医学生社会支持与焦虑、抑郁及生活质量的相关分析

Correlation analysis between social support and anxiety,depression,and quality of life in medical students

目的：了解医学生焦虑、抑郁、生活质量和社会支持的现状,分析社会支持与医学生焦虑、抑郁和生活质量的关系。方法：整群、随机抽取南通大学1-5年级医学生779人、非医学生388人（对照）为研究对象。采用焦虑自评量表（Self-Rating Anxiety Scale,SAS）、自评抑郁量表（Self-Rating Depression Scale,SDS）、SF-36生活质量简明量表、社会支持评定量表（Social Support Rating Scale,SSRS）进行问卷调查。SPSS 17.0进行数据处理,用χ2检验、两独立样本均数t检验、相关分析和多元线性回归分析对资料进行统计分析。结果：有效调查医学生715人,非医学生359人。医学生与非医学生之间SAS、SDS、SF-36及SSRS得分差异均无统计学意义（P均〉0.05）。医学生SAS、SDS、SF-36总分及SSRS总分分别为：40.42±9.58（95%CI：39.72～41.13）、46.97±11.04（95%CI：46.13～47.76）、76.10±14.44（95%CI：75.01～77.14）和39.31±6.67（95%CI：38.82～39.80）。不同性别、民族、生源地和家庭经济的医学生之间部分量表得分的差异具有统计学意义（P〈0.05）。回归分析结果表明,SSRS总分对SAS得分有负面影响,主观支持、客观支持及支持利用度对SDS得分有负面影响,SSRS总分对生理领域（physical component summary,PCS）得分有积极影响;主观支持及客观支持对心理领域（mental com-ponent summary,MCS）得分有积极影响;主观支持、客观支持及支持利用度对生活质量（quality of life,QOL）总分有积极影响。结论：医学生并非为大学生群体中焦虑、抑郁易发和生活质量易受损的高危人群。在注意培养医学生建立整体的社会支持网络,从主观支持、客观支持和社会支持利用度3个方面共同提高社会支持的程度的同时,医学院校在教育的过程中也应注重对男生、少数民族、来自省外和家庭经济不好的医学生的心理健康和生活质量给予更多关注,使医学生能够有意识地提高自身的心理素养,增强心理调适能力以降低焦虑、抑郁情绪的发生和提高生活质量。

Objective： To investigate the status of the anxiety,depression,and quality of life（QOL） in medical students and analyze the correlation between social support and anxiety,depression,and QOL.Methods： 779 medical students and 388 non-medical students（control group） were selected from Nantong University by cluster random sampling method.Self-Rating Anxiety Scale（SAS）,Self-Rating Depression Scale（SDS）,the Medical Outcomes Study 36-Item Short-Form Health Survey（SF-36）,and Social Support Rating Scale（SSRS） were used to investigate the objects.SPSS 17.0 was used for statistics analysis,including data description,t-test and correlation,and multiple linear regression analysis.Results： In the investigation 715 medical students and 359 non-medical students（effective samples） were obtained.The score of SAS,SDS,SF-36,and SSRS was no significant difference between medical students and non-medical students.The score of SAS,SDS,SF-36（total）,and SSRS（total） in medical students was 40.42±9.58（95%CI： 39.72-41.13）,46.97±11.04（95%CI： 46.13-47.76）,76.10±14.44（95%CI： 75.01-77.14） and 39.31±6.67（95%CI： 38.82-39.80） respectively.The score of some scales showed significant difference between different sex,nationality,areas,and family economy state（P〈0.05）.The results of regression analysis showed that total score of SSRS had negative influence to core of SAS;objective support,subjective support and utilization of support had negative influence to core of SDS;total score of SSRS had positive influence to core of PCS;objective support and subjective support had positive influence to core of MCS;objective support,subjective support and utilization of support had positive influence to total score of QOL.Conclusions： Medical students were not the high risk population of anxiety,depression,and less QOL.In order to decrease the rate of anxiety and depression as well as improve the QOL in medical students,the whole social support system should be trained to build,and improve the social support through improve objective support,subjective support and utilization of support.At the same time,more attention should be paid to mental health and QOL of male students,minority,other provinces,and poor family economy state to help medical students improve their psychological quality consciously and enhance their ability of psychological adjustment.