Thiemann Pia, Quince Thelma, Benson John, Wood Diana, Barclay Stephen
Primary Care Unit, University of Cambridge, Cambridge, United Kingdom; School of Clinical Medicine, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
Primary Care Unit, University of Cambridge, Cambridge, United Kingdom; School of Clinical Medicine, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
J Pain Symptom Manage. 2015 Sep;50(3):335-342.e2. doi: 10.1016/j.jpainsymman.2015.03.014. Epub 2015 May 13.
Death anxiety (DA) is related to awareness of the reality of dying and death and can be negatively related to a person's psychological health. Physicians' DA also may influence their care for patients approaching death. Doctors face death in a professional context for the first time at medical school, but knowledge about DA among medical students is limited.
This study examined medical students' DA in relation to: 1) its severity, gender differences, and trajectory during medical education and 2) its associations with students' attitudes toward palliative care and their psychological health.
Four cohorts of core science and four cohorts of clinical students at the University of Cambridge Medical School took part in a questionnaire survey with longitudinal follow-up. Students who provided data on the revised Collett-Lester Fear of Death Scale were included in the analysis (n = 790).
Medical students' DA was moderate, with no gender differences and remained very stable over time. High DA was associated with higher depression and anxiety levels and greater concerns about the personal impact of providing palliative care.
The associations between high DA and lower psychological health and negative attitudes toward palliative care are concerning. It is important to address DA during medical education to enhance student's psychological health and the quality of their future palliative care provision.
死亡焦虑（DA）与对死亡现实的认知相关，且可能与一个人的心理健康呈负相关。医生的死亡焦虑也可能影响他们对临终患者的护理。医生在医学院时首次在职业环境中面对死亡，但医学生对死亡焦虑的了解有限。
本研究考察医学生的死亡焦虑与以下方面的关系：1）其严重程度、性别差异以及在医学教育过程中的变化轨迹；2）其与学生对姑息治疗的态度及其心理健康的关联。
剑桥大学医学院的四个核心科学队列和四个临床学生队列参与了一项有纵向随访的问卷调查。分析纳入了在修订的科利特 - 莱斯特死亡恐惧量表上提供数据的学生（n = 790）。
医学生的死亡焦虑处于中等水平，无性别差异，且随时间保持非常稳定。高死亡焦虑与更高的抑郁和焦虑水平以及对提供姑息治疗的个人影响的更大担忧相关。
高死亡焦虑与较低的心理健康以及对姑息治疗的消极态度之间的关联令人担忧。在医学教育过程中应对死亡焦虑以增强学生的心理健康及其未来提供姑息治疗的质量很重要。
