医学生焦虑症状与社会生态学风险因素的关联

王凯; 永忠甜; 陈晋; 朱文华; 王立言; 王莉

doi:10.16835/j.cnki.1000-9817.2024104

医学生焦虑症状与社会生态学风险因素的关联

doi: 10.16835/j.cnki.1000-9817.2024104

王凯¹,
永忠甜¹,
陈晋²,
朱文华²,
王立言³,
王莉^1, ,

1.
山西医科大学公共卫生学院儿少卫生教研室，太原 030001
2.
太原市中小学学生卫生保健所
3.
山西医科大学汾阳学院基础医学部

基金项目: 中国青少年行为健康新型风险因素监测与队列研究(横向合作项目)

详细信息

作者简介:
王凯(1996-)，女，河北唐山人，在读硕士，主要研究方向为儿童青少年健康促进

通讯作者:
王莉，E-mail: wangli_1@sxmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 B844.2 G478 R193
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- 被引次数: 0
出版历程
- 收稿日期: 2023-11-30
- 修回日期: 2024-01-30
- 网络出版日期: 2024-04-25
- 刊出日期: 2024-04-25

Association between anxiety symptoms and social-ecological risk factors among medical students

1.
Department of Child and Adolescent Health, School of Public Health, Shanxi Medical University, Taiyuan (030001), Shanxi Province, China

摘要

摘要: 目的了解医学院校大学生焦虑症状及其与社会生态学风险因素的关系，为促进医学生心理健康提供参考依据。方法于2021年9—10月，采用方便整群抽样方法纳入1 274名太原市某医学院校大一至大四年级学生，采用广泛性焦虑量表-7和青少年社会生态学风险因素评定问卷进行调查。采用多因素二元Logistic回归分析医学生焦虑症状与社会生态学风险因素关联性。结果医学生焦虑症状总检出率为16.2%。不同年级(大一：19.9%，大二：13.0%，大三：14.0%，大四：18.9%)和朋友数量(≤2个：22.8%，3~5个：14.4%，≥6个：11.8%)的医学生焦虑症状检出率差异均有统计学意义(χ²值分别为8.70，16.34，P值均 < 0.05)。Spearman秩相关分析显示，社会生态学风险因素个人、家庭、学校、社区、政策、文化、时间维度及总和不同风险等级构成与焦虑症状得分均呈正相关(r值分别为0.33，0.25，0.32，0.16，0.15，0.16，0.16，0.35，P值均 < 0.01)。Logistic回归分析显示，社会生态学风险因素个人维度高风险与医学生焦虑症状检出率呈正相关(OR=3.32，95%CI=1.66~6.61)，调整协变量年级和朋友数量后两者仍呈正相关(OR=2.98，95%CI=1.49~5.94)(P值均 < 0.01)。结论社会生态学风险因素中暴露于个人维度高风险会增加医学生焦虑症状的发生风险。应该重点关注个人层面对自身焦虑的影响，促进医学生心理健康水平。
- 焦虑 /
- 累积生态风险 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To understand anxiety symptoms among medical college students and their relationship with social-ecological risk factors, so as to provide reference for mental health promotion among medical students. Methods From September to October 2021, a convenient cluster sampling method was used to include 1 274 freshmen to senior students of a medical school in Taiyuan City, and the Generalized Anxiety Disorder-7 and adolescent social-ecological risk factors assessment questionnaire were used. Multivariate binary Logistic regression was used to analyze the association between anxiety symptoms and social-ecological risk factors among medical students. Results The overall detection rate of anxiety symptoms among medical students was 16.2%. The rate of anxiety varied significantly by grade (freshman: 19.9%, sophomore: 13.0%, junior: 14.0%, senior: 18.9%) and number of friends (≤2: 22.8%, 3-5: 14.4%, ≥6: 11.8%) (χ²=8.70, 16.34, P < 0.05). Spearman correlation analysis showed that individual, family, school, community, policy, culture, time, and total score in socio-ecological risk factors were positively associated with anxiety symptom scores at different levels of risk (r=0.33, 0.25, 0.32, 0.16, 0.15, 0.16, 0.16, 0.35, P < 0.01). Logistic regression analysis showed that high risk for personal dimension of the socio-ecological risk factors was positively associated with rate of anxiety symptoms among medical students (OR=3.32, 95%CI=1.66-6.61), and remained positively associated (OR=2.98, 95%CI=1.49-5.94) after adjusting for grade and number of friends (P < 0.01). Conclusions Exposure to high personal dimensions of socio-ecological risk factors increases the risk of developing anxiety symptoms among medical students. A focus should be placed on the personal factors associated with anxiety to promote medical students' mental health.
- Anxiety /
- Cumulative ecological risk /
- Mental health /
- Regression analysis /
- Students
注释:

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表 1 不同人口学特征医学生焦虑症状检出率比较

Table 1. Comparison of the detection rate of anxiety symptoms in medical students with different demographic characteristics

人口学指标	选项	人数	焦虑症状人数	χ²值	P值
性别^*	男	384	71(18.5)	1.98	0.16
	女	888	136(15.3)
年级^*	大一	377	75(19.9)	8.70	0.03
	大二	338	44(13.0)
	大三	351	49(14.0)
	大四	206	39(18.9)
家庭居住地^*	农村	541	85(15.7)	3.83	0.15
	乡镇	224	46(20.5)
	城市	491	73(14.9)
是否独生子女^*	是	340	48(14.1)	1.72	0.19
	否	919	158(17.2)
父亲文化程度^*	小学及以下	219	42(19.2)	2.31	0.51
	初中	513	80(15.6)
	高中或中专	276	40(14.5)
	大专及以上	263	45(17.1)
母亲文化程度^*	小学及以下	265	44(16.6)	1.24	0.74
	初中	496	81(16.3)
	高中或中专	270	39(14.4)
	大专及以上	238	43(18.1)
感知家庭经济状况^*	差或较差	384	71(18.5)	2.98	0.23
	中等	792	118(14.9)
	较好或好	95	18(18.9)
朋友数量/个^*	≤2	355	81(22.8)	16.34	< 0.01
	3~5	680	98(14.4)
	≥6	237	28(11.8)
注： ()内数字为检出率/%；*表示数据有缺失。

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表 2 不同社会生态学风险因素医学生焦虑症状检出率比较

Table 2. Comparison of anxiety symptoms detection rates among medical students with different social-ecological risk factors

社会生态学风险因素	风险等级	人数	焦虑症状人数	χ²值	P值
个人^*	低	328	17(5.2)	104.50	< 0.01
	中	698	100(14.3)
	高	241	88(36.5)
家庭^*	低	335	22(6.6)	75.46	< 0.01
	中	673	100(14.9)
	高	256	84(32.8)
学校^*	低	327	21(6.4)	100.78	< 0.01
	中	643	82(12.8)
	高	297	102(34.3)
社区^*	低	376	34(9.0)	38.16	< 0.01
	中	600	94(15.7)
	高	296	79(26.7)
政策^*	低	342	34(9.9)	25.03	< 0.01
	中	650	104(16.0)
	高	273	68(24.9)
文化^*	低	701	85(12.1)	21.04	< 0.01
	中	407	82(20.1)
	高	165	40(24.2)
时间^*	低	414	46(11.1)	15.67	< 0.01
	中	599	102(17.0)
	高	253	57(22.5)
总和^*	低	314	17(5.4)	119.29	< 0.01
	中	633	77(12.2)
	高	292	105(36.0)
注： ()内数字为检出率/%；*表示数据有缺失。

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表 3 社会生态学风险因素与医学生焦虑症状的多因素Logistic回归分析(n=1 274)

Table 3. Multivariate Logistic regression of social-ecological risk factors and anxiety symptoms among medical students(n=1 274)

社会生态学风险因素	风险等级	模型1		模型2
社会生态学风险因素	风险等级	OR值(95%CI)	P值	OR值(95%CI)	P值
个人	中	1.80(0.99~3.26)	0.06	1.73(0.95~3.15)	0.07
	高	3.32(1.66~6.61)	< 0.01	2.98(1.49~5.94)	< 0.01
家庭	中	1.33(0.76~2.31)	0.32	1.35(0.77~2.36)	0.29
	高	1.78(0.93~3.38)	0.08	1.78(0.94~3.40)	0.08
学校	中	1.05(0.52~2.10)	0.90	1.08(0.54~2.17)	0.83
	高	1.80(0.81~4.00)	0.15	1.92(0.86~4.28)	0.11
社区	中	1.02(0.62~1.67)	0.95	1.04(0.63~1.72)	0.87
	高	1.18(0.67~2.06)	0.57	1.23(0.70~2.17)	0.47
政策	中	1.08(0.66~1.76)	0.77	1.15(0.70~1.90)	0.58
	高	0.85(0.47~1.52)	0.58	0.97(0.53~1.77)	0.93
文化	中	1.40(0.97~2.03)	0.07	1.39(0.96~2.02)	0.09
	高	1.15(0.70~1.91)	0.58	1.16(0.70~1.92)	0.57
时间	中	1.15(0.76~1.74)	0.52	1.28(0.83~1.95)	0.26
	高	1.04(0.62~1.73)	0.88	1.23(0.73~2.07)	0.44
总和	中	1.19(0.51~2.76)	0.69	1.12(0.48~2.62)	0.80
	高	2.02(0.68~6.05)	0.21	1.83(0.61~5.52)	0.28
注：模型1未调整协变量，模型2调整协变量年级、朋友数量。

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