CAJ | 학술논문

　　目的评估医学生的心理健康状况。方法采用心理压力源量表、应对方式问卷及症状自评量表对浙江中医药大学临床医学系各年级学生进行问卷调查。结果收回有效问卷578份，问卷有效率为96.33%。心理压力源量表平均总分为（79.02±16.83）分，男生的心理压力主要来源为考研、学业、就业；女生的主要压力源为同学竞争、考研、学业；各个年级中主要压力源为学业和就业。心理应对方式的评分依次为解决问题（0.52±0.22）分、求助（0.42±0.40）分、自责（0.41±0.21）分、合理化（0.40±0.17）分、幻想（0.35±0.21）分和退避（0.31±0.19）分，各应对方式间差异有统计学意义（F=44.65，P＜0.05）。不同性别在避退因子、解决问题因子上的评分差异有统计学意义（t分别=2.23、3.35，P均＜0.05）。症状自评量表中女性的躯体化、强迫、人际敏感、抑郁、焦虑、恐怖因子评分均高于男性（t分别=5.46、11.36、3.84、3.37、2.78、3.37，P均＜0.05），而男性的偏执、精神病因子评分高于女性（t分别=3.53、2.03， P均＜0.05）；症状自评量表（SCL-90）的各因子总评分除躯体化因子与常模差异无统计学意义之外（t=0.42，P＞0.05），强迫、人际敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性因子等评分均高于常模值（t分别=11.38、8.24、10.29、6.87、5.32、13.86、4.72、9.05，P均＜0.05）。结论临床医学生的心理压力较大，应对方式总体上较为成熟，强迫、人际敏感、抑郁等心理问题较多见。
　　목적평고의학생적심리건강상황。방법채용심리압력원량표、응대방식문권급증상자평량표대절강중의약대학림상의학계각년급학생진행문권조사。결과수회유효문권578빈，문권유효솔위96.33%。심리압력원량표평균총분위（79.02±16.83）분，남생적심리압력주요래원위고연、학업、취업；녀생적주요압력원위동학경쟁、고연、학업；각개년급중주요압력원위학업화취업。심리응대방식적평분의차위해결문제（0.52±0.22）분、구조（0.42±0.40）분、자책（0.41±0.21）분、합이화（0.40±0.17）분、환상（0.35±0.21）분화퇴피（0.31±0.19）분，각응대방식간차이유통계학의의（F=44.65，P＜0.05）。불동성별재피퇴인자、해결문제인자상적평분차이유통계학의의（t분별=2.23、3.35，P균＜0.05）。증상자평량표중녀성적구체화、강박、인제민감、억욱、초필、공포인자평분균고우남성（t분별=5.46、11.36、3.84、3.37、2.78、3.37，P균＜0.05），이남성적편집、정신병인자평분고우녀성（t분별=3.53、2.03， P균＜0.05）；증상자평량표（SCL-90）적각인자총평분제구체화인자여상모차이무통계학의의지외（t=0.42，P＞0.05），강박、인제민감、억욱、초필、활대、공포、편집、정신병성인자등평분균고우상모치（t분별=11.38、8.24、10.29、6.87、5.32、13.86、4.72、9.05，P균＜0.05）。결론림상의학생적심리압력교대，응대방식총체상교위성숙，강박、인제민감、억욱등심리문제교다견。
Objective To evaluate the state of mental health of medical students. Methods The medical students of Zhejiang Chinese Medical University were investigated by Beck-Srivastava Stressor Inventory (BSSI), the Coping Style Questionnaire (CSQ) and Symptom Checklist 90 (SCL-90). Results A total of 578 valid questionnaires were collected, the effective rate was 96.33%. The average score of BSSI is(79.02±16.83). The boy main stressors are exams for postgrad-uate, study and employment while the girl main stressors are classmate competition,exams for postgraduate and study. Study and employment are main stressors in various grades. The score of CSQ in proper sequence are solving problem (0.52±0.22), asking for help(0.42±0.40), self-accusation(0.41±0.21), rationalization(0.40±0.17), fantasy(0.35±0.21) and retreat (0.31±0.19).The difference has statistical significance (F=44.65,P<0.05). There are significant differences in retreat and solving problem between boys and girls(t=2.23, 3.35,P<0.05). The score of somatization, obsessive-compul-sion,interpersonal sensitivity, depression, anxiety, phobia of girl are significantly higher than that of boy (t=5.46, 11.36, 3.84, 3.37, 2.78, 3.37,P<0.05) while the score of paronoid,psychosis of boy are significantly higher than girl (t=3.53,2.03,P<0.05). The score of obsessive-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid and psychosis were significantly higher than those of the norm value (t=11.38, 8.24, 10.29, 6.87, 5.32, 13.86, 4.72, 9.05,P<0.05) except for somatization factor (t=0.42,P>0.05). Conclusions The psychological stress of medical students is strong. Their coping styles are mature in gen-eral. The obsessive-compulsive, interpersonal sensitivi-ty, depression are usual psychological problems.