医学生焦虑与睡眠质量的关系:应对方式的中介作用

Medical students'anxiety and sleep quality:the mediating roles of coping style

目的:探讨睡眠质量、应对方式与医学生焦虑之间的关系及内在的作用机制。方法:运用抑郁-焦虑-压力自评量表(DASS-21)、匹兹堡睡眠质量指数量表(PSQI)、简易应对方式问卷(SCSQ),于2023年4月至6月多阶段分层整群随机抽取贵州省7639名医学生开展现场调查,采用Boostrap法进行中介效应检验。结果:焦虑检出率为45.00%,睡眠障碍检出率为19.30%,消极应对方式检出率为56.85%。医学生焦虑得分与睡眠质量各维度及总得分呈正相关(r_(s)=0.19~0.47,P<0.001),与消极应对得分呈正相关(r_(s)=0.18,P<0.001),与积极应对得分呈负相关(r_(s)=-0.29,P<0.001)。中介效应结果显示,应对方式的中介作用的95%CI为0.01~0.36,消极应对的间接效应值为0.02(95%CI 0.01~0.36),积极应对的间接效应值为0.13(95%CI 0.11~0.15)。应对方式在焦虑与睡眠质量之间起部分中介作用,中介效应占总效应的比例为12.93%。结论:应对方式是医学生睡眠质量与焦虑之间的中介因素;高校应重视促进医学生积极情绪与掌握正确、积极的应对学业、人际关系等不良情绪和心理压力必需的相关技能,提高医学生心理健康水平。

Objective:To investigate the relationship between sleep quality,coping style and anxiety of medical students and their internal mechanism.Methods:Using the Pittsburgh Sleep Quality Index(PSQI),Simplified Coping Style Questionnaire(SCSQ),and Depression-Anxiety-Stress Self-rating Scale(DASS-21),a total of 7639 medical students in Guizhou province were randomly selected by multi-stage stratified cluster sampling from April to June 2023 to conduct a field survey.Boostrap method was used to test the mediating effect.Results:The percentage of medical students who had anxiety was 45.00%,had sleep disorder were 19.30%,and used negative coping style were 56.85%.The anxiety score of medical students was positively correlated with each dimension and total score of sleep quality(r_(s)=0.19-0.47,P<0.001),positively correlated with negative coping score(r_(s)=0.18,P<0.001),and negatively correlated with positive coping score(r_(s)=-0.29,P<0.001).The mediating impact results revealed that the 95%CI of the mediating effect of coping style was 0.01-0.36,the indirect effect of negative coping was 0.02(95%CI 0.01-0.36),and the indirect effect of positive coping was 0.13(95%CI 0.11-0.15).The relationship between anxiety and sleep quality was somewhat mediated by coping style,which accounted for 12.93%of the overall effect.Conclusion:Coping style is the mediating factor between sleep quality and anxiety in medical students.In order to raise the mental health of medical students,colleges and universities should pay attention to promoting their positive emotions and mastering the relevant skills necessary to correctly and actively deal with bad emotions and psychological pressure such as academic and interpersonal relationships.