儿科住院医师规范化培训医师心理健康现状及其影响因素分析

Analysis of mental health status and influencing factors of pediatric resident trainees

目的了解儿科住院医师规范化培训(简称住培)医师心理健康现状及其影响因素。方法采用横断面问卷调查方法,2021年11月对深圳市儿童医院2018~2020级326名儿科住培医师以症状自评量表(Symptom Check List-90,SCL-90)进行心理健康调查。采用t检验,Kruskal-Wallis H检验和logistic回归分析方法处理数据。结果医师SCL-90总分为(127.6±34.4)分,总分大于160分者占比1.6%(5/311),阳性项目数超过43项者占比2.6%(8/311)。强迫症状为阳性率最高的单项因子[46.9%(146/311)],其次为抑郁[28.0%(87/311)]和人际关系敏感[24.1%(75/311)]。社会招收医师强迫症状因子评分高于研究生[(1.6±0.5)分比(1.5±0.6)分],其差异具有统计学意义(P=0.044)。有社团经历的医师人际关系敏感因子评分低于无社团经历者[(1.3±0.4)分比(1.4±0.5)分],其差异具有统计学意义(P=0.038)。2020级医师总分、强迫症状、抑郁、人际关系敏感、焦虑等评分均低于2018级和2019级医师[(116.2±21.9)分比(134.1±40.3)分和(132.0±34.8)分,(1.4±0.4)分比(1.7±0.7)分和(1.6±0.3)分,(1.2±0.4)分比(1.5±0.4)分和(1.5±0.5)分,(1.2±0.3)分比(1.4±0.3)分和(1.4±0.3)分,(1.2±0.1)分比(1.4±0.4)分和(1.4±0.5)分],其差异均具有统计学意义(均P<0.05)。多因素分析结果提示,年级是SCL-90阳性的危险因素(OR=1.813,95%CI:1.805~1.862)。结论儿科住培医师心理健康状态总体欠佳,心理健康问题较为普遍;年级是其心理健康状态的主要影响因素。住培基地需要更多地关注儿科住培医师群体的心理健康问题。

Objective To understand the current mental health status of pediatric resident trainees receiving standardized resident training and to explore the influencing factors.Methods The survey used a cross-section questionnaire based on Symptom Checklist 90(SCL-90).In November 2021,the questionnaires were distributed to 326 pediatric resident trainees who received standardized resident training in Shenzhen Children's Hospital from 2018 to 2021.The survey data were analyzed by t-test,Kruskal-Wallis H test and logistic regression analysis.Results The total score of SCL-90 from the trainees was(127.6±34.4).The percentage of resident trainees with total score was more than 160 was 1.6%(5/311)and the percentage of trainees with positive items more than 43 was 2.6%(8/311).Among the factors,the positive rate of obsessive symptoms was the highest[46.9%(146/311)],followed by depression[28.0%(87/311)]and interpersonal sensitivity[24.1%(75/311)].The score of obsessive symptom in socially recruited pediatric resident trainees(1.6±0.5)was significantly higher than that of postgraduates(1.5±0.6),P=0.044.The score of interpersonal sensitivity in trainees with community experience(1.3±0.4)was significantly lower than that of those without community experience(1.4±0.5),P=0.038.All scores from Grade 2020 trainees were significantly lower than those from trainees of Grade 2018 and 2019:the total score(116.2±21.9),(134.1±40.3)and(132.0±34.8);the score of obsessive symptoms(1.4±0.4),(1.7±0.7)and(1.6±0.3);depression(1.2±0.4),(1.5±0.4)and(1.5±0.5);interpersonal sensitivity(1.2±0.3),(1.4±0.3)and(1.4±0.3);anxiety(1.2±0.1),(1.4±0.4)and(1.4±0.5),all P<0.05.Multivariate analysis suggested that the grade(OR=1.813,95%CI:1.805-1.862)was a risk factor in mental health of pediatric resident trainees.Conclusions The mental health status of pediatric resident trainees is generally poor and the grade is the main influencing factor of their mental health.More attention should be paid to the mental health of trainees in the standardized resident training program.