住院医师规范化培训中医师心理健康状况影响因素与改善对策  

Risk factors and intervention strategy for psychological health problems among residents during residency standardized training

作　　者：刘春晓[1] 吴婧[1] 周洪敏[1] 罗天友[1] 吴忠均[1] 王小文[1] 赵钰琪 LIU Chunxiao;WU Jing;ZHOU Hongmin;LUO Tianyou;WU Zhongjun;WANG Xiaowen;ZHAO Yuqi(The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China)

机构地区：[1]重庆医科大学附属第一医院研究生管理处,重庆400016

出　　处：《中国毕业后医学教育》2017年第1期23-25,29,共4页Chinese Journal of Graduate Medical Education

基　　金：重庆市研究生教改基金资助项目(yjg173088);重庆市研究生教改基金资助项目(yjg153082)

摘　　要：住院医师规范化培训医师(住院医师)兼具临床医师和学员双重角色,在当前医学教育模式以及医疗政策改革的背景下,其心理健康状况不容忽视。主要表现为:强迫症和抑郁症,其主要影响因素有周工作时间、医患关系、培训身份以及自我效能感等。本研究通过对以上影响因素的分析,探究改善心理健康状况的对策,主要措施包括:通过分析住院医师心理健康调查问卷制定个性化改善措施;实施"双导师"制度,通过建立QQ群、微信群等方式加强导师与学员之间的联系;挑选有效上传下达的班干部树立模范标杆形象,并从导师和班干部角度综合学员心理健康状况信息进行分析,制定针对性改善对策;开展人文教育大讲坛、"加强医患沟通,提高病员就医满意度"专题讲座,塑造优秀品质,提升住院医师自身素质和沟通能力,加强住院医师展示自我价值,增强职业幸福感,提高自我效能感得分;下发《住院医师、护士规范化培训学员管理规定(暂行)》,明确了住院医师的义务和权利,规定住院医师除享有国家法定假期外,还享有参加执业医师资格考试、找工作等带薪休假;提高住院医师待遇,为其创造良好的工作、学习及生活条件。Residents as dual roles of doctors and students,their psychological health problems should not be ignored under the current medical education mode and health care policy reform.Psychological health problems of residents during residency standardized training manifested mainly as obsession and depression.The risk factors of psychological health problems include week working time,doctor-patient relationship,training status and self-efficacy.The strategies for improving resident psychological health according to analysis of mental health questionnaires as follows:Implement the dual tutorial system,Enhancing connections between tutors and residents through establishing QQ group,WeChat group et al.Building positive and active image by picking leaders who can reach both superiors and inferiors.Moreover,analyzing students'mental health situations from both tutors'and leaders'perspectives and making pertinent strategies.Conducting special lectures,Shaping excellent qualities,reinforcing residents to exhibit self-value and communicational ability,boosting happiness of occupation,improving scores of self-efficacy,Increasing salaries.Enjoying the right in according with the Regulation of Standardized Training of Residents,Nurses(Temporary),such as have a good studying and working condition for residents and holidays with salaries to take medical license examination and to look for jobs,in addition to have national statutory vacations.

关 键 词：住院医师规范化培训 住院医师 心理健康 

分 类 号：R197.3[医药卫生—卫生事业管理]