Michels Philip J, Probst Janice C, Godenick Mark T, Palesch Yuko
Department of Family and Preventive Medicine, University of South Carolina School of Medicine, SC 29203, USA.
Acad Med. 2003 Jan;78(1):69-79. doi: 10.1097/00001888-200301000-00013.
To study the dimensions of anxiety and anger experienced by a statewide sample of South Carolina family practice residents.
A total of 350 family practice residents from seven programs participated. Each resident completed the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Profile of Mood States, the Hassles Scale, the Maslach Burnout Inventory, and the State-Trait Anger Expression Inventory (STAXI) on at least one occasion. We analyzed reported anxiety and anger by gender, year of training, race, marital status, type of program (community hospital versus university), location of program, and season of the year.
Residents reported lower levels of anxiety and anger across most dimensions compared with the adult populations on which the tests were standardized and with other resident and practicing physician populations. The residents did not demonstrate excessive levels of anger as a trait or in response to situations, nor did they significantly suppress anger. Although the residents reported a higher frequency of hassles than did normal populations, they did not consider these hassles severe. A higher than normal level of depersonalization was found among male, Caucasian, and third-year residents.
These family medicine residents did not experience excessive levels of anxiety or anger during residency training either as a trait, state or somatic response. Extensive social and emotional "in-house" support, attention to stress-management skills, and the moderate personality characteristics of family practice residents help explain these findings. Initial assessment of psychological functioning and early remediation and program support during training may significantly reduce the potential for residents' impairment.
研究南卡罗来纳州家庭医学住院医师全州样本所经历的焦虑和愤怒程度。
来自七个项目的总共350名家庭医学住院医师参与了研究。每位住院医师至少一次完成了贝克抑郁量表、状态-特质焦虑量表、情绪状态剖面图、烦恼量表、马氏职业倦怠量表以及状态-特质愤怒表达量表(STAXI)。我们按性别、培训年份、种族、婚姻状况、项目类型(社区医院与大学)、项目地点以及一年中的季节分析了报告的焦虑和愤怒情况。
与测试标准化所依据的成年人群以及其他住院医师和执业医师人群相比,住院医师在大多数维度上报告的焦虑和愤怒水平较低。住院医师并未表现出作为一种特质或对情境做出反应时的过度愤怒水平,他们也没有显著抑制愤怒。尽管住院医师报告的烦恼频率高于正常人群,但他们并不认为这些烦恼严重。在男性、白种人和三年级住院医师中发现了高于正常水平的去个性化现象。
这些家庭医学住院医师在住院医师培训期间,无论是作为特质、状态还是躯体反应,都没有经历过度的焦虑或愤怒。广泛的社会和情感“内部”支持、对压力管理技能的关注以及家庭医学住院医师适度的人格特征有助于解释这些发现。培训期间对心理功能的初步评估以及早期补救和项目支持可能会显著降低住院医师受损的可能性。