规范化培训住院医师心理健康现状及影响因素分析

doi:10.3760/cma.j.issn.1673-677X.2018.05.013

中华医学教育杂志 ›› 2018, Vol. 38 ›› Issue (5): 694-698.DOI: 10.3760/cma.j.issn.1673-677X.2018.05.013

规范化培训住院医师心理健康现状及影响因素分析

张磊, 吴皓, 堵明辉, 王筝扬

310000杭州,浙江大学医学院附属邵逸夫医院精神卫生科

收稿日期:2018-04-03 出版日期:2018-10-01 发布日期:2020-12-09
通讯作者: 张磊, Email: 3311007@zju.edu.cn
基金资助:
浙江省自然科学基金青年基金项目(LQ16H090001)

The current situation of mental health in standardized training residents and impact factors analysis

Zhang Lei, Wu Hao, Du Minghui, Wang Zhengyang

Psychiatry Department,Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China

Received:2018-04-03 Online:2018-10-01 Published:2020-12-09
Contact: Zhang Lei, Email: 3311007@zju.edu.cn
Supported by:
Zhejiang Provincial Natural Science Foundation of China Under Grant(LQ16H090001)

摘要/Abstract

摘要： 目的通过了解规范化培训住院医师存在的心理问题、影响因素,探讨改善其心理健康的措施。方法选择在浙江大学医学院附属邵逸夫医院参加规范化培训的244名住院医师(以下简称规培医师)为研究对象,采用问卷调查的形式了解规培医师存在的心理问题,按照每个选项的百分比进行数据的分析。结果 56.6%(138/244)的规培医师经常或一直感到压力,31.6%(77/244)的规培医师心理健康状况不佳。规培医师心理健康主要影响因素包括学习工作压力、经济收入低、对积极心理调节和异常心理识别等心理健康知识的了解不够等。结论通过缓解规培医师学习工作压力、提高他们的收入、培养基于实践学习的能力、增加其对心理健康知识的了解、支持性心理干预活动等措施,可以改善规培医师心理健康不佳的状况。

关键词: 规范化培训, 住院医师, 心理健康, 影响因素, 分析

Abstract: Objective To explore measures to improve mental health in standardized training residents, analyzing the problems and impact factors of them. Methods The residents in Sir Run Run Shaw Hospital were selected as the research object. Through questionnaire, the paper explored the problems of mental health, and the data from the investigation were analyzed. Results 56.6%(138/244)of the residents felt great pressure, 31.6%(77/244)of the residents' mental health was not optimal. Work load, income and mental health knowledge understanding level were the main factors influencing the residents' mental health. Conclusions Lessening the working pressure, increasing the income, cultivating the practice-based learning ability, mental health education and supportive psychological intervention were the main measures to improve the mental health in standardized training residents.

Key words: Standardized training, Residents, Mental health, Impact factors, Analysis

张磊, 吴皓, 堵明辉, 王筝扬. 规范化培训住院医师心理健康现状及影响因素分析[J]. 中华医学教育杂志, 2018, 38(5): 694-698.

Zhang Lei, Wu Hao, Du Minghui, Wang Zhengyang. The current situation of mental health in standardized training residents and impact factors analysis[J]. Chinese Journal of Medical Education, 2018, 38(5): 694-698.

参考文献

[1] 沈奕帆,何玉霞,简榕,等. 某三级甲等医院住院医师规范化培训学员心理健康状况及影响因素研究[J]. 华西医学,2017(1):112-116.DOI: 10.7507/1002-0179.201511001.
Shen YF, He YX, Jian R, Mental health status and influencing factors of resident standardized trainees in a first class of the third grade hospital[J]. West China Medical Journal, 2017(1):112-116. DOI: 10.7507/1002-0179.201511001.
[2] 石崧,周莹,刘菲,等. 重视规范化培训中住院医师心理问题[J]. 继续医学教育,2012,26(7): 14-15.DOI: 10.3969/j.issn.1004-6763.2012.07.004.
[3] 谢海鲲,王志锋,李宁燕,等. 全科医生职业压力应对方式与身心健康的关联研究[J]. 职业与健康,2017,33(4):456-460. DOI:10.13329/j.cnki.zyyjk.2017.0139.
Xie HK, Wang ZF, Li NY. Relationship among vocational stress, coping style, and physical and mental health of general practitioners[J]. Occupation and Health, 2017,33(4):456-460. DOI:10.13329/j.cnki.zyyjk.2017.0139.
[4] Ogrinc G, Headrick LA, Mutha S, et al. A framework for teaching medical students and residents about practice-based learning and improvement, synthesized from a literature review[J]. Acad Med,2003,78(7):748-756.
[5] Ayas NT, Barger LK, Cade BE, et al. Extended work duration and the risk of self-reported percutaneous injuries in interns[J]. JAMA,2006,296(9):1055-1062. DOI: 10.1001/jama.296.9.1055.
[6] Barger LK, Cade BE, Ayas NT, et al. Extended work shifts and the risk of motor vehicle crashes among interns[J]. N Engl J Med,2005,352(2):125-134. DOI: 10.1056/NEJMoa041401.
[7] Landrigan CP, Rothschild JM, Cronin JW, et al. Effect of reducing interns' work hours on serious medical errors in intensive care units[J]. N Engl J Med,2004,351(18):1838-1848. DOI: 10.1056/NEJMoa041406.
[8] Barger LK, Ayas NT, Cade BE, et al. Impact of extended-duration shifts on medical errors, adverse events, and attentional failures[J]. PLoS Med,2006,3(12):e487. DOI: 10.1371/journal.pmed.0030487.
[9] Philibert I, Friedmann P, Williams WT. New requirements for resident duty hours[J]. JAMA,2002,288(9):1112-1114. DOI: 10.1001/jama.288.9.1112.
[10] Meltzer DO, Arora VM. Evaluating resident duty hour reforms: More work to do[J]. JAMA,2007,298(9):1055-1057. DOI: 10.1001/jama.298.9.1055.
[11] Thanarajasingam U, Mcdonald FS, Halvorsen AJ, et al. Service census caps and unit-based admissions: Resident workload, conference attendance, duty hour compliance, and patient safety[J]. Mayo Clin Proc,2012,87(4):320-327. DOI: 10.1016/j.mayocp.2011.12.012.
[12] Block L, Habicht R, Wu AW, et al. In the wake of the 2003 and 2011 duty hours regulations, how do internal medicine interns spend their time [J] ? J Gen Intern Med,2013,28(8):1042-1047. DOI: 10.1007/s11606-013-2376-6.
[13] 周跃萍,周莲英. 不同职业人员工作压力源及压力反应的比较研究[J]. 心理学探新,2004,24(1):63-65,69.
Zhou YP, Zhou LY. Comparative study on the job and life stressors and response[J]. Psychological Exploration,2004,24(1):63-65,69.
[14] 董霏,罗园园. 医师心理健康状况与应对方式的初步研究[J]. 职业与健康,2006,22(3):161-165. DOI: 10.13329/j.cnki.zyyjk.2006.03.001.
Dong F, Luo YY. Preliminary research on the psychological health of the doctors and relevant countermeasures[J].Occupatiom and Health,2006,22(3):161-165. DOI: 10.13329/j.cnki.zyyjk.2006.03.001.
[15] Glass DC, Mcknight JD, Valdimarsdottir H. Depression, burnout, and perceptions of control in hospital nurses[J]. J Consult Clin Psychol,1993,61(1):147-155.
[16] 黄蕾,何文娟,汪浩,等. 巴林特小组在住培医师规范化培训中的探索与实践[J]. 上海医药,2017,38(22):3-6. DOI: 10.3969/j.issn.1006-1533.2017.22.002.
Huang L, He WJ, Wang H, et al.Exploration and practice of Balint group in the standardized training of resident doctors[J]. Shanghai Medical & Pharmaceutical Journal,2017,38(22):3-6. DOI: 10.3969/j.issn.1006-1533.2017.22.002.
[17] Martelli MF, Auerbach SM, Alexander J, et al. Stress management in the health care setting: Matching interventions with patient coping styles[J]. J Consult Clin Psychol,1987,55(2):201-207.

规范化培训住院医师心理健康现状及影响因素分析

The current situation of mental health in standardized training residents and impact factors analysis

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