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医学专业学生以及理工科学生的健康促进因素:一项比较性纵向研究的设计与基线结果

Health-promoting factors in medical students and students of science, technology, engineering, and mathematics: design and baseline results of a comparative longitudinal study.

作者信息

Kötter Thomas, Tautphäus Yannick, Scherer Martin, Voltmer Edgar

机构信息

Institute for Social Medicine and Epidemiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck 23562, Germany.

出版信息

BMC Med Educ. 2014 Jul 4;14:134. doi: 10.1186/1472-6920-14-134.

Abstract

BACKGROUND

The negative impact of medical school on students' general and mental health has often been reported. Compared to students of other subjects, or employed peers, medical students face an increased risk of developing depression, anxiety and burnout. While pathogenetic factors have been studied extensively, less is known about health-promoting factors for medical students' health. This longitudinal study aims to identify predictors for maintaining good general and mental health during medical education. We report here the design of the study and its baseline results.

METHODS

We initiated a prospective longitudinal cohort study at the University of Lübeck, Germany. Two consecutive classes of students, entering the university in 2011 and 2012, were recruited. Participants will be assessed annually for the duration of their course. We use validated psychometric instruments covering health outcomes (general and mental health) and personality traits, as well as self-developed, pre-tested items covering leisure activities and sociodemographic data.

RESULTS

At baseline, compared to students of STEM (science, technology, engineering, and mathematics) subjects (n = 531; 60.8% response rate), a larger proportion of medical students (n = 350; 93.0% response rate) showed good general health (90.9% vs. 79.7%) and a similar proportion was in good mental health (88.3% vs. 86.3%). Medical students scored significantly higher in the personality traits of extraversion, conscientiousness, openness to experience and agreeableness. Neuroticism proved to be a statistically significant negative predictor for mental health in the logistic regression analyses. Satisfaction with life as a dimension of study-related behaviour and experience predicted general health at baseline. Physical activity was a statistically significant predictor for general health in medical students.

CONCLUSIONS

Baseline data revealed that medical students reported better general and similar mental health compared to STEM students. The annual follow-up questionnaires, combined with qualitative approaches, should clarify wether these differences reflect a higher resilience, a tendency to neglect personal health problems - as has been described for physicians - before entering medical school, or both. The final results may aid decision-makers in developing health-promotion programmes for medical students.

摘要

背景

医学院校对学生总体健康和心理健康的负面影响屡有报道。与其他学科的学生或在职同龄人相比,医学生患抑郁症、焦虑症和职业倦怠的风险更高。虽然对发病因素已进行了广泛研究,但对于促进医学生健康的因素却知之甚少。这项纵向研究旨在确定在医学教育期间维持良好总体健康和心理健康的预测因素。我们在此报告该研究的设计及其基线结果。

方法

我们在德国吕贝克大学开展了一项前瞻性纵向队列研究。招募了2011年和2012年连续入学的两个班级的学生。在他们的课程期间,每年对参与者进行评估。我们使用经过验证的心理测量工具,涵盖健康结果(总体健康和心理健康)和人格特质,以及自行开发并经过预测试的项目,涵盖休闲活动和社会人口统计学数据。

结果

在基线时,与STEM(科学、技术、工程和数学)学科的学生(n = 531;应答率60.8%)相比,医学生(n = 350;应答率93.0%)中更大比例的学生表现出良好的总体健康(90.9%对79.7%),心理健康良好的比例相似(88.3%对86.3%)。医学生在外向性、尽责性、经验开放性和宜人性等人格特质方面得分显著更高。在逻辑回归分析中,神经质被证明是心理健康的一个具有统计学意义的负向预测因素。作为与学习相关行为和经历的一个维度,生活满意度在基线时预测总体健康。体育活动是医学生总体健康的一个具有统计学意义的预测因素。

结论

基线数据显示,与STEM专业学生相比,医学生报告的总体健康状况更好,心理健康状况相似。年度随访问卷与定性方法相结合,应能阐明这些差异是反映了更高的恢复力、一种在进入医学院之前像医生那样忽视个人健康问题的倾向,还是两者兼而有之。最终结果可能有助于决策者为医学生制定健康促进计划。

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