International medical students’ acculturation and self-rated health status in Hungary: a cross-sectional study

Abstract

Background Over the past few decades, the number of international students has increased dramatically. These students have to adjust to unfamiliar social, cultural, and educational environments. The concept of acculturation has been applied in multiple studies on various health outcomes. This study investigated the relationship between acculturation and self-rated health (SRH) among international medical students. Methods A cross-sectional study was conducted among international medical students at the University of Szeged, Hungary between April and October 2021. A total of 326 participants filled out questionnaires about sociodemographic characteristics, acculturation, and SRH. The modified Stephenson multigroup acculturation scale (SMAS) was used to assess the acculturation status; the scale defined acculturation as the degree of dominant society immersion (DSI, 12 items) and ethnic society immersion (ESI, 16 items). To measure SRH, participants were asked to rate their current general health and mental health. The data were analyzed by using descriptive statistics and the multiple logistic regression model. Results 32.5% of the students reported having poor general and 49.7% poor mental health. We have found that acculturation was associated with SRH in multivariable logistic regression models controlling for sociodemographic characteristic. Bidimensional acculturation, such as ESI and DSI significantly influenced SRH as the likelihood of poor general health decreased (OR = 0.50; 95% CI = 0.31–0.81, P = 0.005), when the ESI was higher, whereas the likelihood of poor mental health decreased (OR = 0.52; 95% CI = 0.35–0.79, P = 0.002) if students had a greater DSI. Conclusion Both types of immersion can affect the students’ SRH. If the student could integrate better into their own ethnic group, their general health was better, and if they could strongly integrate into the Hungarian society, their mental health was more favorable. Acculturation measures should be promoted by academics and public health professionals in order to better understand their role in the behaviors, health outcomes, and health care use of medical international students. These findings will help professionals shape culturally sensitive prevention and counselling strategies for international student populations.

Healthcare-seeking of medical students: the effect of socio-demographic factors, health behaviour and health status – a cross-sectional study in Hungary

“…However, another study claims that only students with symptoms of the disease at a severe stage would come to seek medical assistance [ 7 , 31 ]. When analysing between local and international students, there may be several things that need to be considered, as it is known in the previous research that the mental health of international students might be influenced by the process of acculturation that they experience [ 11 ].…”

“…According to a study conducted in Hungary [ 10 ], Hungarian students reported less mental well-being than students from the Mediterranean region, Israel, and Scandinavia. Furthermore, it was discovered that 49.7% of foreign students in Hungary who self-reported their mental health had poor mental health [ 11 ]. Meanwhile, the chronic disease burden is increasing globally.…”

Healthcare-seeking of medical students: the effect of socio-demographic factors, health risk behaviour and health status – a cross-sectional study in Hungary

“…However, another study claims that only students with symptoms of the disease at a severe stage would come to seek medical assistance [7,20]. When analysing between local and international students, there may be several things that need to be considered, as it is known in the previous research that the mental health of international students might be in uenced by the process of acculturation that they experience [21].…”

International and domestic university students’ mental health over the course of the COVID-19 pandemic in Germany: Comparison between 2020, 2021, and 2022

“…Besides the common-shared burdens that domestic and international university students have faced during the pandemic, international students additionally faced the challenges of adapting to living in a new country, with its new social, cultural, and educational aspects. High levels of acculturative stress and difficulties in adjusting to the host country have been reported even before the COVID-19 pandemic [ 5 , 16 ]. Therefore, social distancing and isolation experienced by the students due to the host country government’s restriction measures during the pandemic might have had even larger negative effects on their mental health than on their domestic counterparts [ 11 ].…”