【作者】 李冬；

【导师】 李士雪；

【作者基本信息】 山东大学 ， 社会医学与卫生事业管理， 2009， 硕士

【摘要】 大学生的心理健康问题已越来越为高校和社会各界所广泛关注。大学生处在成长成才的关键时期,在社会转型逐步推进,社会竞争日益激烈,社会发展日新月异的时代背景下,更容易产生心理困扰并引发心理问题。大学生心理健康的好坏直接影响到高校人才培养目标能否实现,进而深刻影响到国家人才战略能否得以实现。目前,围绕大学生心理健康,国内外相关研究机构和学者展开了大量相关研究并取得了大量成果。作为一名从事一线工作的思想政治教育工作者,本人长期面对的是医科大学生,对他们的心理状况有着比较全面的了解。医科大学生是高校中的一个特殊群体。医科大学生由于其学习环境、学习强度、职业要求、职业期望的特殊性,他们的心理状况体现出不同于其他学科学生的特点。同时,处在求学阶段的大学生,其自身的世界观、人生观和价值观正在形成阶段,他们的心理健康状况成为高校乃至全社会非常关注的问题。医科大学生将来的服务对象是具有复杂心理活动的病人,其自身的心理健康与否显得尤为重要。加强对医科大学生的心理健康状况的研究和探讨,改进对医科大学生心理健康教育工作,是高校广大教育工作者应重点加强的地方。本人结合自己的工作经验,针对医科大学生的自身特点,运用社会学的知识和统计学的手段,对山东大学部分医科大学生的心理健康状况进行了调查分析,了解了医科大学生心理健康的整体状况,分析了影响医科大学生心理健康的各种因素,并据此提出了开展心理健康教育的相关对策,希望能够为将来加强医科大学生心理健康教育、切实改进医科大学生心理健康状况提供可参考的依据。方法本次研究采用整群抽样方法,按大医科的范围,从山东大学医学院1—6年级,口腔医学院、公共卫生学院、护理学院1—5年级,药学院1—4年级共调查1256人,其中男生505人(40.2%),女生751人(59.8%)。调查工具采用(1)研究对象的基本情况调查问卷,调查影响研究对象心理健康状况的相关因素;(2)采用国际通用的精神症状自评量表SCL—90,调查研究对象的心理状况。将所得原始数据录入Excel2003,应用SPSS16.0统计软件包进行数据的统计和分析。用均值±标准差描述各因子得分;两样本均数的比较采用t检验,三组及以上样本均数的比较应用单因素方差分析(f检验),采用广义线形模型分析SCL—90量表十个因子的影响因素。研究结果(1)我校医科大学生心理健康状况与全国青年常模相比,躯体化、人际关系敏感、抑郁、敌对、恐怖、偏执和精神病性等因子分均低于全国常模(P＜0.05),其余因子分无统计学差异(P＞0.05),提示我校医科大学生的心理健康状况好于全国常模;医科女大学生在人际关系敏感、抑郁、焦虑、恐怖等四个因子得分均高于医科男大学生(P＜0.05),其余因子得分无统计学差异(P＞0.05),提示医科男大学生的心理状况好于医科女大学生;不同年级医科大学生在SCL—90各因子分得分具有统计学差异(P＜0.05);一-三年级学生的得分高于四-六年级,提示高年级学生心理健康状况好于低年级学生。不同学院医科学生在躯体化、强迫、人际关系、焦虑、敌对、恐怖和其他因子等七个因子得分有统计学意义差异(P＜0.05),其中药学院学生在躯体化等七个因子中得分最高,亦即心理健康状况最差,而公共卫生在躯体化等七个因子中得分最低,亦即心理健康状况最好;其他因子得分无统计学差别(P＞0.05)。医科贫困生与非贫困生在强迫、人际关系敏感、焦虑、敌对、恐怖、其他六个因子得分有统计学差异(P＜0.05),贫困学生得分高于非贫困学生,提示前者心理健康状况较差;其他因子得分无统计学差异(P＞0.05);来自不同地区的医科学生在强迫、人际关系敏感、抑郁、恐怖和精神病性等五个因子得分有统计学差异(P＜0.05);来自省外城市学生在这五个因子中得分最低,亦即心理健康状况最好,来自省外农村学生在这五个因子中得分最高,亦即心理健康状况最差。在躯体化等五个因子得分无统计学差异(P＞0.05);医科独生子女与非独生子女相比,在人际关系敏感、恐怖和精神病性三个因子得分有统计学差异(P＜0.05),非独生子女子在这三个因子的得分高于独生子女在这三个因子得分,提示前者心理健康状况较差;其他因子得分无统计学差异(P＞0.05):获得奖学金医科学生与没有获得奖学金的学生在强迫和抑郁两个因子得分有统计学差异(P＜0.05),没有获得奖学金学生的得分高于获得奖学金学生的得分,提示前者心理健康状况较差。其他因子得分无统计学差异(P＞0.05);不同成绩排名的医科学生在强迫、抑郁、敌对和其他四个方面因子得分有统计学差异(P＜0.05),成绩居于班级1/3的学生在强迫等因子中的得分最低,亦即心理健康状况最好,成绩居于后1/3的学生在强迫等因子中的得分最高,亦即心理健康状况最差,成绩居于中间1/3的学生在强迫等因子中的得分处于中间。其他因子得分无统计学差异(P＞0.05);而医科学生是否任学生干部、是否获得校级荣誉在各因子的得分无统计学差异(P＞0.05)。(2)研究发现该研究样本中医科大学生阳性总检出率为12.8%,其中,强迫(3.3%)、人际关系敏感(2.0%)、抑郁(1.8%)、敌意(1.8%)和焦虑(1.4%)阳性检出率较高,妄想(0.8%)、恐怖(0.6%)、精神病性(0.6%)和躯体化(0.5%)阳性检出率较低。(3)广义线性模型分析结果表明,性别对强迫、人际关系敏感、抑郁、焦虑、恐怖等因子有影响;年级对躯体化、强迫、人际关系敏感、抑郁、焦虑、敌意、恐怖、妄想、精神病性和其他因子有影响;学院对躯体化、强迫、人际关系敏感、抑郁、焦虑、敌意和其他有影响;是否贫困对强迫、人际关系敏感、焦虑、恐怖和精神病性因子有影响;家庭所在地对人际关系敏感、恐怖因子有影响;成绩情况对其他因子有影响。结论:通过分析发现,我校医科大学生心理健康状况较好,但因为学生个体的差异和具体环境的影响,有少数学生还存在一些心理问题。因此,在实际的心理健康教育工作中,广大思想教育工作者和心理健康教育专业课教师应该分清原因,区分类别,把握重点,针对不同性别、不同年级的学生采取个性化的教育工作;要特别加强对贫困生、学习困难学生等特殊群体的教育力度;要把心理卫生工作的重点放在农村来源学生,加强人际关系、压力管理等方面的教育;开展形式多样的心理健康教育活动,强化心理咨询和心理危机干预工作,帮助他们促进人格完善,解除心理困扰,增进身心和谐,开发自身潜能,顺利度过大学生活,成为医科领域的优秀人才。更多还原

【Abstract】 [Objective] The mental health of college students has been increasing for all sectors of the community college and attention. University students in the crucial period of growth into competent and useful, step by step in the social transformation of society in an increasingly competitive era of social development in the context of the ever-changing and more prone to psychological distress and lead to psychological problems. Mental health of university students a direct impact on personnel training to colleges and universities can achieve the goal, and then a profound impact on the national human resources strategy can be realized.At present, the focus on mental health, domestic and foreign research institutions and scholars to start a large number of relevant studies and obtained a large number of results. Engaged in work as a front-line workers of the ideological and political education, I am facing a long-term medical students on their psychological state has a more comprehensive understanding. College of Medical Students is a special group. Medical students as a result of their learning environment, learning the strength, job requirements, professional expectations are unique, they reflect the psychological state is different from the characteristics of students in other academic disciplines. At the same time, university students in the school, its own world outlook, outlook on life and values of the emerging stage, the mental health of their colleges and universities and even the whole society has become very concerned about the issue. Medical students to serve the future is a complex mental activity of patients, their own mental health it is important or not.Strengthen the mental health of medical students to study and explore the situation to improve mental health education of medical students is working in the education sector colleges and universities should focus on enhancement. I combine the work of their own experience of medical students for their own characteristics, the use of the sociology of knowledge and statistical means of Shandong University, part of the mental health of medical students conducted a survey of the state, medical students about the overall state of mental health, Medical analysis of the impact of mental health factors, and accordingly proposed to carry out the relevance of mental health education measures for the future hope to be able to strengthen mental health education of medical students, and effectively improve the mental health of medical students to provide a basis for reference.[Methods] The study used random cluster sampling method, in accordance with the scope of major medical, from Shandong University School of Medicine, 1-6 grade, School of Dental Medicine, School of Public Health, School of Dental Medicine, College of Nursing, 1-5 grade, 1-4 year College of Pharmacy were 1256 survey, of whom 505 were boys (40.2%), 751 girls (59.8%). Survey instrument used (1) study the basic situation of the questionnaire, the survey studied the impact of mental health-related factors; (2) the spirit of international SCL SCL-90, investigation and study of the psychological state of the object. Will be derived from the original data entry Excel2003, application package SPSS16.0 statistics and analysis of statisticaldata. Mean (X|-)±S standard deviation used to describe the factor score; the two samples were compared using the number of t tests, and more than three sets of samples were found to compare the number of the application of one-way ANOVA (f test), using generalized linear model analysis of SCL-90 Scale factor of ten factor. [Results](1) Medical School Mental Health with the national norm compared to youth, somatization, interpersonal sensitivity, depression, hostility, terror, paranoia and psychosis and other factors such as factor scores were lower than the national norm (P <0.05 ), and the remaining factors were no significant differences (P> 0.05), showed that medical students of our school mental health better than the national norm;Female medical students in interpersonal relationships, depression, anxiety, terror, such as the four factor scores were higher than male medical students (P<0.05), the remaining factors were no significant differences (P>0.05), male medical students indicated that the psychological the situation of female students is better than medicine;Medical students at different levels of the SCL-90 factor scores are the number of statistically significant differences (P <0.05); one - third-grade students scored higher than fourth - sixth grade, high-grade students showed that mental health is better than the lower grades the level of student mental health.Different faculties in the mental health of medical students somatization, compulsion, interpersonal relationships, anxiety, hostility, fear and other factors, such as the seven factors were statistically significant differences (P<0.05), divided equally between the other factor was no significant difference (P>0.05);Poor students and non-poor students in the mental health level of compulsion, interpersonal sensitivity, anxiety, hostility, acts of terror, the other six factors were statistically significant differences (P<0.05); in regard to other factors there was no significant difference (P>0.05);Medical students from different regions in the forced mental health, interpersonal sensitivity, depression, mental illness, such as terror and the five factors were statistically significant differences (P<0.05), five in the somatization factor of the difference was not statistically significance (P>0.05);Compared with non-one-child only child in the interpersonal sensitivity, terror and the mentally-sharing factor of three differences were significant (P<0.05), a number of other factors were not statistically significant differences (P>0.05);Medical students receive scholarships and scholarship has not been forced to be divided equally between the two factors and depression were statistically significant differences (P<0.05), other factors do not share statistically significant difference (P>0.05);Different results in the forced ranking of medical students, depression, hostility and other four factors were statistically significant differences in sharing (P<0.05), other factors do not share statistically significant difference (P>0.05);And whether or not any student leaders, whether honorary colonel in the mental health of medical students is not statistically significant differences (P>0.05).(2) study found that a sample of the study of medical students with psychological problems in the total detection rate of 12.8 percent, which forced (3.3%), interpersonal sensitivity (2.0%), depression (1.8%), hostility (1.8%) and anxiety (1.4%) is more serious, paranoid (0.8%), terrorism (0.6%), psychotic (0.6%) and somatization (0.5%) less.(3) generalized linear model analysis showed that the gender of the forced, interpersonal sensitivity, depression, anxiety, terror and other factors affecting; grade of somatization, compulsion, interpersonal sensitivity, depression, anxiety, hostility, terror, paranoia, mental impact and other factors; College of somatization, compulsion, interpersonal sensitivity, depression, anxiety, hostility and other influential; whether the poverty of coercion, interpersonal sensitivity, anxiety, terror and the mentally influential factor; home of interpersonal sensitivity, terror influential factor; performance impact on other factors. [Conclusion]Through the analysis found that school mental health of medical students is better, but because of individual differences in students and the specific environmental impacts, there are a few students there are still some psychological problems. As a result, the actual work of mental health education, the general thinking of educators and mental health education courses should be to distinguish the reasons for teachers to distinguish between the categories, and grasp key points, for different gender, different students take the education of personalization; should strengthen its of poor students, students with learning difficulties and other special education groups; to mental health work in rural areas focus on the sources of students, strengthen interpersonal relationships, stress management education; to carry out a variety of mental health education activities, and strengthen psychological counseling and psychological crisis intervention work, to help them promote the perfect personality, the lifting of psychological distress and promote mental and physical harmony, and the development of their own potential and have successfully got through college life and become the field of medical talents.更多还原