International students’ adjustment to the educational environment of the Russian university: medical and psychological aspect of socio-cultural integration

Anna Mikhailovna Markus; Inna Nickolaevna Dmitrusenko; Igor Andreevich Tishevskoy

Science for Education Today

2023, vol. 13, issue 5 http://en.sciforedu.ru/

ISSN 2658-6762

DOI: 10.15293/2658-6762.2305.10

Research Full Article/ Article language: English

International students' adjustment to the educational environment of the Russian university: medical and psychological aspect of socio-cultural integration

Anna M. Markus1, Inna N. Dmitrusenko1, Igor A. Tishevskoy2

1 South-Ural State University (National Research University), Chelyabinsk, Russian Federation 2 Chelyabinsk State University, Chelyabinsk, Russian Federation

Abstract

Introduction. The increase in the number of academic exchange programmes for students contributes to a significant growth in the number of international students in Russian universities who often experience a sense of dislocation and have to adjust to new academic and cultural environments. The key problem of integrating international students into the Russian educational environment is their psychological adjustment, which determines not only their academic attainment, but also indicators of their health and social well-being.

The purpose of this article is to identify psychological and medical factors and manifestations of adjustment to the educational environment of the Russian university for international students, as well as to assess their satisfaction with medical and psychological support during their studies at university.

Materials and Methods. The study has been conducted on the basis of an anthropo-systemic methodological approach, which implies a focus on improving constructive strategies and resources for students that allow them to overcome various difficulties more effectively, as well as on developing intercultural communication skills, creating internal and external conditions for self-fulfillment. Questionnaires designed to study medical and psychological aspects of the international students' adjustment to the educational environment of the Russian university were used as research methods.

Results. The study has revealed that 33 per cent of participating international students demonstrated 'low ' and 'below average' levels of adjustment. 'Above average' and 'high ' levels of adjustment were revealed in 56 per cent of participants. Only 11 per cent of the sample demonstrated the 'average' level of adjustment. At the same time, international students showed a low degree of self determination in relation to the future career and prospects for personal development and a high demand for assistance in understanding the importance of professionalization and revealing students' abilities for self-development and self-determination.

For citation

Markus A. M., Dmitrusenko I. N., Tishevskoy I. A. International students' adjustment to the educational environment of the Russian university: Medical and psychological aspect of socio-cultural integration. Science for Education Today, 2023, vol. 13 (5), pp. 195-217. DOI: http://dx.doi.org/10.15293/2658-6762.2305.10

0 Corresponding Author: Igor Andreevich Tishevskoy, i_tishevskoy@mail.rii

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The analysis of the demand and experience of receiving medical services by international students revealed that about 80% of the participants sought medical help. About 73% of them were fully or partially satisfied with the quality of medical services provided, 10% were dissatisfied with the quality, and 17% found it difficult to assess the quality of medical care.

The study reveals the following drawbacks in the complex work implemented by university departments responsible for optimizing psychological and medical indicators of international students' adaptation: time-limits for the examination of patients by a medical worker, difficulties in communication between a specialist and an international student determined by language and cultural barriers, as well as the fact that 'supporting' university staff insufficiently take into account the above-mentioned low degree of international students' self-determination.

Conclusions. The conducted research has identified a range of degrees in international students' adjustment to the Russian educational environment with a small number of individuals with an average degree of adjustment. The main unfavorable psychological factor in the international students' adjustment is low level of their professional self-determination and insufficient formation ofpersonal development prospects. The level and availability of medical care provided to international students in Russia satisfy most of them. The key problem that reduces international students' satisfaction with the quality of medical services is difficulties in social communication with employees ofmedical institutions.

Keywords

Psychological adaptation; Psychological stress; Medical support; Foreign students; Educational environment; Higher education; International students' satisfaction.

Introduction

Modern education system enables foreign students to exercise their right to academic mobility both within the framework of undergraduate and graduate studies, and when entering postgraduate studies. In the universities of the Russian Federation, foreign students constitute special social groups with their own specific processes of adaptation to the educational environment.

To describe these processes and adaptation problems that foreign students face in universities in other countries, A. Furnham [1] applied the concept of "international student syndrome". In accordance with this concept, it can be argued that the difficulties that foreign students face are caused not only by the specific educational environment (in our case, Russian), but also by the need to integrate into a new cultural space. This integration is associated with adaptation to new, unusual rules and traditions of the host country, with the need to know and comply with

unfamiliar norms of behavior. In the process of such adaptation, foreign students are forced to adapt to living conditions being deprived of everyday family support [2], which facilitates overcoming the difficulties associated with cultural stigmatization, the presence of a language barrier and disorientation in the new organizational and educational field. A detailed study of the problems of foreign students' adaptation to the educational environment of a Russian university is very relevant, since the maladjustment of students has not only educational and pedagogical aspects, but also medical and psychological ones that determine the level of health and quality of life of foreign students during the period of study.

Psychological aspects of the adaptation of foreign students to an unusual educational environment were considered by L. K. Newsam and P. Cooper. They found that getting into a new educational environment, foreign students go through a three-stage process of psychological

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Science for Education Today

2023, vol. 13, issue 5

http://en.sciforedu.ru/

ISSN 2658-6762

adaptation [3], consisting of the stage of emotional uplift, the stage of confusion, depression and culture shock, and the stage of creating new own adaptation strategies [4].

H. Forbes-Mewett in his works [5; 6] describes the presence of somatic problems in foreign students associated with mental health and psychological stress: confusion, depression, loneliness, insomnia

International students face a variety of sources of psychological stress, but the stressors associated with academic activities are of the greatest importance. Among them, these authors distinguish [7]: unusual ways of presenting educational material, a language barrier, as well as difficulties in interpersonal interaction with teachers and other students.

According to A. Altissimo [8], international students experience difficulties in implementing interpersonal interaction both during the educational process and in extracurricular activities. These facts were confirmed in a study by K. Koo et al. [9], which revealed that foreign students experience significant difficulties associated with the psychological mood and emotional experiences. The result of these psychological factors is frequent conflict situations of an interpersonal nature in study groups consisting of foreign students, which lead to the formation of a feeling of social isolation among students, giving rise to negative emotions, expressed in a decrease in educational motivation and a desire to participate in extracurricular forms of student activity.

Yue Qi L. et al. [10] note that psychological and socio-cultural adaptation have a positive correlation. The author emphasizes the need to include training programs to familiarize foreign students with strategies to overcome migration,

1 Berebin M. A., Tishevskoy I. A. To the question of the functional and systemic organization of the phenomenon of human adaptation. Mental and socio-psychological

academic and life stresses; development of interpersonal communication skills in order to improve relations in students' microgroup. Pointing to the possibility of expanding the described correlation, Sheng L. et al. [11] believe that there is a phenomenon of complex influence of academic adaptation on the psychological and sociocultural adaptation of foreign students.

One of the mechanisms that disrupt the adaptation of foreign students to a new educational environment is an excessive level of stress. In this regard, the studies of E. V. Tikhonova, M. A. Kosycheva and G. I. Efremova [12] are important, which revealed that a high level of stress in students leads to the formation of depressions that disrupt their social and educational activities, including by increasing the level of conflict. Studies by foreign scientists [13; 14] found that the likelihood of psychological stress and the occurrence of mental health problems may be increased due to ethnic discrimination and financial problems.

The concept of stress as a universal nonspecific adaptation syndrome suggests the existence of correlations between psychophysiological and mental components, on the one hand, and indicators of somatic health, on the other hand1. In this regard, M. A. Kitzrow [15] emphasizes that the mental health of students has a strong influence on the manifestations of physical and emotional well-being, as well as on the quality of interpersonal interactions of students.

The facts cited in the scientific literature [16] suggest that foreign students are at high risk of psychological and medical maladaptation, which suggests the need for a comprehensive consideration of the problem of foreign students'

adaptation: problems, theories and practices, 2005,

pp. 148-151. (In Russian) URL: https://klex.ru/dmk

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adaptation to a new educational and socio-ethno-cultural environment. As part of an integrated approach to solving the problems of reducing psychological stress of foreign students [17; 18], it is recognized as mandatory to organize special preventive measures at the university.

According to V. V. Ryzhov and M. A. Fabulova [19], ensuring the optimal level of psychological adaptation of foreign students in a higher educational institution, which contributes to their personal growth, is one of the priority goals in optimizing the educational environment. Comprehensive work on the psychological adaptation of students is impossible without close interaction between teachers and entire higher education teams with foreign students.

For a comprehensive assessment of the adaptation of foreign students to the new educational environment, T. G. Bokhan, O. V. Terekhina and M. V. Shabalovskaya [20] proposed to take into account the following parameters: self-awareness and self-esteem, a sense of recognition and approval, a sense of satisfaction, the assimilation of culturally appropriate behavior, perceptual maturity, and health status. Based on this, it seems logical to include medical support for foreign students in a set of health-saving measures aimed at creating conditions conducive to the maintenance and preservation of the mental and physical health of students. The medical component in the comprehensive work to preserve the health of students in Russian universities is regulated by the Federal Laws of the Russian Federation "On Education in the Russian Federation"2, 3.

With regard to the medical aspect of foreign students' adaptation to the Russian educational system, it should be recognized that there are no systematic studies that consider it in combination with the psychological and pedagogical components of adaptation. Most often, in order to study the medical problems of foreign students [21; 22], which may be associated with their maladjustment in the new educational and sociocultural environment, scientists analyze the list of health problems this category of students might seek medical advice. In foreign studies on this subject, the main focus is not on the structure of medical problems of foreign students, but on the analysis of their learning difficulties and on the study of possible ways and strategies to overcome them.

Federal Law "On Education in the Russian Federation" obliges students to take care of maintaining and strengthening health, strive for moral, spiritual and physical development and improvement [23].

The purpose of the article is to identify psychological and medical factors, and manifestations of adaptation to the educational environment of Russian university for foreign students, as well as to assess the level of their satisfaction with medical and psychological support during their studies at university.

Methods

The study is carried out on the basis of an anthropo-systemic methodological approach, which implies a focus on improving constructive strategies, resources for students that allow them

2 Russian Federation. Laws. Federal Law of the Russian

Federation No. 323-FZ of November 21, 2011: "On the Basics of Public Health protection in the Russian Federation". (In Russian) URL: https://minzdrav.gov.ru/docu-ments/7025-federalnyy-zakon-323-fz-ot-21-noyabrya-2011-g

3 Russian Federation. Laws. Law on Education: Federal Law of the Russian Federation No. 273-FZ of December 29, 2012 "On Education in the Russian Federation". -Yoshkar-Ola: Research Institute for Monitoring the Quality of Education, 2012. - 126 p. (In Russian) URL: https://www.consultant.ru/docu-ment/cons doc LAW 140174/

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to more effectively overcome various difficulties, as well as on developing intercultural communication skills, creating internal and external conditions for self-realization.

Questionnaires designed to study the medical and psychological aspects of the foreign students' adaptation to the educational environment of Russian university were used as research methods:

1. The questionnaire, developed by the authors, is aimed at studying the level of

satisfaction among foreign students with the work of university departments designed to promote the psychological comfort of students in a new educational environment, as well as the features of their stress-coping behavior in a situation of educational stress. In total, foreign students of South Ural State University were asked to anonymously answer 8 open questions of the questionnaire, formulated in English (Table 1).

Table 1

Questionnaire for foreign students "Satisfaction with the work of university departments designed to contribute to the psychological comfort of students"

Instructions: Read each question of the questionnaire and express your opinion, please.

1. How do you manage stress?

2. Do you think interactive lectures on intercultural communication can help reduce stress?

3. Do you think interactive lectures on adaptation in the Russian educational environment can help reduce stress?

4. What topic(s), in your opinion, should be presentedfor general information in team building trainings?

5. What forms ofpsychological support for international students do you know ?

6. Would you like to participate in trainings on emotional self-regulation, team building, stress, etc.? If you have already participated, write in which events.

7. What, in your opinion, should be added to the educational process to reduce psychological stress?

8. How, in your opinion, is it necessary to develop your abilities for self-development and self-determination?

2. Questionnaire "Diagnosis of socio-psychological adaptation" (K. Rogers, R. Diamond, modified by A. K. Osnitsky). This technique is intended for diagnosing a complex of psychological manifestations that accompany the process of socio-psychological adaptation. To process the empirical results of the study regarding the methodology of socio-psychological adaptation, the STATA program was used, the results are presented as the

arithmetic mean for the group (M), median (Me) and quartiles Q1 and Q 3. The methodology includes the use of various scales, to achieve the goals of our study, we limited ourselves to the analysis of the following integral indicators: "adaptability", "self-acceptance", "acceptance of others", "emotional comfort".

The stimulus material of the method is represented by 101 statements. Specific is the fact that when answering, respondents are asked to

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answer in the third person singular, without using pronouns.

Scale A determines the level of a person's adaptability to being in society in accordance with certain requirements and with his own needs, motives and intentions.

The S scale highlights the self-esteem of the individual, the degree of satisfaction of the individual with his characteristics.

The L scale reflects the degree of a person's need for interaction with others, the presence of aspirations in joint activities. K. Rogers considered this indicator as a positive disposition to another person who had unconditional value. The researcher noted the relationship between self-acceptance (objectification of self-esteem) and the acceptance of others. According to K. Rogers4, acceptance of a person by others contributes to the process of acceptance of oneself.

Scale E is associated with the degree of certainty of emotional attitude to reality [24].

3. Questionnaire "Self-assessment of psychological adaptability". This questionnaire diagnoses the levels of development of socio-psychological adaptability, the peculiarities of relationships with others, the adaptation of foreign students to a changing environment, highlights the speed of adaptation to changes. As one of the adaptive factors, the level of development of adaptability is distinguished. Adaptability is considered as an integral part of personality, capable of changing depending on the lifestyle of a person, on the conditions of training and education [25]. Five levels of socio-psychological adaptability are typologically presented: high (8-10 points), above average (67 points), average (5 points), below average (34 points), low (2-1 points).

4. A questionnaire consisting of 9 questions aimed at identifying and analyzing the experience of interaction between foreign students and medical institutions providing medical and preventive care during the period of study at a Russian university (Table 2).

Table 2

Questionnaire for foreign students "Your experience of interaction with medical institutions in Russia and proposals for its optimization"

1. How often do you apply for medical assistance in Russia?

iНе можете найти то, что вам нужно? Попробуйте сервис подбора литературы.

2. Do you know about medical organizations (centers) for international students of SUSU?

3. Have you ever applied for medical help to these organizations?

4. Are you satisfied with the quality of services provided by the SUSU Medical Center?

5. What are the positive points when contacting a medical organization (center)?

6. Indicate the things you were not satisfied with when visiting a medical organization (center)? Write the name of the medical organizations (centers).

7. What was the most difficult thing for you when visiting a medical organization (center)?

8. Indicate the aspects of adaptation to the Russian educational environment that are the most problematic for you.

9. How much are you satisfied with the medical care in Chelyabinsk?

4 Rogers K. R. Client-centered psychotherapy: theory, modern practice and application. Moscow: Psychotherapy, 2007, 560 p. (In Russian) URL: https://avidread-ers.ru/book/kliento-centrirovannaya-terapiya.html

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All questionnaires were filled out anonymously by the participants of the study; only data on age, gender, country of origin, and course of study were reported from personal information.

52 foreign students of South Ural State University from China, Kazakhstan, Syria, Mongolia, Iraq, Yemen, Nigeria, Iran, Uzbekistan, Kyrgyzstan took part in the study on a voluntary informed basis. At the time of the study (from September 8 to November 15, 2022), they were in their first or second year; of these, 34 were male and 18 were female.

Results

The results of the survey using the questionnaire "Satisfaction with the work of university departments designed to promote the psychological comfort of students" (see Table 1) revealed that foreign students studying at South Ural State University do not have significant problems caused by academic stress. The analysis of the methods of coping with stress showed that 37 students (71 %) use listening to music to overcome stress, 30 respondents (57 %) resort to switching from educational activities to other activities (sports, communication with friends, entertainment, etc.). It turned out that about half of foreign students, 26 people (50 %) periodically try to move away from the problem, not thinking about the presence of stress, and only four students (7 % of the sample) indicated that they had sought the help of a psychologist-consultant in the Center for Sociocultural Adaptation (CSA) of South-Ural State University.

The analysis of responses to the questions aimed at studying the expectations of foreign

students to optimize the work of university departments, designed to help them overcome academic stress, revealed the following suggestions and wishes:

1) 33 respondents (64 %) found it useful to conduct regular interactive lectures on the ways and methods of getting rid of stress, where solutions will be presented in an understandable concise form.

2) 33 people (64 %) indicated that interactive lectures covering the issues of cohesion of the educational team have a positive effect on reducing stress, respectively, these respondents spoke about the appropriateness of holding them for international students.

3) 30 respondents (57 %) in their responses emphasized the desirability of conducting trainings for foreign students and designated the following topics as desirable for them: "Taking into account the interests of students" and "Socio-cultural differences and features of the inner world of representatives of various nations and peoples".

4) 11 respondents (21 %) also spoke in favor of the importance of holding group trainings, but considered the topic "Microclimate in the study group" to be more in demand for them.

The results of the diagnosis of psychological manifestations that accompany the process of socio-psychological adaptation, obtained using the technique of C. Rogers-R. Diamond in the modification of A. K. Osnitsky are presented in Table 3.

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Table 3

Psychological manifestations accompanying the process of socio-psychological adaptation (according to the method of K. Rogers-R. Diamond, modified by A. K. Osnitsky)

Integral indicator M±o Me Q1; Q3

(A) Adaptability 68,32±9,11 91 (81; 99)

(S) Self-acceptance 73,98±8,54 75 (43; 94)

(L) Acceptance of others 65,23±7,01 41 (28; 55)

(E) Emotional Comfort 44,92±4,17 43 (30; 50)

According to the data obtained, the average value of the integral indicators of the adaptability of foreign students is 68.32 (A=68.32), which corresponds to the lower limit of the norm in terms of adaptability. Based on this, it can be argued that the processes of socio-psychological adaptation of foreign students in the studied sample proceed without external and internal contradictions, they carry out their main academic activities and quite successfully try to meet role expectations.

The values of other studied integral indicators correspond to the values "above the norm" (S=73.98, L=65.23, E=44.92), which allows us to characterize foreign students in the studied group as optimistic, with a positive self-assessment of their personal qualities, with high self-satisfaction and realizing that they are interesting to others. In relation to others, they are accepting, tolerant of their weaknesses and shortcomings, tend to give positive assessments.

Based on the values of the indicator "E" ("Emotional comfort") obtained in the studied group, it can be assumed that foreign students do not have tension, anxiety, and also that they have emotional balance. It seems that the students who took part in the study are satisfied with the surrounding reality and they are optimistic.

The results obtained during testing of foreign students at South Ural State University using the methodology "Self-assessment of psychological adaptability" (Fig. 1) indicate an uneven distribution among this category of students with different levels of adaptability. The average level of adaptability was revealed in only 6 people (11 %), the level of adaptability "above average" prevails (18 people, 33 % of respondents), and the levels "high" and "below average" were found in the same number of respondents, respectively (11 people, 22 %). A low level of psychological adaptation was found in 6 respondents (11 %).

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Fig. 1. The ratio of foreign students with different levels of psychological adaptability development

Such a deviation of the distribution of the studied indicator in the studied group of respondents from the normal distribution allows us to speak about the heterogeneity of the sample of subjects in terms of the level of psychological adaptability. This means that, on the one hand, there is a predominance of students with "high" and "above average" levels of psychological adaptability, which indicates a rather high ability of most foreign students to adapt to the peculiarities of the new educational environment. On the other hand, a fairly large number of participants with a "below average" level (along with the presence in the sample of individuals with a low level of psychological adaptability) indicates the relevance of developing preventive work among foreign students and determines among them the primary category of students for social and pedagogical support and for implementation of medical and psychological support measures. The identification of such a group among foreign students seems to be an important step in diagnosing psychological

adaptability already at the stage of their immersion in an unusual educational environment (immediately after moving to Russia and starting classes), which subsequently expands the possibilities of their differentiated pedagogical, psychological and medical support and is quite complementary to the principles organizing a support system for the process of students' adaptation at South Ural State University.

At South Ural State University, psychological support for the process of adaptation of students coming from other countries is carried out in stages. At the first stage, activities are carried out to determine the methods, forms and methodological techniques for working with students, while preference is given mainly to interactive introductory trainings, lectures and seminars, which reveal the subject of adaptive capabilities of students. Coordination and implementation of the main activities of the SUSU Center for Social Adaptation (CSA SUSU) is carried out by a consultant psychologist responsible for:

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- conducting psychological and pedagogical diagnostics, focused on identifying the level of adaptive capabilities of foreign students;

- individual counseling with foreign students who experience certain difficulties in the Russian educational environment;

- conducting interactive trainings, lectures and seminars that contribute to leveling or reducing the level of stress and reducing stressful situations, revealing the topic of team building and a favorable psychological climate in the study group.

If the psychologist-consultant reveals a request or signs of the need for a consultation with a doctor, he/she facilitates the foreign student's request for medical assistance and/or support, which complements the possibilities of saving the health of this category of students within the framework of medical examination.

As a result of such an organization of the medical support system, the level of medical services provided to foreign students at the South Ural State University can be assessed as quite high. This is ensured by the presence and high degree of coordination of the SUSU Medical Center established in 1999 and the student polyclinic. Students can contact a medical center or clinic and quickly receive high-quality and fast medical care and psychological support. When visiting the SUSU Medical Center, foreign students take a structured survey with a standard set of questions about possible medical problems in Russian or one of four foreign languages (English, Arabic, French or Chinese). The time limit for a medical worker to collect complaints, the limited number of standard questions in the questionnaire, as well as the difficulties in communication between a specialist and a foreign student, due to the language barrier and the patient's anxiety, significantly reduce the effectiveness of a specialist's understanding of the

specifics of complaints and problems with which a foreigner seeks medical help.

In order to improve the efficiency of identifying complaints and collecting anamnesis, it seems appropriate to develop a special questionnaire with ready-made answers and "open" questions, which foreign students could fill out on their own while waiting for an appointment or even before visiting a doctor, without experiencing the stress associated with time limits for formulation of answers and direct social contact with a specialist who is not fluent in the corresponding foreign language. As an option for formatting questions in the questionnaire, it is possible to offer possible answers, choosing which a foreign student could note not only the symptoms of his ailment (pain, weakness, chills, etc.), but also the level of their severity, for example, on a five-point scale from 0 to 4, where 0 points - there is no symptom, and 4 points - the symptom is severe and manifests itself often. In addition to questionnaires, it is advisable to develop case tasks for foreign students aimed at familiarizing them with the basics of behavior when visiting a medical organization in Russia, as well as with the realities of organizing medical care in our country (responsibility of medical workers for observing medical secrecy, issues of deontology, status of doctor in Russian society). The main tasks in the implementation of such cases can be considered the formation of a minimum vocabulary among foreign students, as well as the development of social competencies which are necessary for visiting a medical institution.

In order to optimize the communication of SUSU Medical Center employees with foreign students, the university provides them with the opportunity to improve their English language for free under the program of additional linguistic training "Lingua". However, it is worth noting that this program is mainly focused on mastering

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the generally accepted vocabulary for everyday communication, so the medical staff of the Center have to improve the specialized vocabulary of medical terms on their own.

General management, coordination and direct participation in the medical support of foreign students is carried out by the Director of the SUSU Medical Center, who, in particular, holds informational meetings with foreign students that contribute to the familiarization of foreign students with a healthy lifestyle, and also advises them on various issues (on the dangers of smoking and alcohol, about the benefits of vaccination, etc.). These activities are aimed at improving the quality of life and health of students. Despite the presence of the listed events in the schedule of the SUSU Medical Center, they are not popular among foreign students. The low activity of visiting such events by foreign students is due to a number of reasons. So, for example, for students from Arab countries, a tendency is typical to displace the symptoms of the disease from consciousness and not to recognize the fact of the disease, its fear, denial, in particular, because of the fear of condemnation by others. Foreign students from Arab countries do not trust a doctor who does not behave in accordance with the high social status of representatives of this profession in Arab countries, and the politeness of Russian doctors is perceived as a manifestation of uncertainty, weakness and a tendency to submit, which devalues a specialist in their eyes. Another common reason for the unpopularity of preventive talks and consultations is the skepticism of foreign students towards the staff of the SUSU Medical Center, which is directly related to the inadequate perception of Russian realities, including in the field of healthcare, for example, doubts are expressed about the observance of medical secrecy in the Russian medical environment, the observance of traditions privacy in accordance with their cultural norms.

To find out possible directions for optimizing the medical support of foreign students, taking into account their expectations and suggestions, the authors conducted an appropriate survey (see Table 2). 52 foreign students took part in this survey. 11 people (21.2 %) have never sought treatment in Russia, and of the remaining respondents (41 people, 78.8 %) 38 people (73.1 %) reported that they rarely or from time to time sought medical care in Russia, and 3 people (5.7 %) seek medical advice frequently.

Later, when analyzing foreign students' assessments of their experience of visiting medical institutions in Russia, we took into account the answers of only those students who at least once received medical care in healthcare institutions of the Russian Federation (n=41). In this group of respondents, 17 people (41.4 %) stated that they were completely satisfied with the quality of medical care, 13 people (31.7 %) were partially satisfied with the quality of service, 4 foreign students (9.8 %) were dissatisfied with the quality of service, and 7 people (17.1 %) found it difficult to assess the quality of medical care received.

When analyzing what foreign students liked the most about receiving medical care, among the statements of foreign students who received medical care in our country (n=41), the statements with the highest rank were taken into account (they were either the only ones in the response to the corresponding question, or were indicated first among several characteristics). Among these positive characteristics of medical care, the following were most often mentioned: "competence of medical personnel" (mentioned by 25 people, 61 %), and, by a wide margin, "friendly atmosphere" (4 people, 7.8 %). Two people (4.9 % each) indicated "the interior design of the medical center" and "the overall quality of the medical service provided" as positive

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impressions of the experience of staying in medical institutions. 6 people out of 41 (14.7 %), when answering this question, either found it difficult to answer it, or indicated that they "did not like anything".

Similarly, we analyzed the statements reflecting the reasons for dissatisfaction with the quality of medical care in medical institutions of the Russian Federation among foreign students with relevant experience (n=41). There were 17 (41.5 %) such students, and 23 students (56.1 %) indicated that they were quite satisfied with the quality of medical care, and 1 person (2.4 %) found it difficult to answer this question. Among the reasons for dissatisfaction with the quality of medical care in medical institutions of the Russian Federation, 5 people (12.2 %) indicated the hostility of medical personnel and their excessive haste in the provision of medical services, 4 people (9.8 %) noted a low level of foreign language proficiency by medical personnel, 3 foreign students (7.3 %) were impressed by the low professional competence of medical personnel, one person (2.4 % each) was dissatisfied with the large number of visitors in the medical institution and the inconvenient work schedule that coincides with the schedule of studies at the university. Two respondents (4.9 %), when answering the question about the reasons for dissatisfaction with the quality of medical services provided, reported a large number of reasons for their dissatisfaction, but did not specify them.

With the quality of medical services in the Russian Federation as a background characteristic, at the next stage, the situation with the satisfaction of foreign students (n=52) with the level of medical support and service in the educational environment of South Ural State University, implemented by the SUSU Medical Center, was analyzed. The result of this analysis shows that during their studies at SUSU,

approximately % of the respondents have never used the services of the SUSU Medical Center: 40 people (76.9 %) have never sought medical care in the Center, and only 12 people (23.1 %) have ever used its services. During the survey among these 12 people who sought care in the SUSU Medical Center, 9 respondents (75 %) indicated that they were completely satisfied with the quality of medical care, and 3 people (25 %) were partially satisfied, of those who reported dissatisfaction with the quality of medical care at the SUSU Medical Center, was not identified. The revealed facts allow us to state that the quality of medical care and support at the SUSU Medical Center, in comparison with the quality of service in other medical institutions of the Russian Federation, is assessed by foreign students as higher.

In addition, as further prospects for optimizing the preventive work of the SUSU Medical Center, one can point out the need to openly and easily implement advertising of the medical and preventive services of the Medical Center in the educational space of SUSU, in hostels and places of organized leisure for foreign students. The relevance of this area of work is confirmed by the revealed fact that at the time of the survey among foreign students, only 36 out of 52 respondents (69.2 %) have information about the existence of a special Medical Center.

Comparison of the structure of activities of the SUSU Medical Center and the profile of foreign students' wishes for its optimization allows us to make proposals for a structural model for organizing the activities of a Russian university to improve the medical and psychological indicators of adaptation of foreign students (Fig. 2). It consists of a target component, a scientific support component, procedural-organizational and result-oriented blocks.

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Social order Export of education Teory and practice of education

An excerpt from the Federal Law of December 29, 2012 No. 273-FZ "On Education in the Russian Federation":

- provision of primary health care in the manner prescribed by the legislation in the field of health protection;

- determination of the optimal educational and extracurricular workload, the regime of training sessions;

- promoting and teaching healthy lifestyle skills, etc.

Mandatory medical check-up

(clause 13, art. 1 of the Federal Law No. 274 07/01/2021)

Target component Purpose: optimize the comprehensive medical and psychological support of foreign students in the Russian educational environment Tasks:

1. To study the current state of medical and psychological support;

2. To describe ways to optimize the medical and psychological support of foreign students in the Russian educational environment;

3. To develop recommendations for optimal in-

Organizational component

1 .Initial (before the start of studies), 2. Intermediate (first year of study) and 3. Final (senior years of study) stages:

1 .Registration of medical documents, medical check-up; 2. Information about providing medical and psychological assistance (adaptation period), medical and psychological counseling, psychological training, medical check-up; 3. Consulting assistance

Content component: General

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Medical and psychological activities (operational and preventive direc

tions)

Medical and psychological assistance Preventive, diagnostic and advisory directions Solving individual psychophysiological problems Psychological aspect

- positive, adaptive and problematic psychological support

- development of adaptive technologies to eliminate psychological difficulties

- prolonged psychological interaction

- diagnostics of personality development of foreign students.

Medical aspect

- organization and creation of conditions for disease prevention

- diagnostics of foreign students' physical health

- health-saving function.

Technological component:

Psychodiagnostics (multidimensional

scales, questionnaires) Organization of interaction with a psychologist-consultant, with representatives of a medical institution Trainings Project activity Interaction analysis

Extra technologies:

Case tasks Interactive lectures

M

0 n

1 t

0 r

1

n g

f

0 r m a t

1 v e

f i n a l

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Result block

Criteria

1. usefulness of trainings on interaction with medical workers;

2. the quality of medical and psychological care;

3. availability (openness) of information on the provision of medical and psychological services;

4. convenience of the location of medical organizations;

5. opening hours;

6. the attitude of medical organizations staff towards foreign students.

Fig. 2. Structural model of organizing the activities of a Russian university to improve the medical and psychological indicators of foreign students' adaptation

Conclusions

Summing up the results of the study of medical and psychological support organization for foreign students' adaptation in the educational environment, it seems possible to draw the following conclusions. Firstly, the problem of improving medical and psychological indicators of foreign students' adaptation to the educational environment is very relevant, but little studied. Scattered publications on this issue reveal the presence of close relationships and the additive nature of the interaction of pedagogical, psychological and medical adaptation factors that act in a complex and determine the total level of foreign students' adaptation to a new educational environment for them.

Secondly, judging by the reviews of foreign students, the main shortcomings in the implementation of the complex work of the university departments, which is aimed at optimizing both psychological and medical indicators of foreign students' adaptation, relate to the fact that specialists interacting with foreign students do not sufficiently take into account the low degree of foreign students' self-determination. This was manifested in the

requests of foreign students for help in understanding the importance of this process and help in revealing the students' abilities for self-development and self-determination. It seems that such work will help to update the psychological assistance and pedagogical support for students and make it more flexible and adaptive to emerging trends in the educational environment and students' needs. In this context, the importance of the work of specialists who are responsible for implementing foreign students' adaptation is increasing. They should constantly study and take into account the feedback and opinions of foreign students on the sufficiency and adequacy of assistance to them, analyze weaknesses and contribute to their elimination.

The state of the problem of foreign students' medical and psychological adaptation to the educational environment was studied and the difficulties in implementing the complex work of South Ural State University departments aimed at optimizing both psychological and medical indicators of foreign students' adaptation were analyzed. Based on the analysis, we can propose as a promising model the following structure for organizing the work of a university to improve

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medical and psychological indicators of foreign students' adaptation (see Fig. 2).

The following can be considered as the main recommendations for organizing university work aimed at optimizing the indicators of medical and psychological adaptation of foreign students:

1. It is necessary not only to improve the professional competence of medical personnel, but also to improve the quality of social communication of medical personnel with foreign students (to overcome the language barrier, as well as to eliminate the hostility and excessive haste of medical personnel when working with patients).

2. It is advisable to establish high-quality and persistent information to foreign students about the need to have a medical examination in case of manifestations of any kind of disease, including through the use of open sources, for example, a university website, a student group in instant messengers, on the website vk.com. and so on.

3. The need to openly and easily introduce advertising for psychological support activities (trainings, thematic groups, lectures, seminars, individual and crisis counseling), including on the topics of "Self-regulation", "Teambuilding" and "Prevention of stress", as well as medical and preventive services in the educational space of the university, in hostels and places of organized leisure for foreign students.

In conclusion, it seems important to take into account the identified problematic aspects in the organization of the complex work of the university administration, aimed at the medical and psychological adaptation of foreign students to the educational environment. This will allow not only to implement the principles of academic mobility in practice, but will also contribute to a wide intercultural and scientific exchange between representatives of young scientists' communities from different countries.

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Accepted: 9 September 2023 Published: 31 October 2023

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Submitted: 05 July 2023

The authors' stated contribution:

Anna Mikhailovna Markus

Contribution of the co-author: main author of the study, collecting empirical material, performing statistical procedures, formatting the text of the article. Inna Nickolaevna Dmitrusenko

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Contribution of the co-author: collection of materials, literary review. Igor Andreevich Tishevskoy

Contribution of the co-author: organization of the study, concept and design of the study, interpretation of the results and general guidance of the study.

All authors reviewed the results of the work and approved the final version of the manuscript.

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Information about competitive interests:

The authors claim that they do not have competitive interests.

Information about the Authors

Anna Mikhailovna Markus

Candidate of Philological Sciences, Associate Professor, Department of Foreign Languages,

South Ural State University (National Research University), 76, Lenin prospekt, 454080, Chelyabinsk, Russian Federation. ORCID ID: https://orcid.org/0000-0003-4200-4344 E-mail: markusam@susu.ru

Inna Nickolaevna Dmitrusenko

Candidate of Pedagogic Sciences, Associate Professor, Department of Foreign Languages,

South Ural State University (National Research University), 76, Lenin prospekt, 454080, Chelyabinsk, Russian Federation. ORCID ID: https://orcid.org/0000-0001-6633-4327 E-mail: dmitrusenkoin@susu.ru

Igor Andreevich Tishevskoy

Candidate of Medical Sciences, Associate Professor, Department of Psychology, Chelyabinsk State University,

129, ulitsa Bratiev Kashirinykh, 454001, Chelyabinsk, Russian Federation. ORCID ID: https://orcid.org/0000-0003-0371-057X E-mail: i_tishevskoy@mail.ru

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УДК 316.613+378.44+159.923+57.017.3 DOI: 10.15293/2658-6762.2305.10

Научная статья / Research Full Article Язык статьи: английский / Article language: English

Адаптация иностранных студентов в российскую образовательную среду университета: медико-психологический аспект социокультурной интеграции

А. М. Маркусь &1, И. Н. Дмитрусенко1, И. А. Тишевской2

Проблема и цель. Повышение академической мобильности студентов способствует значительному росту числа иностранных студентов в российских университетах, которые оказываются в непривычной для них образовательной среде и поэтому вынуждены адаптироваться к новым академическим и культурным реалиям. Ключевой проблемой интеграции иностранных студентов в российскую образовательную среду является их психологическая адаптация, определяющая не только успешность учебной деятельности студентов, но и показатели их здоровья и социального благополучия. Цель статьи - выявить психологические и медицинские факторы и проявления адаптации к образовательной среде российского вуза иностранных студентов, а также оценить уровень их удовлетворенности медико-психологическим сопровождением в период обучения.

Методология. Исследование проводится на основе антропо-системного методологического подхода, предполагающего концентрацию на совершенствовании конструктивных стратегий, ресурсов у обучающихся, позволяющих им эффективнее преодолевать различные трудности, а также на развитии навыков межкультурной коммуникации, создании внутренних и внешних условий для самореализации. В качестве исследовательских методов применялись опросники, предназначенные для изучения медико-психологических аспектов адаптации иностранных студентов к образовательной среде российского вуза.

Результаты. В изученной выборке иностранных студентов выявлено отсутствие «нормальности» в распределении показателя адаптивности: преобладают студенты с уровнями адаптивности «выше среднего» и «высокий» (56 % суммарно) и «низкий» и «ниже среднего» (33 % суммарно), а уровень адаптивности «средний» был выявлен только у 11 % испытуемых.

Библиографическая ссылка: Маркусь А. М., Дмитрусенко И. Н., Тишевской И. А. Адаптация иностранных студентов в российскую образовательную среду университета: медико-психологический аспект социокультурной интеграции // Science for Education Today. - 2023. - Т. 13, № 5. -С. 195-217. DOI: http://dx.doi.org/10.15293/2658-6762.2305.10

1 Южно-Уральский государственный университет (национальный исследовательский университет), Челябинск, Россия 2 Челябинский государственный университет, Челябинск, Россия

Автор для корреспонденции: Игорь Андреевич Тишевской, i_tishevskoy(a>mail.ru © А. М. Маркусь, И. Н. Дмитрусенко, И. А. Тишевской, 2023

(£) ®

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Вместе с тем у иностранных студентов были выявлены низкая степень самоопределения в отношении профессии и перспектив личностного развития и высокий запрос на помощь в осмыслении важности профессионализации и раскрытии имеющихся у студентов способностей к саморазвитию и самоопределению. Проведенный анализ востребованности и опыта получения медицинских услуг иностранными студентами выявил, что среди них за медицинской помощью обращалось примерно 80 %, из которых около 73 % были полностью или частично удовлетворены качеством оказанных медицинских услуг, 10 % остались недовольны их качеством, а 17 % затруднились оценить качество медицинского обслуживания. Основными недостатками в реализации комплексной работы подразделений вуза, нацеленной на оптимизацию психологических и медицинских показателей адаптации иностранных студентов, оказались: наличие лимита времени медицинского работника, отведенного на сбор жалоб; сложности коммуникации специалиста и иностранного студента, обусловленные языковым и культурным барьером; недостаточный учет в работе «сопровождающих» специалистов вуза низкой степени самоопределения иностранных студентов.

Заключение. Проведенное исследование свидетельствует о наличии разной степени адап-тированности иностранных студентов к российской образовательной среде при малой численности лиц со средней степенью адаптированности. Основными неблагоприятными психологическими факторами адаптации иностранных студентов являются низкий уровень их профессионального самоопределения и недостаточная сформированность перспектив личностного развития. Уровень и доступность медицинской помощи, предоставляемой иностранным студентам в России, удовлетворяет большинство из них. Ключевой проблемой, снижающей оценку иностранными студентами качества медицинских услуг, является сложность налаживания социальной коммуникации с сотрудниками медучреждений.

Ключевые слова: психологическая адаптация; психологический стресс; медицинское сопровождение; иностранные студенты; российская образовательная среда; высшее образование; удовлетворенность иностранных студентов.

1. Furnham A. The mental health of foreign students // Social science and medicine. - 1983. -Vol. 17 (6). - P. 365-370. URL: http://www.academia.edu/33902951/The_mental_health_of_for-eign_students

2. Walkiewicz M., Guziak M. Availability of psychological support for medical students in Poland // International Journal of Occupational and Environmental Health. - 2021. - Vol. 34 (1). - P. 8799. DOI: https://doi.org/10.13075/ijomeh.1896.01539

3. Newsome L. K., Cooper P. W. International students' cultural and social experiences in a British University: "Such a hard life [it] is here" // Journal of International Students. - 2016. - Vol. 6 (1). -P. 195-215. DOI: https://doi.org/10.32674/jis.v6i1.488

4. Holubnycha L., Matsapura L., Miroshnik L., Hetmanets I., Kovalchuk O., Khodakovska O. Psychophysiological Adaptation of International Students to Learning Abroad // International Journal of Innovative Research and Scientific Studies. - 2022. - Vol. 5 (1). - P. 37-46. DOI: https://doi.org/10.53894/ijirss.v5i1.359

5. Forbes-Mewett H. Mental health and international students: Issues, challenges and effective practice // International Education Association of Australia (IEAA). - July 2019. - P. 1-18. URL: https://research.monash.edu/en/publications/mental-health-and-international-students-issues-chal-lenges-and-ef

СПИСОК ЛИТЕРАТУРЫ

Science for Education Today

2023, vol. 13, issue 5 http://en.sciforedu.ru/ ISSN 2658-6762

6. Forbes-Mewett H., Sawyer A.-M. International students and mental health // Journal of International Students. - 2016. - Vol. 6 (3). - P. 661-677. DOI: https://doi.org/10.32674/jis.v6i3.348

7. Vatansever M., Georgieva E., Velkova A. Stress factors and depression levels of international medical students in Bulgaria and Turkish medical students // Education in Medicine Journal. - 2021. -Vol. 13 (3). - P. 55-64. DOI: https://doi.org/10.21315/eimj2021.13.3.6

8. Altissimo A. Support in international students' relationships. - Beings, Belongings and Places, 2020. - P. 241-251. DOI: https://doi.org/10.1007/978-3-658-31364-7_8

9. Koo K., Kim Y. W., Lee J., Nyunt G. "It's My Fault": Exploring Experiences and Mental Wellness Among Korean International Graduate Students // Journal of International Students. - 2021. -Vol. 11 (4). - P. 790-811. DOI: https://doi.org/10.32674/jis.v11i4.2801

10. Yue Qi L., Roslan S., Zaremohzzabieh Z. Perceived Social Support and Psychological Well-Being of International Students: The Mediating Effects of Resiliency and Spirituality // Asian Journal of University Education. - 2021. - Vol. 17 (3). - P. 220-234. DOI: https://doi.org/ 10.24191/ajue.v17i3.14502

11. Sheng L., Dai J., Lei J. The impacts of academic adaptation on psychological and sociocultural adaptation among international students in China: The moderating role of friendship // International Journal of Intercultural Relations. - 2022. - Vol. 89. - P. 79-89. DOI: https://doi.org/ 10.1016/j.ij intrel.2022.06.001

12. Tikhonova E. V., Kosycheva M. A., Efremova G. I. Primary professionalization of foreign students: barriers, stigmatization, adaptation // Integration of Education. - 2021. - Vol. 25 (4). - P. 608-628. DOI: https://doi.org/10.15507/1991-9468.105.025.202104.608-628 URL: https://eli-brary.ru/item.asp?id=47395888

13. Jin L., Acharya L. Developing Tailored Messages to Improve Mental Health and Adjustment of Asian International Students // Journal of International Students. - 2022. - Vol. 12 (2). - P. 817842. DOI: https://doi.org/10.32674/jis.v12i2.3594

14. Baghoori D., Roduta Roberts M., Chen S.-P. Mental health, coping strategies, and social support among international students at a Canadian university // Journal of American College Health. -2022. - P. 1-12. DOI: https://doi.org/10.1080/07448481.2022.2114803

15. Kitzrow M. A. The mental health needs of today's college students: Challenges and recommendations // NASPA Journal. - 2003. - Vol. 41 (1). - P. 165-179. URL: https://ccvillage.buf-falo.edu/wp-content/uploads/sites/74/2017/06/NASPA-Mental-Health-Needs-of-College-Stu-

16. Marangell S., Baik C. International Students' Suggestions for What Universities Can Do to Better Support Their Mental Wellbeing // Journal of International Students. - 2022. - Vol. 12 (4). -P. 933-954. DOI: https://doi.org/10.32674/jis.v12i4.3877

17. Bore M., Pittolo C., Kirby D., Dluzewska T., Marlin S. Predictors of psychological distress and well-being in a sample of Australian undergraduate students // Higher Education Research & Development. - 2016. - Vol. 35 (5). - P. 869-880. DOI: https://doi.org/10.1080/07294360.2016.1138452

18. Larcombe W., Finch S., Sore R., Murray C. M., Kentis S., Mulder R. A., Tokatlidis O., Williams D. A. Prevalence and socio-demographic correlates of psychological distress among students at an Australian university // Studies in Higher Education. - 2014. - Vol. 41 (6). - P. 1074-1091. DOI: https://doi.org/10.1080/03075079.2014.966072

19. Рыжов В. В., Фабулова М. А. Психологическое сопровождение духовно-нравственного развития студентов средствами иностранного языка // Вестник университета. - 2012. - № 10. -С. 305-312. URL: https://elibrary.ru/item.asp?id=18344985

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2023, vol. 13, issue 5 http://en.sciforedu.ru/

ISSN 2658-6762

20. Бохан Т. Г., Терехина О. В., Шабаловская М. В. К вопросу оснований психологического сопровождения образования иностранных студентов с позиции антропо-системного подхода в психологии // Научно-педагогическое обозрение. - 2022. - № 5. - С. 158-168. БОТ:

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Поступила: 05 июля 2023 Принята: 9 сентября 2023 Опубликована: 31 октября 2023

Маркусь Анна Михайловна: сбор эмпирического материала, выполнение статистических процедур, оформление текста статьи.

Дмитрусенко Инна Николаевна: сбор материалов, литературный обзор.

Тишевской Игорь Андреевич: организация исследования, концепция и дизайн исследования, интерпретация результатов и общее руководство.

Все авторы ознакомились с результатами работы и одобрили окончательный вариант рукописи.

https://doi.org/10.23951/2307-6127-2022-5-158-168

URL:

https://eli-

Заявленный вклад авторов:

Информация о конфликте интересов:

Авторы заявляют об отсутствии конфликта интересов.

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Информация об авторах

Маркусь Анна Михайловна

доцент,

кафедра иностранных языков,

Южно-Уральский государственный университет (национальный

исследовательский университет),

проспект Ленина 76, 454080, Челябинск, Россия.

ORCID ID: https://orcid.org/0000-0003-4200-4344

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E-mail: markusam@susu.ru

Дмитрусенко Инна Николаевна

доцент,

кафедра иностранных языков,

Южно-Уральский государственный университет (национальный

исследовательский университет),

454080, г. Челябинск, проспект Ленина, 76, Россия.

ORCID ID: https://orcid.org/0000-0001-6633-4327

E-mail: dmitrusenkoin@susu.ru

Тишевской Игорь Андреевич

кандидат медицинских наук, доцент, кафедра психологии,

Челябинский государственный университет, ул. Братьев Кашириных, 129, 454001, г. Челябинск, Россия. ORCID ID: https://orcid.org/0000-0003-0371-057X E-mail: i_tishevskoy@mail.ru

International students’ adjustment to the educational environment of the Russian university: medical and psychological aspect of socio-cultural integration Текст научной статьи по специальности «Фундаментальная медицина»

Аннотация научной статьи по фундаментальной медицине, автор научной работы — Anna Mikhailovna Markus, Inna Nickolaevna Dmitrusenko, Igor Andreevich Tishevskoy

Похожие темы научных работ по фундаментальной медицине , автор научной работы — Anna Mikhailovna Markus, Inna Nickolaevna Dmitrusenko, Igor Andreevich Tishevskoy

Адаптация иностранных студентов в российскую образовательную среду университета: медико-психологический аспект социокультурной интеграции

Текст научной работы на тему «International students’ adjustment to the educational environment of the Russian university: medical and psychological aspect of socio-cultural integration»