Perfectionism, Stress, and the Doctor of Physical Therapy Student
Purpose/Hypothesis: Doctor of Physical Therapy students report increased stress due to educational high standards and performance expectations. In general, and especially among perfectionists, there is limited understanding of how successful these students cope with this increased stress. Ineffective stress management strategies may exacerbate depressive symptoms and result in reduced sleep which ultimately impacts academic performance. Improving resiliency among graduates may help mitigate burnout among health care providers. The purpose of this study examined perfectionism among Doctor of Physical Therapy students and assessed its relationship to perceived stress and sleep.
Number of Subjects: 121 Doctor of Physical Therapy students
Materials and Methods: Researchers conducted a non-experimental study using a single-site, cross-sectional design. A convenience sample of Doctor of Physical Therapy students were invited to complete an online survey measuring perfectionism (Almost Perfect Scale-Revised (APS-R)), perceived stress (Perceived Stress Scale (PSS-10)), and sleep quality (Pittsburg Sleep Quality Index (PSQI)). Participants consented via an online informed consent form. This study was approved by the IRB at a public university in Texas.
Results: Researchers identified 41.2% Adaptive Perfectionists (AP), 23.7% Maladaptive Perfectionists (MP), and 35.1% non-perfectionist (NP). Additionally, the mean PSS-10 score was as follows: overall 14.78 (SD 5.96), female students 15.03 (SD 6.36), male students 14.25 (SD 5.05), AP 12.83 (SD 6.30), MP 17.96 (SD 5.81), and NP 14.93 (SD 4.69). For comparison, PSS-10 normative data for a sample less than 25 years old was 16.78 and for a sample 25-34 years old was 17.46. The researchers identified 61.4% students had good sleep quality, and 38.6% had poor sleep quality. More specifically, PSQI scores were as follows: AP 4.66 (SD 2.46), for MP 6.33 (2.83), and for NP 5.28 (SD 2.99). For comparison, a PSQI of 6 or greater indicated significant sleep issues in a college population. Among physical therapy students, there was a moderate, positive correlation between perfectionism and perceived stress; a low, positive correlation between perceived stress and sleep quality; and little, if any correlation between perfectionism and sleep quality.
Conclusions: Almost two-thirds of the students were perfectionists with the majority of perfectionists being APs. Overall, perceived stress levels were lower than the age-matched norm sample. More specifically, MPs reported the highest stress levels and APs the lowest. Additionally, MPs had poorer sleep quality than APs.
Clinical Relevance: This research is relevant since a better understanding of perfectionism and its association with stress perception and sleep quality while in physical therapy school may result in earlier identification of students at risk for burnout. Identifying those at risk for burnout prior to becoming novice clinicians may increase the window of opportunity for teaching effective stress management strategies.