Journal of Education and Health Promotion

Abstract BACKGROUND: The academic environment is a challenge for dental students due to the multiple
sources of stress they face. For this reason, the present study analyzes the psychometric properties
of the Dental Environment Stress (DES) questionnaire. The secondary objective was to identify the
specific sources of stress perceived by dental students related to gender and years of study.
MATERIALS AND METHODS: A cross‑sectional study was conducted among dental
students (n = 340; Mage = 22.45) from the Romanian University of Medicine and Pharmacy in
October– December 2019. The factorial structure of the questionnaire was performed by means
of the confirmatory factor analysis (CFA) and the multi group‑CFA. The convergent and divergent
validities were measured by associating DES with scales that measure depression, anxiety, and
tension/stress (Depression Anxiety Stress Scale‑21‑R), perceived stress (Perceived Stress Scale‑14),
and life satisfaction (Satisfaction with Life Scale).
RESULTS: New measure obtained supported a five‑factor and thirty‑item structure, which is gender
invariant. All the factors within DES have a significant positive correlation with depression, anxiety,
tension/stress, and perceived stress and a negative correlation with life satisfaction. The Cronbach’s
α coefficients are acceptable (range: 0.67–0.89). The female students perceive aspects related to
performance, the relations with the faculty, clinical responsibilities, and personal life to be more
stressful than males. Senior students perceive more stressed aspects related to personal life, while
freshmen have higher scores on stress associated with clinical responsibilities.
CONCLUSIONS: The present results show that DES has psychometric properties which are adequate
for the assessment of dental stress in the case of Romanian students; nevertheless, it is necessary
to extend the use of DES to students attending other universities and to dental practitioners.