某医科院校硕士新生心理健康的影响因素及预测列线图

Influencing Factors and Predictive Nomogram of Mental Health of Master Freshmen in A Medical College

目的探索医科院校硕士新生心理健康影响因素,构建风险预测列线图模型,为采取针对性的促进研究生心理健康措施提供参考。方法于2020年11-12月,对某医学院校参加选修课的所有硕士新生进行结构化问卷调查,通过单因素及二分类Logistic回归分析建立心理健康风险预测模型,并绘制列线图,同时对构建的模型进行预测效果评价。结果506名研究生新生中筛查结果为阳性者180例,阳性发生率为35.6%。自我隐瞒平均得分为(25.367±8.98)分,神经质平均得分为(24.777±7.185)分,严谨性平均得分为(34.931±5.731)分,宜人性平均得分为(36.063±5.428)分,开放性平均得分为(32.276±5.884)分,外向性平均得分为(28.515±7.381)分,心理压力平均得分为(99.007±36.271)分;睡眠质量平均得分为(7.104±2.223)分;经二分类Logistic回归分析显示,每周的锻炼时间(OR=0.921,95%CI:0.862~0.984)是心理健康的保护因素;自我隐瞒总分(OR=1.054,95%CI:1.021~1.089)、人际压力(OR=1.118,95%CI:1.019~1.226)、择业压力(OR=1.128,95%CI:1.038~1.226)、情绪压力(OR=1.262,95%CI:1.116~1.426)、神经质(OR=1.098,95%CI:1.046~1.153)和睡眠质量得分(OR=1.266,95%CI:1.115~1.438)是心理健康的独立危险因素。所构建的列线图模型C-index为0.924,校正C-index为0.917,AUC值为0.884。结论医科院校硕士新生的心理健康阳性检出率较高,受到每周锻炼时间、自我隐瞒程度、人际压力、择业压力、情绪压力、神经质和睡眠质量的影响,该研究构建的列线图模型具有较好的预测性能和实用价值。

Objective To explore the influencing factors of mental health of master freshmen in a medical college,and to construct a risk prediction nomogram model so as to provide reference for taking targeted measurements to promote mental health of postgraduates.Methods From November to December 2020,a structured questionnaire survey was conducted on all master's freshmen who participated in elective courses.A mental health risk prediction model was established by single factor and two-category logistic regression analysis,and a nomogram was drawn.At the same time,the prediction effect of the constructed model was evaluated.Results Among the 506 people,180 cases had positive screening results,with a positive incidence of 35.6%.the average score for self-concealment was(25.367±8.980);the average score for neuroticism was(24.777±7.185);the average score for rigor was(34.931±5.731).the average score for pleasantness was(36.063±5.428).the average score for openness was(32.276±5.884).the average score for extraversion was(28.515±7.381);the average score of psychological stress was(99.007±36.271).and the average score of sleep quality was(7.104±2.223).Two-category logistic regression analysis showed that weekly exercise time(OR=0.921,95%CI:0.862-0.984)was the protective factor of mental health.Total scores of self-concealment(OR=1.054,95%CI:1.021-1.089),interpersonal pressure(OR=1.118,95%CI:1.019-1.226),and job-hunting pressure(OR=1.128,95%CI:1.038-1.226),emotional stress(OR=1.262,95%CI:1.116-1.426),neuroticism(OR=1.098,95%CI:1.046-1.153)and sleep quality(OR=1.266,95%CI:1.115-1.438)were independent risk factors for mental health.The constructed nomogram model C-index was 0.924,the corrected C-index was 0.917,and the AUC value was 0.884.Conclusion The positive detection rate of mental health of master freshmen in medical colleges is high,which is influenced by weekly exercise time,self-concealment,interpersonal pressure,career choice pressure,emotional pressure,nervousness and sleep quality.The nomogram model constructed in this study has good predictive performance and practical value.