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本科医学生中的抑郁与压力

Depression and stress amongst undergraduate medical students.

作者信息

Ludwig Allison B, Burton William, Weingarten Jacqueline, Milan Felise, Myers Daniel C, Kligler Benjamin

机构信息

Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA.

Montefiore Medical Center, 111 E. 210th Street, Rosenthal Pavilion, Room 4, Bronx, NY, 10467, USA.

出版信息

BMC Med Educ. 2015 Aug 27;15:141. doi: 10.1186/s12909-015-0425-z.

Abstract

BACKGROUND

The demands placed on medical trainees pose a challenge to personal wellbeing, leading to burnout and erosion of empathy. However, it is unclear at what point in medical education this decline begins. Although many schools have begun to design and implement wellness programs for their students, the medical education community's experience in evaluating their impact is limited.

METHODS

The authors designed a wellness needs assessment of all medical students at the Albert Einstein College of Medicine in order to assess students' health behaviors, stress and depressive symptoms. The online survey was administered to all medical students from the classes of 2014 and 2015 at the beginning of their first year of medical school and again at the end of their third year. Chi-square and T-tests were run comparing the survey responses of the two classes.

RESULTS

There was a significant increase in perceived stress from an average of 5.51 in the first year to 6.49 in the third year (p = .0001). The number of students at risk for depression, defined as a CES-D score greater than 16, was 94 (28.4%) in the first year and 131 (39.0%) in their third year (p = .004).

CONCLUSIONS

This study demonstrates a significant increase in the proportion of students at risk for depression in their third year as compared to the first year as well as an increase in perceived stress. In response to these findings, the authors took a multi-disciplinary approach in the development of a comprehensive program to address student wellness, including efforts to address issues specific to the clinical clerkships. This program is unique in that its design, inception and ongoing evaluation have taken the needs of an entire medical school class into account.

摘要

背景

对医学实习生的要求给个人幸福带来了挑战,导致职业倦怠和同理心的丧失。然而,尚不清楚这种下降在医学教育的哪个阶段开始。尽管许多学校已经开始为学生设计和实施健康计划,但医学教育界在评估其影响方面的经验有限。

方法

作者对阿尔伯特爱因斯坦医学院的所有医学生进行了一项健康需求评估,以评估学生的健康行为、压力和抑郁症状。在线调查在2014级和2015级所有医学生入学第一年开始时以及第三年末进行。进行卡方检验和T检验以比较两个班级的调查回复。

结果

感知压力从第一年的平均5.51显著增加到第三年的6.49(p = .0001)。抑郁风险学生人数(定义为CES-D得分大于16)在第一年为94人(28.4%),第三年为131人(39.0%)(p = .004)。

结论

本研究表明,与第一年相比,第三年有抑郁风险的学生比例显著增加,且感知压力也有所增加。针对这些发现,作者采取了多学科方法来制定一项全面计划以解决学生健康问题,包括努力解决临床实习特有的问题。该计划的独特之处在于其设计、启动和持续评估都考虑到了整个医学院班级的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/388f/4551568/a11ec2655930/12909_2015_425_Fig1_HTML.jpg

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