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改善中国医学生的心理健康和同理心管理:一项随机对照研究。

Improvement of the management of mental well-being and empathy in Chinese medical students: a randomized controlled study.

机构信息

Clinical Trials Unit, the First Affiliated Hospital, Sun Yat-sen University, 510080, Guangzhou, China.

Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, 510080, Guangzhou, China.

出版信息

BMC Med Educ. 2021 Jul 10;21(1):378. doi: 10.1186/s12909-021-02813-6.

Abstract

BACKGROUND

Among Chinese medical students, there is a high prevalence of mental health-related issues and low empathy. Effective strategies to improve this situation are lacking. This study aims to investigate the efficacy of the intervention courses designed to enhance the mental health and empathy of senior Chinese medical students.

METHODS

A total of 146 3rd - and 4th -year medical students were randomized to an intervention group (n = 74) and a control group (n = 72). A pilot study including 5 pre-clinical students and 5 interns was first carried out to determine the themes and content of the intervention courses. The designed courses were delivered in the intervention group once a month three times, while the control group had no specific intervention. Five self-assessment questionnaires, including the General Self-Efficacy (GSE) scale, Medical Outcomes Study Short Form 8 (SF-8), Patient Health Questionnaire-9 (PHQ-9), Maslach Burnout Inventory (MBI), and Jefferson Scale of Empathy-Health Care Provider Student version (JSE-HPS), were completed by the students before and one month after the courses to evaluate their levels of self-efficacy (SE), quality of life (QoL), depression, burnout, and empathy, respectively. Qualitative data were collected via e-mail two years after the intervention.

RESULTS

Compared to the control group, the intervention group showed significantly higher scores for empathy (111.0 [IQR 102.0, 118.0] vs. 106.0 [IQR 93.0, 111.5]; P = .01) and QoL (32.0 [IQR 28.0, 35.0] vs. 29.5 [IQR 26.0, 34.0]; P = .04). The rate of depression was significantly lower in the intervention group than in the control group (13.5 % vs. 29.2 %; chi-square test, P = .02). However, no significant differences in self-efficacy (25.6 ± 4.8 vs. 24.3 ± 6.3; P = .16) or burnout (27.0 % vs. 34.7 %; Chi-square test, P = .31) were observed between the two groups.

CONCLUSIONS

The intervention courses had a positive impact on mental well-being and empathy in senior Chinese medical students, which might help provide novel information for their incorporation into the medical school curriculum.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02645643; Date of registration: 05/01/2016.

摘要

背景

在中国医学生中,心理健康相关问题的发生率较高,同理心较低。缺乏有效的策略来改善这种情况。本研究旨在探讨旨在提高中国高年级医学生心理健康和同理心的干预课程的效果。

方法

共有 146 名 3 年级和 4 年级医学生被随机分为干预组(n=74)和对照组(n=72)。首先对 5 名临床医学学生和 5 名实习医生进行了一项试点研究,以确定干预课程的主题和内容。设计的课程每月在干预组中进行一次,共进行三次,而对照组则没有具体的干预。学生在课程前后一个月分别填写了五个自我评估问卷,包括一般自我效能感量表(GSE)、医疗结果研究 8 项简短量表(SF-8)、患者健康问卷-9(PHQ-9)、马斯拉赫倦怠量表(MBI)和杰斐逊同理心量表-医疗保健提供者学生版(JSE-HPS),以分别评估他们的自我效能感(SE)、生活质量(QoL)、抑郁、倦怠和同理心水平。干预两年后通过电子邮件收集定性数据。

结果

与对照组相比,干预组的同理心得分显著更高(111.0 [IQR 102.0, 118.0] 与 106.0 [IQR 93.0, 111.5];P=0.01)和生活质量(32.0 [IQR 28.0, 35.0] 与 29.5 [IQR 26.0, 34.0];P=0.04)。干预组的抑郁发生率明显低于对照组(13.5%与 29.2%;卡方检验,P=0.02)。然而,两组之间的自我效能感(25.6±4.8 与 24.3±6.3;P=0.16)或倦怠(27.0%与 34.7%;卡方检验,P=0.31)没有明显差异。

结论

干预课程对中国高年级医学生的心理健康和同理心产生了积极影响,这可能为将其纳入医学院课程提供新的信息。

试验注册

ClinicalTrials.gov 标识符:NCT02645643;注册日期:2016 年 5 月 1 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2003/8272356/455cfa63d035/12909_2021_2813_Fig1_HTML.jpg

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