本科和研究生入学的医学生在进入医学院第一年时心理困扰增加。
Elevated psychological distress in undergraduate and graduate entry students entering first year medical school.
机构信息
School of Rural Health, Monash University, Churchill, Australia.
出版信息
PLoS One. 2020 Aug 10;15(8):e0237008. doi: 10.1371/journal.pone.0237008. eCollection 2020.
BACKGROUND
Psychological distress in medical students is a global issue and poses a risk to their health, academic performance, and ability to care for patients as clinicians. There has been limited research on psychological distress levels in students prior to starting medicine and no direct comparison between undergraduate and graduate-entry students.
METHODS
Psychological distress was assessed using the 21-item Depression Anxiety and Stress Scale in 168 undergraduate-entry and 84 graduate-entry medical students at two separated campuses of the same university in the orientation week prior to starting classes. Mean scores and severity proportions were compared between the two cohorts of students. Demographic data was also collected and compared to distress scores using subgroup analysis.
RESULTS
The response rate for the study was 60.9%. The majority of undergraduate and graduate-entry medical students were within the normal limits for depression (67.2% versus 70.2%, p = 0.63), anxiety (56.5% versus 44.0%, p = 0.06), and stress scores (74.4% versus 64.2%, p = 0.10). There was no significant difference between severity groups except for severe stress (2.3% versus 9.5%, p = 0.01). The mean scores of the clinically distressed groups indicated moderate levels of depression, moderate anxiety, and moderate stress scores. There were no significant differences between undergraduate or graduate-entry students for depressive ([Formula: see text] = 17.02 versus 15.76, p = 0.43), anxiety ([Formula: see text] = 14.22 versus 13.28, p = 0.39), and stress scores ([Formula: see text] = 20.83 versus 22.46, p = 0.24). Female gender and self-believed financial concerns were found be associated with higher levels stress in graduate entry students.
CONCLUSIONS
The majority of medical students enter medical school with normal levels of psychological distress. However, a large number of undergraduate and graduate-entry medical students have significant levels of depressive, anxiety, and stress levels, without a significant difference between undergraduate or graduate-entry students. There are several limitation of this study but the results suggest that education and intervention may be required to support students from the earliest weeks of medical school.
背景
医学生的心理困扰是一个全球性问题，会对他们的健康、学业成绩以及作为临床医生照顾患者的能力造成威胁。虽然有研究关注医学生在开始学医前的心理困扰水平，但很少有研究对本科入学和研究生入学的医学生进行直接比较。
方法
在开学前的迎新周，我们使用 21 项抑郁焦虑和压力量表对同一所大学的两个校区的 168 名本科入学和 84 名研究生入学的医学生进行心理困扰评估。比较了两组学生的平均得分和严重程度比例。同时还收集了人口统计学数据，并通过亚组分析将其与困扰得分进行比较。
结果
该研究的应答率为 60.9%。大多数本科和研究生入学的医学生的抑郁得分（67.2%对 70.2%，p=0.63）、焦虑得分（56.5%对 44.0%，p=0.06）和压力得分（74.4%对 64.2%，p=0.10）都处于正常范围内。除严重压力外（2.3%对 9.5%，p=0.01），两组的严重程度没有显著差异。临床困扰组的平均得分表明，他们存在中度抑郁、中度焦虑和中度压力。本科和研究生入学的医学生之间的抑郁得分（[Formula: see text]=17.02 对 15.76，p=0.43）、焦虑得分（[Formula: see text]=14.22 对 13.28，p=0.39）和压力得分（[Formula: see text]=20.83 对 22.46，p=0.24）没有显著差异。研究发现，女性性别和自我认为的经济问题与研究生入学学生的更高水平压力有关。
结论
大多数医学生进入医学院时的心理困扰处于正常水平。然而，仍有大量本科和研究生入学的医学生存在显著的抑郁、焦虑和压力水平，而且本科和研究生入学的医学生之间没有显著差异。本研究存在一些局限性，但结果表明，从医学院的最早阶段开始，可能需要教育和干预来支持学生。
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