“双轨合一”培训模式下住院医师的抑郁症状和知觉压力

Depression and perceived stress among the medical residents under the“unified double-track”training systems

目的:专业型硕士研究生培养与住院医师规范化培训并轨(以下简称“双轨合一”)是我国医学教育的重大改革,本研究旨在调查“双轨合一”模式下参与住院医师规范化培训的专业型研究生和从社会招录的规范化培训住院医师(以下简称社会规培生)的抑郁症状及知觉压力情况,并探讨抑郁症状与知觉压力之间的关系。方法:选取湖南某三甲医院住院医师规范化培训医师330例(其中专业型研究生235名和社会规培生95名),使用中文版知觉压力量表(Chinese Perceived Stress Scale,CPSS)和抑郁自评量表(Self-Rating Depression Scale,SDS)分别评估和对比专业型研究生和社会规培生的知觉压力及抑郁症状情况。采用Pearson相关分析探究专业型研究生和社会规培生抑郁症状与知觉压力的相关性,比较二者的压力来源。结果:在被调查的235名专业型研究生中,148名(63.0%)存在抑郁症状,162名(68.9%)知觉压力升高,主要压力为学业压力、科研压力和就业压力。在95名社会规培生中,52名(54.7%)存在抑郁症状,58名(61.1%)知觉压力升高,主要压力为经济压力、就业压力和学业压力。专业型研究生抑郁症状评分与知觉压力评分均较社会规培生显著增加(分别t=2.110,P=0.036;t=2.810,P=0.005)。不同性别间住院医师的CPSS和SDS得分差异无统计学意义(分别t=−0.968,P=0.334;t=0.462,P=0.644)。抑郁症状与知觉压力之间存在显著正相关(r=0.854,P<0.001)。结论:住院医师(包括专业型研究生和社会规培生)存在抑郁症状与较高的知觉压力水平,两者呈正相关。在“双轨合一”的培训模式下,专业型研究生抑郁症状与知觉压力水平均高于社会规培生。

Objective:It is an important reform for medical education in China to combine professional postgraduate training with standardized resident training.This study aims to evaluate the depression and perceived stress in postgraduate students of clinical medicine and residents from society and to determine the relation between depression and perceived stress in medical residents.Methods:Chinese Perceived Stress Scale(CPSS)and Self-Rating Depression Scale(SDS)were applied to 330 residents(including 235 postgraduate students of clinical medicine and 95 residents from society)from a Class-A Grade-3 genernal hospital in Hunan Province to evaluate and compare the depression and perceived stress in postgraduate students of clinical medicine and residents from society.Pearson correlation analysis was performed to assess the association between depression and perceived stress.Stress resources between 2 groups of residents were observed and compared.Results:Of the 235 postgraduate students of clinical medicine,148(63.0%)showed depression and 162(68.9%)showed elevated perceived stress.Main stress resources were academic pressure,scientific research pressure,and employment pressure.Of the 95 residents from society,52(54.7%)showed depression and 58(61.1%)showed elevated perceived stress.Main stress resources were economic stress,employment pressure,and academic pressure.The scores of CPSS and SDS were significantly higher in postgraduate students of clinical medicine than those in residents from society(t=2.110,P=0.036;t=2.810,P=0.005,respectively),while gender showed no difference in the scores of CPSS and SDS(t=−0.968,P=0.334;t=0.462,P=0.644,respectively).There was a significant positive correlation between depression and perceived stress(r=0.854,P<0.001).Conclusion:Residents(including postgraduate students of clinical medicine and residents from society)possess depression and elevated perceived stress with positive correlation.The postgraduate students of clinical medicine show higher level of depression and perceived stress than the residents from society under the“unified double-track”training system.