Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, 69115 Heidelberg, Germany.
Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tubingen, Eberhard-Karls-University Tubingen, 72076 Tubingen, Germany.
Int J Environ Res Public Health. 2018 Dec 11;15(12):2820. doi: 10.3390/ijerph15122820.
(1) Medical doctors and medical students show increased psychological stress levels. International medical students seem to be particularly vulnerable. (2) We compared different methods of assessing stress levels in international and local first year medical students. First, study participants completed questionnaires related to stress, depression, empathy, and self-efficacy (MBI, PSQ, PHQ-9, JSPE-S, and GSE) at three separate points in time (T1 to T3). Second, their heart rate variabilities (HRVs) were recorded in an oral examination, a seminar, and in a relaxing situation. Third, hair samples were collected at the beginning and at the end of the semester to assess the cortisol concentration. (3) Included were 20 international and 20 local first semester medical students. At T1, we found considerable differences between international and local students in the JSPE-S; at T2 in the MBI factor "professional efficacy", the PHQ-9, and in the JSPE-S; and at T3 in the MBI factors "cynicism" and "professional efficacy", the PHQ-9, and in the JSPE-S. International and local students also differed concerning their HRVs during relaxation. Over the course of the semester, international students showed changes in the MBI factors "emotional exhaustion" and "professional efficacy", the PHQ-9, and the GSE. Local students showed changes in the GSE. No effects were found for students' hair cortisol concentrations. (4) All participants showed low levels of stress. However, while international students experienced their stress levels to decrease over the course of the semester, local students found their stress levels to increase.
（1）医生和医学生表现出更高的心理压力水平。国际医学生似乎尤其脆弱。（2）我们比较了评估国际和本地一年级医学生压力水平的不同方法。首先，研究参与者在三个不同时间点（T1 到 T3）完成了与压力、抑郁、同理心和自我效能感相关的问卷（MBI、PSQ、PHQ-9、JSPE-S 和 GSE）。其次，在口腔考试、研讨会和放松状态下记录了他们的心率变异性（HRV）。第三，在学期开始和结束时采集头发样本以评估皮质醇浓度。（3）包括 20 名国际和 20 名本地一年级医学生。在 T1，我们发现国际学生和本地学生在 JSPE-S 方面存在相当大的差异；在 T2，MBI 因子“职业效能”、PHQ-9 和 JSPE-S 方面存在差异；在 T3，MBI 因子“犬儒主义”和“职业效能”、PHQ-9 和 JSPE-S 方面存在差异。国际学生和本地学生在放松时的 HRV 也存在差异。整个学期，国际学生在 MBI 因子“情绪疲惫”和“职业效能”、PHQ-9 和 GSE 方面表现出变化。本地学生在 GSE 方面表现出变化。学生头发皮质醇浓度没有变化。（4）所有参与者的压力水平都较低。然而，虽然国际学生在整个学期经历了压力水平的降低，但本地学生发现他们的压力水平在增加。
