AIM: To assess the general health of final year college students using the

standardized tool of General Health Questionnaire-28 (GHQ-28).

INTRODUCTION : Health, as defined by World Health Organisation (WHO),
is a state of complete physical, mental and social well being and not merely the
absence of a disease or infirmity. 

Physical health means being free from any sort of illness/injury and is vital for
overall well being. On the other hand, mental health, as defined by The World
Health Organisation is a state of well being in which the individual realises his
or her own abilities, can cope with the normal stresses of life, can work
productively and fruitfully, and is able to make a contribution to his or her
community and not just the absence of a mental illness.
Standardised Tool : General Health Questionnaire – A screening device used to
measure/identify non-psychotic and minor psychotic disorders in the general
population and within the community. 

This questionnaire focuses on 2 major areas- the ability to carry out normal
functioning and the appearance of new and distressing phenomena.
RESEARCHES:
1) Psychological distress such as stress, anxiety and depression are frequent
among students which can affect their academic performance, physical
health and psychosocial well-being. The aim of this study was to assess
the symptoms of depression, anxiety, stress among undergraduate
students studying in a govt. degree college, Bagalkot. A total of 133
undergraduate students from Govt. First Grade College, Bagalkot, were
included based on universal sampling method. Questionnaires based
study was conducted using the Depression Anxiety, Stress Scale
(DASS-21) and General health questionnaire (GHQ-28) for assessing the
severity of Depression, Anxiety, Stress and emotional distress among
students respectively.

The result was that Level of anxiety was more than depression followed
by stress based on DASS 21. It has a high internal consistency and a
useful instrument to measure the psychological wellbeing of degree
students in Bagalkot. Based on GHQ, females had significant emotional
distress as compared to males. Conclusion: Results indicate high grade of
depression, anxiety and stress among undergraduate students. This
indicates the amount of burden students have to bear in current scenario.
2) In another research, the psychological health of Indian medical college
students was assessed and also the effects of academic examination
stressor using GHQ was determined. 150 students (100 males and 50
females) were selected from the 2013 batch of a university. Data about
stress was collected using the GHQ questionnaire prior to and during the
annual examination. On statistically analysing the results of the study, it
was found that all medical students had a significantly higher value of
GHQ scores, both before (p- 0.002) and during (p- 0.025). Female
students assessed their physical health status and general stress level as
worse compared to males (p<0.001)

The conclusion was that students have psychological stress that gets
exaggerated during the examinations.
The present study aims to assess the general health of final year college
students, using the GHQ-28.
METHOD :
Method of sampling used : Purposive sampling
Preliminary information :
Name of the participant : Ragini Kashyap
Age of the participant : 20
Gender : Female
Course : B.A. Political Science Honors
Year : 3rd
DESCRIPTION OF THE TOOL : GHQ was developed by Goldberg in
1978. It has been translated into 38 different languages and is probably the
most common assessment o mental well being. It is developed as a screening
tool to detect those likely to have or are at a risk of developing psychiatric
disorders or other common mental health problems/domains of depression,
anxiety, somatic symptoms, social withdrawal, etc. GHQ is available in 4
forms :
- GHQ-12
- GHQ- 28
- GHQ-30
 - GHQ- 60
Out of these, GHQ 28 is the most popular and widely used version. The four
sub scales, each containing seven items, of the questionnaire are as follows:
A. Somantic symptoms (items 1-7)
B. Anxiety (items 8-14)
C. Social dysfunction ( items 15- 21)
D. Severe depression (items 22-28)
There are different methods to score the GHQ-28. It can be scored from 0 to
3 for each response with a total possible score on the ranging from 0 to 84.
Using this method, a total score of 23/24 is the threshold for the presence of
distress. Alternatively the GHQ-28 can be scored with a binary method
where Not at all, and No more than usual score 0, and rather more than usual
and Much more than usual score 1. Using this method any score above 4
indicates the presence of distress.
Numerous studies have investigated reliability and validity of the GHQ-28 in
various clinical populations. Test-retest reliability has been reported to be
high (0.78 to 0 0.9) (Robinson and Price 1982) and interrater and intrarater
reliability have both been shown to be excellent (Cronbach’s α 0.9–0.95)
(Failde and Ramos 2000). High internal consistency has also been reported
(Failde and Ramos 2000). The GHQ-28 correlates well with the Hospital
Depression and Anxiety Scale (HADS) (Sakakibara et al. 2009) and other
measures of depression (Robinson and Price 1982). The GHQ-28 was
developed to be a screening tool and for this reason responsiveness in terms
of Minimal Detectable Change (MDC) and Minimally Clinically Important
Difference (MCID) have not been established.
PROCEDURE: A subject was chosen using the purposive sampling method.
Purposive sampling relies on the judgement of the researcher when it comes to
selecting the units (e.g., people, cases/organizations, events, pieces of data) that
are to be studied. Usually, the sample being investigated is quite small,
especially when compared with probability sampling techniques. The main goal
of purposive sampling is to focus on particular characteristics of a population
that are of interest, which will best enable you to answer your research
questions. Here, while selecting the subject it was made sure that the subject
was a female, final year college student rather than randomly selecting a
student.
The next step was to start working on rapport formation with the subject. The
examiner started off by introducing herself to the subject. The subject was then
made to feel comfortable and at ease. Questions such as, “How are you doing
today?”, “How has your day been so far?” and et cetera were asked.
It was then explained to the subject that it is completely up to her to participate
in the practical conduction and that all her responses to the test items will be
kept confidential. She was made to understand that she was voluntarily signing
up for the practical and had the option of withdrawing consent at any point.
The practical was conducted in the practical lab of the college with the subject
sitting on the left hand side of the examiner. The following instructions were
given to the subject:
1. All the information received from the conduction will be strictly used for
only educational purposes and will be kept confidential.
2. The test has a total of 28 items. All of these items are statements related
to general health.
3. You have to respond to these statements on a first instinct basis. The
responses have to be on the basis of how you have been feeling for the
past few weeks and not in distant past.
4. Underline/tick the response you relate the most to.
RESULT: There are different methods to score the GHQ-28. It can be scored
from 0 to 3 for each response with a total possible score on the ranging from 0
to 84. Using this method, a total score of 23/24 is the threshold for the presence
of distress. Alternatively the GHQ-28 can be scored with a binary method where
Not at all, and No more than usual score 0, and rather more than usual and
Much more than usual score 1. Using this method any score above 4 indicates
the presence of distress or ‘caseness’. We used the former method to score the
responses.
A score of 13 was observed which signals towards low level of distress in the
subject.
DISCUSSION: We talked about how the aim of this practical was to assess the
general health of final year college students. Keeping in mind that last year of
college is the time when you have to start thinking about future prospects as to
whether to go for a job, further studies or take a break, it can result to a lot of
stress. Added to this are parental as well as societal expectations that students
are constantly under the pressure of fulfilling. And not just the last year of
college but this age in general is one which comes with a lot of transitions,
changes and challenges that can be triggers for distress in one’s life. It is not
rare to come across news headlines of students committing suicides or
attempting it when they can’t deal with this distress. Therefore it is imperative
to always have an eye out to notice the early signs of distress which can be
found in the form of somatic symptoms, social dysfunction, anxiety and
depression.
The subject here however scored 13 on GHQ-28 which signifies low levels of
stress in an individual. This is a good sign and conveys that the subject adapts
effective stress coping strategies. Following are a few ways that one can resort
to, to deal with stress:
1. Keep a positive attitude – sometimes the way you think about things can
make all of the difference. Your attitude can help offset difficult
situations.
2. Accept that there are events you cannot control – when you know there
are times when you have given all that you can to a situation, it allows
you to expend energy where it can be more effective.
3. Learn to relax – purposeful relaxation, such as deep breathing, muscle
relaxation and meditation is essential in training your body to relax.
Relaxation should be a part of your daily regimen.
4. Be active regularly – being active also helps your body more easily fight
stress because it is fit.
5. Eat well-balanced meals – staying on track with healthy eating habits is a
great way to manage stress.
6. Rest and sleep - your body needs time to recover from stressful events, so
sleep is an important part of caring for yourself.
7. Find your stressors and effective ways to cope with them - remember
that you can learn to control stress because stress comes from how you
respond to stressful events.

CONCLUSION: The subject scored a 13, thus signifying low levels of stress
and a good general health.