摘要:

目的了解臨床醫(yī)學研究生心理壓力來源及影響因素，為研究生心理健康教育提供支持依據(jù)。

方法采用自行設計的研究生心理壓力調(diào)查問卷，對462名臨床醫(yī)學研究生心理壓力現(xiàn)狀及影響因素進行調(diào)查分析。

結(jié)果462名醫(yī)學研究生中，有壓力感知的311人(67.32%)。居住地為城鎮(zhèn)的醫(yī)學研究生壓力感知高于農(nóng)村和城市(P < 0.05)，博二及以上年級有壓力人數(shù)高于博一(P < 0.05)。研究生壓力源由高到低依次為學習、環(huán)境、就業(yè)、經(jīng)濟、情感因素。有壓力感知的311名醫(yī)學研究生中，感受壓力持續(xù)時間 < 6個月(短期)230人(73.95%)，≥6個月(長期)81人(26.05%)。性別和壓力源中學習、就業(yè)、情感和經(jīng)濟因素為壓力感知時間的影響因素(P < 0.05~P < 0.01)。女生較男生更容易產(chǎn)生長期壓力，壓力源中情感和經(jīng)濟因素會增加長期壓力的風險(P < 0.05~P < 0.01)。

結(jié)論醫(yī)學研究生壓力感知率較高，居住地和年級是壓力感知的影響因素，性別、壓力源中情感和經(jīng)濟因素是壓力持續(xù)時間的影響因素。教學管理部門應關(guān)注高年級和居住地為城鎮(zhèn)的學生，注重升學、就業(yè)等壓力易發(fā)生的時段，給予學生有針對性的心理輔導，導師及專職班主任共同配合，引導醫(yī)學研究生積極應對工作與學習中的壓力。

Abstract:

ObjectiveTo understand the sources and influencing factors of psychological stress among clinical medical graduate students, and provide support for graduate students' mental health education.

MethodsA self-designed Graduate Psychological Stress Survey Questionnaire was used to investigate and analyze the current status and influencing factors of psychological stress among 462 clinical medical graduate students.

ResultsAmong the 462 medical graduate students, 311 students (67.32%) had stress perception.Medical graduate students who resided in cities and towns had a higher perception of stress than those in rural areas and cities (P < 0.05), and the number of people with stress in the second year and above of doctoral program was higher than that in the first year of doctoral program (P < 0.05).The sources of stress from high to low were as follows: learning, environment, employment, economy, and emotion factors.Among the 311 medical graduate students with stress perception, 230 students (73.95%) felt stress for less than 6 months (short-term) and 81 students (26.05%) felt stress for more than 6 months (long-term).Gender and stress sources including learning, employment, emotion, and economy factors were the influencing factors of perceived stress time (P < 0.05 to P < 0.01).Female students were more prone to long-term stress than male students, and emotion and economy factors of stress sources increased the risk of long-term stress (P < 0.05 to P < 0.01).

ConclusionsThe stress perception rate of medical graduates is relatively high, residence and grade are the influencing factors of stress perception, and gender, emotion and economy factors of stress sources are the influencing factors for the duration of stress.Teaching management departments should pay attention to students in senior grades and those who live in cities and towns, and also to the time periods when pressure is prone to occur such as entering higher education and employment, provide targeted psychological counseling to students, and cooperate with tutors and full-time head teachers to guide medical graduate students in handling the pressures and challenges of work and study actively.

表  1   研究生心理壓力相關(guān)因素分析[n；百分率(%)]

項目 n 有壓力 無壓力 χ2 P 院校   A校 118 81(68.64) 37(31.36)   B校 158 104(65.82)) 54(34.18) 0.96 >0.05   C校 116 76(65.52) 40(34.48)   D校 70 50(66.67) 20(33.33) 專業(yè)   專業(yè)學位 344 230(66.86) 114(33.14) 0.13 >0.05   科學學位 118 81(68.64) 37(31.36) 性別   男 228 151(66.23) 77(33.77) 0.24 >0.05   女 234 160(68.38) 74(31.62) 是否為獨生子女   是 185 121(65.41) 64(34.59) 0.51 >0.05   否 277 190(68.59) 87(31.41) 家庭居住地   城市 162 101(62.35) 61(37.65)6.19 < 0.05   城鎮(zhèn) 111 85(76.58) 26(23.42)   農(nóng)村 189 126(66.67) 63(33.33) 學歷層次   碩士生 408 272(66.67) 136(33.33) 0.67 >0.05   博士生 54 39(72.22) 15(27.78) 碩士年級   研一 205 131(63.90) 74(36.10)1.85 >0.05   研二 114 77(67.54) 37(32.46)   研三 89 64(71.91) 25(28.09) 博士年級   博一 27 16(59.26) 11(40.74) 4.66 < 0.05   博二及以上 27 23(85.19) 4(14.81)

表  2   醫(yī)學研究生心理壓力持續(xù)時間相關(guān)因素分析[n；百分率(%)]

項目 n 壓力持續(xù)時間短 壓力持續(xù)時間長 χ2 P 獨生子女   是 121 86(71.07) 35(28.93) 0.85 >0.05   否 190 144(75.79) 46(24.21) 家庭居住地   城市 101 75(74.26) 26(25.74)0.42 >0.05   城鎮(zhèn) 84 64(76.19) 20(23.81)   農(nóng)村 126 91(72.22) 35(27.78) 性別   男 151 102(67.54) 49(32.45) 6.25 < 0.05   女 160 128(80.00) 32(20.00) 環(huán)境因素   是 237 171(72.15) 66(27.85) 2.19 >0.05   否 74 59(79.73) 15(20.27) 學習因素   是 257 182(70.82) 75(29.18) 7.56 < 0.01   否 54 48(88.89) 6(11.11) 就業(yè)因素   是 193 135(69.95) 58(30.05) 4.24 < 0.05   否 118 95(80.51) 23(19.49) 情感因素   是 106 65(61.32) 41(38.68) 13.33 < 0.01   否 205 165(80.49) 40(19.51) 經(jīng)濟因素   是 147 90(61.22) 57(38.78) 23.46 < 0.01   否 164 140(85.37) 524(14.63)

表  3   醫(yī)學研究生壓力持續(xù)時間多因素logistic回歸分析

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