目的 探索五年制临床医学专业学生在实习期间的心理压力及其特点,为促进医学生心理健康、制定科学临床实习方案提供参考。方法 选取中山大学2016级和2017级参加实习的318名五年制临床医学专业学生为研究对象,了解其一般情况和实习期间心理压力,并采用t检验、方差分析、SNK-q检验和χ²检验分析组间差异。结果 临床医学专业本科生实习期间心理压力的评分为(3.00±1.02)分,临床实习压力、自我发展与择业压力、生活压力和社交压力4个维度的评分分别为(2.68±0.74)分、(2.57±0.82)分、(2.52±0.79)分和(2.11±0.74)分,且维度之间评分差异具有统计学意义(P＜0.001)。农村户籍学生总压力感评分高于城镇户籍学生,其评分分别为(2.62±0.74)分和(2.45±0.71)分;家庭经济紧张医学生总压力感评分高于宽裕医学生,其评分分别为(2.73±0.76)分和(2.01±0.66)分;性格内向医学生总压力感评分高于性格开朗医学生,其评分分别为(2.80±0.84)分和(2.34±0.71)分;其差异均具有统计学意义(均P＜0.05)。结论 临床医学专业本科生在实习期间面临实习本身、社交、生活、自我发展与择业等各方面压力,且受家庭经济、户籍、性格等因素影响。医学教育工作者应当关注学生在实习期间的心理问题,制定更为科学合理的实习方案,以减少学生心理压力。

Objective To explore the characteristics of psychological stress of students from five-year program in clinical practice, so as to provide reference basis for promoting medical students' mental health and formulating scientific clinical practice plan. Methods Totally 318 students from five-year program of Sun Yat-sen University enrolled in 2016 and 2017 were selected as research objects,and the questionnaire for investigating general situation and the scale of psychological stress during clinical practice were used to carry out the survey. The difference between groups was analyzed by t-test, analysis of variance, snk-q test and χ² test. Results The score of psychological stress during clinical practice was (3.00±1.02). The scores of stress during clinical practice, stress on self-development and career choice, personal life and social activity were (2.68±0.74),(2.57±0.82),(2.52±0.79) and (2.11±0.74) respectively. The score difference among the dimensions was statistically significant (P<0.001). The students from rural area had higher scores of total stress (2.62+0.74) than those from urban areas (2.45+0.71). The total stress score of medical students with family economic stress (2.73±0.76) was higher than that of medical students with well-off(2.01±0.66). The total stress score of introverted medical students was higher than that of cheerful medical students with the scores as (2.80±0.84) and (2.34±0.71) respectively. The differences were statistically significant (all P<0.05). Conclusions Clinical undergraduates are faced with the pressure from clinical practice, social life, self-development and career selection during clinical practice, and influenced by family economics, registered residence and personality. Medical educators should pay attention to their psychological pressure and influencing factors, and to formulate scientific clinical practice to reduce their psychological pressure.