医学生焦虑症状与社会生态学风险因素的关联

Association between anxiety symptoms and social-ecological risk factors among medical students

目的了解医学院校大学生焦虑症状及其与社会生态学风险因素的关系,为促进医学生心理健康提供参考依据。方法于2021年9—10月,采用方便整群抽样方法纳入1274名太原市某医学院校大一至大四年级学生,采用广泛性焦虑量表-7和青少年社会生态学风险因素评定问卷进行调查。采用多因素二元Logistic回归分析医学生焦虑症状与社会生态学风险因素关联性。结果医学生焦虑症状总检出率为16.2%。不同年级(大一:19.9%,大二:13.0%,大三:14.0%,大四:18.9%)和朋友数量(≤2个:22.8%,3~5个:14.4%,≥6个:11.8%)的医学生焦虑症状检出率差异均有统计学意义(χ^(2)值分别为8.70,16.34,P值均<0.05)。Spearman秩相关分析显示,社会生态学风险因素个人、家庭、学校、社区、政策、文化、时间维度及总和不同风险等级构成与焦虑症状得分均呈正相关(r值分别为0.33,0.25,0.32,0.16,0.15,0.16,0.16,0.35,P值均<0.01)。Logistic回归分析显示,社会生态学风险因素个人维度高风险与医学生焦虑症状检出率呈正相关(OR=3.32,95%CI=1.66~6.61),调整协变量年级和朋友数量后两者仍呈正相关(OR=2.98,95%CI=1.49~5.94)(P值均<0.01)。结论社会生态学风险因素中暴露于个人维度高风险会增加医学生焦虑症状的发生风险。应该重点关注个人层面对自身焦虑的影响,促进医学生心理健康水平。

Objective To understand anxiety symptoms among medical college students and their relationship with social-ecological risk factors,so as to provide reference for mental health promotion among medical students.Methods From September to October 2021,a convenient cluster sampling method was used to include 1274 freshmen to senior students of a medical school in Taiyuan City,and the Generalized Anxiety Disorder-7 and adolescent social-ecological risk factors assessment questionnaire were used.Multivariate binary Logistic regression was used to analyze the association between anxiety symptoms and social-ecological risk factors among medical students.Results The overall detection rate of anxiety symptoms among medical students was 16.2%.The rate of anxiety varied significantly by grade(freshman:19.9%,sophomore:13.0%,junior:14.0%,senior:18.9%)and number of friends(≤2:22.8%,3-5:14.4%,≥6:11.8%)(χ^(2)=8.70,16.34,P<0.05).Spearman correlation analysis showed that individual,family,school,community,policy,culture,time,and total score in socio-ecological risk factors were positively associated with anxiety symptom scores at different levels of risk(r=0.33,0.25,0.32,0.16,0.15,0.16,0.16,0.35,P<0.01).Logistic regression analysis showed that high risk for personal dimension of the socio-ecological risk factors was positively associated with rate of anxiety symptoms among medical students(OR=3.32,95%CI=1.66-6.61),and remained positively associated(OR=2.98,95%CI=1.49-5.94)after adjusting for grade and number of friends(P<0.01).Conclusions Exposure to high personal dimensions of socio-ecological risk factors increases the risk of developing anxiety symptoms among medical students.A focus should be placed on the personal factors associated with anxiety to promote medical students'mental health.