Background: Stress is one of the most significant mental health problems among university students aged 18 to 24. University students are developing into adulthood while facing stress from several factors, including personal lifestyle and interpersonal interactions with their peers.

Objective: To determine the factors associated with high-to-severe stress among university students in northern Thailand.

Materials and Methods: A cross-sectional study design was applied to elicit information among randomly selected students attending three universities located in the Chiang Rai, Chiang Mai, and Pha Yao Provinces in northern Thailand in the 2018 to 2019 academic year. A validated questionnaire and the Suanprung Stress Test 20 (SPST-20) were used to collect information and assess stress levels. Participants filled out all forms voluntarily, which took 20 minutes each. Chi-square and logistic regression were used to determine the factors associated with high and severe stress at α=0.05.

Results: Six hundred fifty-five students were recruited into in the present study. Most students were female (62.6%) and third year students (39.7%). Two-thirds of the students reported less regular exercise (60.2%), and almost half of the students accessed the internet 6 to 9 hours per day (47.3%), and 80.8% of these internet users used the application Facebook. One-fifth of the students had had sexual intercourse (20.9%). Almost half the of students had high stress levels (44.3%), and 16.6% of students had severe stress levels. In the multivariable model, three variables were statistically associated with high-to-severe stress among these students. Students who did not respond to the sexual intercourse experience question had a greater chance, 1.71 (95% CI 1.15 to 2.55) times greater, of high-to-severe stress than those who responded negatively to this question. Those students whose fathers graduated primary school had a greater chance of high-to-severe stress than those whose parents had no education of 3.64 times (95% CI 1.60 to 8.31). Students whose parents had high parental conflicts had greater chance of high-to-severe stress than those students whose parents had no parental conflict of 2.29 times (95% CI 1.18 to 4.47).

Conclusion: Appropriate health interventions should be urgently implemented among university students to reduce stress, particularly among those who do not express their sexual intercourse experience, whose parents have little education, and whose parents have high parental conflicts.

Keywords: Stress, University student, Factors associated, SPST-20

DOI: doi.org/10.35755/jmedassocthai.2020.06.10877

Received 26 Nov 2019 | Revised 7 Apr 2020 | Accepted 9 Apr 2020