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住院医师规范化培训临近结业学员焦虑和抑郁及相关因素问卷调查
徐炜1,潘碧波2,吴思成3,李畅4,田诗音1,冷峰1,徐正梅1*
0
(1. 海军军医大学(第二军医大学)长征医院医务处, 上海 200003;
2. 海军军医大学(第二军医大学)教务处, 上海 200433;
3. 上海交通大学医学院附属第九人民医院临床研究中心生物统计研究室, 上海 200011;
4. 海军军医大学(第二军医大学)长海医院医务处, 上海 200433
*通信作者)
摘要:
目的 了解住院医师规范化培训(以下简称规培)临近结业学员的焦虑和抑郁情况及其影响因素,为规培临近结业学员的心理健康保健和规培教学管理体系的完善提供循证依据。方法 结合焦虑自评量表和抑郁自评量表制作调查问卷,对某军医大学2所附属医院2018年7月出站的252名规培学员进行调查并分析。结果 共发放问卷252份,回收有效问卷252份,有效回收率为100%。其中男123人(48.8%),女129人(51.2%);平均年龄为(28.3±2.1)岁;本科87人(34.5%),硕士138人(54.8%),博士27例(10.7%);规培1年者27人(10.7%),规培2年者96人(38.1%),规培3年者129人(51.2%);来自“985”院校或“211”院校者151人(59.9%),其他院校者101人(40.1%);军人20人(7.9%)。94.4%(238/252)的规培临近结业学员表现为焦虑状态,60.3%(152/252)的规培临近结业学员表现为抑郁状态。经检验,规培临近结业学员焦虑的严重程度与培训年限有关(χ2=14.214,P=0.027),抑郁的发生与院校类别有关(“985”或“211”院校vs其他院校:χ2=5.691,P=0.017;军队院校vs地方院校:χ2=5.069,P=0.024),该群体的焦虑状态和抑郁之间未见明显相关性(r=0.025,P=0.696)。结论 规培临近结业学员同时面临医疗、就业、结业等多重压力,出现焦虑、抑郁状态比例远高于一般人群及医护人员。医院教学管理部门应予以足够重视,积极采取干预措施。
关键词:  住院医师  规范化培训  焦虑  抑郁
DOI:10.16781/j.0258-879x.2019.10.1157
投稿时间:2019-02-15修订日期:2019-04-26
基金项目:
Anxiety and depression among students before finishing the standardized resident training program
XU Wei1,PAN Bi-bo2,WU Si-cheng3,LI Chang4,TIAN Shi-yin1,LENG Feng1,XU Zheng-mei1*
(1. Medical Affair Office, Changzheng Hospital, Naval Medical University(Second Military Medical University), Shanghai 200003, China;
2. Office of Teaching Affairs, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
3. Biostatistics Office of Clinical Research Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China;
4. Medical Affair Office, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Objective To understand the anxiety and depression status of students before finishing the standardized resident training program (SRTP) and the influencing factors, so as to provide evidence-based basis for improving the mental health and management system for those residents. Methods A questionnaire survey was conducted by combining the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS). The participants were the graduating students of SRTP from two affiliated hospitals of a military medical university, and they were surveyed and analyzed in Jul. 2018. Results A total of 252 questionnaires were distributed and 252 valid questionnaires were returned, with a recovery rate of 100%. There were 123 (48.8%) males and 129 (51.2%) females, with an average age of (28.3±2.1) years old. There were 87 (34.5%) undergraduate students, 138 (54.8%) master degree student, and 27 (10.7%) doctor degree students. Twenty-seven (10.7%) students were trained for one year, 96 (38.1%) for 2 years, and 129 (51.2%) for 3 years. There were 151 (59.9%) students from "985" universities or "211" universities (key universities in China), and 101 (40.1%) from other universities. Twenty (7.9%) participants were in military service. We found that 94.4% (238/252) of the graduating students were in an anxious state and 60.3% (152/252) in a depress state. The severity of anxiety was related to the length of training (χ2=14.214, P=0.027). Depression was related to the type of university ("985" or "211" universities vs others, χ2=5.691, P=0.017; military colleges vs regional colleges, χ2=5.069, P=0.024). No relation was found between depression and anxiety state in the participants (r=0.025, P=0.696). Conclusion Graduating students from SRTP are faced with multiple pressures such as medical job, employment and graduation, and the incidence rates of anxiety and depression are much higher than those of the general population and medical staff. Sufficient attention and intervention measures should be actively taken for prevention of depression and axiety.
Key words:  resident physician  standardized training  anxiety  depression