Dental environmental stressors and their association with perceived stress among undergraduate dental students at a Palestinian University: a cross-sectional study using DES and PSS-10.

Background: Dental education is associated with considerable academic, clinical, and psychological stress. This study aimed to assess perceived stress levels among undergraduate dental students in Palestine and identify dental environmental stressors associated with perceived stress. Methods: A cross-sectional study was conducted among undergraduate dental students in the first to fourth academic years at An-Najah National University. A total population sampling approach was used, and all eligible students were invited to participate. Data were collected using a self-administered electronic questionnaire that included demographic and health-related variables, the Perceived Stress Scale-10 (PSS-10), and the Arabic 41-item Dental Environment Stress (DES) scale. Descriptive statistics, Pearson's chi-square or Fisher's exact tests, non-parametric comparisons, Spearman's correlation, and multiple linear regression were performed. Results: Of 950 invited students, 635 valid responses were included in the final analysis. The mean PSS-10 score was 24.50 ± 5.88, with 61.4% of students reporting moderate stress and 35.4% reporting high stress. The DES total item mean was 1.53 ± 0.50, with 66.3% reporting moderate dental environmental stress. Internal consistency was good for PSS-10 (Cronbach's alpha = 0.833) and excellent for the modified DES scale (Cronbach's alpha = 0.928). The DES score was moderately correlated with the PSS-10 score (rho = 0.554, Conclusion: Perceived stress was common among dental students, with dental environmental stressors strongly associated with overall perceived stress. Workload, self-efficacy, female sex, and academic stage should be considered when designing student support and stress-reduction interventions.