McLuckie Alan, Matheson Katherine M, Landers Ashley L, Landine Jeff, Novick Jason, Barrett Tessa, Dimitropoulos Gina
University of Calgary, Calgary, AB, Canada.
University of Ottawa, Ottawa, ON, Canada.
Acad Psychiatry. 2018 Feb;42(1):41-47. doi: 10.1007/s40596-017-0800-7. Epub 2017 Nov 9.
Psychological distress is pervasive among medical students and residents (MSR) and is associated with academic under-performance, decreased empathy, burnout, and suicidal ideation. To date, there has been little examination of how demographic and socioeconomic factors influence trainee's psychological distress levels, despite suggestion that financial concerns are a common source of stress. Recent Canadian studies examining the prevalence of distress, burnout, and resilience in MSR are limited.
Undergraduate and postgraduate medical trainees attending a Canadian university were surveyed. The questionnaire included standardized instruments to evaluate psychological distress, burnout, and resilience. Additional items explored MSR living and domestic circumstances, and anticipated debt upon training completion. Ordinary least squares regression models determined predictors of psychological distress, risk for burnout, and resiliency. Logistic regression of psychological distress predicted risk of MSR contemplating dropping out of their training program.
Feeling emotionally/psychologically unsupported while attending university was a key predictor of psychological distress and burnout, while feeling supported reduces this risk. Risk for burnout increased with each year of medical training. Psychologically distressed MSR were at significantly greater odds of contemplating dropping out of their medical training program.
Our results point to the important opportunity universities and medical schools have promoting MSR well-being by reducing institutional stressors, as well as teaching and promoting self-care and burnout avoidance techniques, instituting wellness interventions, and developing programs to identify and support at risk and distressed students.
心理困扰在医学生和住院医师中普遍存在，且与学业成绩不佳、同理心下降、职业倦怠和自杀意念相关。尽管有研究表明经济担忧是常见的压力源，但迄今为止，关于人口统计学和社会经济因素如何影响实习生心理困扰水平的研究较少。近期加拿大关于医学生和住院医师困扰、职业倦怠及心理复原力患病率的研究有限。
对就读于加拿大一所大学的本科和研究生医学实习生进行了调查。问卷包括评估心理困扰、职业倦怠和心理复原力的标准化工具。其他项目探讨了医学生和住院医师的生活及家庭情况，以及培训结束后的预期债务。普通最小二乘法回归模型确定了心理困扰、职业倦怠风险和心理复原力的预测因素。心理困扰的逻辑回归预测了医学生和住院医师考虑退出培训项目的风险。
在大学期间感到情感/心理上未得到支持是心理困扰和职业倦怠的关键预测因素，而感到得到支持则会降低这种风险。职业倦怠风险随着医学培训年限的增加而增加。有心理困扰的医学生和住院医师考虑退出医学培训项目的可能性显著更高。
我们的研究结果指出，大学和医学院有重要机会通过减少机构压力源、教授和推广自我护理及避免职业倦怠的技巧、开展健康干预措施以及制定识别和支持有风险及困扰学生的项目来促进医学生和住院医师的幸福感。
