麻醉学住院医师规范化培训学员身心健康状况的调查分析

An investigation of the physical and mental health of trainees receiving standardized residency training of anesthesiology in four large teaching hospitals in Wuhan,China

目的初步调查武汉地区四家大型教学医院麻醉学住院医师规范化培训学员的身心健康状态,并分析其危险因素。方法选取武汉市4家大型综合性教学医院麻醉学住院医师规范化培训学员作为研究对象,借助SCL-90症状自评量表(symptom checklist-90,SCL-90)、艾森克人格量表(Eysenck personality questionnaire,EPQ)对麻醉学员展开心理健康和人格状态调查。采用SPSS 22.0进行独立样本t检验或者单因素方差分析及卡方检验。采用Logistic回归对SCL-90结果影响因素进行分析。结果本次调查共发放问卷328份,有效回收326份(回收率99.39%),其中68人(20.86%)显示心理状况异常(SCL-90总分大于160),其中强迫症状、忧郁较高。心理异常学员表现倾向型神经质、倾向型精神质人格特征,且异常人格特征比例比心理正常学员高。单因素分析显示,住培年级、科研压力、月值班次数、人格特征与学员心理异常相关。多因素分析显示,月值班5次以上(B=0.997,P=0.039,OR=2.709,95%CI:1.051~6.986),科研压力极其严重(B=3.235,P=0.002,OR=25.412,95%CI:3.239~199.363),情绪不稳定(B=2.015,P<0.001,OR=7.504,95%CI:3.529~15.954),精神质异常(B=1.640,P<0.001,OR=5.154,95%CI:2.510~10.581)是学员心理异常的危险因素;外向型人格(B=-2.758,P<0.001,OR=0.063,95%CI:0.019~0.215)是学员心理异常的保护因素。结论武汉地区4家大型教学医院麻醉住培学员心理异常阳性率为20.86%,其可能影响因素与月值班次数、科研压力、工作压力、不同人格特征有关。

Objective To investigate the physical and mental health of trainees receiving standardized residency training of anesthesiology in four large teaching hospitals in Wuhan,China,as well as related risk factors.Methods The trainees who received standardized residency training of anesthesiology in four large general teaching hospitals in Wuhan were selected as subjects,and Symptom Checklist-90(SCL-90)and Eysenck Personality Questionnaire were used to investigate mental health and personality state.SPSS 22.0 was used to perform the independent samples t-test,a one-way analysis of variance,and the chi-square test,and Logistic regression was used to analyze the influencing factors for SCL-90.Results A total of 328 questionnaires were distributed and 326 valid questionnaires were collected,with a recovery rate of 99.39%.Among these trainees,68(20.86%)were found to have abnormal mental status(SCL-90 score>160),with a relatively high proportion of the trainees with obsessive-compulsive symptoms or depression.The trainees with abnormal mental status showed the personality characteristics of tendency neuroticism and tendency psychoticism,and compared with the trainees with normal mental status,the trainees with abnormal mental status showed a higher proportion of trainees with abnormal personality characteristics.The univariate analysis showed that the grade of residency training,scientific research pressure,monthly on-duty frequency,and personality characteristics were associated with abnormal mental status,and the multivariate analysis showed that a monthly on-duty frequency of>5 times(B=0.997,odds ratio[OR]=2.709,95%CI:1.051-6.986,P=0.039),great pressure of scientific research(B=3.235,OR=25.412,95%CI:3.239-199.363,P=0.002),emotional instability(B=2.015,OR=7.504,95%CI:3.529-15.954,P<0.001),and psychosomatic abnormalities(B=1.640,OR=5.154,95%CI:2.510-10.581,P<0.001)were risk factors for psychological abnormality in trainees,while extroversion personality(B=-2.758,OR=0.063,95%CI:0.019-0.215,P<0.001)was a protective factor against abnormal mental status.Conclusions The positive rate of psychological abnormality is 20.86%among trainees receiving standardized residency training of anesthesiology in four large teaching hospitals in Wuhan,and possible influencing factors include monthly on-duty frequency,scientific research pressure,work pressure,and different personality characteristics.