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Cross-cultural Differences in Mental Health, Quality of Life, Empathy, and Burnout between US and Brazilian Medical Students

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Abstract

Objective

This study aimed to compare mental health, quality of life, empathy, and burnout in medical students from a medical institution in the USA and another one in Brazil.

Methods

This cross-cultural study included students enrolled in the first and second years of their undergraduate medical training. We evaluated depression, anxiety, and stress (DASS 21), empathy, openness to spirituality, and wellness (ESWIM), burnout (Oldenburg), and quality of life (WHOQOL-Bref) and compared them between schools.

Results

A total of 138 Brazilian and 73 US medical students were included. The comparison between all US medical students and all Brazilian medical students revealed that Brazilians reported more depression and stress and US students reported greater wellness, less exhaustion, and greater environmental quality of life. In order to address a possible response bias favoring respondents with better mental health, we also compared all US medical students with the 50% of Brazilian medical students who reported better mental health. In this comparison, we found Brazilian medical students had higher physical quality of life and US students again reported greater environmental quality of life. Cultural, social, infrastructural, and curricular differences were compared between institutions. Some noted differences were that students at the US institution were older and were exposed to smaller class sizes, earlier patient encounters, problem-based learning, and psychological support.

Conclusion

We found important differences between Brazilian and US medical students, particularly in mental health and wellness. These findings could be explained by a complex interaction between several factors, highlighting the importance of considering cultural and school-level influences on well-being.

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Authors and Affiliations

  1. School of Medicine, Federal University of Juiz de Fora, Av. Eugênio do Nascimento s/n, Juiz de Fora, Brazil, 36038-330

    Giancarlo Lucchetti, Alessandra Lamas Granero Lucchetti, Ivana Lúcia Damásio Moutinho & Oscarina da Silva Ezequiel

  2. School of Medicine, Pontifical Catholic University of Sao Paulo, São Paulo, SP, Brazil

    Rodolfo Furlan Damiano

  3. Southern Illinois University School of Medicine, Carbondale, IL, USA

    Lisabeth F. DiLalla

  4. Southern Illinois University School of Medicine, Springfield, IL, USA

    J. Kevin Dorsey

Authors
  1. Giancarlo Lucchetti
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  2. Rodolfo Furlan Damiano
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  3. Lisabeth F. DiLalla
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  4. Alessandra Lamas Granero Lucchetti
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  5. Ivana Lúcia Damásio Moutinho
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  6. Oscarina da Silva Ezequiel
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  7. J. Kevin Dorsey
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Corresponding author

Correspondence to Giancarlo Lucchetti.

Ethics declarations

The project was approved by both the institutional review board (IRB) of the University Teaching Hospital/UFJF in Brazil and the IRB of the Southern Illinois University School of Medicine—USA. In the USA, the IRB gave expedited approval because all forms were completed anonymously and completion of questionnaires was taken as consent, and therefore informed consent was not required, whereas in Brazil students were asked to sign an informed consent form.

Disclosure

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Funding Sources

Rodolfo Furlan Damiano received scholarship from CAPES (Coordination for the Improvement of Higher Education Personnel), Brazil.

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Lucchetti, G., Damiano, R.F., DiLalla, L.F. et al. Cross-cultural Differences in Mental Health, Quality of Life, Empathy, and Burnout between US and Brazilian Medical Students. Acad Psychiatry 42, 62–67 (2018). https://doi.org/10.1007/s40596-017-0777-2

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  • DOI: https://doi.org/10.1007/s40596-017-0777-2

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