广东省住培医师心理健康状况与住培满意度的关系——基于职业压力的中介作用

Study on the Relationship between the Mental Health Status of Resident Standardized Training Doctors in Guang-dong and Their Satisfaction Degree Based on The Mediating Role of Occupational Stress

目的:探讨住培满意度对住培医师心理健康状况的影响,以及职业压力在影响路径上的中介作用。方法:2022年11月至2023年4月期间,通过在线问卷调查的方式,纳入广东省住培医师5198例,使用住培医师一般情况调查表、住培满意度调查表、职业压力源量表、症状自评量表(SCL-90)收集数据,利用中介效应检验三步法和Bootstrap方法进行中介作用分析。结果:广东省住培医师心理健康状况自评筛查阳性2147例(41.30%),各因子阳性率从高到低分别是强迫症(37.90%)、抑郁(30.63%)、人际敏感(26.28%)、焦虑(21.84%)、敌对(19.51%)、躯体化(19.08%)、偏执(18.33%)、精神病性(17.49%)、恐怖(15.18%);中介作用分析结果显示,工作负荷、职业发展、人际关系、医患关系、组织管理、外部环境、职业兴趣等七个维度的职业压力均在住培满意度影响住培医师心理健康状况路径上起到中介作用。结论:广东省住培医师心理健康状况总体较差;住培满意度通过缓释住培医师的职业压力,进而改善其心理健康状况。因此,采取优化住培管理、重视临床教学、有效心理干预等措施降低住培医师的职业压力,有助于缓释较低的住培满意度对住培医师心理健康状况的负面影响。

Objective To explore the influence of satisfaction degree of resident standardized training on mental health status of resident standardized training doctors and the mediating role of occupational stress in the influence path.Methods From November 2022 to April 2023,a total of 5198 resident standardized training doctors in Guangdong Province were included in the study through an online questionnaire survey.Data were collected by using the Resident Standardized Training Doctor General Situation Questionnaire,Resident Standardized Training Satisfaction Questionnaire,Occupational Stressors Inventory,and Symptom Check List-90(SCL-90).The mediation effect was analyzed by using the three-step method of mediation effect test and Bootstrap method.Results There were 2147(41.30%)positive cases in the self-evaluation check of mental health status of resident standardized training doctors in Guangdong Province.The positive rates of various factors ranked from high to low as obsessive-compulsive disorder(37.90%),depression(30.63%),interpersonal sensitivity(26.28%),anxiety(21.84%),hostility(19.51%),somatization(19.08%),paranoia(18.33%),psychotic(17.49%),and phobia(15.18%).The mediating effect analysis showed that seven dimensions of occupational stress,including workload,career development,interpersonal rela-tionships,doctor-patient relationships,organizational management,external environment,and career interests,all of which played a mediating role in the path of the impact of resident standardized training satisfaction on the mental health status of resident standardized training doctors.Conclusion The overall mental health status of resident standardized training doctors in Guangdong Province is poor.The satisfaction degree of resident standardized training can improve the mental health status of resident stand-ardized training doctors by alleviating their occupational stress.Therefore,taking effective measures to reduce the occupational stress of resident standardized training doctors is helpful to alleviate the negative impact of low satisfaction on the mental health sta-tus of resident standardized training doctors.