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5 年来医学生健康趋势:健康课程有何影响?

Trends in medical students' health over 5 years: Does a wellbeing curriculum make a difference?

机构信息

Medical Programme Directorate, University of Auckland, New Zealand.

Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.

出版信息

Int J Soc Psychiatry. 2023 May;69(3):675-688. doi: 10.1177/00207640221133944. Epub 2022 Dec 1.

Abstract

BACKGROUND

Trends in New Zealand (NZ) medical students' health and the influence of a wellbeing curricula are unknown.

METHODS

The author's collected self-report data from NZ medical students on 'Graduation Day' from 2014 to 2018, using a serial cross-sectional survey design with validated scales assessing psychological health, stigma, coping, and lifestyle. Comparisons were made with NZ general population same-age peers. Analyses examined trends, differences between 'cohorts' of students receiving different exposures to a wellbeing curriculum, and correlations between students' own lifestyle practices and their frequency of talking with patients about those topics.

RESULTS

Of 1,062 students, 886 participated. The authors found statistically significant self-reported increases from 2014 to 2018 for negative psychological indices, including scores for distress and burnout, suicidal thoughts in the preceding year, and the likelihood of being diagnosed with an anxiety disorder. There was a significant increase in numbers of students reporting having their own doctor as well as increased healthy coping strategies and a significant decrease in stigma scores. Academic cohorts of students who had completed a wellbeing curriculum were more likely to report high distress levels, having been diagnosed with a mood disorder, and being non-drinkers than students without wellbeing training. When compared to NZ peers, medical students smoked less, exercised more, and were less likely to have diagnosed mood and anxiety disorders, but reported more distress. The authors found a significant correlation between the amount of exercise students undertook and their likelihood to discuss exercise with patients.

CONCLUSIONS

NZ medical students have better physical health than general population peers and are more likely to discuss exercise with patients if exercising themselves. However, cohorts of graduating students report increasing distress despite the implementation of a wellbeing curriculum. Research is needed into mechanisms between students' self-awareness, willingness to report distress, stigma, mind-set, coping, and psychological outcomes, to inform curriculum developers.

摘要

背景

新西兰(NZ)医学生健康状况的趋势以及健康课程的影响尚不清楚。

方法

作者使用连续横断面调查设计,从 2014 年至 2018 年期间收集了 NZ 医学生在“毕业日”的自我报告数据,使用经过验证的量表评估心理健康、污名、应对方式和生活方式。将其与 NZ 同龄一般人群进行比较。分析考察了趋势、接受不同健康课程暴露的“学生群体”之间的差异,以及学生自身生活方式实践与其与患者讨论这些主题的频率之间的相关性。

结果

在 1062 名学生中,有 886 名学生参与了研究。作者发现,从 2014 年到 2018 年,学生的负面心理指数呈统计学显著增长,包括困扰和倦怠评分、前一年的自杀念头以及焦虑障碍的诊断可能性。报告自己的医生的学生人数增加,健康应对策略增加,污名评分降低。完成健康课程的学生学术群体更有可能报告有较高的困扰水平、被诊断为情绪障碍以及不饮酒,而没有接受健康培训的学生则更有可能报告。与 NZ 同龄人相比,医学生吸烟较少,锻炼更多,被诊断为情绪和焦虑障碍的可能性较小,但报告的困扰更多。作者发现,学生锻炼量与他们与患者讨论锻炼的可能性之间存在显著相关性。

结论

与一般人群同龄人相比,新西兰医学生的身体健康状况更好,如果自己锻炼,更有可能与患者讨论锻炼。然而,尽管实施了健康课程,毕业学生群体的困扰仍在增加。需要研究学生自我意识、报告困扰、污名、思维模式、应对方式和心理结果之间的机制,为课程开发者提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdd7/10149885/2a1438a9ba84/10.1177_00207640221133944-fig1.jpg

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