医学生心理健康纵向轨迹及预测因子:潜在生长混合模型分析。

IF 5.2 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES
Yinhai Chen, Xu Ran, Tong Zhou, Rong Huang, Lin Su, Xiong Ke
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引用次数: 0

摘要

背景:高压的医学教育环境对医学生的长期心理健康提出了重大挑战。虽然焦虑和抑郁在医学生中有很好的记录,但很少有研究探索这些症状随时间的发展轨迹。本研究旨在探讨医学生焦虑和抑郁症状的两年发展轨迹,并确定这些轨迹的关键预测因素。方法:本纵向研究涉及一所中国医学院的810名医学生,数据收集分四波,历时两年。共有730名学生完成了基线调查并被纳入分析,有效回复率为90.1%。参与者完成了抑郁症患者健康问卷-9 (PHQ-9)和焦虑症广泛性焦虑障碍-7 (GAD-7)量表。使用潜在生长混合模型(LGMM)来识别抑郁和焦虑症状的潜在轨迹,并使用全信息最大似然估计来处理缺失的随访数据。进行回归分析以确定这些轨迹的预测因子。结果:抑郁和焦虑症状的四波数据均与模型拟合良好。抑郁有两条轨迹:缓慢下降组(92.0%)和显著增加组(8.0%)。焦虑表现出低水平缓慢下降组(72.7%)、高水平显著下降组(21.2%)和低水平显著上升组(6.1%)三种轨迹。这些轨迹的重要预测因素包括家庭结构、与父母和室友的关系质量、社会支持、过去的自杀念头和自残行为。较高的社会支持水平与症状轨迹的减少有关,而不良的家庭关系和过去的自杀意念则预示着症状的增加。结论:医学生抑郁和焦虑症状具有明显的发展轨迹,为有针对性的心理干预提供了依据。加强社会支持应是教育机构和决策者的优先事项。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mental health longitudinal trajectories and predictors in medical students: Latent growth mixture model analysis.

Background: The high-pressure environment of medical education presents significant challenges to the long-term psychological well-being of medical students. Although anxiety and depression are well-documented among medical students, few studies have explored the developmental trajectories of these symptoms over time. This study aims to explore the two-year developmental trajectories of anxiety and depression symptoms in medical students and identify key predictors of these trajectories.

Methods: This longitudinal study involved 810 medical students from a Chinese medical school, with data collected over four waves spanning two years. A total of 730 students completed the baseline survey and were included in the analysis, yielding a valid response rate of 90.1%. Participants completed the Patient Health Questionnaire-9 (PHQ-9) for depression and the Generalized Anxiety Disorder-7 (GAD-7) scale for anxiety. Latent Growth Mixture Modelling (LGMM) was used to identify the latent trajectories of depression and anxiety symptoms, with full information maximum likelihood estimation applied to handle missing follow-up data. Regression analysis was conducted to determine predictors of these trajectories.

Results: The four waves of data for both depression and anxiety symptoms fit the model well. Depression followed two trajectories: a slowly decreasing group (92.0%) and a significantly increasing group (8.0%). Anxiety exhibited three trajectories: a low level-slow decreasing group (72.7%), a high level-significantly decreasing group (21.2%) and a low level-significantly increasing group (6.1%). Significant predictors of these trajectories included family structure, quality of relationships with parents and roommates, social support, past suicidal ideation and self-harming behaviour. Higher levels of social support were associated with decreasing symptom trajectories, whereas poor family relationships and past suicidal ideation predicted increasing symptoms.

Conclusions: Depression and anxiety symptoms in medical students follow distinct developmental trajectories, providing a basis for targeted psychological interventions. Strengthening social support should be a priority for educational institutions and policymakers.

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来源期刊
Medical Education
Medical Education 医学-卫生保健
CiteScore
8.40
自引率
10.00%
发文量
279
审稿时长
4-8 weeks
期刊介绍: Medical Education seeks to be the pre-eminent journal in the field of education for health care professionals, and publishes material of the highest quality, reflecting world wide or provocative issues and perspectives. The journal welcomes high quality papers on all aspects of health professional education including; -undergraduate education -postgraduate training -continuing professional development -interprofessional education
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