医学生睡眠质量调查及相关因素分析

背景睡眠障碍影响身心健康,目前医学生的睡眠问题研究在本科生中开展较多,而关于其他类医学生睡眠质量问题尚未充分探讨.目的了解本科生、七年制学生和硕士研究生等三类医学生的睡眠质量及其影响因素,为提高医学生的睡眠质量提供科学依据.设计抽样调查.地点、对象和方法在华中科技大学同济医学院中以整群抽样的方法抽取本科生、七年制学生和硕士研究生998人,采用自制的睡眠状况调查表进行调查.收回有效问卷918份,男生389人,女生529人,年龄16～35岁.主要观察指标使用匹兹堡睡眠质量指数(Pittsburg sleep quality index,PSQI)评价学生的睡眠质量,以≥8分为存在睡眠障碍的标准;影响因素包括一般状况和心理卫生状况.结果17.32%的人有睡眠质量问题,本科生、七年制学生和硕士生的睡眠障碍现患率分别是23.37%,14.02%和12.16%,本科生睡眠障碍现患率显著高于七年制学生和硕士生(x2=16.07,P＜0.01).逐步回归分析发现影响睡眠质量的因素包括睡眠环境差、寝具不适、焦虑、抑郁、学习紧张和锻炼少.本科生PSQI总分显著高于七年制学生和硕士生(F=15.20,P＜0.05);七年制学生入睡时间得分显著低于本科生和硕士生(F=9.17,P＜0.05);硕士生睡眠时间得分显著低于本科生、七年制学生(F=18.72,P＜0.05);硕士生日间功能得分显著低于本科生和七年制学生(F=14.62,P＜0.05).相关分析发现,焦虑症状和抑郁症状与PSQI正相关(r=0.510 5,0.445 1,P＜0.000 1).生活满意度与PSQI负相关(r=-0.299 2,P＜0.000 1).结论三类医学生存在不同程度的睡眠质量问题,本科生的睡眠质量最差;影响睡眠质量的因素包括睡眠环境差、寝具不适、焦虑、抑郁、学习紧张和锻炼少;睡眠质量越差,则焦虑、抑郁症状越重,生活满意度越差.

Sleep quality of medical students and the related factors

BACKGROUND: Sleep disorders affect the physical health and mental well-being of human beings. There has been much research about the sleep problems among undergraduate medical students, while the sleep quality of other types of medical students is not well discussed.OBJECTIVE: To investigate the sleep quality of undergraduates, seven-year program students and graduate students, and the influencing factors so as to provide a scientific basis for improving the sleep quality of medical students.DESIGN: A sampled survey.SETTING, PARTICIPANTS and METHODS: With cluster sampling method, a total of 998 subjects were selected from Tongji Medical College of Huazhong University of Science and Technology, involving undergraduates,seven-year program students and graduate students, and a self-made sleep status questionnaire was used for a survey. We got 918 valid questionnaires,including 389 males and 529 females, with an age range of 16 to 35 years old.MAIN OUTCOME MEASURES: The sleep quality of the students was evaluated in the light of the Pittsburgh sleep quality index(PSQI) . The score no less than 8 was taken as the criterion of having a sleep disorder. The influencing factors included general status and psychological health status.RESULTS: 17.32% of the people had problems in sleep quality. The prevalence rates of the sleep disorder were 23.37%, 14.02% and 12. 16% in undergraduates, seven-year course students and graduate students respectively. The former one was significantly higher than the latter two(x2 = 16. 07, P ＜ 0.01 ). Stepwise regression analysis found that the factors that affected the sleep quality were bad sleep environment, discomfort of the bedclothes, anxiety, depression, great pressure from study and taking little exercise. The score of PSQI of undergraduates was significantly higher than that of the other two sorts of students( F = 15.20, P ＜ 0.05). The score of sleep latency of seven-year program students was significantly lower than that of the other two sorts of students( F = 9. 17, P ＜ 0.05), and the score of sleep duration of graduate students was significantly lower than that of the other two sorts of students( F = 18.72, P ＜ 0. 05) . The score of daytime function of graduate students was significantly lower than that of the other two sorts of students ( F = 14.62, P ＜ 0. 05). The correlation analysis indicated that anxiety and depression were positively correlated with PSQI ( r = 0.510 5,0. 445 1, P ＜ 0. 000 1), while the living satisfaction was negatively correlated with PSQI ( r = - 0. 299 2, P ＜ 0. 000 1 ).CONCLUSION: Medical students suffered from the problem with the sleep quality to a varying degree. The sleep quality of undergraduates was the worst. The contributing factors toward poor sleep quality were bad sleep environment, discomfort of the bedclothes, anxiety, depression, great pressure from study, and taking little exercise. The poorer the sleep quality was, the more serious symptoms of anxiety and depression there would be, and the worse the living satisfaction was.