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題名：醫學生知覺壓力與心理健康之關係
書刊名：醫學教育
作者：呂碧鴻／陳秀蓉 引用關係／高美英
作者(外文)：Lue, Bee-horng／Chen, Hsiu-jung／Kao, Meei-ying
出版日期：2006
卷期：10:1
頁次：頁25-33
主題關鍵詞：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
原始連結：連回原系統網址new window
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  • 被引用次數被引用次數:期刊(5) 博士論文(1) 專書(1) 專書論文(0)
  • 排除自我引用排除自我引用:5
  • 共同引用共同引用:24
  • 點閱點閱:8
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.
期刊論文
1.朱錦鳳、段亞新(20021200)。大學生身心適應調查表之編製及學生困擾分析。測驗統計年刊，10，1-38。new window  延伸查詢new window
2.張天鈞(19991200)。通識教育課程缺課原因之探討。醫學教育，3(4)，47-54。new window  延伸查詢new window
3.Tyssen, R.、Vaglum, P.、Grønvold, N. T.(2001)。Factors in medical school that predict postgraduate mental health problems in need of treatment: A nationwide and longitudinal study。Med. Educ.，35(2)，110-120。  new window
4.Clark, D. C.、Zeldow, P. B.(1988)。Vicissitudes of depressed mood during four years of medical school。JAMA，260(17)，2521-2528。  new window
5.Vitaliano, P. P.、Russo, J.、Carr, J. E.、Heerwagn, J. H.(1984)。Medical school pressures and their relationship to anxiety disorder。J. Nerv. Ment. Disord.，172(12)，730-736。  new window
6.Engel, G. L.(1997)。The need for a new medical model: a challenge for biomedicine。Science，196(4286)，129-136。  new window
7.Wolf, T. M.(1994)。Stress, coping and health: Enhancing well-being during medical school。Med. Educ.，28(1)，8-17。  new window
8.Guthrie, E. A.、Black, D.、Shaw, C. M.(1995)。Tomenson B. Embarking upon a medical career: psychological morbidity in first year medical students。Med. Educ.，29，337-341。  new window
9.Firth, J.(1986)。Levels and sources of stress in medical students。Br Med J.，292(6529)，1177-1180。  new window
10.Aktekin, M.、Karaman, T.、Senol, Y. Y.(2001)。Anxiety, depression and stressful life events among medical students: a prospective study in Antalya, Turkey。Med. Educ.，35(1)，12-17。  new window
11.Notman, M. T.、Salt, P.、Nadelson, C. C.(1984)。Stress and adaptation in medical students: Who is most vulnerable?。Compr. Psych.，25(3)，355-366。  new window
12.Vitaliano, P. P.、Maiuro, R. D.、Russo, J.(1989)。Medical student distress: A longitudinal study。J. Nerv. Ment. Dis.，177，70-76。  new window
13.Bramness, J. G.、Fixdal, T. C.、Vaglum, P.(1991)。Effect of medical school stress on the mental health of medical students in early and late clinical curriculum。Acta. Psychiatr. Scand.，84，340-345。  new window
14.Dahlin, M.、Joneborg, N.、Runeson, B.(2005)。Stress and depression among medical students: a cross-sectional study。Medical Education，39(6)，594-604。  new window
15.Vitaliano, P. P.、Maiuro, R. D.、Mitchell, E.(1989)。Perceived stress in medical school: resistors, persistors, adaptors and maladaptors。Soc. sci. med.，28，1321-1329。  new window
16.Folkman, S.、Moskowitz, J. T.(2000)。Positive affect and other side of coping。Am. Psychol.，55，647-654。  new window
17.謝博生(19970600)。醫師教育模式之變遷。醫學教育，1(2)，3-10。new window  延伸查詢new window
圖書
1.Lazarus, R. S.(1999)。Stress and emotion: A new synthesis。New York, NY：Springer。  new window
2.謝博生(1997)。醫學教育理念與實務。台北：金銘圖書。  延伸查詢new window
3.Stewart, M.、Brown, J. B.、Weston, W. W.(1995)。Patient-Centered Medicine。California：Sage。  new window
4.Derogatis, L. R.(1979)。A manual for SCL-90-R。Baltimore。  new window
 
 
 
 
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