【作者】 丁大为；

【导师】 邓云龙；

【作者基本信息】 中南大学 ， 应用心理学， 2008， 硕士

【摘要】 目的:调查湖南省医学院校的实习期医学生受虐情况,探讨医学生虐待与受虐者抑郁症状和焦虑症状的关系。方法:以分层随机整群抽样的方法,共调查了湖南省6所医学院校的8家直属附属医院共329名实习医学生,应用抑郁自评量表、焦虑自评量表和医学生实习事件调查表,对实习生进行以医院为单位的现场施测。结果:共调查了329名实习期医学生,收回有效问卷312份,有效率为94.8%。在312名医学生中,有244(78.2%)名学生经历过至少一次虐待事件,其中女生有128人(76.6%)、男生有116人(80.0%)经历过至少一次虐待事件.在医学生虐待的五种类型中,有210名(67.3%)学生经历过至少一次的言语虐待事件,排在五种虐待类型中的首位,其他依次为学业虐待(n=165,52.9%)、性别歧视(n=105,33.7%)、性骚扰(n=91,29.2%)和躯体虐待(n=60,19.2%).在施虐者中,主治医师和护士以17%的比例并列排在了首位,其他依次为病人(16.3%)、住院医师(16.2%)、其他(12.7%)、主任医师或教授(9.3%)、学生(5%)、医技人员(4%)和医院后勤人员(2.5%)。在虐待事件发生所在的科室中,外科以29.5%的比例排在众科室第一,其他依次为内科(22.8%)、妇产科(14.4%)、其他(13.5%)、儿科(6.8%)、急诊科(5.4%)、传染科(4.1%)和麻醉科(3.4%)。医学生虐待与学生的抑郁、焦虑症状间的Kruskal-Wallis H检验显示:学业虐待组间(χ~2=9.74,p=0.02)和受虐种类组间(χ~2=33.55,p=0.00)的抑郁自评量表得分有显著性差异;言语虐待组间(χ~2=9.85,p=0.00)、躯体虐待组间(χ~2=9.49,p=0.00)、性骚扰组间(χ~2=15.96,p=0.00)和受虐种类组间(χ~2=37.96,p=0.00)的焦虑自评量表得分有显著性差异。进一步的NemenyO检验显示:学业虐待中组4的抑郁自评量表得分高于组1;受虐种类中组4、组5、组6的抑郁自评量表得分高于组1,组6的抑郁自评量表得分高于组2和组3。言语虐待和躯体虐待中组3的焦虑自评量表得分均高于组1和组2;性骚扰中组4的焦虑自评量表得分高于组1;受虐种类中组4、组5、组6的焦虑自评量表得分高于组1,组6的焦虑自评量表得分高于组2和组3。结论:在湖南省医学院校中存在较普遍的医学生虐待现象。其中性骚扰的男生比例高于女生,而其他各形式虐待类型均无男女间差异。在各类型医学生虐待中,学业虐待对学生的抑郁症状有一定影响;而言语虐待、躯体虐待和性骚扰对学生的焦虑症状有一定影响。更多还原

【Abstract】 Objective: To investigate the information of medical student abuse during clinical clerkships in Hunan province. To approach the relationship between medical student abuse and depression or anxiety in abused students.Method: A questionnaire was developed with vignettes describing abusive situations that medical students could have met during medical clinical clerkships. The questionnaire was handed to students with 2 other rating scales: self-rating depression scale and self-rating anxiaty scale. The study population comprised 329 medical students in 8 teaching hospitals in Hunan province. These questionnaires were answered anonymously and returned as soon as finished to ensure confidentiality.Result: Of the 329 students surveyed, 312 questionnaires were available, the response rate was 94.8%. Of the respondents, 244 (78.2%) students reported at least one instance of abuse, 80.0% of the men (n=116)and 76.6% of the women(n=128) had experienced at least one instance of abuse. In all five types of medical student abuse we investigated: verbal abuse, physical abuse, academic abuse, sexual harassment and gender discrimination, verbal abuse (n=210,67.3%)was the most common type of medical student abuse which followed by academic abuse (n=165,52.9%) , gender discrimination (n=105,33.7%), sexual harassment (n=91,29.2%) and physical abuse (n=60,19.2%) .In the sources of perpetrators, attending physician(17%) and nurse(17%) were identified the most frequently as the sources of perpetrators which followed by Patients( 16.3%), resident physician(16.2%), others(12.7%), chief physician or professor (9.3%) , peers (5%) , meditech technician (4%) and service personnel (2.5%) . In the sources of abusive site, surgical department(29.5%) was reported the most common abusive site which followed by department of internal medicine (22.8%) , obstetric and gynecologic department (14.4%) , others (13.5%) , department of pediatrics (6.8%), emergency department (5.4%), infection department (4.1%) and anaesthesiology department (3.4%) . Kruskal-Wallis H test showd that self-rating depression scale scores among academic abuse groups (x~2=9.74,p=0.02) and numbers of abuse type groups(x~2 =33.55, p=0.00) were significant; the self-rating anxiety scale scores among vebal abuse groups(x~2 =9.85,p=0.00), physical abuse groups(x~2=9.49,p=0.00), sexual harassment groups (x~2=15.96,p=0.00) and numbers of abuse type groups(x~2 =37.96,p=0.00) were significant. Nemenyi test showed that in academic abuse groups, the self-rating depression scale score of group 4 was higher than group 1; in numbers of abuse type groups, the self-rating depression scale score of group 4、group 5 and group 6 were higher than group 1, the self-rating depression scale score of group 6 was higher than group 2 and group 3. Nemenyi test showed that in verbal abuse groups and physical abuse groups, the self-rating anxiety scale score of group 3 was higher than group 1 and group 2, in sexual harassment groups, the self-rating anxiety scale score of group 4 was higher than group 1; in numbers of abuse type groups, the self-rating anxiety score of group 4、group 5 and group 6 were higher than group 1, the self-rating anxiety scale score of group 6 was higher than group 2 and group 3.Conclusion: The phenomenon of medical student abuse is common in Hunan province. Male experience more sexual harassment than female, there are no difference between male and female in other types of medical student abuse. Academic abuse can influence depression symptom; verbal abuse, physical abuse and sexual harassment can influence anxiety symptom.更多还原