摘要
目的:了解海南医学院校大中专实习学生在医学临床实习过程中生活、应付和心理健康情况。方法:选择2002年实习的海南省属医学院校学生,海南省属医学院校大中专实习学生806名,其中男235名,女571名。采用大中专学生生活事件量表(是自评量表,影响程度分为5级,从毫无影响到影响极重分别记0,1,2,3,4分。影响持续时间分3个月内、半年内、1年内、1年以上共4个等级,分别记1,2,3,4分)、应付方式问卷(是自评问卷,共有100个条目,分为解决问题、自责、求助、幻想、退避、合理化6个分量表。每个分量表分值越高表示越倾向使用该应对方式)、症状自评量表(以躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性9个因子作为观察指标,按照0~4的5级评分,0=无,l=轻度,2=中度,3=相当重,4=严重,以因子均分≥3为存在心理问题的标准)和社交焦虑量表(含有6个条目,回答时采用5级分制,0代表极不相符,4代表极为相符)对学生进行正负件生活事件、应付方式和心理健康调查。结果:所纳入的806人均进入结果分析。①症状自评量表评定结果:症状发生率由高到低依次为:强迫、人际敏感、敌对、偏执、焦虑、恐怖等。男生在焦虑、恐怖和阳性项目数项目评分上低于女生;本科学生在强迫、人际关系、焦虑、恐怖、偏执、精神疾病各因子及总分和总均分上均低于专科学生;在省级医院实习的学生强迫因子低于在地市级医院实习的学生,敌对因子高于在地市级医院实习的学生。②正负性生活事件分析:医学院校大中专实习学生正性生活事件比较中,人际关系和心理支持、奖励与成功、经济或身体变好和总分女生得分均高于男生;奖励与成功因子省级医院得分高于地市级医院,人际关系和心理支持、经济或身体变好、其他和总分因子的得分均低于地市级医院;人际关系和心理支持、奖励与成功、经济或身体变好、其他和总分中专的得分均高于本科。医学院校大中专实习学生负性生活事件比较中,人际矛盾和心理支持丧失因子男生低于女生,处罚与失败因子男生却高于女生;经济或身体变坏和其他这两个因子中,地市级医院均高于省级医院;本科学生在经济或身体变坏和其他因子上低于中专学生。③应付方式分析:女生在解决问题、求助、幻想和退避因子中均高于男生;解决问题和求助因子地市级医院略高于省级医院;本科学生在求助、解决问题因子上高于专科生,在自责和合理化因子上低于中专生。④社交焦虑因素分析:男生仅在人际敏感因子上低于女生;本科在社交焦虑表达方式上均低于中专生;护理专业学生在社交焦虑表达方式上均低于临床医学学生。⑤医学院校学生心理问题的发生与其应付方式、社交焦虑表达方式和正、负性事件均存在一定的相关。结论:医学院校实习学生,心理健康状况总体女生不如男生、中专学生不如本科学生、地市级医院实习的学生不如省级医院实习的学生,回归分析发现:医学院校大中专学校的实习学生正负件生活事件、应付方式和心理反应密切相关。强迫、焦虑、恐怖、精神疾病是学生常见的心理不良反应;应加强实习学生在学习、人际关系和生活环境方面的生活质量指导以及心理辅导和干预。
AIM: To understand the situation of life, management ways and psychological health in clinical practice of the students of Hainan provincial medical colleges and schools. METHODS: To choose 806 practice students of Hainan provincial medical colleges and schools, among them, 235 males and 571 females; 264 of Hainan Medical College, 249 of Hainan Provincial Health School, 149 of Hainan Provincial Second Health School, 144 of Danzhou City Health School; 264 undergraduates and 542 of technical secondary school. Lifeevents scale of college students, coping way questionnaire, symptom self-evaluate scale and sociality anxiety scale were adopted to investigate the student's positive-negative life-events, management ways and psychological health. RESULTS: All the 806 students were involved in the analysis of results. ①Symptom Self-evaluate Scale shows that the symptom incidence rate from high to low is compulsion, interpersonal sensitivity, hostility, crankiness, anxiety, ghastfulness etc. The scores of anxiety, ghastfulness and positive item number of males are lower than those of female; The scores of compulsion, interpersonal sensitivity, anxiety, ghastfulness, crankiness, psychosis factors of the undergraduates were lower than those of technical secondary school students. The compulsion factor scores of the practice students in provincial hospital were lower than those of the students in the city's hospital, and the hostility factor scores were higher than those of the practice students in city's hospital.②Positive-negative life-events analysis results showed that in positive life-events, the schoolgirls' scores of interpersonal relationship or psychic support, encouragement or success, economy or body becoming better and total score were higher than the schoolboys'; encouragement or success factor scores in provincial hospital are higher than those in city's hospital, and the scores of interpersonal relationship or psychic support, economy or body becoming better, the others and total score were lower than those in city's hospital; technical secondary school students' scores of interpersonal relationship or psychic support, encouragement or success, economy or body becoming better, the others and total score were higher than the undergraduates'. And in the negative life-events, the schoolboys' scores of interpersonal relationship contradiction or psychic support lost factor were lower than the schoolgirls', punishment or fail factor scores were higher than the schoolgirls'; economy or body becoming worse and the other factors scores of the students in city's hospital were higher than those in provincial hospital, and of the undergraduates were lower than those of technical secondary school students.③Coping way analysis shows: the schoolgirls' scores of problem solving, recourse, illusion and retreat factors were higher than the schoolboys'; the problem solving and recourse factors scores of the students in city's hospital were slightly higher than those in provincial hospital; the scores of undergraduates' recourse, problem solving factors were higher than those of technical secondary school students, and of self-accusation, rationalization factors were lower than those of technical secondary school students. ④Sociality anxiety analysis shows: the schoolboys' interpersonal sensitivity factor scores only were lower than the schoolgirls', the undergraduates' sociality anxiety expression ways factor scores were lower than those of technical secondary school students, and the nursing students' were also lower than the clinical students'. ⑤The mentality problems of students in medical colleges and schools were correlated with the coping ways, sociality anxiety, expression ways and position-negative life-events. CONCLUSION: Stresses, anxieties, terrors and mental diseases were common negative psychological reactions. So, directions on the students'quality of life in their studies, social relationships and life environments should be strengthened; and psychological consultations and interventions should be given.
出处
《中国临床康复》
CSCD
北大核心
2005年第32期103-107,共5页
Chinese Journal of Clinical Rehabilitation
基金
2000年海南省卫生厅资助课题(琼卫2000-59)~~