Butterfield P S
Division of Research and Evaluation in Medical Education, Ohio State University College of Medicine, Columbus.
Arch Intern Med. 1988 Jun;148(6):1428-35.
A review of empiric studies of the stresses of residency training and descriptions of intervention programs and mental health resource surveys published since 1980 indicated that inadequate sleep and fatigue are major stressors for residents, but they are only part of a more complex situation influenced by time demands, social support, and maturational factors. Other important stressful aspects of training appear to be those that interfere with social support. Increased anger, not depression, is emerging as the predominant mood change during residency, but the effects of any mood change on patient care have not been studied. Despite growing evidence of the need for change in training programs, especially attention to the affiliative needs of residents, few intervention programs have been reported.
一项对自1980年以来发表的住院医师培训压力的实证研究、干预项目描述以及心理健康资源调查的综述表明，睡眠不足和疲劳是住院医师的主要压力源，但它们只是受时间需求、社会支持和成熟因素影响的更复杂情况的一部分。培训中其他重要的压力方面似乎是那些干扰社会支持的方面。在住院医师培训期间，愤怒情绪增加而非抑郁情绪增加正成为主要的情绪变化，但尚未研究任何情绪变化对患者护理的影响。尽管越来越多的证据表明培训项目需要改变，尤其是要关注住院医师的归属需求，但报道的干预项目却很少。
