摘要:

目的了解臨床醫(yī)學(xué)研究生心理壓力來(lái)源及影響因素，為研究生心理健康教育提供支持依據(jù)。

方法采用自行設(shè)計(jì)的研究生心理壓力調(diào)查問(wèn)卷，對(duì)462名臨床醫(yī)學(xué)研究生心理壓力現(xiàn)狀及影響因素進(jìn)行調(diào)查分析。

結(jié)果462名醫(yī)學(xué)研究生中，有壓力感知的311人(67.32%)。居住地為城鎮(zhèn)的醫(yī)學(xué)研究生壓力感知高于農(nóng)村和城市(P < 0.05)，博二及以上年級(jí)有壓力人數(shù)高于博一(P < 0.05)。研究生壓力源由高到低依次為學(xué)習(xí)、環(huán)境、就業(yè)、經(jīng)濟(jì)、情感因素。有壓力感知的311名醫(yī)學(xué)研究生中，感受壓力持續(xù)時(shí)間 < 6個(gè)月(短期)230人(73.95%)，≥6個(gè)月(長(zhǎng)期)81人(26.05%)。性別和壓力源中學(xué)習(xí)、就業(yè)、情感和經(jīng)濟(jì)因素為壓力感知時(shí)間的影響因素(P < 0.05~P < 0.01)。女生較男生更容易產(chǎn)生長(zhǎng)期壓力，壓力源中情感和經(jīng)濟(jì)因素會(huì)增加長(zhǎng)期壓力的風(fēng)險(xiǎn)(P < 0.05~P < 0.01)。

結(jié)論醫(yī)學(xué)研究生壓力感知率較高，居住地和年級(jí)是壓力感知的影響因素，性別、壓力源中情感和經(jīng)濟(jì)因素是壓力持續(xù)時(shí)間的影響因素。教學(xué)管理部門(mén)應(yīng)關(guān)注高年級(jí)和居住地為城鎮(zhèn)的學(xué)生，注重升學(xué)、就業(yè)等壓力易發(fā)生的時(shí)段，給予學(xué)生有針對(duì)性的心理輔導(dǎo)，導(dǎo)師及專(zhuān)職班主任共同配合，引導(dǎo)醫(yī)學(xué)研究生積極應(yīng)對(duì)工作與學(xué)習(xí)中的壓力。

Abstract:

ObjectiveTo understand the sources and influencing factors of psychological stress among clinical medical graduate students, and provide support for graduate students' mental health education.

MethodsA self-designed Graduate Psychological Stress Survey Questionnaire was used to investigate and analyze the current status and influencing factors of psychological stress among 462 clinical medical graduate students.

ResultsAmong the 462 medical graduate students, 311 students (67.32%) had stress perception.Medical graduate students who resided in cities and towns had a higher perception of stress than those in rural areas and cities (P < 0.05), and the number of people with stress in the second year and above of doctoral program was higher than that in the first year of doctoral program (P < 0.05).The sources of stress from high to low were as follows: learning, environment, employment, economy, and emotion factors.Among the 311 medical graduate students with stress perception, 230 students (73.95%) felt stress for less than 6 months (short-term) and 81 students (26.05%) felt stress for more than 6 months (long-term).Gender and stress sources including learning, employment, emotion, and economy factors were the influencing factors of perceived stress time (P < 0.05 to P < 0.01).Female students were more prone to long-term stress than male students, and emotion and economy factors of stress sources increased the risk of long-term stress (P < 0.05 to P < 0.01).

ConclusionsThe stress perception rate of medical graduates is relatively high, residence and grade are the influencing factors of stress perception, and gender, emotion and economy factors of stress sources are the influencing factors for the duration of stress.Teaching management departments should pay attention to students in senior grades and those who live in cities and towns, and also to the time periods when pressure is prone to occur such as entering higher education and employment, provide targeted psychological counseling to students, and cooperate with tutors and full-time head teachers to guide medical graduate students in handling the pressures and challenges of work and study actively.

表  1   研究生心理壓力相關(guān)因素分析[n；百分率(%)]

項(xiàng)目 n 有壓力 無(wú)壓力 χ2 P 院校   A校 118 81(68.64) 37(31.36)   B校 158 104(65.82)) 54(34.18) 0.96 >0.05   C校 116 76(65.52) 40(34.48)   D校 70 50(66.67) 20(33.33) 專(zhuān)業(yè)   專(zhuān)業(yè)學(xué)位 344 230(66.86) 114(33.14) 0.13 >0.05   科學(xué)學(xué)位 118 81(68.64) 37(31.36) 性別   男 228 151(66.23) 77(33.77) 0.24 >0.05   女 234 160(68.38) 74(31.62) 是否為獨(dú)生子女   是 185 121(65.41) 64(34.59) 0.51 >0.05   否 277 190(68.59) 87(31.41) 家庭居住地   城市 162 101(62.35) 61(37.65)6.19 < 0.05   城鎮(zhèn) 111 85(76.58) 26(23.42)   農(nóng)村 189 126(66.67) 63(33.33) 學(xué)歷層次   碩士生 408 272(66.67) 136(33.33) 0.67 >0.05   博士生 54 39(72.22) 15(27.78) 碩士年級(jí)   研一 205 131(63.90) 74(36.10)1.85 >0.05   研二 114 77(67.54) 37(32.46)   研三 89 64(71.91) 25(28.09) 博士年級(jí)   博一 27 16(59.26) 11(40.74) 4.66 < 0.05   博二及以上 27 23(85.19) 4(14.81)

表  2   醫(yī)學(xué)研究生心理壓力持續(xù)時(shí)間相關(guān)因素分析[n；百分率(%)]

項(xiàng)目 n 壓力持續(xù)時(shí)間短 壓力持續(xù)時(shí)間長(zhǎng) χ2 P 獨(dú)生子女   是 121 86(71.07) 35(28.93) 0.85 >0.05   否 190 144(75.79) 46(24.21) 家庭居住地   城市 101 75(74.26) 26(25.74)0.42 >0.05   城鎮(zhèn) 84 64(76.19) 20(23.81)   農(nóng)村 126 91(72.22) 35(27.78) 性別   男 151 102(67.54) 49(32.45) 6.25 < 0.05   女 160 128(80.00) 32(20.00) 環(huán)境因素   是 237 171(72.15) 66(27.85) 2.19 >0.05   否 74 59(79.73) 15(20.27) 學(xué)習(xí)因素   是 257 182(70.82) 75(29.18) 7.56 < 0.01   否 54 48(88.89) 6(11.11) 就業(yè)因素   是 193 135(69.95) 58(30.05) 4.24 < 0.05   否 118 95(80.51) 23(19.49) 情感因素   是 106 65(61.32) 41(38.68) 13.33 < 0.01   否 205 165(80.49) 40(19.51) 經(jīng)濟(jì)因素   是 147 90(61.22) 57(38.78) 23.46 < 0.01   否 164 140(85.37) 524(14.63)

表  3   醫(yī)學(xué)研究生壓力持續(xù)時(shí)間多因素logistic回歸分析

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