Please cite this article in press as: Bíró É, et al. Social support contributes to resilience among physiotherapy students: a cross sectional survey and focus group study. Physiotherapy (2015), http://dx.doi.org/10.1016/j.physio.2015.05.002 ARTICLE IN PRESS PHYST-834; No. of Pages 7 Physiotherapy xxx (2015) xxx–xxx Social support contributes to resilience among physiotherapy students: a cross sectional survey and focus group study Éva Bíró a,∗ , Ilona Veres-Balajti b , Karolina Kósa a,1 a Division of Health Promotion, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai st. 26/b, H-4028 Debrecen, Hungary 2 b Department of Physiotherapy, Faculty of Public Health, University of Debrecen, Kassai st. 26/b, H-4028 Debrecen, Hungary 2 Abstract Objective The present study, taking a resource-oriented approach to mental health, aimed at investigating mental resilience and its determinants among undergraduate physiotherapy students using quantitative and qualitative tools. Design A questionnaire-based cross-sectional survey supplemented by 2 focus groups. Setting One university in Hungary. Participants 130 physiotherapy students at years 1, 2, and 3. Main outcome measures Sense of coherence, a measure of dynamic self-esteem, as well as social support from family and peers were used to assess mental well-being. A screening instrument for psychological morbidity and perceived stress were used as deficiency-oriented approaches. Student opinions were gathered on positive and negative determinants of mental health. Results Resilience was lower [mean difference 4.8 (95% CI −3.4; 13.1)], and the occurrence of psychological morbidity (32.5% vs. 0%) was higher among female compared to male students. However, the proportion of students fully supported by their peers was higher among females (63% vs. 37.5%). Female students, unlike their male counterparts, experienced higher stress compared to their peers in the general population. Social support declined as students progressed in their studies though this proved to be the most important protective factor for their mental well-being. Conclusions Results were fed back to the course organizers recommending the implementation of an evidence-based method to improve social support as delineated by the Guide to Community Preventive Services of the US the outcomes of which are to be seen in the future. © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved. Keywords: Mental health; Psychological resilience; Social support; Physiotherapy students Introduction Competent and credible health professionals who are fit to practice [1] are essential for the provision of patient care [2]. Having uncovered and/or untreated health problems is but one of numerous reasons of impaired fitness for service ∗ Correspondence: Kassai st. 26/b, H-4028 Debrecen, Hungary. Tel.: +36 52 460 190; fax: +36 52 460 195. E-mail addresses: biro.eva@sph.unideb.hu (É. Bíró), balajti.ilona@sph.unideb.hu (I. Veres-Balajti), kosa.karolina@sph.unideb.hu (K. Kósa). 1 Present address: Department of Behavioural Sciences, Faculty of Public Health, University of Debrecen, Hungary. 2 Postal address: POB. 2, 4012 Debrecen, Hungary. [1], especially in an environment like health care where high levels of occupational stress are pervasive [3]. Stress, and especially chronic stress is an important health problem that has been linked, among others, to anxiety, depression, post- traumatic stress disorder [4,5]. Occupational stress is also a known risk factor for burnout that severely impairs the quality of care [6,7] and is difficult to act upon [8]. However, even cumulative stress experiences do not inevitably lead to mental disorders if individual coping resources and psychosocial factors, such as social support, self-esteem and personal control, moderate the effects of stressors [9]. Improvement of the mental well-being of care providers increases job performance and the qual- ity of patient care, and decreases absenteeism, turnover, http://dx.doi.org/10.1016/j.physio.2015.05.002 0031-9406/© 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.