Cross-cultural Adaptation Of International Medical Students In China And The Influencing Factors

Objective:There are three purples of this study:1. To investigate the general cross-cultural adaptation and the level of the difficulties of the international medical students in China.2. To investigate and compare the mental health status of the international medical students and Chinese medical students.3. To explore the correlative factors with cross-cultural adaptation and mental health of the international medical students.Method:The objects of the study were 233 international medical students from Shandong University School of Medicine, and 246 Chinese students from the same grade and same professional as the contral group. The Sociocultural Adaptation Scale (SCAS), Acculturative Stress Scale for International Students (ASSIS), General Health Questionnaire-28 (GHQ-28), Positive and Negative Affect Schedule (PANAS), Ladder Scale, Intercultural Sensitivity Scale (ISS), Adult Attachment Scale (AAS), the Acculturation Index, and self-made questionnaire for general condition were used to investigate cross-cultural adaptation of the international medical students and compare the mental health of the international medical students and Chinese medical students.Results:1. International students would encounter many problems in the process of cross-cultural adaptation. The mainly problems are:communicating with people of a different ethnic group, finding food that you enjoy, making friends, making yourself understood, dealing with the climate. The mainly acculturative stresses of the international medical students are:homesickness, perceived discrimination and the Stress Due to Change/Culture Shock. The international medical students had a significantly higher score than Chinese medical students in the acculturative stresses (P>0.05), and the females had a higher stress than males (P> 0.05). The cultural integration strategy showed that, the international medical students maily adopted the separation strategy (56.7%), and then the marginalization strategy (25.3%), integration strategy (14.2%) and assimilation strategy (3.9%).2. The prevalence of psychological problems among international medical students was 36.9%,27.1% in males and 43.8% in females. And the Chinese medical students was 31.3%,23.4% in males and 35.2% in females. Females had a higher prevalence of psychological problems than males (P< 0.05), while there was no significant difference between Chinese students and international students (P> 0.05). International medical students had a significantly higher score than Chinese medical students in the anxiety and insomnia dimension among GHQ-28 (P< 0.01). While Chinese medical students had a significant higher score than international medical students in the social dysfunction dimension (P< 0.01). The scores of the positive affect and the three stage life satisfaction of international medical students were significantly higher than Chinese medical students (P< 0.01). But the level of well-being among international students still declined obviously than before (P< 0.01). Females’level of mental health was significantly lower than males’.3. General social factors, intercultural adaptability and attachment style all had a significant correlation with cross-cultural adaptation and mental health of the international medical students in different extent. Hierarchical regression analysis showed that the sociocultural adaptation’s significant predictive factors entering the final regression model mianly included the intercultural sensitivity and attachment anxiety, followed by age and positive guidance of the coping style, the explanation at a rate of 30.4%. The acculturative stress’s significant predictive factors entering the final regression model mianly included the attachment anxiety, intercultural sensitivity, attachment dependence and the positive guidance of the coping style, the explanation at a rate of 44.4%. The mental health’s significant predictive factors entering the final regression model mianly included the attachment anxiety and the cultural integration strategy, then the general social indicator like the social support, age and marital status, the explanation at a rate of 65.3%.Conclusion:1. A few international students in China exist some adjustment problems. International medical students have a significantly higher acculturative stresses than Chinese medical students.2. Both the Chinese and the international medical students exist some psychological problems. The international medical students have a higher anxiety and insomnia than Chinese medical students, while the Chinese medical students have a higher social dysfunction than international medical students. However, the level of positive affect and well-beings of the international medical students are better than Chinese medical students. What’s more, females’level of mental health was significantly lower than males’.3. The cultural integration strategy of the international medical students maily is the separation strategy (56.7%), and then the marginalization strategy (25.3%) and integration strategy (14.2%), the assimilation strategy (3.9%) is less.4. The correlative factors about the cross-cultural adaptation and mental health contains the general social factors, intercultural adaptability and attachment style. The significant predictive factors of the sociocultural adaptation and acculturative stress mainly are intercultural sensitivity and attachment anxiety. The significant predictive factors of the mental health mainly are attachment anxiety and the cultural integration strategy, and then the general social indicators including social social support, age and marital status.