Chew-Graham Carolyn A, Rogers Anne, Yassin Nuha
School of Primary Care, University of Manchester, UK.
Med Educ. 2003 Oct;37(10):873-80. doi: 10.1046/j.1365-2923.2003.01627.x.
Medical education is reported to be demanding and stressful and previous work with doctors suggests that there is a resistance within the profession to help-seeking and an ad hoc approach to dealing with stress and distress.
To explore the attitudes of medical students at the University of Manchester, UK to the causes of stress and to examine their views on help-seeking.
A qualitative study using semistructured interviews, with analysis of the data using the technique of constant comparison.
Medical students at the University of Manchester were invited to participate in the study. Sampling made the research representative of medical students in terms of gender, ethnicity and UK/overseas students. Semistructured interviews, with open questions, were conducted and audio-taped with consent. The tapes were transcribed verbatim. The schedule was revised in the light of the emerging themes.
Medical students recognised that studying medicine contributes to stress, as experienced in their undergraduate careers. Students reported that perceptions of stigma associated with mental illness, including stress, were prevalent in the student body and were perceived to continue throughout the medical profession. Avoidance of appropriate help-seeking behaviour starts early and is linked to perceived norms which dictate that experiencing a mental health problem may be viewed as a form of weakness and has implications for subsequent successful career progression.
The preparation of medical students for life as doctors involves more than facilitation of the acquisition of knowledge and skills, so that new doctors can conform to the principals of professional conduct. Support and mentoring are required so that stress can be identified early and dealt with appropriately.
据报道,医学教育要求高且压力大,以往对医生的研究表明,该职业内部存在抗拒寻求帮助的现象,应对压力和困扰的方式也较为随意。
探讨英国曼彻斯特大学医学生对压力成因的态度,并考察他们对寻求帮助的看法。
采用半结构化访谈的定性研究,运用持续比较技术对数据进行分析。
邀请曼彻斯特大学的医学生参与研究。抽样确保研究在性别、种族以及英国/海外学生方面能够代表医学生群体。进行半结构化访谈,提出开放性问题,并在征得同意后进行录音。录音逐字转录。根据新出现的主题对访谈提纲进行修订。
医学生认识到本科阶段学习医学带来了压力。学生们表示,对包括压力在内的精神疾病相关污名的认知在学生群体中普遍存在,且在整个医学职业中都被认为会持续存在。避免寻求适当帮助的行为很早就开始了,并且与被认为的规范有关,这些规范表明经历心理健康问题可能被视为一种软弱的表现,并且会对后续的职业成功发展产生影响。
让医学生为成为医生后的生活做好准备,所涉及的不仅仅是促进知识和技能的获取,以便新医生能够遵守职业行为准则。还需要支持和指导,以便能够尽早识别压力并进行适当处理。