摘要
目的了解山东地区某大型三级甲等综合医院(以下简称三甲医院)住培医师抑郁自评的整体情况,探究其影响因素,为改善其心理健康状态提供参考,以运动处方、巴林特小组方式进行干预,评价其一般效果。方法采用问卷调查的方式,对某三甲医院住培医师124人进行调查测试,调查量表包括抑郁自评量表(self-rating depression scale,SDS)(以下简称SDS抑郁量表)及自制的一般情况量表,制定运动处方及巴林特小组干预模式,评估干预效果。结果SDS抑郁量表自评粗分均值:(35.59±6.905),标准分均值:(44.60±8.763),两者皆大于中国常模[粗分(33.46±8.55),标准分(41.88±10.57)],P<0.01。共检出抑郁症状者27人(22.67%),其中轻度抑郁症状者22人(18.49%),占抑郁症状者81.48%。单因素χ~2检验显示规培年限(χ~2=7.05,P=0.029)、因公进餐延迟(χ~2=21.458,P=0.0002)、医患沟通(χ~2=4.495,P=0.034)、对医学事业态度自评(χ~2=11.302,P=0.004)为抑郁检出的相关因素。多因素logistic回归分析显示,抑郁症状检出的显著性危险因素为规培年限(P<0.031,OR=2.232,95%CI=1.075~4.633)、因公进餐延迟(P<0.001,OR=3.176,95%CI=1.583~6.373)、对医学事业态度自评(P<0.007,OR=3.348,95%CI=1.392~8.057)。经干预3个月后SDS抑郁量表自评均分较干预前皆有所降低(t_1=5.94,P_1<0.05;t_2=6.29,P_2<0.05)。结论住培医师心理健康状况不容乐观,较社会一般人群存在更高的抑郁倾向,其主要表现为轻度抑郁症状。其危险性因素为规培年限增加、因公误餐频数大、无感甚至厌倦的医学态度、医患沟通障碍,且前三者具有高显著性。通过运动处方及巴林特小组干预可改善其已有抑郁症状,降低抑郁症状检出率。
Objective To study the overall situation of self-evaluation of depression in current medical residents,to explore the relative factors and to provide references to improve the mental health of residents.To observe intervene conditions by the exercise prescription and Balint Group service and evaluate their effects.Methods 124 medical residents of a large comprehensive hospital in Shandong Province were tested by the way of questionnaire survey,The survey scale included Selfrating scale(SDS)and self-made general scale,making service with exercise prescription and Balint Group.The intervention effect was evaluated.Results The average total score of SDS among the 124 residents was(35.59±6.905),the average standard score was(44.60±8.763),both were higher than the norm[(33.46±8.55),(41.88±10.57)]in china(P<0.001).27 residents showed depression symptoms(P=22.67%),22(P=18.49%)with light depression,occupied 81.48%in the 27 residents.Theχ2analysis showed that the years of residents worked(χ2=7.05,P=0.029),eating delay because of heave work(χ2=21.458,P=0.0002),doctor-patient communication(χ2=4.495,P=0.034),attitude to medical business(χ2=11.302P,=0.004)were the related risks.Logistic analysis showed the notable risk factors to depression were the years of residents worked(P<0.031,OR=2.232,95%CI=1.075,4.633),eating delay because of heave work(P<0.001,OR=3.176,95%CI=1.583,6.373),attitude to medical business(P<0.007,OR=3.348,95%CI=1.392,8.057).After the intervention,each average total score was significantly lower than those before the intervene(t1=5.94,P1<0.05;t2=6.29,P2<0.05).Conclusion The mental health status of the medical residents is not optimistic.Compared with the general population in society,they have higher depression,which mainly focus on light depression.The risk factors include the increase of working years,high frequency of meal delay because of heavy work and pessimistic medical attitude,doctor-patient communication obstacles.The first three were the notable risk factors.It can improve the existing depression symptoms and reduce the detection rate of depressive symptoms through the exercise prescription intervention and new Balint Group intervention.
作者
仇跃
李培杰
宋洁
丁磊
尤艺
章政
CHOU Yue;LI Pei-jie;SONG Jie;DING Lei;YOU Yi;ZHANG Zheng(Department of General Practice,The Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Medical Education,Qingdao Municipal Hospital,Qingdao 266000,China;Department of Health Care,The Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Medical Office,The Affiliated Hospital of Qingdao University,Qingdao 266000,China)
出处
《中国全科医学》
CAS
北大核心
2017年第B12期479-482,共4页
Chinese General Practice
