0026thinsp;10.98). However, differences in MSS scores across disease categories were not statistically significant (F(6,113) = \u0026ndash;, p\u0026thinsp;=\u0026thinsp;0.665).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMedical Student Syndrome Scores by Most Feared Disease\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMost Feared Disease\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeart attack\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e43.31\u0026thinsp;\u0026plusmn;\u0026thinsp;10.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCardiac disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e45.78\u0026thinsp;\u0026plusmn;\u0026thinsp;17.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypertension (HTN)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e64.60\u0026thinsp;\u0026plusmn;\u0026thinsp;27.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiabetes Mellitus (DM)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e49.07\u0026thinsp;\u0026plusmn;\u0026thinsp;25.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInfectious disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e51.15\u0026thinsp;\u0026plusmn;\u0026thinsp;18.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCancer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e46.00\u0026thinsp;\u0026plusmn;\u0026thinsp;18.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSkin disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e49.00\u0026thinsp;\u0026plusmn;\u0026thinsp;10.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e47.68\u0026thinsp;\u0026plusmn;\u0026thinsp;18.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.665\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis chapter will compare the results of the studies that conducted on the same topic, also will include study' recommendations, limitations and conclusion.\u003c/p\u003e\u003cp\u003eAlso, the sample included representative participants that reflected the general population, and covered alot of factors such as sociodemographic characteristics of the participents including age, gender, various years of study and other factors that reflect the characteristics of entire population.\u003c/p\u003e\u003cp\u003eIn regard to the study\u0026rsquo;s sample and sampling method, the sample size considered enough for this study, as it helped in collecting enough information, this will facilitate the generalization process of our findings. Also the data collection of the research was also strong, as manifested by the very low percentage of missing data.\u003c/p\u003e\u003cdiv id=\"Sec24\" class=\"Section2\"\u003e\u003ch2\u003eComparison between the results of this study and previous studies\u003c/h2\u003e\u003cp\u003eThe prevelance of MSS in study [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] was 78.2%. The factors that associated with this syndrome were gender in which male medical students have a higher rate of MSS (65.6%) compared to female medical students. In contrast our study showed that the overall prevelance of MSS was 43.35%, indicating a moderate level of MSS. And the age wasn't associated with the prevelance of MSS. On other hand two studies [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] showed that age was associated with higher levels of MSS (for students under 22 years old).\u003c/p\u003e\u003cp\u003eThe results of two studies [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] showed that medical students tended to encounter MSS more frequently as their education advanced. But study by [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] showed that the advancment in years of study lead to lower score of MSS. On other hand our study and previous research [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] showed absence of relationship with nurses' year of study and the prevelance of MSS, but third-year students had the highest mean scores (51.75\u0026thinsp;\u0026plusmn;\u0026thinsp;21.54).\u003c/p\u003e\u003cp\u003eThe results of our study [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] showed that regarding marital status, divorced participants had the highest mean MSS scores (67.40\u0026thinsp;\u0026plusmn;\u0026thinsp;33.10), followed by married participants (54.27\u0026thinsp;\u0026plusmn;\u0026thinsp;24.20) and single participants (46.04\u0026thinsp;\u0026plusmn;\u0026thinsp;16.40); however, these differences were not statistically significant (p\u0026thinsp;=\u0026thinsp;0.253). But study by showed that marital status plays a crucial role in the occurrence of MSS; being married considerably raises MSS rates among medical students (53.8% compared to 21.3%, P\u0026thinsp;=\u0026thinsp;0.018).\u003c/p\u003e\u003cp\u003eThe results of study [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] by showed that the medical students were noted to have a greater fear of diabetes, hypertension, headaches, and cancer respectively. On other hand our study showed that fear of high blood pressure associated with the highest mean score (M\u0026thinsp;=\u0026thinsp;64.60, SD\u0026thinsp;=\u0026thinsp;27.91), followed by infectious diseases (M\u0026thinsp;=\u0026thinsp;51.15, SD\u0026thinsp;=\u0026thinsp;18.08), and diabetes (M\u0026thinsp;=\u0026thinsp;49.07, SD\u0026thinsp;=\u0026thinsp;25.90).\u003c/p\u003e\u003cp\u003eOur results indicated that 43.35% of students suffered from MSS indicating moderate severity. These findings agreed with study [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] that indicated to the presence of moderate stress caused by MSS. But this study indicated that the degree of stress is associated with gender; female students experience a higher level of stress compared to male. These findings contraindicated with our study and study conducted by [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] in which botg studies showed that female participants reported higher mean MSS scores than males, but this difference did not reach significance (p\u0026thinsp;=\u0026thinsp;0.167).\u003c/p\u003e\u003cp\u003ePrevious study conducted by and showed that the occurrence of MSS was 62.2%, and it's linked with being in the middle years of study. On other hand, our results showed that 43.35% of students suffered from MSS indicating moderate severity. And according to years of study, the results showed that third-year students had the highest mean scores (51.75\u0026thinsp;\u0026plusmn;\u0026thinsp;21.54), but it did not reach significant level (p-value 0.534). These deffirences may be related to the use of various sampling methods between both studies (convenience in our study, and simple random sampling by [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study examined the prevalence of Medical Student Syndrome (MSS) and its associated factors among nursing students at the Arab American University Palestine. The findings revealed a moderate overall level of MSS, with no statistically significant differences across gender, age group, academic year, or other sociodemographic variables. Although MSS was present among students, its distribution appeared relatively uniform across subgroups. These results highlight the importance of recognizing illness-related anxiety among nursing students and underscore the need for targeted awareness and support strategies within academic institutions. Further multi-center and longitudinal research is recommended to deepen understanding of MSS, explore its underlying determinants, and develop effective interventions that promote psychological well-being and academic success among future healthcare professionals.\u003c/p\u003e\u003cdiv id=\"Sec26\" class=\"Section2\"\u003e\u003ch2\u003eRecommendations\u003c/h2\u003e\u003cp\u003eBased on the findings of this study, several recommendations are proposed. First, future research should include multi-center studies across universities in the West Bank to obtain a larger and more representative sample, allowing for a clearer understanding of how different demographic and academic variables may influence the prevalence of Medical Student Syndrome (MSS). Second, it is recommended to expand the target population in upcoming studies to include healthcare providers in hospitals as well as individuals from the general community in order to better assess the broader prevalence and characteristics of MSS. Finally, raising awareness among nursing students, university staff, and healthcare professionals about MSS its symptoms, contributing factors, and effective coping strategies is essential to supporting early recognition and promoting healthier psychological and academic well-being.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec27\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eThis study has several limitations that should be acknowledged. First, political circumstances in Palestine posed challenges in obtaining participants\u0026rsquo; responses from multiple universities, which limited the ability to conduct a broader multi-center investigation. Second, the use of a cross-sectional design restricts the ability to establish causal relationships, and other research designs particularly interventional or longitudinal studies may yield stronger evidence to inform practice. Finally, time constraints restricted data collection to nursing students only, preventing the inclusion of students from other faculties who may also experience Medical Student Syndrome. These limitations should be considered when interpreting the findings and planning future research.\u003c/p\u003e\u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eAAUP\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eArab American University Palestine\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eIRB\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eInstitutional Review Board\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMSS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMedical Student Syndrome\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSD\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eStandard Deviation\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eK-S Test\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eKolmogorov\u0026ndash;Smirnov Test.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003cp\u003ePrior to initiating data collection, the study was conducted in accordance with the nursing faculty guidelines at AAUP, and ethical approval was obtained from the Institutional Review Board (IRB) at the Arab American University Palestine (IRB Approval No. R-2025/A/4/N). Written informed consent was obtained from each participant after clearly explaining the purpose of the study, assuring them of their anonymity, confidentiality, and their right to withdraw at any stage without any consequences. Participants were also informed that they could request access to the study results upon completion. All ethical procedures followed the principles outlined in the Declaration of Helsinki for research involving human subjects [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003cp\u003eNot applicable\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eCompeting interests\u003c/h2\u003e\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eNone\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eENZ conceptualized the study, designed the methodology, supervised the research process, contributed to data analysis, and critically revised the manuscript. BFS contributed to conceptualization, coordinated data collection, performed data entry and statistical analysis, drafted major sections of the manuscript, and participated in revision. SNA assisted in tool adaptation, data collection, and preliminary data processing, and contributed to writing the results and discussion. QZA contributed to the literature review, reference organization, data verification, and drafting of the introduction. MEA participated in data collection, supported statistical analysis, and assisted in preparing tables and figures. MHD provided methodological supervision, contributed to interpretation of findings, and reviewed the final manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgment\u003c/h2\u003e\u003cp\u003eNot applicable.\u003c/p\u003e\u003ch2\u003eAvailability of data and materials\u003c/h2\u003e\u003cp\u003eThe data sets supporting the current research results are available from the corresponding authors upon request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbdullah SH, Ahmed AE, Algebail HGE, Fatooh A, Ismail LNA, Radwan NK, Sakan NB, Barqawi HJ. Medical Students' Syndrome among Medical Students in the University of Sharjah, UAE. Avicenna J Med. 2023;13(2):77\u0026ndash;81.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEslami Shahrbabaki M, Ahmadipour Farsangi H, Bagheri F. Medical Students\u0026rsquo; Syndrome: A Cross Sectional Study from South East of Iran. \u003cem\u003eShiraz E-Medical Journal\u003c/em\u003e 2018, In Press.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBin Abdulrahman K, Bahmaid R, Alrajhi D, Alturki B, Alhazani F, Alayed F. Medical students\u0026rsquo; syndrome among medical students in Riyadh, Saudi Arabia. World Family Med J /Middle East J Family Med 2023, 21.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eElobaid M, Abdelgyoum H, Omer L, Mohammed R, Musa M, Taha A. Prevalence, Knowledge and Risk Factors of Medical Student Syndrome Among Medical Students at the university of Khartoum, March 2022; 2024.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAkbar S, Riaz M, Munawar L, Shakoor S. Medical Student Syndrome: A Hypochondriacal Distress In Undergraduates\u0026ndash; Verity Or Myth. J Bahria Univ Med Dent Coll. 2020;10:200\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e!!!. INVALID CITATION !!! [6].\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlsamhori J, Alsamhori AR, Alsamhori A, Rihani J, Shaban L, Omeish R. Medical Student Syndrome in Medical University students in Jordan: A Cross-sectional Study. Int J Med Students. 2023;11:S61.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSchizophr C, Psychoses R, Ahmed N. Epidemiology of Medical Students Syndrome in Tikrit Medical College. 2023.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMohamed K, Albelowi A, Alruhily A, Ternati M, Saleh M, Alfagi A. Medical student syndrome in Saudi Arabia; a cross-sectional study. Int J Med Developing Ctries 2024:1.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSherif HA, Tawfeeq K, Mohamed Z, Abdelhakeem L, Tahoon SH, Mosa M, Samy K, Hamdy K, Ellakwa L, Elnoamany S. Medical student syndrome: a real disease or just a myth?\u0026mdash;a cross-sectional study at Menoufia University, Egypt. Middle East Curr Psychiatry. 2023;30(1):42.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSzczurek K, Furgał N, Szczepanek D, Zaman R, Krysta K, Krzystanek M. Medical Student Syndrome\u0026mdash;A Myth or a Real Disease Entity? Cross-Sectional Study of Medical Students of the Medical University of Silesia in Katowice, Poland. Int J Environ Res Public Health. 2021;18:9884.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNepal S, Atreya A, Bhandari S, Sapkota L, Menezes R, Gnawali L, Adhikari K. Prevalence of Medical Student Syndrome among Medical Students of Nepal. J Nepal Health Res Counc. 2024;22:616\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAfifi O, Althagafi S, AlSufyani M, Shawky O, Alomairi N, Masoodi I. The health anxiety in medical students, a comparative study from Taif University: Medical student\u0026rsquo;s syndrome revisited. British Journal of Medical Practitioners, 2019, Volume 12 Number 1. \u003cem\u003eBritish Journal of Medical Practitioners\u003c/em\u003e 2019, Volume 12.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlzahrani M, Alenazi S, Alawlah A, Almadhi A, Albazie O, Alharbi A, Alsamhan A, Sami W, Ibn Auf A, Mohammed E. Prevalence of stress among students of the College of Medicine, Majmaah University, Saudi Arabia, 2019-20. Majmaah J Health Sci. 2022;10:133.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWorld Medical Association. Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e!!!. INVALID CITATION !!! [15].\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWani F, Thirunavukkarasu A, Thirunavukkarasu A, Dar UF, Wani FA, Sirhani A, Alsamarh AN, Alshammery TD, Alghotaight A. Medical Students\u0026rsquo; Syndrome\u0026ndash;A Myth or Reality? A Cross Sectional Study among Medical Students of Jouf University, Saudi Arabia. Indian Journal of Public Health Research \u0026amp; Development. 2019; 10 (11): 1812\u0026ndash;1816. \u003cem\u003eIndian Journal of Public Health Research and Development\u003c/em\u003e 2019, 10:1812\u0026ndash;1816.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"medical student syndrome; medical students' disease, students, Palestine, MSS","lastPublishedDoi":"10.21203/rs.3.rs-8065122/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8065122/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eMedical Students Syndrome (MSS) is defined that medical students show health related anxiety and irrational fear during studying a specific disease related to the fact that they falsely related their symptoms to the disease that is being studied. So, this intense and irrational fear and anxiety can cause many physical symptoms that affect the students' quality of life.\u003c/p\u003e\u003ch2\u003ePurpose\u003c/h2\u003e\u003cp\u003eThis study aimed to assess the occurrence of medical student syndrome and associated factors among AAUP nursing students in Palestine.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eQuantitative descriptive cross-sectional study design conducted at large university in Palestine. The sampling method was convenience sampling. Data collected by self-administered questionnaire and analyzed by using SPSS 27.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe prevalence of MSS was 43.35%, indicating a moderate response level of stress among nursing students at AAUP. For the factors that are associated with this syndrome, and despite the presence of variation in mean score between independent variable, but there were no any significant relationship between them at (p \u0026minus;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eIt's important to raise awareness among nursing students about stress caused by MSS. Also, it's important to share this issue with other health care providers to determine the appropriate methods to deal with this stress.\u003c/p\u003e","manuscriptTitle":"Occurrence of Medical Student Syndrome and Associated Factors Among AAUP Nursing students in Palestine","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-08 13:09:50","doi":"10.21203/rs.3.rs-8065122/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-12-08T12:44:43+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-07T18:58:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"149546710179996091599230296195108974259","date":"2025-12-06T20:13:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"45544379234633952188434236902755769049","date":"2025-12-04T20:12:50+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-04T20:10:02+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-12T12:49:14+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-11T11:33:29+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-11T11:33:25+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-11-08T16:02:46+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b1d322c8-3ecc-4ee9-9d6c-606778624892","owner":[],"postedDate":"December 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-12-08T13:09:50+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-08 13:09:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8065122","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8065122","identity":"rs-8065122","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}