生态系统理论下医学生心理健康状况影响因素分析  

Factors influencing mental health of medical students based on an ecological systems theory perspective

作　　者：许晨晨 吴若脩 王瓅珠 李墨萱 张志豪 XU Chenchen;WU Ruoxiu;WANG Lizhu;LI Moxuan;ZHANG Zhihao(The Fourth School of Clinical Medicine,Nanjing Medical University,Nanjing(211166),Jiangsu Province,China;不详)

机构地区：[1]南京医科大学第四临床医学院,江苏211166 [2]南京医科大学医政学院 [3]南京医科大学药学院 [4]中国科学院生物物理研究所

出　　处：《中国学校卫生》2025年第3期402-405,411,共5页Chinese Journal of School Health

基　　金：江苏省高校哲学社会科学专题研究项目思想政治工作专项项目(2023SJSZ0132);江苏省大学生创新创业训练计划重点项目(202410312007Z);南京医科大学2023年度教育研究课题(2023LX002)。

摘　　要：目的基于生态系统理论分析医学院校学生心理健康状况的影响因素,为构建医学生心理健康保障体系提供参考。方法2024年6月,采用问卷调查和专家访谈法,对中国东部地区19所不同类型医科院校采用分层整群随机抽取方法抽取1760名学生进行调查,通过描述性统计、交叉分析、分层线性回归分析、构建结构方程模型等方法进行统计学分析。结果医学院校学生对学校满意度较高(65.85%)、社会领悟支持较强(57.16%),有较高的抑郁水平(44.89%),但人际交往正常(91.14%)。分层线性回归分析显示,社会领悟支持得分高(β=-11.40)、对学校满意(β=-4.85)以及污名化求助得分低(β=9.31)均对医学生心理健康状态产生积极作用(P值均<0.05)。结构方程模型分析显示,社会领悟支持和自我污名化情况对医学生抑郁程度(β值分别为-0.32,-0.53)和人际关系敏感度(β值分别为-0.31,0.58)有显著影响(P值均<0.01)。通过专家访谈可知,学校与家庭、高校、社会三方联动具有积极意义。结论社会领悟支持和自我污名化情况对医学生的心理健康状况有着显著影响。家庭、高校、社会三方联动有助于改善医学生心理健康状况。Objective To analyze factors impacting mental health status of medical students based on ecological systems theory,so as to provide reference for the mental health promotion system for medical students.Methods In June 2024,1760 medical school students randomly selected from 19 different kinds of medical colleges in eastern China by stratified cluster were surveyed using questionnaires and expert interviews.Descriptive statistics,cross-analysis,hierarchical linear regression analysis,structural equation models were used for data analysis.Results Medical school students had higher satisfaction with the school(65.85%)and a great sense of perceived social support(57.16%).Furthermore,91.14%of the students had normal interpersonal relationships.However,44.89%reported that their mental health was impacted by high level of depression.The hierarchical linear regression analysis showed that the mental health outcomes of the medical students were positively predicted by higher perceived social support scores(β=-11.40),institutional satisfaction(β=-4.85),and lower help-seeking stigma scores(β=9.31)(P<0.05).The structural equation modeling showed that the status of both perceived social support and self-help-seeking stigma had significant impacts on depression severity(β=-0.32,-0.53)and interpersonal relationship sensitivity(β=-0.31,0.58)among medical students(P<0.01).Through expert interviews,collaborations between the school and the tripartite organization(families,universities and society)was of growing importance.Conclusions Perceived social support and self-stigma have a significant impact on the mental health status of medical students.The problem of self-stigma of medical students should be paid attention to.Therefore,families,universities and society should work together to improve the mental health of medical students.

关 键 词：精神卫生 回归分析 模型 结构 学生 

分 类 号：R179[医药卫生—妇幼卫生保健] G444[医药卫生—公共卫生与预防医学] R193[哲学宗教—心理学]