Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, PR China.
Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9 West Section of Lvshun South Road, Lvshunkou District, Dalian, 116044, Liaoning, PR China.
BMC Psychiatry. 2023 Jun 5;23(1):398. doi: 10.1186/s12888-023-04894-7.
BACKGROUND: Although life satisfaction is a predictor of depressive and anxiety symptoms, the mechanisms underlying this association are poorly understood. This study examined how psychological capital (PsyCap), a positive psychological state, mediated the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic. METHODS: A cross-sectional survey was conducted at three medical universities in China. A self-administered questionnaire was distributed to 583 students. Depressive symptoms, anxiety symptoms, life satisfaction, and PsyCap were measured anonymously. A hierarchical linear regression analysis was performed to explore the effects of life satisfaction on depressive and anxiety symptoms. Asymptotic and resampling strategies were used to examine how PsyCap mediates the association between life satisfaction and depressive and anxiety symptoms. RESULTS: Life satisfaction was positively associated with PsyCap and its four components. There were significant negative associations between life satisfaction, psychological capital, resilience, optimism, and depressive and anxiety symptoms among medical students. Self-efficacy was negatively associated with depressive and anxiety symptoms. Psychological capital (a×b = -0.3201, BCa 95% CI: -0.3899, -0.2446; a×b = -0.2749, BCa 95% CI: -0.3817, -0.1996), resilience (a×b = -0.2103, BCa 95% CI: -0.2727, -0.1580; a×b = -0.1871, BCa 95% CI: -0.2520, -0.1414), optimism (a×b = -0.2100, BCa 95% CI: -0.3388, -0.1150; a×b = -0.1998, BCa 95% CI: -0.3307, -0.0980), and self-efficacy (a×b = -0.0916, BCa 95% CI: 0.0048, 0.11629; a×b = 0.1352, BCa 95% CI: 0.0336, 0.2117) significantly mediated the association between life satisfaction and depressive and anxiety symptoms. LIMITATIONS: This was a cross-sectional study, and causal relationships between the variables could not be ascertained. Self-reported questionnaire instruments were used for data collection, which may have recall bias. CONCLUSIONS: Life satisfaction and PsyCap can be used as positive resources to reduce depressive and anxiety symptoms among third-year Chinese medical students during the COVID-19 pandemic. Psychological capital and its components (self-efficacy, resilience, and optimism) partially mediated the relationship between life satisfaction and depressive symptoms, and completely mediated the relationship between life satisfaction and anxiety symptoms. Therefore, improving life satisfaction and investing in psychological capital (especially self-efficacy, resilience, and optimism) should be included in the prevention and treatment of depressive and anxiety symptoms among third-year Chinese medical students. Additional attention is needed to pay for self-efficacy in such disadvantageous contexts.
背景：尽管生活满意度是抑郁和焦虑症状的预测因素，但两者之间的关联机制仍不清楚。本研究旨在探讨积极心理状态心理资本（PsyCap）如何在新冠疫情期间，中介生活满意度与中国医学生抑郁和焦虑症状之间的关系。
方法：在中国三所医科大学进行了一项横断面调查。向 583 名学生匿名发放了一份自我管理问卷。抑郁症状、焦虑症状、生活满意度和心理资本均进行了测量。采用分层线性回归分析探讨生活满意度对抑郁和焦虑症状的影响。采用渐近和重抽样策略检验心理资本如何中介生活满意度与抑郁和焦虑症状之间的关系。
结果：生活满意度与心理资本及其四个组成部分呈正相关。医学生的生活满意度、心理资本、韧性、乐观与抑郁和焦虑症状之间存在显著负相关。自我效能与抑郁和焦虑症状呈负相关。心理资本（a×b=-0.3201，BCa95%CI：-0.3899，-0.2446；a×b=-0.2749，BCa95%CI：-0.3817，-0.1996）、韧性（a×b=-0.2103，BCa95%CI：-0.2727，-0.1580；a×b=-0.1871，BCa95%CI：-0.2520，-0.1414）、乐观（a×b=-0.2100，BCa95%CI：-0.3388，-0.1150；a×b=-0.1998，BCa95%CI：-0.3307，-0.0980）和自我效能（a×b=-0.0916，BCa95%CI：0.0048，0.11629；a×b=0.1352，BCa95%CI：0.0336，0.2117）均显著中介了生活满意度与抑郁和焦虑症状之间的关系。
局限性：这是一项横断面研究，不能确定变量之间的因果关系。数据收集采用自我报告的问卷工具，可能存在回忆偏倚。
结论：生活满意度和心理资本可以作为积极资源，降低新冠疫情期间中国医学生的抑郁和焦虑症状。心理资本及其组成部分（自我效能、韧性和乐观）部分中介了生活满意度与抑郁症状之间的关系，完全中介了生活满意度与焦虑症状之间的关系。因此，提高生活满意度和投资心理资本（尤其是自我效能、韧性和乐观）应被纳入中国医学生抑郁和焦虑症状的预防和治疗中。在这种不利的情况下，应特别关注自我效能。
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