内观认知疗法对医学生焦虑水平、自我效能感和应对方式的干预及机制  

Study of the interventions and mechanisms of the Naikan cognitive therapy on anxiety levels,self-efficacy and coping styles of medical students

作　　者：王宇暄 毛富强[1] 彭悦悦 郭子熊 江珊 王书哲 王新琦 WANG Yuxuan;MAO Fuqiang;PENG Yueyue;GUO Zixiong;JIANG Shan;WANG Shuzhe;WANG Xinqi(Department of Psychiatry and Psychology,Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]天津医科大学精神卫生与心理学系,300070

出　　处：《中国健康心理学杂志》2024年第5期781-787,共7页China Journal of Health Psychology

基　　金：天津市高校思想政治教育工作研究基地项目(编号:JJSZZ202307004)。

摘　　要：目的:探究内观认知疗法对医学生焦虑水平、自我效能感和应对方式的影响,并考察医学生内观认知疗法干预、自我效能感、应对方式和焦虑水平间的关系,以期为医学生心理健康教育工作和NCT疗法的作用机制研究提供理论支持。方法:采用随机数字表法将70名符合筛选标准的研究对象随机分配到内观认知疗法组和心理健康教育组,每组35人。内观认知疗法组接受为期7天的内观认知疗法干预,心理健康教育组接受相同时间的常规心理健康教育,最终共68人完成试验(内观认知疗法组34人,心理健康教育组34人)。干预前后使用SAS、GSES、SCSQ量表对两组研究对象进行测评。结果:①干预前,内观认知疗法组与心理健康教育组在焦虑,自我效能感,积极和消极应对方式得分上均不存在显著差异。②干预后,内观认知疗法组焦虑得分显著降低(t=5.835;P<0.01),自我效能感和积极应对方式得分均显著升高(t=2.289,4.668;P<0.05),消极应对方式得分不存在显著差异,干预前后心理健康教育组在上述所有量表得分中均不存在显著差异。③干预后,内观认知疗法组自我效能感和积极应对方式得分显著高于心理健康教育组(t=2.653,3.122;P<0.01),焦虑得分显著低于心理健康组(t=2.562;P<0.05)。④中介效应检验方面,内观认知疗法既可以直接影响医学生焦虑水平(β=-0.293,95%CI=-3.755~0.008),也可以通过自我效能感的中介作用(β=-0.307,95%CI=-0.612~-0.028)、积极应对方式的中介作用(β=0.140,95%CI=-0.293~-0.004)及自我效能感和积极应对方式的链式中介作用(β=0.222,95%CI=-0.553~-0.022)间接影响医学生焦虑水平。结论:内观认知疗法是一种能够有效降低医学生焦虑水平的干预手段,既能直接缓解焦虑,也能通过提高医学生自我效能感水平,改善积极应对方式间接降低医学生焦虑水平。Objective:To investigate the effects of cognitive therapy on anxiety level,self-efficacy and coping styles of medical students,and to examine the relationship between Naikan cognitive therapy intervention,self-efficacy,coping styles and anxiety level of medical students,with a view to providing theoretical support for the work of mental health education for medical students and the research of the mechanism of action of NCT therapy.Methods:Seventy study participants who met the screening criteria were randomly assigned to the Naikan cognitive therapy group and the mental health education group using the random number table method,with 35 participants in each group.The Naikan cognitive therapy group received a 7-day semi-centralized Naikan cognitive therapy intervention,and the mental health education group received regular mental health education for the same period of time,with a total of 68 people eventually completing the trial(34 in the Naikan cognitive therapy group and 34 in the mental health education group).Before and after the intervention,the SAS,GSES,and SCSQ scales were used to measure the study subjects in both groups.Results:①Before the intervention,there were no significant differences in anxiety,self-efficacy,positive coping styles,and negative coping styles scores between the endoscopic cognitive therapy group and the mental health education group.②After the intervention,there was a significant decrease in anxiety scores(t=5.835;P<0.01),a significant increase in self-efficacy,positive coping scores(t=2.289,4.668;P<0.05),and no significant difference in negative coping scores in the Naikan cognitive therapy group,and no significant difference in scores of all the above mentioned scales between the mental health education group before and after the intervention.③After the intervention,the self-efficacy and positive coping style scores of the Naikan cognitive therapy group were significantly higher than those of the mental health education group(t=2.653,3.122;P<0.01),and the anxiety scores wer

关 键 词：内观认知疗法 医学生 焦虑水平 应对方式 自我效能感 

分 类 号：R395.6[哲学宗教—心理学] B844.2[医药卫生—医学心理学]