医学生生命意义感与自杀意念的关系

目的 对医学生的生命意义感及自杀意念进行调查研究,探讨医学生自杀意念的影响因素以及生命意义感与自杀意念的关系。 方法 于2020年5至10月采用随机分层整群抽样法选择某两医学院2 000名医学生,采用自编一般情况调查表、生命意义感量表(PIL)、Beck自杀意念量表中文版(BSI-CV)对其进行问卷调查;收集有效问卷1 847份。 结果 1 847名医学生平均(19.39±1.26)岁,过去一周自杀意念检出率为21.33%;生命意义感平均(53.73±17.18)分;有自杀意念的医学生生命意义得分低于无自杀意念的(t=-16.041,P<0.001);生命意义感与自杀意念呈负相关(r_s=-0.390,P<0.001);多因素Logistic回归结果显示,与医学生自杀意念相关的因素有:生命意义感得分高(OR=0.521,95%CI=0.472~0.575),家庭教育方式为民主型(参考组为其他)(OR=0.583,95%CI=0.360~0.944),亲朋好友无自杀行为(OR=0.555,95%CI=0.382~0.806),遇到压力和困难时不能得到帮助(OR=1.527,95%CI=1.003~2.323),知心朋友的数量(参考组3个及以上)为0个(OR=2.494,95%CI=1.650~3.769)、1个(OR=1.955,95%CI=1.432~2.669),认为理想与现实(参考组为无差距)差距很大(OR=2.084,95%CI=1.220~3.559)、差距非常大(OR=2.235,95%CI=1.171~4.264)。 结论 医学生的自杀意念检出率不容乐观;生命意义感得分低的医学生更易产生自杀意念;生命意义感与自杀意念存在关联;医学院校应采取针对性措施如加强生命意义感教育从而降低医学生的自杀意念。

Relationship between sense of meaning in life and suicidal ideation in medical students

Objective To investigate the sense of meaning in life and suicidal ideation in medical students, so as to explore their relationship and influencing factors. Methods From May to October 2020, 2 000 medical students from Weifang Medical College and Binzhou Medical College were selected by random stratified cluster sampling method, and surveyed with a self-compiled general questionnaire, Purpose in Life Test(PIL)and Beck Suicidal Ideation Scale Chinese Version(BSI-CV). A total of 1 847 valid questionnaires were collected. Results The average age of medical students was(19.39±1.26)years, and the detection rate of suicidal ideation in the past week was 21.33%. The average score of the sense of meaning in life was 53.73±17.18. Medical students with low sense of meaning in life were more likely to develop suicidal ideation than those with high scores (t=-16.041, P<0.001). There was a negative correlation between sense of meaning in life and suicidal ideation(r_s=-0.390, P<0.001). Multiple Logistic regression showed that the factors related to suicidal ideation were high sense of meaning in life(OR=0.521, 95%CI: 0.472-0.575), democratic child discipline(the reference group was other)(OR=0.583, 95%CI: 0.360-0.944), no friends or relatives committing suicide(OR=0.555, 95%CI: 0.382-0.806), unavailability of help under stress and difficulties(OR=1.527, 95%CI: 1.003-2.323), number of close friends(3 or more in the reference group)being 0(OR=2.494, 95%CI: 1.650-3.769)and 1(OR=1.955, 95%CI: 1.432-2.669), gap between ideal and reality(no gap in the reference group)being large(OR=2.084, 95%CI: 1.220-3.559)and very large(OR=2.235, 95%CI: 1.171-4.264). Conclusion The rate of suicidal ideation among medical students is high. Those with low sense of meaning in life are more likely to develop suicidal ideation. The sense of meaning in life is associated with suicidal ideation. Medical colleges and universities should take targeted measures such as strengthening the sense of meaning in life education so as to reduce suicidal ideation.