摘要:

目的了解臨床醫(yī)學(xué)研究生心理壓力來源及影響因素，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)查問卷，對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)時間 < 6個月(短期)230人(73.95%)，≥6個月(長期)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)因素為壓力感知時間的影響因素(P < 0.05~P < 0.01)。女生較男生更容易產(chǎn)生長期壓力，壓力源中情感和經(jīng)濟(jì)因素會增加長期壓力的風(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)時間的影響因素。教學(xué)管理部門應(yīng)關(guān)注高年級和居住地為城鎮(zhèn)的學(xué)生，注重升學(xué)、就業(yè)等壓力易發(fā)生的時段，給予學(xué)生有針對性的心理輔導(dǎo)，導(dǎo)師及專職班主任共同配合，引導(dǎo)醫(yī)學(xué)研究生積極應(yīng)對工作與學(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) 專業(yè)   專業(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   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   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)時間相關(guān)因素分析[n；百分率(%)]

項(xiàng)目 n 壓力持續(xù)時間短 壓力持續(xù)時間長 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)時間多因素logistic回歸分析

變量 β SE Waldχ2 P OR(95%CI) 性別(男) -0.621 0.278 4.98 < 0.05 0.538(0.312~0.927) 壓力源   學(xué)習(xí)因素 0.803 0.481 2.79 >0.05 2.233(0.870~5.731)   就業(yè)因素 0.001 0.317 0.00 >0.05 1.001(0.538~1.864)   情感因素 0.583 0.292 3.99 < 0.05 1.792(1.011~3.178)   經(jīng)濟(jì)因素 1.073 0.304 12.48 < 0.01 2.925(1.612~5.305) 常量 -1.647 0.625 6.94 < 0.05 0.193 [1] 譚天賜. 后疫情時代醫(yī)學(xué)院校研究生抑郁焦慮狀況及影響因素研究[D]. 廣州: 南方醫(yī)科大學(xué). 2021. [2] 侯琳, 紀(jì)超, 張鎮(zhèn). 國內(nèi)醫(yī)學(xué)研究生壓力狀況分析[J]. 基礎(chǔ)醫(yī)學(xué)與臨床, 2019, 39(10): 1503. doi: 10.3969/j.issn.1001-6325.2019.10.025 [3]

PUTHRAN R, ZHANG MW, TAM WW, et al. Prevalence of depression amongst medical students: a meta-analysis[J]. Med Educ, 2016, 50(4): 456. doi: 10.1111/medu.12962

[4]

MAO Y, ZHANG N, LIU J, et al. A systematic review of depression and anxiety in medical students in China[J]. BMC Med Educ, 2019, 19(1): 327. doi: 10.1186/s12909-019-1744-2

[5]

LIU S, YANG L, ZHANG C, et al. Online mental health services in China during the COVID-19 outbreak[J]. Lancet Psychiatry, 2020, 7(4): e17. doi: 10.1016/S2215-0366(20)30077-8

[6] 李秀川, 劉春芳, 楊婷婷, 等. 臨床護(hù)生實(shí)習(xí)后期壓力源及其應(yīng)對方式的調(diào)查分析[J]. 蚌埠醫(yī)學(xué)院學(xué)報(bào), 2022, 47(7): 984. doi: 10.13898/j.cnki.issn.1000-2200.2022.07.035 [7] 胥欣, 楊雨飛, 孫婷, 等. 后疫情時代臨床醫(yī)學(xué)研究生焦慮抑郁狀態(tài)調(diào)查[J]. 武漢大學(xué)學(xué)報(bào), 2021, 42(6): 902. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYK202106008.htm [8] 李輝雁, 吳虹林, 匡銘, 等. 后疫情時代新型冠狀病毒肺炎局部暴發(fā)防控期間醫(yī)學(xué)研究生心理健康狀況調(diào)查[J]. 實(shí)用醫(yī)學(xué)雜志, 2021, 37(23): 3067. doi: 10.3969/j.issn.1006-5725.2021.23.021 [9] 譚天賜, 胡光麗, 張小遠(yuǎn), 等. 臨床醫(yī)學(xué)研究生焦慮狀況及影響因素分析[J]. 徐州醫(yī)科大學(xué)學(xué)報(bào), 2021, 41(1): 30. https://www.cnki.com.cn/Article/CJFDTOTAL-XZYX202101008.htm [10] 郭莉莉, 閆俊萍, 郝百旺. 不同年級醫(yī)學(xué)研究生精神心理癥狀與壓力的相關(guān)性分析[J]. 護(hù)理研究, 2022, 36(9): 1638. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202209025.htm [11]

SAN LAZARO CAMPILLO I, MEANEY S, MCNAMARA K, et al. Psychological and support interventions to reduce levels of stress, anxiety or depression on women's subsequent pregnancy with a history of miscarriage: an empty systematic review[J]. BMJ Open, 2017, 7(9): e017802. doi: 10.1136/bmjopen-2017-017802

[12] 侯廣彥, 吳川香, 譚小蝶. 健康青海戰(zhàn)略背景下大學(xué)生心理健康狀況及調(diào)適策略研究[J]. 青海師范大學(xué)學(xué)報(bào)(社會科學(xué)版), 2022, 44(3): 138. https://www.cnki.com.cn/Article/CJFDTOTAL-QHSZ202203022.htm [13] 陳晨. 抗疫精神融入大學(xué)生思想政治教育的價(jià)值與路徑[J]. 教育探索, 2020, (4): 63. https://www.cnki.com.cn/Article/CJFDTOTAL-SEEK202004015.htm

相關(guān)知識

青少年心理健康問題的影響因素及對策分析
嬰兒撫觸健康教育效果評價(jià)及影響因素分析
體重污名對肥胖大學(xué)生心理健康的影響及對策研究.pdf
社交媒體對大學(xué)生心理健康的影響及防范策略研究
健身健美運(yùn)動對大學(xué)生心理健康影響及對策研究
影響學(xué)生心理健康的因素淺析
家庭教育對小學(xué)生心理健康的影響及優(yōu)化策略
家庭教育對幼兒心理健康的影響研究
《家庭環(huán)境對兒童心理健康的影響研究》教育教學(xué)論文
青少年健康成長發(fā)育影響因素及其干預(yù)策略

網(wǎng)址: 臨床醫(yī)學(xué)研究生心理壓力影響因素及健康教育對策分析 http://www.u1s5d6.cn/newsview203339.html