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POSITIVE MENTAL HEALTH IN STUDENTS OF THE HEALTH AREA IN

CARTAGENA, COLOMBIA.

Article · May 2018

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AARJMD VOLUME 5 ISSUE 5 (MAY 2018) ISSN : 2319 - 2801

A Peer Reviewed International Journal of Asian

Academic Research Associates

AARJMD
ASIAN ACADEMIC RESEARCH
JOURNAL OF MULTIDISCIPLINARY

POSITIVE MENTAL HEALTH IN STUDENTS OF THE HEALTH AREA IN

CARTAGENA, COLOMBIA

COGOLLO Z 1; DE ARCO L 2; GRAJALES A 3; PARDO M 4; REDONDO I5;

ACEVEDO L6; HERNÁNDEZ L7
1
Nurse, MSc and PhD in public health. Full Professor, Collective Health Care Research
Group, Faculty of Nursing, University of Cartagena. (Cartagena -Colombia).
2,3,4,5,6
Nursing students University of Cartagena, Cartagena (Colombia).
7
Nurse Hospital Universitario Del Caribe, Master's student of Nursing in Mental Health
University of Cartagena, Collective Health Care Research Group, Faculty of Nursing,
University of Cartagena. (Cartagena- Colombia).

Abstract

Objective: to determine the positive mental health of the students enrolled in health studies
of a University in the city of Cartagena, Colombia. Method: a cross-sectional descriptive
quantitative study, consisted of 352 students from the health area. A sociodemographic
survey and the positive mental health scale of María Teresa Lluch were used to collect the
information. Results: 73.9% of the participants had low positive mental health, 88.5% had
low personal satisfaction, 75% showed low pro-social attitude, 51.7% showed low self-
control, 83.5% low autonomy, 71% low problem solving and self-actualization and 53.7%
showed low interpersonal relationship skills. Conclusion: we concluded that the majority of
the students who participated in the study, presented low levels of positive mental health with
respect to each factor in the scale; personal satisfaction, pro-social attitude, self-control,
autonomy, problem solving and self-actualization and interpersonal skills, which results
ranged from low to medium.
Keywords: Mental health, students, promotion, prevention. (fuente.DeCS)

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INTRODUCTION

Traditionally, mental health has been defined from a negative perspective, taking the disease
as a reference. Like so, health is considered as the absence of the disease based on the
traditional clinical model where the main objective is to treat people with mental illness and
cure them (1). However, this model limits the integral aspects of the mental health concept, as
the harmony and well-being of people in their biological, cognitive, affective and behavioral
facets, covering the most extensive areas of personal, family and social life (2). In this sense,
mental health involves changing the perspective focused on mental disorders by the positive
aspects of personal well-being (3).

This is how Jahoda M. develops a model with six criteria that address PMH; attitudes towards
oneself, growth and self-actualization, integration, autonomy, perception of reality and
control of the environment; which makes the PMH for Jahoda a multidimensional conception
that defends the promotion of mental health, changing the perspective of disease prevention
or recovery (3).

From this positive perspective, it is important to consider the context in which each
individual develops, favoring or not the appearance of some positive or negative behaviors
that may affect the way of relating and coping with daily life stresses. Similarly, university
students are subjected to a set of highly stressful situations such as academic overload that
requires dedicating hours of study and concentration (4). Enrolling in the university means
approaching an unknown world, living new experiences and testing their selves in an
environment far from their own. Consequently, in some cases, this requires leaving home,
family, friends and their everyday environment; which produces a significant interruption of
their support networks (5).

Along these lines, it is not strange that students present adaptation difficulties when exposed
to several factors that threaten their comfort zone and thus their well-being. This makes it
necessary to approach the reality that these students live, not only their cognitive, affective or
social characteristics, as done traditionally, but also from a mental health perspective,
considering that this can affect their ability to progress at an educational level marked by
academic, personal and social demands (5).

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Studies around the world have shown the influence of positive mental health on the
improvement of university students. Garcia, Et al, based on the model of Mayer and Salovey,
found that college students with high levels of emotional intelligence responded to stress with
less suicidal ideation, depression and hopelessness, while low levels were associated with
disruptive, aggressive behaviors, recklessness and deficient interpersonal and social skills,
antisocial behavior and possible substance abuse (6). Reboredo, Et al, in a study involving
students of medicine, dentistry, psychology and nursing, evaluated the attention, emotional
repair and clarity of emotions, reporting that dental students present the highest scores, in
addition they deduced that professional success depends on the emotional intelligence more
than the IQ (7).

In Colombia, Navarro in a more specific study concerning the Llunch model, found medium
to low levels in characteristics such as personal satisfaction, prosocial attitude, self-control
and interpersonal skills (1). Medina, in Armenia reported low levels for emotional self-
control (2) and Barreto when studying medical students also mentioned low levels in this
aspect (8).

When looking at mental health from an PMH perspective, it is necessary to understand

through scientific research, the processes that underlie the qualities and positive emotions of
human beings, which allow them to face the stress factors of everyday life, which have been
ignored for a long time by science. The objective of the present investigation is to determine
the positive mental health of the students of the health area of a University in the city of
Cartagena, Colombia.

METHODOLOGY

Quantitative, descriptive, cross-sectional study. This research has the approval of the ethics
committee of the University of Cartagena and the signed consent approval of students over 18
years of age and of tutors or parents in the case of minors (9).

The population consisted of 1913 students enrolled in the health area of the University of
Cartagena, distributed as follows: Faculty of Nursing: 438, Faculty of Medicine: 700, Faculty
of Pharmaceutical Chemistry: 281 and Faculty of Dentistry: 494 students. A probabilistic

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sample of 352 students was taken, through a random sampling by conglomerates in several
stages, the confidence level was 95% and a margin of error of 5%.

The students completed the sociodemographic survey that investigates the individuals’
characteristics, focusing on aspects of personal identification. This was purposely done by
researchers to identify spesific aspects such as age, sex, socioeconomic status, marital status
and occupation, for the positive mental health measurement, the researchers used the
instrument designed by María Teresa Lluch in 1999 (10). The questionnaire is made up of 39
items divided into six factors such as personal satisfaction 8, pro-social attitude 5, self-control
5, autonomy 5, problem solving and self-actualization 9 and interpersonal relationship skills
7. The response options are: always, almost always, quite often, sometimes, never, or almost
never.

Statistical analysis

The data was stored, processed and analyzed in an Excel sheet. A transversal descriptive
analysis of the variables investigated was carried out. Frequencies and percentages were
established for the qualitative variables and means and standard deviation (SD) were
calculated for the quantitative variables. All calculations were performed with a confidence
level of 95% (95% CI).

RESULTS

The study involved 352 students from the health area of a University in the city of Cartagena,
82 nursing students, 127 Medicine undergraduates, 90 from Dentistry and 53 from
Pharmaceutical Chemistry, they all answered the survey in a satisfactory manner, 56% (197)
were females and 44% (155) were males, 81.8% (288) were over 18 years old and 18.2% (54)
were under. The majority of students belonged to socio-economic levels 1 and 2, 29.5% (104)
and 30.1% (106) respectively, most of them were single 93.5% (329); Regarding
employment, 91.8% (323) had no jobs and 8.2% (29) studied and worked.

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The distribution by semesters is shown in table 1, (see table 1):

Table No. 1. Distribution of students per semester studied, University in Cartagena.

Semester Frequency Percentage

1 36 10,2

2 52 14,8

3 44 12,5

4 33 9,4

5 50 14,2

6 32 9,1

7 25 7,1

8 18 5,1

9 44 12,5

10 18 5,1

Regarding the results of the Positive Mental Health scale: 73.9% of the students showed low
positive mental health (see table 2). Regarding the factors evaluated by the instrument,
personal satisfaction was low with 88, 5% (315), as well as the pro-social attitude 75%, self-
control 51.7%, autonomy 83.5%, problem solving and self-actualization 71% and
interpersonal skills 53.7% (see table 3)

Table No. 2. Positive mental health in students of the health area.

Positive Mental Health Frequency Percentage

Baja 260 73,9

Media 91 25,9

Alta 1 0,3

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Table No. 3. Distribution of positive mental health factors in students in the health area.

Positive Mental Health Frequency

Integral factors of Positive Mental Health

Low Medium High

F % F % F %

Personal Satisfaction 315 89,5 35 9,9 2 0,6

Pro-social Attitude 264 75,0 84 23,9 4 11,1

Self-control 182 51,7 152 43,2 18 5,1

Autonomy 294 83,5 51 14,5 7 2,0

Problem solving and self-actualized 250 71,0 70 19,9 32 9,1

Interpersonal relationship skills 189 53,7 157 44,6 6 1,7

DISCUSSION

The majority of participants in the study 73.9% presented low levels of positive mental
health. Similarly, Lanchipa in his study, also reported that the students who participated
58.1% had a poor levels of positive mental health (11).

However, other studies, for example, Medina et al, found that 91% of participants had high
levels of positive mental health (2). Similarly, high levels of PMH 73.2% reported the
General Directorate of Health and Consumers in Europe when conducting a mental health
survey (Eurobarometer) in the population surveyed (12).

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It is important to consider that the variations in the results can be explained by the
heterogeneity of the populations, different cities of the world or even in the same country.
Consequently, different cultural characteristics can influence in the way people perceive
themselves and assume their daily difficulties, likewise the young individuals that are
studying in the university present different difficulties that affect their well-being and prevent
them from adapting appropriately. The majority of undergraduate students enroll at their late
adolescence, a stage during which some mental health problems tend to emerge with
particular intensity that may have occurred in previous stages (13).

On the other hand, scientific articles report that mental health depend on the influence of
external factors such as family, university, society and the progress of various personality
characteristics and sociodemographic characteristics (14). Favorable or adverse conditions
within the family, social and environmental levels are also indicators of psychological well-
being and / or mental illness. Mohd, in a study at a University of Malaysia, found that the
main factors associated with emotional disorders in university students were: feeling under
pressure due to exams, lack of family support and experiencing pressure from their teachers
(15).

when analyzing the different factors of the Positive Mental Health scale, 89.5% of the
students presented low personal satisfaction, similar data found by Martínez, regarding
personal satisfaction 81.3% (16). On the other hand, high levels of personal satisfaction,
informed Castillo in 62% of the students (17). Data contrary to those of Navarro who
observed that in 74% of the participants showed medium levels of personal satisfaction and
11% showed high levels (1).

The pro-social attitude was low in 75% of the students, Navarro also reported that 65% of the
students in his study had low levels of pro-social attitude and only 17% had high levels (1);
Castillo, on the other hand, found that 59% of the participants had average levels of pro-
social attitude (17) whereas, Londoño reported a high levels of pro-social attitude in 59% of
the psychology students (18).

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Regarding self-control, 51.7% of the students presented low levels, Castillo also observed
that 53% of the students have low levels of self-control (17); contrary to Navarro where 80%
of the participants had average levels of self-control (1).

With respect to Autonomy, 83.5% of students do not have an adequate way to deal with
conflicts, that is, low tolerance towards anxiety and stress in conflicted situations where they
should balance their emotions. Different data was reported by Ortega, in a study on stress and
positive mental health in nursing students at the University of Rovira; the study revealed
average levels of autonomy in 46% and only 15.5% of the surveyed showed high levels of
autonomy (19). Castillo, on the other hand, found that 74% had a medium level of autonomy
(17).

In this sense, Lluch suggests that this factor may reflect the independence of the population
studied as one of the positive mental health references, bearing in mind that the degree of
dependence/ independence in the face of social influences is an indicator of mental health
status, in which the psychologically healthy person has a certain autonomy and does not
depend fundamentally on the world and on others (10).

Autonomy, is of great importance, and it’s only relevant to deepen in its study, it has been
shown that university students must face stressful periods that require different psychological
resources, also, they may experience lack of control over the environment that makes them
seek social support sources, which although they are considered as protective factors, they
may or not damage these fellow’s autonomy.

In relation to problem solving and self-actualization, 71% of the participants showed low
levels, different from Castillo who reported 89% of high levels of problem solving and self-
actualization (17), and Ortega, where 46% of the sample studied showed average levels
regarding this factor, and only 29.9% showed high levels (19).

Regarding Interpersonal Relationship Skills, in this present study, 53.7% of the students
presented low ability, findings different from those of Ortega, who reported that 71.3% of the

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participants had high levels of interpersonal relationship skills (19). In addition, Castillo,
reported high levels of interpersonal relationship skills in 60% of the students (17).

Regarding the sociodemographic characteristics investigated in this study, 56% of the

participants were women, over 18 years 81.8%; 59, 6% belonged to socio-economic levels of
1 and 2, 93.5% were single and 91.8% had no jobs. Findings consistent with that of Perez et
al in a study on mental health and psychological well-being among university students in
Jalisco, where they observed that 53% of the students were women, 91.36% were single and
87.24% were economically dependent on their parents (20). Contrary to the data found by
Higuita E, where 51% were male and 42.1% belonged to socio-economic level 3, whereas the
age range was similar in both investigation (21). The fact that the majority of the students
belong to strata 1 and 2 supposes less economic resources and less possibilities of satisfying
their daily needs and activities. Difficulties in the daily upkeep, nutrition, transportation and
poor resources for academic work can affect their mental health harmony, and may subject
them to suffer from mental disorders such as depression (22).

University life confronts its students with multiple stress factors, such as the academic
overload that requires dedicating hours of classroom concentration and at home studying, or
the changes that strike their lifestyles when growing from adolescence to adulthood (5).
Enrolling in the University means approaching an unknown world, living new experiences
and testing their own abilities beyond their comfort zone, where in some cases, this requires
leaving their homes, families, friends and the daily environment, which may cause a
significant interruption of their supporting networks. (20)

The data in this study emphasize the relevance of positive mental health as an essential
element in the mental harmony and well-being of students, which allows them to strengthen
their personal resources and therefore, face appropriately the stressors and the pressures of
life. In addition, university studies highlight the need for wide-range promotional and
preventive strategies, that should be linked as far as possible to the training plans, to allow the
strengthening of students from a positive mental health point of view, changing the traditional
professional approach that was focused on the scientific field specifically, to a more modern
one that includes aspects relating to the development of emotional and behavioral skills, in

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addition to addressing how to handle customized individual needs that a significant number
of younglings are demanding in this stage of their lives .

The importance of this study is derived from the fact that it is the first of its kind to be held in
the University of Cartagena, most of the researches previously, were focused specifically on
the students’ mental health, studying the presence of emotional symptoms, particularly
anxiety and depression. In this regard, it is important to begin spreading the concept of PMH,
and include its indicators when designing interventions, hence, it will change the views that
establish preventive measures in the search to strengthen mental health. Limitations may arise
with respect to inaccurate information, when students fake the answers, as it is a descriptive
study that does not precisely conclude the causality existing between the variables studied.

CONCLUSIONS

It is established that the vast majority of students who participated in the study had low levels
of positive mental health; likewise, this was reflected in each of the factors that made up the
scale; personal satisfaction, pro-social attitude, self-control, autonomy, problem solving and
self-actualization, and interpersonal skills, which results ranged from low to medium levels.

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