This observational cross-sectional study aims to examine the relationship between test anxiety, bowel health, and constipation in university students. The study will include undergraduate students aged 18 years and older who are studying in the Physiotherapy and Rehabilitation Department at Lokman Hekim University and who are in their final examination period. Participants will complete self-report questionnaires during a single face-to-face assessment session. Constipation status will be evaluated using the Rome IV criteria, stool form will be assessed using the Bristol Stool Scale, constipation severity will be assessed using the Constipation Severity Instrument, and test anxiety level will be assessed using the Test Anxiety Inventory. Sociodemographic characteristics and bowel-related symptoms will also be recorded. The study does not include any intervention or treatment. The findings are expected to help better understand whether test anxiety during examination periods is associated with bowel health problems and constipation in university students.
Constipation is a common gastrointestinal problem that may affect quality of life, daily activities, and psychosocial well-being. University students may be particularly vulnerable to bowel habit changes during examination periods because of increased academic stress and test-related anxiety. This study is designed as an observational, cross-sectional, and analytical study. It will evaluate whether test anxiety is associated with bowel health indicators and constipation among university students during the final examination period. The study will be conducted at Lokman Hekim University with undergraduate students from the Department of Physiotherapy and Rehabilitation. After providing informed consent, participants will complete self-report forms and questionnaires in a single face-to-face assessment session. The assessment will include questions about sociodemographic characteristics, bowel habits, bowel-related symptoms, constipation status, stool form, constipation severity, and test anxiety level. No intervention, treatment, randomization, or follow-up assessment will be performed. The study is expected to provide information about the possible relationship between psychological stress related to examinations and bowel health in university students. The findings may contribute to a better understanding of stress-related bowel problems and may support future preventive approaches for young adults.
Study Type
OBSERVATIONAL
Enrollment
200
Participants completed assessment forms and diaries. No intervention was administered.
Lokman Hekim University, Ankara, Ankara
Ankara, Ankara, Turkey (Türkiye)
RECRUITINGConstipation Status Assessed by the Rome IV Criteria
Constipation status will be assessed using the Rome IV criteria. This outcome will be reported as a binary classification: presence or absence of constipation. Participants will be classified as having constipation or not having constipation according to constipation-related symptoms, including reduced stool frequency, straining, hard stools, sensation of incomplete evacuation, sensation of anorectal obstruction, and need for manual maneuvers. The Rome IV criteria will not be reported as a scale score.
Time frame: Baseline (Day 1)
Constipation Severity Assessed by the Constipation Severity Instrument
Constipation severity will be assessed using the Constipation Severity Instrument. The scale includes 16 items and evaluates constipation-related symptoms across three subdomains: obstructive defecation, colonic inertia, and pain. The total score ranges from 0 to 73, with higher scores indicating more severe constipation symptoms.
Time frame: Baseline (Day 1)
Stool Form Assessed by the Bristol Stool Scale
Stool form will be assessed using the Bristol Stool Scale. The Bristol Stool Scale is a 7-point stool form classification scale ranging from Type 1 to Type 7. Type 1 indicates separate hard lumps, and Type 7 indicates watery stool with no solid pieces. Higher scores do not indicate a better or worse outcome; lower scores generally indicate harder stool forms, while higher scores indicate looser stool forms. Participants will be asked to select the stool type that best represents their most common stool form during the last week.
Time frame: Baseline (Day 1)
Test Anxiety Level Assessed by the Test Anxiety Inventory
Test anxiety level will be assessed using the Test Anxiety Inventory. The scale consists of 20 self-report items evaluating cognitive, emotional, and physiological symptoms of anxiety experienced before and during examinations. Total scores range from 20 to 80, with higher scores indicating higher test anxiety.
Time frame: Baseline (Day 1)
Bowel Habits and Bowel-Related Symptoms
Bowel habits and bowel-related symptoms will be assessed using a researcher-developed evaluation form. The form includes questions about stool frequency, postponement of defecation, perceived bowel health, preferred toilet type, and symptoms such as abdominal pain, bloating, gas, diarrhea, nausea, vomiting, indigestion, and constipation during the last week.
Time frame: Baseline (Day 1)
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