住院医师规范化培训学员考前焦虑抑郁情况调查及影响因素分析

孙晔; 刘思遥; 陈世裕; 胡婷; 陈耀德; 牛红心; 陆伶俐

doi:10.16766/j.cnki.issn.1674-4152.003651

住院医师规范化培训学员考前焦虑抑郁情况调查及影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003651

1.
南方医科大学珠江医院全科医学科，广东广州 510200
2.
南方医科大学珠江医院神经内科

基金项目:

全国全科医学教育教学研究课题 A-YXGP20210201-04

南方医科大学2022年度校级教学质量与教学改革工程建设项目 ZL2022121

2022年度广东省本科高校在线课程指导委员会研究课题项目 2022ZXKC076

详细信息

通讯作者:
陆伶俐，E-mail：lulingli@smu.edu.cn

中图分类号: R192.3
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- 被引次数: 0
出版历程
- 收稿日期: 2023-10-10
- 网络出版日期: 2024-11-19

Investigation and analysis of pre-exam anxiety and depression among standardized training program participants for resident physicians

1.
Department of General Practice, ZhuJiang Hospital of Southern Medical University, Guangzhou, Guangdong 510200, China

摘要

摘要: 目的了解广东省各住院医师规范化培训(简称规培)基地规培学员临近考试前的焦虑和抑郁情况及其影响因素，为减轻规培学员的考前心理压力提供建议和应对措施。方法 2023年5月19日—8月9日, 将Zung氏焦虑自评量表和Zung氏抑郁自评量表通过问卷星发布，对广东省各规培基地的学员进行焦虑和抑郁水平调查和相关分析。结果共回收有效问卷205份，规培学员中焦虑发生率为16.6%(34/205)，轻度占11.7%(24/205)，中度占4.9%(10/205)，焦虑标准得分为(39.51±10.27)分；抑郁发生率为20.5%(42/205)，轻度占16.6%(34/205)，中度占3.9%(8/205)，抑郁标准得分为(38.98±11.49)分，抑郁严重程度指数为0.37±0.11。规培学员在面临三大考试前焦虑情况差异有统计学意义(H=7.312，P=0.026)。其中，面临执业医师资格考试的压力最大。不同生源规培学员在面临三大考试前抑郁情况差异有统计学意义(P < 0.05)。其中全日制专业型研究生最容易面临考前抑郁。规培学员焦虑抑郁与应考有明显相关性(r=0.651，P＜0.01)。结论规培学员临近考试容易出现焦虑、抑郁情况，各规培基地关注考试通过率的同时，更应重视规培学员的心理健康。
- 住院医师规范化培训 /
- 焦虑自评量表 /
- 抑郁自评量表
Abstract: Objective The purpose of this study is to examine pre-exam anxiety and depression among participants in the standardized training program for resident physicians in Guangdong Province. The study aimed to identify the influencing factors and provide suggestions and countermeasures to reduce psychological pressure before exams. Methods The Zung ' s self-rating anxiety scale and the Zung ' s self-rating depression scale were released through questionnaire star to conduct a survey and analyze the anxiety and depression levels among trainees at various training bases in Guangdong Province from May 19 to August 9, 2023. Results A total of 205 valid questionnaires were collected. The incidence of anxiety was 16.6% (34/205), of which 11.7% (24/205) was mild anxiety and 4.9% (10/205) was moderate anxiety. The standard score for anxiety was 39.51±10.27. The incidence of depression was 20.5% (42/205), of which 16.6% (34/205) was mild depression and 3.9% (8/205) was moderate depression. The standard score for depression was 38.98±11.49, and the severity index of depression was 0.37±0.11. There were statistically significant differences in anxiety levels of students before the three major examinations (H=7.312, P=0.026). The pressure faced by participants during the medical practitioner qualification examination was significantly greater. There were significant differences in the degree of depression among students with different sources before facing the three major exams (P < 0.05). Full-time professional graduate students were more likely to experience pre-exam depression. There was a significant correlation between anxiety, depression, and exam stress (r=0.651, P < 0.01). Conclusion The results indicate that trainees are prone to anxiety and depression before exams. Therefore, it is crucial for standardized training bases of residents to give priority to the mental health of students while paying attention to the examination.
- Standardized residency training /
- Self-rating anxiety scale /
- Self-rating depression scale

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表 1 规培学员考前SAS得分频率分析

Table 1. Frequency analysis of SAS scores for pre-exam residents in standardized training programs

项目	无焦虑 [例(%)]	轻度焦虑 [例(%)]	中度焦虑 [例(%)]	焦虑人数 [例(%)]	焦虑标准得分 (x±s，分)	统计量	P值
性别
男性	65(31.7)	10(4.9)	3(1.5)	13(6.3)	39.31±10.14	0.223^b	0.824
女性	106(51.7)	14(6.8)	7(3.4)	21(10.2)	39.64±10.39
年龄段
＜25岁	65(31.7)	7(3.4)	4(2.0)	11(5.4)	40.34±10.16	1.099^c	0.335
25~30岁	93(45.4)	15(7.3)	6(2.9)	21(10.2)	39.41±10.57
＞30岁	13(6.3)	2(1.0)	0	2(1.0)	36.07±8.09
人员类别
本单位住院医师	17(8.3)	0	1(0.5)	1(0.5)	38.50±9.58	2.282^c	0.080
外单位委托培养住院医师	45(22.0)	7(3.4)	3(1.5)	10(4.9)	38.40±10.58
面向社会招收住院医师	69(33.7)	8(3.9)	2(1.0)	10(4.9)	38.41±9.84
全日制专业型研究生	40(19.5)	9(4.4)	4(2.0)	13(6.3)	42.66±10.43
年级
2020级	89(43.4)	12(5.9)	3(1.5)	15(7.3)	38.50(30.00, 45.00)^a	0.203^d	0.903
2021级	33(16.1)	6(2.9)	4(2.0)	10(4.9)	41.00(28.00, 49.00)^a
2022级	49(23.9)	6(2.9)	3(1.5)	9(4.4)	39.50(31.00, 46.00)^a
考试
年度考	34(16.6)	5(2.4)	1(0.5)	6(3.0)	34.50(28.00, 44.75)^a	7.312^d	0.026
执业医师资格考试	54(26.3)	9(4.4)	4(2.0)	13(6.3)	41.00(33.00, 48.00)^a
结业考	83(40.5)	10(4.9)	5(2.4)	15(7.3)	38.00(30.00, 45.00)^a
注：^a数据不符合正态分布，以M(P₂₅, P₇₅)表示。^b为t值，^c为F值，^d为H值。

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表 2 205名规培学员的SAS、SDS得分与全国常模比较(x±s，分)

Table 2. Comparison of SAS and SDS scores for 205 standardized training program participants with national norms (x±s, point)

组别	人数	SAS标准得分	SDS标准得分
本样本	205	39.51±10.27	38.98±11.49
全国常模	1 138	37.23±12.59	41.88±10.57
t值		2.820	-3.567
P值		0.005	＜0.001

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表 3 规培学员考前抑郁严重程度指数频率分析[例(%)]

Table 3. Frequency analysis of pre-exam depression severity index among standardized training program participants

项目	无抑郁 [例(%)]	轻度抑郁 [例(%)]	中度抑郁 [例(%)]	抑郁人数 [例(%)]	抑郁严重程度指数	统计量	P值
性别
男性	59(28.8)	16(7.8)	3(1.5)	19(9.3)	0.39±0.12	0.263^b	0.793
女性	104(50.7)	18(8.8)	5(2.4)	23(11.2)	0.39±0.11
年度考	34(16.6)	5(2.4)	1(0.5)	6(2.9)	0.37±0.12	1.869^c	0.157
执业医师资格考试	50(24.4)	15(7.3)	2(1.0)	17(8.3)	0.41±0.11
结业考	79(38.5)	14(6.8)	5(2.4)	19(9.3)	0.38±0.12
人员类别
本单位住院医师	15(7.3)	2(1.0)	1(0.5)	3(1.5)	0.38±0.12	2.771^c	0.043
外单位委托培养住院医师	47(22.9)	7(3.4)	1(0.5)	8(3.9)	0.37±0.11
面向社会招收住院医师	63(30.7)	13(6.3)	3(1.5)	16(7.8)	0.38±0.12
全日制专业型研究生	38(18.5)	12(5.9)	3(1.5)	15(7.3)	0.42±0.11
年龄段
＜25岁	62(30.2)	11(5.4)	3(1.5)	14(6.8)	0.40(0.29, 0.48)^a	3.611^d	0.164
25~30岁	88(42.9)	21(10.2)	5(2.4)	26(12.7)	0.35(0.28, 0.49)^a
＞30岁	13(6.3)	2(1.0)	0	2(1.0)	0.31(0.26, 0.44)^a
年级
2020级	84(41.0)	17(8.3)	3(1.5)	20(9.8)	0.35(0.29, 0.48)^a	0.382^d	0.826
2021级	31(15.1)	8(3.9)	4(2.0)	12(5.9)	0.38(0.26, 0.50)^a
2022级	48(23.4)	9(4.4)	1(0.5)	10(4.9)	0.39(0.30, 0.48)^a
注：^a数据不符合正态分布，以M(P₂₅, P₇₅)表示。^b为t值，^c为F值，^d为H值。

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表 4 规培学员考前焦虑与抑郁的相关性分析(例)

Table 4. Correlational analysis of pre-exam anxiety and depression among standardized training program participants (cases)

抑郁分级	焦虑分级
抑郁分级	无焦虑	轻度焦虑	中度焦虑
无抑郁	153	17	1
轻度抑郁	9	14	1
中度抑郁	1	3	6
注：Kendall相关系数为0.570, P＜0.01。

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