中华医学教育杂志 ›› 2026, Vol. 46 ›› Issue (10): 736-742.DOI: 10.3760/cma.j.cn115259-20251119-01486

• 心理健康教育 • 上一篇    下一篇

突发公共卫生事件视域下住院医师工作适应性与学习需求的回顾性研究

杨纨1, 杨蕊1, 张春妤1, 谷士贤2, 王冠2, 李蓉1   

  1. 1北京大学第三医院妇产科,北京 100191;
    2北京大学第三医院教育处,北京 100191
  • 收稿日期:2025-11-19 出版日期:2026-10-01 发布日期:2026-09-30
  • 通讯作者: 杨蕊, Email: yrjeff@126.com
  • 基金资助:
    北京大学医学部教学改革课题(2023YB40)

A retrospective study on work adaptation and learning needs of resident physicians in the context of public health emergencies

Yang Wan1, Yang Rui1, Zhang Chunyu1, Gu Shixian2, Wang Guan2, Li Rong1   

  1. 1Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China;
    2Department of Education, Peking University Third Hospital, Beijing 100191, China
  • Received:2025-11-19 Online:2026-10-01 Published:2026-09-30
  • Contact: Yang Rui, Email: yrjeff@126.com
  • Supported by:
    Teaching Reform Project of Peking University Health Science Center (2023YB40)

摘要: 目的 在突发公共卫生事件中,住院医师面临巨大的身心挑战。本研究通过系统分析应急状态转换期住院医师的工作适应特征与学习需求变化,旨在为构建有助于提升该群体心理健康水平与应急反应能力的支持体系提供依据。方法 以2022年12月新型冠状病毒感染防控政策调整为切入点,采用问卷调查方法,一次性收集突发公共卫生事件早期(严格防控期间,2019年12月—2022年11月)与转换期(应对模式转换期,2022年12月)两个阶段住院医师的工作适应性与学习需求信息。通过滚雪球抽样法,共回收来自18个省、自治区、直辖市的213份有效问卷,采用卡方检验和多因素Logistic回归进行统计分析。结果 转换期住院医师自评“可调适心理压力”的比例较早期上升[67.1%(143/213)比46.9%(100/213),P<0.001],但抑郁倾向未呈现同步加剧。性别差异分析显示,在转换期,男性住院医师的抑郁倾向检出率高于女性[33.3%(30/90)比17.1%(21/123),P=0.006]。多因素logistic回归分析表明,男性(OR=2.585,95%CI:1.099~6.084,P=0.030)、较长工时(11~12小时/天:OR=4.594,P=0.033;13~14小时/天:OR=4.359,P=0.034;>14小时/天:OR=4.952,P=0.033)、科研时间不足(OR=3.479,95%CI:1.477~8.192,P=0.004)是抑郁风险的独立危险因素;有导师指导(OR=0.326,95%CI:0.123~0.865,P=0.024)是研究生/博士后群体的独立保护因素。结论 突发公共卫生事件应对模式转换期,住院医师群体虽然普遍经历压力剧增,但男性住院医师的抑郁风险高于女性。男性医师、超长工作时间、低科研时间投入人群是抑郁高危亚群,而导师指导机制可以显著缓冲心理风险的影响。建议将导师指导策略纳入住院医师规范化管理体系,以提升住院医师的应急心理韧性。

关键词: 问卷调查, 公共卫生, 住院医师, 心理健康, 导师制

Abstract: Objective During public health emergencies, resident physicians face enormous physical and mental challenges. This study aims to systematically analyze the changes in work adaptation characteristics and learning needs of resident physicians during the transitional period of emergency response, so as to provide empirical evidence for building a support system that promotes their mental health and enhances their emergency response capacity. Methods Taking the adjustment of COVID-19 prevention and control policies in December 2022 as a starting point, an questionnaire survey was conducted to retrospectively collect data on the work adaptation and learning needs of resident physicians at two time points: the early stage (strict prevention and control period, December 2019-November 2022) and the transition period (policy adjustment period, December 2022). Using snowball sampling, a total of 213 valid responses were collected from 18 provinces, autonomous regions, and municipalities across China. Statistical analyses included chi-square tests and multivariate logistic regression. Results The proportion of resident physicians who reported ″adjustable psychological stress″ increased significantly during the transition period compared with the early stage [67.1% (143/213) vs. 46.9% (100/213), P<0.001], but depressive tendency did not show a concomitant increase. Gender difference analysis revealed that during the transition period, the detection rate of depressive tendency was significantly higher in male than in female resident physicians [33.3% (30/90) vs. 17.1% (21/123), P=0.006]. Multivariate logistic regression analysis indicated that male gender (OR=2.585, 95%CI: 1.099-6.084, P=0.030), longer working hours (11-12 h/d: OR=4.594, P=0.033;13-14 h/d: OR=4.359, P=0.034; >14 h/d: OR=4.952, P=0.033), and insufficient research time (OR=3.479,95%CI:1.477-8.192, P=0.004) were independent risk factors for depressive tendency, whereas having a mentor′s guidance (OR=0.326, 95%CI:0.123-0.865,P=0.024) was an independent protective factor for the postgraduate/postdoctoral cohort. Conclusions During the transition period of public health emergency response, resident physicians universally experienced a sharp increase in stress, yet the risk of depression was higher in males than in females. Male physicians, those with extremely long working hours, and those with low research time input are associated with higher risk for depression, while mentor guidance can significantly buffer psychological risk. It is recommended that mentor-guided strategies be incorporated into the standardized residency management system to enhance the psychological resilience of resident physicians in emergencies.

Key words: Questionnaires, Public health, Resident physicians, Psychological well-being, Mentor guidance

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