The Use of a Geographic Information System (GIS) to Study Spatial Distribution and Factors Associated with Stress Among Thai Adolescents

This research aims to describe the spatial distribution of factors associated with stress among adolescents in the Banpaew District, Samutsakhorn Province of Thailand, by using a Geographic Information System (GIS). A crosssectional study was conducted to analyze the level of stress in a sample of 321 students, aged 12 - 18, during the year 2008 at three schools in the Banpaew District. The data was collected by using questionnaires which collected information from the students about demographic characteristics, stress level, and environmental, personal, and social factors. The information was then used to plot the spatial distribution of stress among adolescents. The results revealed that the majority of students had a moderate stress level (stress score: 27.37 - 37.59, 68.5%), followed by a smaller group who had a low stress level (stress score: < 27.37, 16.8%). Only 14.6% had a high stress level (stress score: > 37.59). It was found that the level of stress was strongly associated with problems with friends (adjusted OR = 3.32, 95% CI = 1.55 - 7.09, p = 0.002). Having family size of more than 3 served as a protective factor (adjusted OR = 0.38, 95% CI = 0.16 - 0.91, p = 0.029). From the distribution map of stress in the Banpeaw District, the subdistrict Laksam had a higher frequency of stress amongst students than in other areas. There was no statistically significant clustering pattern of stress detected. The stress of adolescents in the Banpeaw district did not depend upon the geographic variables we mapped (location of factory and nightclub) but rather involved issues of family and peer relationships. These findings indicate that relationships with family and peers rather than specific geographic factors are correlated with stress. Intervention to improve the level of family support and enhance peer relationships would appear to be very important for reducing adolescents' stress.