后疫情时期医学生归属感与心理健康状况的相关性研究

Associations between the sense of school belonging and mental health status among medical students during the post-epidemic period

目的探讨新型冠状病毒疫情防控常态化背景下,医学生的学校归属感现状及与抑郁、焦虑症的关系。方法对8所院校的1629名全日制医学生进行在线问卷调查,测量工具包括学校归属感量表(psychological sense of school membership scale,PSSM-18)、9条条目的患者抑郁自评量表(the 9-item patient health questionnaire,PHQ-9)和7条目广泛性焦虑量表(7-item generalized anxiety disorder scale,GAD-7)。对学校归属感、抑郁症和焦虑症现状进行描述性分析,使用Spearman相关系数分析PSSM-18与PHQ-9、GAD-7得分间的相关性,使用logistic回归分析归属感缺失对抑郁症和焦虑症的影响。结果研究对象的学校归属感平均得分为(77.31±14.12),抑郁症和焦虑症的检出率分别为25.97%(423/1629)和21.92%(357/1629)。PSSM-18得分与PHQ-9得分(r=-0.52,P<0.001)和GAD-7得分(r=-0.49,P<0.001)均呈负相关。在校正协变量后,低归属感的学生出现抑郁症的风险是高归属感学生的4.33倍(OR=4.33,95%CI=2.48~7.43),出现焦虑症的风险是高归属感学生的5.85倍(OR=5.85,95%CI=3.76~8.15)。结论归属感缺失增加抑郁症和焦虑症出现的风险,在疫情防控常态化背景下,学校应加强健康宣教和支持服务,提高医学生的归属感,缓解心理健康问题。

Objective To explore the status of medical students'sense of school belonging and its relationship with depression and anxiety symptoms in the context of COVID-19 prevention and control.Methods An online questionnaire survey was conducted among 1629 full-time students from 8 medical universities.The 18-item psychological sense of school membership scale(PSSM-18),9-item patient health questionnaire(PHQ-9),and 7-item generalized anxiety disorder scale(GAD-7)were used as measurements.Spearman correlation coefficients were used to analyze the correlations between PSSM-18,PHQ-9,and GAD-7 scores.Logistic regressions were used to analyze the impact of lack of school belonging on depression and anxiety symptoms.Results The mean score of school belonging was(77.31±14.12),and the detection rates of depression and anxiety symptoms were 25.97%(423/1629)and 21.92%(357/1629),respectively.PSSM-18 score was negatively correlated with PHQ-9 scores(r=-0.52,P<0.001)and GAD-7 scores(r=-0.49,P<0.001).After adjusting for covariates,students with low school belongingness had 4.33 times the risk of depression symptoms(OR=4.33,95%CI=2.48-7.43)and 5.85 times the risk of anxiety symptoms(OR=5.85,95%CI=3.76-8.15)compared to students with high school belongingness.Conclusion Lack of school belonging increases the risk of depression and anxiety symptoms.Under the normalization of COVID-19 prevention and control,the school should strengthen health education and support services to improve the students'sense of belonging and alleviate their mental health problems.