Cellini Melissa M, Serwint Janet R, Chaudron Linda H, Baldwin Constance D, Blumkin Aaron K, Szilagyi Peter G
Department of Pediatrics, New York Medical College, Valhalla, NY.
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md.
Acad Pediatr. 2017 May-Jun;17(4):424-430. doi: 10.1016/j.acap.2017.01.011. Epub 2017 Jan 27.
Resident mental health (MH) problems can be associated with reduced empathy and increased medical errors. The Accreditation Council for Graduate Medical Education mandates resident MH support services, but it is unknown if these services are accessible and meet resident needs. We sought to describe the prevalence of anxiety and depression in current pediatric residents in New York State (NYS), and their self-reported use of and barriers to support services.
We developed an online survey and distributed it to all categorical pediatric residents in 9 NYS programs. Items addressing self-concern for clinical anxiety and depression and use of MH services were pilot tested for content and construct validity. The validated Patient Health Questionnaire-2 (PHQ-2) measured depressive symptoms. Analyses used descriptive and chi-square tests.
Respondents included 227 residents (54% response rate) distributed across training levels and programs. Many reported "often" or "almost always" feeling stress (52%), physical exhaustion (41%), and mental exhaustion (35%); 11% had PHQ-2-defined depressive symptoms. Some thought that their stress levels raised concern for clinical depression (25%) or anxiety (28%); among these, only 44% and 39%, respectively, had sought care. More women reported physical exhaustion (P < .05). Only 45% of residents reported educational offerings on resident MH; 66% wanted to know more about available resources. Barriers to receipt of services included inflexible schedules (82%), guilt about burdening colleagues (65%), fear of confidentiality breach (46%), and difficulty identifying services (44%).
Pediatric residents frequently experience MH symptoms, but many do not know about or use support services. Programs should enhance MH support by overcoming barriers and increasing resident awareness of services.
住院医师的心理健康（MH）问题可能与同理心降低和医疗差错增加有关。毕业后医学教育认证委员会要求提供住院医师心理健康支持服务，但这些服务是否可及以及是否满足住院医师需求尚不清楚。我们试图描述纽约州（NYS）当前儿科住院医师中焦虑和抑郁的患病率，以及他们自我报告的对支持服务的使用情况和获取服务的障碍。
我们开发了一项在线调查，并将其分发给纽约州9个项目中的所有分类儿科住院医师。针对临床焦虑和抑郁的自我关注以及心理健康服务使用情况的项目进行了内容和结构效度的预测试。经过验证的患者健康问卷-2（PHQ-2）用于测量抑郁症状。分析采用描述性统计和卡方检验。
受访者包括227名住院医师（回复率为54%），分布在不同培训水平和项目中。许多人报告“经常”或“几乎总是”感到压力（52%）、身体疲惫（41%）和精神疲惫（35%）；11%有PHQ-2定义的抑郁症状。一些人认为他们的压力水平引发了对临床抑郁（25%）或焦虑（28%）的担忧；在这些人中，分别只有44%和39%寻求过治疗。更多女性报告有身体疲惫（P <.05）。只有45%的住院医师报告有关于住院医师心理健康的教育课程；66%想了解更多可用资源。获得服务的障碍包括日程安排不灵活（82%）、因给同事带来负担而感到内疚（65%）、担心保密性被破坏（46%）以及难以确定服务（44%）。
儿科住院医师经常出现心理健康症状，但许多人不了解或未使用支持服务。项目应通过克服障碍和提高住院医师对服务的认识来加强心理健康支持。
