Patterns of distress in US medical students
Patterns of distress in US medical students
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DOI：
10.3109/0142159x.2010.531158
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发表时间：
2011-01-01
期刊：
影响因子：
4.7
通讯作者：
Shanafelt, Tait D.
中科院分区：
文献类型：
--
作者：
Dyrbye, Liselotte N.;Harper, William;Shanafelt, Tait D.
背景：医学生个体多重形式的心理困扰是如何共存的还没有正式的研究。目的：探讨医学生中各种形式的痛苦的患病率及其与近期自杀意念或严重的辍学念头的关系。方法：采用标准化工具对美国7所医学院的所有医学生进行倦怠、抑郁、压力、精神生活质量（QOL）、身体生活质量和疲劳的调查。其他项目探讨了最近的自杀意念和从医学院退学的严重想法。结果：医学生中几乎所有（1846/2246,82%）存在至少一种形式的困扰，其中1066（58%）存在>= 3种形式的困扰。在痛苦表现的次数和最近的自杀意念或严重的退学念头之间发现了剂量-反应关系。例如，有2、4或6种痛苦的学生产生自杀意念的可能性分别是没有任何痛苦的学生的5倍、15倍和24倍。在多变量分析中，所有形式的痛苦都与自杀意念或严重的辍学念头独立相关。结论：医学生的苦恼表现多为>= 1，多为同时出现多种形式的苦恼。经历的痛苦形式越多，产生自杀意念和退学念头的风险就越大。
Background: How multiple forms of psychological distress coexist in individual medical students has not been formally studied.Aim: To explore the prevalence of various forms of distress in medical students and their relationship to recent suicidal ideation or serious thoughts of dropping out of school.Methods: All medical students at seven US schools were surveyed with standardized instruments to evaluate burnout, depression, stress, mental quality of life (QOL), physical QOL, and fatigue. Additional items explored recent suicidal ideation and serious thoughts of dropping out of medical school.Results: Nearly all (1846/2246, 82%) of medical students had at least one form of distress with 1066 (58%) having >= 3 forms of distress. A dose-response relationship was found between the number of manifestations of distress and recent suicidal ideation or serious thoughts of dropping out. For example, students with 2, 4, or 6 forms of distress were 5, 15, and 24 fold, respectively, more likely to have suicidal ideation than students with no forms of distress assessed. All forms of distress were independently associated with suicidal ideation or serious thoughts of dropping out on multivariable analysis.Conclusions: Most medical students experience >= 1 manifestation of distress with many experiencing multiple forms of distress simultaneously. The more forms of distress experienced the greater the risk for suicidal ideation and thoughts of dropping out of medical school.