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以患者为中心的教学对医学生对精神病患者的污名化的影响。

The influence of patient-centered teaching on medical students' stigmatization of the mentally ill.

机构信息

Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Düsseldorf, Germany.

Universitätsklinikum Düsseldorf, Centre for Health and Society, Institut für Allgemeinmedizin, Düsseldorf, Germany.

出版信息

GMS J Med Educ. 2023 Jun 15;40(4):Doc46. doi: 10.3205/zma001628. eCollection 2023.

Abstract

AIM

Stigmatization by healthcare workers poses a challenge to providing care to the mentally ill. Bedside teaching during undergraduate medical education offers students an opportunity to directly interact with patients with a range of psychiatric disorders and thereby gather reflective experience. The present study investigates if this . The factors influencing stigmatization were also investigated.

METHOD

This was a prospective, non-randomized, controlled interventional study done in the 2019/20 winter semester involving fourth-year medical students who attended a week-long practical block on psychosomatic medicine (intervention group). This group was compared to students who had attended a week-long practical block with a somatic focus during the same time period (control group). Stigmatization was measured before and immediately upon completion of the week using the MICA-4 scale. Data on age, sex, experience with the mentally ill, interest in psychiatry/psychosomatics, and sense of self-worth were also gathered prior to starting the practical block. Analysis of the sample of 143 students with a complete basic data set was carried out using mixed ANOVA, multiple linear regression and moderator analysis.

RESULTS

In the context of clinical teaching with psychiatric patients, the stigmatization of the mentally ill among medical students decreased significantly more in the intervention group compared to the students in the control group who received instruction on somatic topics (=.019, =.04). In addition, being female, having previous experience with the mentally ill and general interest in the subjects of psychiatry or psychosomatics at T associated with lower stigma. In contrast, stigmatization was increased at the beginning of the study in males and those with low self-esteem. A moderating effect of the factors on stigma reduction was not seen.

CONCLUSION

Undergraduate clinical instruction that enables direct contact and reflective experiences with the mentally ill leads to a reduction in the stigmatizing attitudes held by medical students toward the mentally ill. This underscores the need to have practical clinical instruction using patients.

摘要

目的

医护人员的污名化对精神疾病患者的护理构成挑战。本科医学教育中的床边教学为学生提供了与一系列精神障碍患者直接互动的机会,从而获得反思性经验。本研究旨在调查这种教学方法是否会降低医学生对精神疾病患者的污名化态度。本研究还调查了影响污名化的因素。

方法

这是一项前瞻性、非随机、对照的干预研究,于 2019/20 年冬季学期进行,涉及参加为期一周的身心医学实践课程的四年级医学生(干预组)。将该组与同期参加为期一周的躯体焦点实践课程的学生(对照组)进行比较。使用 MICA-4 量表在一周开始前和结束后立即测量污名化程度。在开始实践课程之前,还收集了年龄、性别、与精神疾病患者的接触经历、对精神病学/身心医学的兴趣以及自我价值感的数据。对 143 名具有完整基本数据集的学生样本进行混合方差分析、多元线性回归和调节分析。

结果

在有精神疾病患者参与的临床教学背景下,与接受躯体主题教学的对照组学生相比,干预组医学生对精神疾病患者的污名化程度显著降低(=.019,=.04)。此外,女性、有先前与精神疾病患者接触的经历以及对精神病学或身心医学主题的普遍兴趣与 T 时的低污名化相关。相反,在研究开始时,男性和自尊心较低的人污名化程度增加。没有观察到这些因素对污名化减少的调节作用。

结论

使医学生能够直接接触和反思精神疾病患者的本科临床教学导致医学生对精神疾病患者的污名化态度降低。这突显了使用患者进行实践临床教学的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5603/10407581/0de82739ce61/JME-40-46-t-001.jpg

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