麻醉学规范化培训住院医师心理健康状况及其影响因素分析  

Analysis of the factors influencing the mental health status of anesthesiology residents during standardized training

作　　者：陶涛[1] 刘艳 李媛[3] 章扬 牛雪芹 王鹏鹏[6] Tao Tao;Liu Yan;Li Yuan;Zhang Yang;Niu Xueqin;Wang Pengpeng(Department of Anesthesiology,The Second Affiliated Hospital of Harbin Medical University,Harbin230103,China;Department of Anesthesiology,Zhuhai People's Hospital Medical Group,Zhuhai440402,China;Department of Anesthesiology,The First Affiliated Hospital of Hainan Medical University,Haikou460106,China;Department of Anesthesiology,The First Affiliated Hospital of Nanchang University,Nanchang360102,China;Department of Psychiatry,The Fourth Affiliated Hospital of Harbin Medical University,Harbin230103,China;Department of Continuing Education,The Second Affiliated Hospital of Harbin Medical University,Harbin230103,China)

机构地区：[1]哈尔滨医科大学附属第二医院麻醉科,哈尔滨230103 [2]珠海市人民医院麻醉科,珠海440402 [3]海南医学院第一附属医院麻醉科,海口460106 [4]南昌大学附属第一医院麻醉科,南昌360102 [5]哈尔滨医科大学附属第四医院精神科,哈尔滨230103 [6]哈尔滨医科大学附属第二医院继续教育部,哈尔滨230103

出　　处：《中华医学教育探索杂志》2024年第11期1572-1578,共7页Chinese Journal of Medical Education Research

摘　　要：目的了解麻醉科住院医师规范化培训住院医师心理健康状况并对其产生原因进行挖掘,旨在提高规范化培训管理人员对住院医师心理健康的关注及掌握情况。方法选取哈尔滨医科大学附属第二医院等10个麻醉学规范化培训基地麻醉科全体在岗住院医师作为对象,发放自设问卷[内容包括一般资料调查表、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、疲劳严重程度量表(fatigue severity scale,FSS)和睡眠状况自评量表(self-rating scale of sleep,SRSS)]对心理状态及压力来源进行调查。根据问卷结果目的性、异质性地抽取哈尔滨医科大学附属第二医院麻醉科住院医师作为访谈对象,进行"一对一"的半结构化深度访谈,以了解诱发情绪或心理问题的主要生活事件及其与规范化培训或专业之间的联系,掌握麻醉科住院医师希望得到的帮助及其对规范化培训方案的建议。采用GraphPad Prism 9.0进行卡方检验、t检验和单因素方差分析;应用数据分析软件(NVivo12)对访谈内容编码、分类;采用Colaizzi七步分析法对资料进行分析并提炼访谈主题。结果共回收有效问卷157例,有效问卷回收率100.00%。麻醉学住院医师焦虑、抑郁、疲劳严重程度和睡眠状况平均得分分别为(50.60±14.16)、(56.31±12.90)、(44.49±13.88)、(27.78±9.40),全部达到轻度诊断标准;分别有16例(10.19%)、18例(11.46%)、47例(29.94%)和19例(12.10%)住院医师达到重度诊断标准。与一年级住院医师相比,三年级住院医师的焦虑[(54.24±13.83)分vs.(47.02±12.04)分,P=0.030]、抑郁[(59.66±12.74)分vs.(51.53±10.76)分,P=0.005]评分增高。最终对24名住院医师进行半结构化访谈。提炼出3个主题:与培训基地相关的心理压力、与个人问题相关的心理压力、未来职业相关心理压力。结论麻醉学规范化培训住院医师心理问题阳性率较高,与工作ObjectiveTo assess the mental health status of anesthesiology residents and identify its influencing factors during standardized training,and to enhance the attention and understanding of standardized training management personnel regarding the mental health of residents.MethodsAll on-duty residents in the anesthesiology departments of ten standardized anesthesiology training bases,including The Second Affiliated Hospital of Harbin Medical University,were selected as subjects.Self-designed questionnaires were distributed,which included a general information survey,the Self-Rating Anxiety Scale(SAS),the Self-Rating Depression Scale(SDS),the Fatigue Severity Scale(FSS),and the Self-Rating Scale of Sleep(SRSS),to investigate the psychological state and sources of stress.Based on the questionnaire results,residents from the Department of Anesthesiology at The Second Affiliated Hospital of Harbin Medical University were purposively and heterogeneously selected as interviewees.One-on-one semi-structured in-depth interviews were conducted to understand the major life events that triggered emotional or psychological issues and their connections with standardized training or the profession.This survey also aimed to understand the support that anesthesiology residents hoped to receive and their suggestions for the standardized training program.The chi-square test,t-test,and one-way analysis of variance were performed using Graphpad Prism 9.0.Interview content was coded and categorized using data analysis software NVivo12.The Colaizzi's seven-step method was used to analyze the data and extract interview themes.ResultsA total of 157 valid questionnaires were recovered,with a response rate of 100.00%.The mean scores of SAS,SDS,FSS,and SRSS were(50.60±14.16),(56.31±12.90),(44.49±13.88),and(27.78±9.40),respectively,all meeting the diagnostic criteria for mild conditions.Of them,16(10.19%),18(11.46%),47(29.94%),and 19(12.10%)residents met the diagnostic criteria for severe conditions.Compared with Grade 1 residents,Grade 3

关 键 词：住院医师规范化培训 心理健康 麻醉医师 现况调查 

分 类 号：R-05[医药卫生]