医学生手机使用与童年期虐待经历及睡眠质量关联

Association of mobile phone use with childhood abuse experiences and sleep quality in medical students

目的探讨手机使用在不同类型童年期虐待经历与医学生睡眠质量关联中的中介效应及性别差异,为促进医学生睡眠质量提供参考。方法采用纵向研究设计,于2019年11—12月选取安徽省2所医学院校大一至大二年级在校生作为基线研究对象,并于2020年5—6月收集随访资料,共6879名学生纳入研究。通过Mann-Whitney U检验医学生基线童年期虐待经历、基线手机使用及随访睡眠质量得分情况的性别间差异,使用Spearman相关分析基线童年期虐待经历、基线手机使用和随访睡眠质量的关联;通过自举(Bootstrap)程序和Process软件检验手机使用的中介效应。结果童年期虐待经历与手机使用和睡眠质量得分均呈正相关(r值分别为0.27,0.24,P值均<0.01),手机使用与睡眠质量得分呈正相关(r=0.31,P<0.01)。总样本中,调整混杂因素后,手机使用在童年期虐待经历(包括情感虐待、躯体虐待、性虐待)和睡眠质量关联中起部分中介作用,中介效应为18.08%(18.12%,17.15%,24.09%)。女生手机使用在童年期情感虐待、性虐待及童年期虐待与睡眠质量关联中的中介效应(18.32%,28.05%,18.24%)总体高于男生(17.81%,18.94%,17.63%)。结论手机使用在童年期虐待经历与医学生睡眠质量关联中起中介作用,控制手机过度使用有助于童年期虐待经历医学生睡眠质量的改善。

Objective To explore the mediating effect and gender difference of mobile phone use in the association between different types of childhood abuse experiences and sleep quality of medical students,so as to provide reference for promoting sleep quality of medical students.Methods A longitudinal study design method was used to select freshmen and sophomores in two medical colleges in Anhui Province from November to December 2019,follow-up data were collected from May to June 2020,and a total of 6879 students were included in this study.Spearman correlation was used to analyze the association between baseline childhood abuse experiences,baseline mobile phone use and follow-up sleep quality.Bootstrap program and Process software were applied to test the mediating effect of mobile phone use in the relationship between childhood abuse and sleep quality.Results Childhood abuse experiences were positively correlated with mobile phone use and sleep quality score(r=0.27,0.24,P<0.01),and mobile phone use was positively correlated with sleep quality score(r=0.31,P<0.01).In the total sample,after adjusting for confounding factors,mobile phone use played a partial mediating role in childhood abuse experiences(including emotional abuse,physical abuse,sexual abuse)and sleep quality,and the mediating effect was 18.08%(18.12%,17.15%,24.09%).The mediating effect of mobile phone use on the relationship between childhood emotional abuse,sexual abuse,childhood abuse and sleep quality in girls(18.32%,28.05%,18.24%)was higher than in boys(17.81%,18.94%,17.63%).Conclusion Mobile phone use has a mediating effect on the relationship between childhood abuse and sleep quality,controlling mobile phone overuse may contribute to improving the sleep quality for those who have experienced childhood abuse.