后疫情时期医学生归属感与心理健康状况的相关性研究

目的 探讨新型冠状病毒疫情防控常态化背景下，医学生的学校归属感现状及与抑郁、焦虑症的关系。方法 对8所院校的1 629名全日制医学生进行在线问卷调查，测量工具包括学校归属感量表（psychological sense of school membership scale，PSSM-18）、9条条目的患者抑郁自评量表（the 9-item patient health questionnaire，PHQ-9）和7条目广泛性焦虑量表（7-item generalized anxiety disorder scale，GAD-7）。对学校归属感、抑郁症和焦虑症现状进行描述性分析，使用Spearman相关系数分析PSSM-18与PHQ-9、GAD-7得分间的相关性，使用logistic回归分析归属感缺失对抑郁症和焦虑症的影响。结果 研究对象的学校归属感平均得分为（77.31±14.12），抑郁症和焦虑症的检出率分别为25.97%（423/1 629）和21.92%（357/1 629）。PSSM-18得分与PHQ-9得分（r=-0.52，P<0.001）和GAD-7得分（r=-0.49，P<0.001）均呈负相关。在校正协变量后，低归属感的学生出现抑郁症的风险是高归属感学生的4.33倍（OR=4.33，95%CI=2.48~7.43），出现焦虑症的风险是高归属感学生的5.85倍（OR=5.85，95%CI=3.76~8.15）。结论 归属感缺失增加抑郁症和焦虑症出现的风险，在疫情防控常态化背景下，学校应加强健康宣教和支持服务，提高医学生的归属感，缓解心理健康问题。

Associations between the sense of school belonging and mental health status among medical students during the post-epidemic period

Objective To explore the status of medical students'' sense of school belonging and its relationship with depression and anxiety symptoms in the context of COVID-19 prevention and control.Methods An online questionnaire survey was conducted among 1 629 full-time students from 8 medical universities. The 18-item psychological sense of school membership scale (PSSM-18), 9-item patient health questionnaire (PHQ-9), and 7-item generalized anxiety disorder scale (GAD-7) were used as measurements. Spearman correlation coefficients were used to analyze the correlations between PSSM-18, PHQ-9, and GAD-7 scores. Logistic regressions were used to analyze the impact of lack of school belonging on depression and anxiety symptoms.Results The mean score of school belonging was (77.31±14.12), and the detection rates of depression and anxiety symptoms were 25.97% (423/1 629) and 21.92% (357/1 629), respectively. PSSM-18 score was negatively correlated with PHQ-9 scores (r=-0.52, P<0.001) and GAD-7 scores (r= -0.49, P < 0.001). After adjusting for covariates, students with low school belongingness had 4.33 times the risk of depression symptoms (OR=4.33, 95%CI=2.48-7.43) and 5.85 times the risk of anxiety symptoms (OR= 5.85, 95%CI=3.76-8.15) compared to students with high school belongingness.Conclusion Lack of school belonging increases the risk of depression and anxiety symptoms. Under the normalization of COVID-19 prevention and control, the school should strengthen health education and support services to improve the students'' sense of belonging and alleviate their mental health problems.