醫學生知覺壓力與心理健康之關係

Perceived Stress in Medical Students and Its Relationship to Mental Health

10.6145/jme.200603_10(1).0004

呂碧鴻(Bee-Horng Lue)；陳秀蓉(Hsiu-Jung Chen)；高美英(Meei-Ying Kao)

醫學生知覺壓力 ； 大學生身心適應困擾 ； 心理健康 ； perceived medical school stress ； college student's adjustment problems ； mental health

Journal of Medical Education

10卷1期（2006 / 03 / 01）

25 - 33

繁體中文

醫學教育內容豐富，醫學生學習過程相當艱辛。許多研究顯示醫學生知覺到的壓力是影響心理健康，甚至未來罹患精神疾病的重要因素。本研究目的是：1.瞭解醫學生感受到的壓力源及其內容。2.評估醫學生心理健康狀態。3.探討心理健康狀態與壓力之關係。以7所醫學院之二年級醫學生為對象，進行問卷調查。包括人口學資料、壓力測量、生活事件、健康狀態等。壓力測量採用醫學生壓力知覺量表及大學生身心適應調查表進行。共有680位醫學生參與研究。結果顯示醫學生知覺壓力，以學業需求之壓力為主，70.6%學生擔心不能精熟所有醫學知識；41.0%學生擔心無法承受臨床訓練所帶來的長時間工作與責任；39.6%學生認為將承受醫學院之嚴厲考驗。一般身心適應困擾，尤其時間管理困擾，亦是重要壓力源。心理健康狀態中，73.8%有情緒問題，75.0%有身體症狀，40.4%有睡眠問題。5.9%的學生有自殺意念。逐步複迴歸分析發現心理健康之預測變項以身心適應困擾為主（解釋變異量22.1%），其他為自覺快樂與健康狀態、及生活事件（共可解釋31.3%之變異量）。而醫學生壓力知覺對心理健康並不具顯著預測效力。本研究結果顯示二年級醫學生一般身心適應之困擾影響心理健康，尤其時間管理困擾須及早介入輔導，教學方式應著重於指導學生『學習如何學習』，以便他們因應未來艱辛的醫學專業學習及確保心理健康。

A considerable amount of research has shown that perceived medical school stress (PMSS) is a hazard to health and is predictive of psychiatric morbidity. The purpose of this study was firstly, to understand perceived stresses among medical students, secondly, to assess their mental health status and finally, to explore the relationship between stressors and mental health. We conducted this study using a questionnaire survey among second year medical students at seven medical schools. The questionnaire included demography, life events and various measures of health status and stress. Stress was assessed using the PMSS scale and the College Students' Adjustment Check List (CSACL). A total of 680 medical students participated in this study. Academic demands as noticed by the PMSS were the most serious concern. Time management problems as identified by the CSACL were also a significant stressor. In total, 70.6% of the students were concerned about not mastering the pool of knowledge, 41.0% of the students were concerned about enduring the workload and responsibility and 39.6% of the students were worried about baptism from faculty. Overall, 73.8% of the students showed emotional problems, 75.0% of the students had somatic symptoms, 40.4% of the students had sleep problems and 5.9% of the students had suicide ideation. Stepwise multiple regression analysis revealed that the score for the CSACL was a significant predictor of the mental health status of the student and explained 22.1% of variance. However, score for the PMSS scale did not show any predictive power with respect to mental health. In conclusion, this study indicates that students mental health is influenced by adjustment problems. It is especially important that time management problems should be identified early and intervention takes place. The teaching method of medical school focusing on ”learning how to learn” should be emphasized. This will help the students to cope in the future with the painstaking nature of the medical profession and, as a result, would also help to improve the student's personal well-being.

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