医学生常见压力源及应对方式调查分析

目的：考察医学院大学生常见压力源及应对方式的年级间差异,为开展医学院大学生心理健康教育提供依据。方法：采用横断面研究,通过问卷对石河子大学的1000名在校医学大学生进行测括。结果：医学生在学业和经济方面压力较大,前途和学业方面压力年级间的差异有统计学意义;积极应对方式高工消极应对,消极应对方式年级间的差异有统计学意义。结论：高校教育针对这一现象,应注重医学生的心理教育。根据各年级所面临的具体压力,分阶段有针对性地采取有效措施,使医学生能采用积极成熟的方式应对压力。     

“双轨合一” 培训模式下住院医师的抑郁症状和知觉压力

目的： 专业型硕士研究生培养与住院医师规范化培训并轨(以下简称“双轨合一”)是我国医学教育的重 大改革,本研究旨在调查“双轨合一”模式下参与住院医师规范化培训的专业型研究生和从社会招录的规范化培训 住院医师(以下简称社会规培生)的抑郁症状及知觉压力情况,并探讨抑郁症状与知觉压力之间的关系。方法： 选取 湖南某三甲医院住院医师规范化培训医师330 例(其中专业型研究生235 名和社会规培生95 名),使用中文版知觉压力 量表(Chinese Perceived Stress Scale,CPSS)和抑郁自评量表(Self-Rating Depression Scale,SDS)分别评估和对比专业 型研究生和社会规培生的知觉压力及抑郁症状情况。采用Pearson 相关分析探究专业型研究生和社会规培生抑郁症状 与知觉压力的相关性,比较二者的压力来源。结果： 在被调查的235 名专业型研究生中,148 名(63.0%)存在抑郁症 状,162 名(68.9%)知觉压力升高,主要压力为学业压力、科研压力和就业压力。在95 名社会规培生中,52 名(54.7%) 存在抑郁症状,58 名(61.1%)知觉压力升高,主要压力为经济压力、就业压力和学业压力。专业型研究生抑郁症状评 分与知觉压力评分均较社会规培生显著增加(分别t=2.110,P=0.036;t=2.810,P=0.005)。不同性别间住院医师的 CPSS 和SDS得分差异无统计学意义(分别t=−0.968,P=0.334;t=0.462,P=0.644)。抑郁症状与知觉压力之间存在显 著正相关(r=0.854,P<0.001)。结论： 住院医师(包括专业型研究生和社会规培生)存在抑郁症状与较高的知觉压力水 平,两者呈正相关。在“双轨合一”的培训模式下,专业型研究生抑郁症状与知觉压力水平均高于社会规培生。     

北京大学临床医学生心理压力现状及对策研究

通过问卷调查的方式,对北京大学人民医院91名临床医学生心理压力现状及产生原因进行调查。结果显示,造成医学生心理压力的重要原因依次为学业课程负担重、择业压力以及医患关系紧张。从人本主义角度出发,应从社会、教育教学管理部门等多个层面入手采取措施,减轻医学生心理压力,培养其形成正确的职业观、择业观和医患观。     

八年制医学生基层社会实践的探索

北京协和医学院的基层社会实践具有悠久的历史传统,并始终坚持医学生应当深入基层,“精英教育”应当脚踏实地的思路.为了使学生进一步了解基层卫生情况,体悟医师社会责任,北京协和医学院组织2008级八年制临床医学专业38名学生进行了为期半个月的基层社会实践.本文通过问卷调查的形式,总结分析了学生对本次基层社会实践的目的、收获,以及对本次实践的总体认可度与建议,旨在为日后的基层社会实践积累经验、探索方向.     

Medical student abuse. Incidence, severity, and significance

In a survey of the incidence, severity, and significance of medical student abuse as perceived by the student population of one major medical school, 46.4% of all respondents stated that they had been abused at some time while enrolled in medical school, with 80.6% of seniors reporting being abused by the senior year. More than two thirds (69.1%) of those abused reported that at least one of the episodes they experienced was of "major importance and very upsetting." Half (49.6%) of the students indicated that the most serious episode of abuse affected them adversely for a month or more; 16.2% said that it would "always affect them." Students identified various types of abuse and proposed a number of measures for the prevention and management of abuse in medical school. We conclude that medical student abuse was perceived by these students to be a significant cause of stress and should be a major concern of those involved with medical student education.     

医学生家庭背景、学医动机与学业成绩的相关分析

目的 了解医学生选择学医的初始动机,揭示医学生学医动机对学业成绩的影响,为医学生的后续有效培养及医学教育提供科学依据。 方法 参考相关文献制作专门的调查问卷,选取粤东某高校在读医学生为研究对象,采用自我管理问卷的方式,调查医学生家庭背景资料及选择医学专业初始动机,对调查对象学医动机相关因素及学业成绩进行分析。 结果 不同性别医学生学医动机没有显示出差异,但是女生专业课平均成绩点数(GPA)均值高于男生,医学生学习成绩之间存在性别差异(P<0.01);不同年级之间医学生学业成绩差异具有统计学意义,年级越高,GPA均值越低(F=3.146,P<0.05);生源地差异显著影响学业成绩,农村生源医学生学业平均GPA高于其他生源地学生,差异具有统计学意义(F=2.751,P<0.05);家庭经济条件对医学生学业成绩具有统计学意义(F=6.470,P<0.01);医学生学业成绩受到多重动机影响,内在动机对医学生学业成绩具有显著影响(从小立志成为医生F=2.424,P<0.05,治病救人F=0.131,P<0.05),外在动机(选择医学有较多出国机会)对学业成绩具有显著影响(F=1.824,P<0.05),成就动机中的医生社会地位高这一选项对医学生学业成绩具有显著影响(F=0.186,P<0.05);社会风气对医学生学医动机及学业成绩的影响差异具有统计学意义(F=0.118,P<0.05)。 结论 家庭背景因素对医学生学医动机具有多方面影响,多重学医动机影响医学生学业成绩。      

A study of faculty attitudes toward Ohio State's three-year medical program.

Three-year curricula, once a proliferating innovation in medical education, are now rapidly waning with the fading of capitation support and the easing of physician manpower shortages. In this article the authors examine faculty opinion of a three-year medical program at the Ohio State University. Using a Likert attitude-scaling technique, the authors developed a questionnaire and administered it to full-time faculty members. Five issues upon which faculty opinion was found to be most diverse include: adequacy of content in a three-year program, time available for faculty to do research, work demands on faculty, basic medical knowledge of three-year students, and quality of post-M.D. positions obtained by three-year graduates. Overall, three general deficiencies in the three-year curriculum, as perceived by faculty, emerged: students have limited instruction in basic medical knowledge and skills; unnecessary emotional, physical, and economic demands are imposed; and neither student learning nor quality of teaching is enhanced.     

医学本科实习生心理适应性状况分析

随机选择100名本院实习的医学本科生进行问卷调查，收回有效问卷95份。结果显示，95名（100．0％）实习生均有不同方面的心理不适应，其中55人（57．9％）生活不适应，65人（67．7％）学习不适应，60人（63．2％）感觉人际不适应，62人（65．3％）感觉到个性心理不适应。45人（47．4％）感到压力很大，35人（36．8％）感到较大压力，只有15人（15．8％）感到压力一般。压力的来源主要包括就业困难、实习与考研矛盾、人际关系不协调、临床技术生疏、经济问题、情感困惑、生活环境的改变。提示参加临床实习的医学本科生的心理适应性有待提高。     

Attitudes, knowledge, and actions with regard to organ donation among Hong Kong medical students

OBJECTIVE. To study attitudes, knowledge, and actions of local medical students with regard to organ donation and self-perceived confidence and competence in approaching potential organ donors. DESIGN. Cross-sectional questionnaire survey. SETTING. Faculty of Medicine, The University of Hong Kong, Hong Kong. PARTICIPANTS. Medical students, years 1-5. MAIN OUTCOME MEASURES. Knowledge on various aspects of organ donation was assessed, and students' self-evaluated competence and confidence about counselling for organ donation was evaluated. Factors influencing attitudes and actions were determined. RESULTS. The response rate was 94% (655/694). A majority (85%) had a 'positive' attitude, but only a small proportion (23%) had signed the organ donation card. Inconvenience and lack of knowledge about organ donor registration, and concerns about premature termination of medical treatment accounted for such discrepancies. Socio-cultural factors such as the traditional Chinese belief in preservation of an intact body after death, unease discussing death-related issues, and family objections to organ donation were significantly associated with a 'negative' attitude. Knowledge and action increased with medical education yet only a small proportion of medical students felt competent and confident in counselling patients on organ donation. CONCLUSIONS. The medical curriculum should increase medical students' awareness of the organ shortage problem. The donor registration system should be made more convenient and public education is recommended to correct misconceptions.     

武汉市某大学医学生网络依赖现状与影响因素分析

目的：了解医学生网络依赖现状与影响因素,为预防医学生网络依赖提供理论依据。方法：通过随机抽样方法,采用Young网络依赖诊断量表和自行编制的影响因素调查表对434名医学生进行问卷调查。结果：医学生网络依赖发生率为10.60%;研究表明,上网时间、学习成绩、寝室活动参与度、班级活动参与度、心理压力来源、电脑拥有情况、电脑主要用途、寝室装饰美化、中学住读适应程度对医学生网络依赖有显著影响（〈0.05）。结论：医学生网络依赖发生率较高,主要受寝室和班级生活相关因素的影响,需要有针对性地进行干预。     

Prenatal testing and pregnancy termination in Sri Lanka: views of medical students and doctors

INTRODUCTION: Prenatal diagnosis and pregnancy termination generate complex ethical issues. Surveys conducted in Sri Lanka among doctors and medical students in 1986 supported a change in law in favour of pregnancy termination when gross genetic defects are detected antenatally. A new generation of prenatal tests has focused attention again on the topic of termination and under what circumstances it might be legally done. The present survey contributes to the debate by means of a survey of doctors and medical students. METHOD: A self-administered questionnaire given to doctors and medical students. RESULTS: Ninety three per cent of doctors and 81% of students accept pregnancy termination as an appropriate course of action if a gross genetic defect is detected antenatally, and 87% of doctors and 80% of students support a change in the law to allow termination of the pregnancy. The corresponding figures in previous surveys were 80%, 69% and 96%, 88% respectively. CONCLUSIONS: A majority of doctors and medical students support a change in law in favour of liberalising pregnancy termination when a genetic defect is detected antenatally.     

In-vitro susceptibility of 400 isolates of Neisseria gonorrhoeae in Vancouver, 1982-84.

Health promotion and treatment programs for adolescents must be tailored to the unique concerns and needs of this population. A questionnaire was mailed to 1000 adolescents aged 12 to 20 years in the Ottawa-Carleton region; 729 responded, giving information on their health concerns and habits. The teenagers reported worrying mostly about chronic conditions such as acne, menstrual disorders, emotional problems, dental problems and being overweight. Some of these conditions can be treated if care is sought. The psychosocial problems most important to the adolescents were school and family problems. Girls tended to report health concerns more often than boys, but there was little variation by age or social group. Although the proportions of adolescents who were smoking cigarettes, drinking alcoholic beverages or using "recreational" drugs or who had ever had sexual intercourse were relatively high, the number of respondents who perceived such habits as health problems was low. There was a low level of concern about birth control among the respondents, including those who indicated that they had had sexual intercourse. The fact that significantly more girls than boys reported that they smoked and had engaged in sexual intercourse suggests specific targets for health promotion activities.     

A survey of fourth-year medical students' decisions regarding family practice as a career

With a decline in the proportion of medical students pursuing family practice careers, it is necessary to better understand the factors influencing their career decisions. The Fishbein model of attitude formation was used as a framework for developing a questionnaire to measure students' attitudes toward a career in family practice and the social support students perceived they had for that career. The questionnaire was administered to fourth-year-medical students a short time before residency match day. Both the attitude and social support scales had excellent psychometric characteristics. The usefulness of these scales in discriminating between career choices of family practice and other clinical careers was tested. The social support scale did not discriminate well, whereas the attitude scale discriminated quite well. The students who chose careers in family practice differed from students who chose other careers in 14 of 19 values about characteristics of family practice but differed from them in only two of 19 beliefs about family practice. The implications for advising medical students about careers in family practice are discussed.     

时间管理倾向对医学生学业拖延的影响:自我同情的中介作用

目的探讨时间管理倾向影响医学生学业拖延的内在机制,为今后的学业拖延干预方案提供理论基础。方法采用分层随机抽样法选取2019年3-6月某市高校499名医学生,采用自编一般资料问卷、时间管理倾向量表、自我同情量表、Aitken拖延量表对其进行调查。结果医学生学业拖延得分为（46.19±8.74）分,处于中等水平。是否为独生子女、不同年级和进入大学以后成绩的学业拖延得分差异均有统计学意义（P < 0.01）;时间管理倾向与学业拖延呈负相关（r=-0.522,P < 0.01）,与自我同情呈正相关（r=0.334,P < 0.01）;自我同情与学业拖延呈显著负相关（r=-0.317,P < 0.01）;时间管理倾向、自我同情与学业拖延的关系显示,时间管理倾向可直接影响医学生学业拖延,也可通过自我同情的部分中介作用影响医学生学业拖延（效应值为10.46%）。结论可以从提高其时间管理能力以及自我同情水平入手改善医学生学业拖延现状。     

Perceived sources of stress among first-year medical students.

A survey of first-year medical students at the University of Toronto shows that academic factors are viewed as the most stressful and social factors as the least stressful. Among anticipated sources of stress those dealing with perceived failure are highly stressful, and those dealing with sexual aspects of the doctor-patient relationship are much less so. Factor analysis reveals that sources of stress are multidimensional rather than unidimensional. Particular socio-demographic antecedent variables are much more highly correlated with stress than are others. In particular, it is found that students in subgroups differing from "mainstream" students feel more stress than their mainstream counterparts. Feelings of stress are also found to be positively related to possible consequences of stress, such as frequency of thinking about dropping out and to number of days off school because of illness.     

The relationship between stress and attitudes toward leisure among first-year medical students

The purpose of the study reported in this article was to examine first-year medical students' attitudes toward their free time and how these attitudes relate to self-reported stress levels. Members of the entering class of 1982-83 at the Southern Illinois University School of Medicine were asked to complete surveys designed to measure perceived stress and leisure attitudes. The results indicated a significant negative correlation between the total leisure scale and the stress scale. This correlation supported the hypothesis that students who perceived that they had high stress levels scored low on the leisure attitude scale. These findings suggest a need for educating students about the benefits of well spent leisure time as a stress management mechanism that is important in coping with daily pressures and anxieties.     

军医大学研究生的生存质量状况及其社会学因素分析

目的 了解军医大学研究生的生存质量状况及其社会学影响因素。方法 采用世界卫生组织生存质量测定量表简表,随机抽取广州市某军医大学在读硕士研究生 189名进行问卷调查。结果军医大学研究生在生存质量各领域的得分 (生理领域: 15. 64±1. 93;心理领域: 14. 67±2. 20;社会领域:14. 53±2. 83;环境领域: 13. 09±2. 26)均明显高于广州市大学本科生的得分;对自身生存质量和健康状况的总体评价大多数处于一般和较好的水平;已婚研究生在社会领域的评分显著高于未婚研究生;经济状况、运动量、专业满意度、就业前景、家庭摩擦和食欲与生存质量的维度多数呈显著相关;多元回归结果表明:就业前景、经济状况、专业满意度、家庭摩擦等因素对军医大学研究生生存质量的影响较大。结论 军医大学研究生的生存质量状况较好,婚姻状况、经济状况、运动量、专业满意度、就业前景、家庭摩擦和食欲等是影响他们生存质量的主要社会学因素。     

The association between resilience and academic performance among nursing students: a cross-sectional study in Japan

Objective: Medical science students, especially nursing students, are more likely to experience academic stress; therefore, resilience helps them focus on their lessons attentively. However, the results of a few existing studies regarding how resilience impacts the academic performance of medical science students are incongruent. This study aimed to investigate whether resilience impacts the academic performance of Japanese nursing students.Methods: We conducted a cross-sectional, self-administered questionnaire survey from September to November 2020. A total of 229 undergraduate nursing students participated in this study; here, resilience was measured using the Bidimensional Resilience Scale, which includes innate factors (optimism, control, sociability, and vitality) and acquired factors (problem-solving, self-understanding, and understanding others). Academic performance was measured using the functional grade point average (f-GPA). Covariates were demographics, pre-entry academic performance levels, medical history, time spent walking, psychological distress, subjective economic status, and part-time jobs. Multivariate regression analyses were performed.Results: Among the 229 participants, the f-GPA mean (standard deviation) was 2.93 (0.46). Only vitality was significantly associated with a higher f-GPA after multiple imputations (β = 0.06; 95% confidence interval = 0.03–0.09; P<0.01). The Poisson regression analysis of 212 participants with all data indicated that vitality was associated with the fourth quartile f-GPA (prevalence ratio, 1.05; 95% confidence interval, 1.03–1.08; P<0.01).Conclusion: There was a significant association between the vitality of resilience components and academic performance among Japanese nursing students. This study suggests that an approach that develops resilience is necessary for the academic success of nursing students.     

Motivation for and concerns about entering a medical programme

The motivation for and concerns about studying medicine and future career plans of students at the Faculty of Medical Sciences, The University of the West Indies (UWI), were studied using a cross-sectional survey that included Year 1 medical students at both the Mona (Jamaica) and St Augustine (Trinidad and Tobago) medical schools of the UWI. The data were collected using a self-administered questionnaire containing structured questions on demographics and family background, motivation for and concerns about studying medicine and future career preferences. A total of 193 students took part in the study, 103 from Mona and 90 from St Augustine (88% response rate). Seventy per cent of the students were between 18 to 22 years of age with 59% being females. The highest rated motives for studying medicine were the 'opportunity for working with people' and an 'interest in human biology'. Female students scored significantly higher for the motive of an 'opportunity for working with people', while males rated the 'social prestige/status' significantly higher. The greatest concerns of the students were 'fear of failure' and 'contracting diseases'. The female students had a greater concern for dealing with the long hours involved in medical training than their male counterparts. Surgical specialties (43%), family medicine (38%) and paediatrics (34%) were the top choices of the students for future specialty and more women than men chose obstetrics. Although the motives that students have reported are varied, there was a reasonable spread of desirable motives. This study provides a baseline for observing possible changes as students advance through medical training. A programme of study that strives to maintain these well-placed motives while providing opportunities for dealing with the concerns of the students will assist in creating caring, empathetic physicians for the Caribbean.