湖北省医学专科生焦虑、抑郁对学习倦怠的影响

Effects of anxiety and depression on learning burnout of medical students in Hubei Province

目的研究医学专科生焦虑和抑郁对学习倦怠的影响以及心理弹性的链式中介效应。方法2019年10—11月,选取湖北省3所院校的医学专科生共625人参与研究。使用大学生学习倦怠量表(LBUS)、自评焦虑量表(SAS)、流调用抑郁自评量表(CES-D)和心理弹性量表(CD-RICS)进行调查。结果625名学生中SAS评分为30.80±8.68,CES-D评分为11.83±4.35,CD-RICS评分为66.45±12.55。LBUS均分为2.79±0.62,情绪低落、行为不当和低成就感3个维度得分分别为2.70±0.58、2.98±0.59和2.79±0.64。根据评分标准,无学习倦怠167人(26.72%),轻度学习倦怠164人(26.24%),中度学习倦怠239人(38.24%),重度学习倦怠55人(8.80%)。4组间SAS评分、CES-D评分、CD-RICS评分、LBUS均分、情绪低落维度、行为不当维度和低成就感均分比较,差异均有统计学意义(均P<0.05)。在低成就感维度,焦虑、抑郁均与学习倦怠呈正相关(r=0.223、0.180,均P<0.05),心理弹性与学习倦怠呈负相关(r=-0.270,P<0.01)。有序多分类logistic回归模型显示,焦虑、抑郁和低心理弹性是发生学习倦怠的危险因素。结构方程模型显示,心理弹性在焦虑、抑郁和学习倦怠之间起中介效应,效应值分别为0.06和0.10,分别占总效应的26%和31%。结论焦虑和抑郁对于医学专科生中的学习倦怠有较大影响,其中主要表现在低成就感维度,心理弹性在其中起中介作用。

Objective To study the effects of anxiety and depression on learning burnout of medical students,explore the chain mediated effect of resilience.Methods From October to November 2019,a total of 625 medical students from three colleges in Hubei Province were selected to participate in this study.The Learning Burnout of Undergraduates Scale(LBUS),Self-Rating Anxiety Scale(SAS),Center for Epidemiological Survey-Depression Scale(CES-D)and Connor-Davidson Resilience Scale(CD-RICS)were used in investigation.Results Among 625 students,the score of SAS,CES-D and CD-RICS was 30.80±8.68,11.83±4.35 and 66.45±12.55,respectively.The LBUS score was 2.79±0.62,and the scores of three dimensions of low mood,inappropriate behavior and low achievement were 2.70±0.58,2.98±0.59 and 2.79±0.64,respectively.According to the scoring criteria,167(26.72%)people had no learning burnout,164(26.24%)had mild student burnout,239(38.24%)had moderate burnout,and 55(8.80%)had severe burnout.There were statistically significant differences in SAS score,CES-D score,CDRICS score,LBUS average score,as well as scores of low mood dimension,misbehavior dimension and low achievement among four groups(all P<0.05).In the low achievement dimension,anxiety and depression were significantly positively correlated with learning burnout(r=0.223,0.180,both P<0.05),and psychological resilience was significantly negatively correlated with learning burnout(r=-0.270,P<0.01).An ordered multi-class logistic regression model showed that anxiety,depression and low resilience were risk factors for learning burnout.The structural equation model showed resilience played a mediating role between anxiety,depression and learning burnout,the effect value was 0.06 and 0.10,accounting for 26%and 31%of the total effect,respectively.Conclusion Anxiety and depression have a greater impact on learning burnout among medical students,which is mainly manifested in the low achievement dimension,and resilience plays a mediating role between them.