Lau Michelle W, Li Wenlong E, Llewellyn Anthony, Cyna Allan M
JMO Unit, Nepean Hospital, Sydney, New South Wales, Australia.
Concord Hospital, Sydney, New South Wales, Australia.
Intern Med J. 2017 Oct;47(10):1190-1196. doi: 10.1111/imj.13545.
BACKGROUND/AIMS: To determine the prevalence of psychological distress in Australian junior medical officers (JMO) and investigate the determinants associated with psychological distress over a 3-year (2014-2016) period.
JMO were surveyed using the 2014-2016 JMO Census (n = 220, 399 and 466 each year; response rate approximately 15%). Levels of psychological distress were assessed using the Kessler Psychological Distress Scale (K10). A K10 ≥ 25 was chosen to indicate high psychological distress, and this determinant was compared to various demographic and work-related factors.
Australian JMO experience a high level of psychological distress (mean: 18.1, median 16.0). There were no differences in demographical variables, such as age, gender, marital status, dependants and between postgraduate years 1 and 2. Increasing hours worked per week was associated with a higher K10, with every hour worked increasing odds by 3%. Attitudinal items, including feeling unwilling to study medicine again, feeling poorly trained and experiences of bullying, were related to high psychological distress. Coping strategies like exercise and spending time with friends correlated positively with lower distress, while time off work, frequent alcohol use, smoking and drug use were associated with increased distress levels. Of those with a high K10, 54.5% indicated that they did not use any form of professional support; 17.83% expressed that given their time again, they would not choose to study medicine.
A focused approach to JMO support and education regarding significant risk factors identified is likely to assist health policies that aim to improve the mental well-being of Australian JMO.
背景/目的:确定澳大利亚初级医务人员(JMO)心理困扰的患病率,并调查2014年至2016年这3年期间与心理困扰相关的决定因素。
使用2014 - 2016年JMO普查对JMO进行调查(每年n = 220、399和466;回复率约为15%)。使用凯斯勒心理困扰量表(K10)评估心理困扰水平。选择K10≥25来表示高度心理困扰,并将该决定因素与各种人口统计学和工作相关因素进行比较。
澳大利亚JMO经历高水平的心理困扰(均值:18.1,中位数16.0)。在年龄、性别、婚姻状况、家属以及研究生一年级和二年级之间等人口统计学变量上没有差异。每周工作时间增加与K10得分较高相关,每工作一小时,几率增加3%。包括再次不愿意学习医学、感觉培训不足和欺凌经历等态度项目与高度心理困扰有关。锻炼和与朋友共度时光等应对策略与较低的困扰呈正相关,而休假、频繁饮酒、吸烟和吸毒与困扰水平增加有关。在K10得分高的人中,54.5%表示他们没有使用任何形式的专业支持;17.83%表示如果重新选择,他们不会选择学习医学。
针对已确定的重大风险因素,对JMO提供有针对性的支持和教育,可能有助于旨在改善澳大利亚JMO心理健康的卫生政策。