Investigation And Analysis On Mental Health Status And Qualitative Research On Stress Source And Coping Style Of Medical Students In Shaanxi Province

With the rapid development of economy and social advances, the humandisease spectrum has undergone tremendous changes, as a result that mentalhealth problems become more visible than before. The Medical students will bemedical workers in the future and undertake the important mission of "savinglives". Therefore their professional psychological level is directly related to thehealth of every patient, which is of great social significance. But with theenrollment expansion in most colleges, the continuous improvement of careerdemands, increasingly severe employment situation and social environmentfactors such as changes in the mental health of medical students has changed. Soit is very important to investigate the mental health status and the psychologicalpressure of medical students.Objective:To investigate the mental health status of medical students through aquestionnaire and then find out the origin of their stress and coping style usingin-depth interviews of phenomenological approach. Its purpose is to providesome useful information and scientific basis for mental health education andmental health interventions of medical students. Methods:1. A total of2770medical students were randomly selected according tocluster sampling. They completed a demographic survey, Symptom Checklist90(SCL-90-R), Depression Status Inventory (DSI), Self-rating Anxiety Scale(SAS), Interpersonal Trust Scale (ITS) and Social Avoidance and Distress Scale(SADS).2. Twenty-eight medical students were selected in this study，and they wereinterviewed with the method of in-depth interview of qualitative research. Thenthe data were processed with the phenomenological research method.Results:1. Characteristics informationThe participants included1257(45.3%) male female students and1513(54.6%) female students. The mean age of all medical students was21(SD=2.34, range=15–35). The study comprised four educational levels and twosorts of grades:521(18.8%) technical secondary school students,1049(37.9%)junior college students,909(32.8%) undergraduates and291(10.5%)graduates;1504(54.3%) junior students and1266(45.7%) senior students,79(2.9%) minorities nationality,557(20.1%) in a single-child family,874(31.6%)in love,212(7.7%) in single-parent family,1907(68.8%) coming from ruralareas.2. The status of mental health(1) The psychological well-being of2770medical students①The results of SCL-90showed that the positive detection rate was966(34.9%) and the factor scores in somatization, anxiety and phobia are higher than both the National College students norm and the National Youth norm(P<0.001). In addition, the factor scores of SCL-90in interpersonal sensitivity,depression, hostility, paranoid ideation, psychoticism were significant lowerthan the national college students norm, and higher than the National Youthnorm (P<0.001).②The Standard score of Self-rating Anxiety Scale is(43.03±9.28) higher than China normal norm(P<0.001), and the positivedetection rate for mild anxiety437(15.8%)，moderate anxiety89(0.3%)，severeanxiety41(0.1%).③The score of Depression Status Inventory (DSI) is(0.63±0.43) higher than normal, and the positive detection rate for milddepression948(34.2%)，moderate depression1389(50.1%)，severe depression37(1.3%).④The score of Interpersonal Trust Scale (ITS) is (78.19±7.76) higherthan theoretical average75.⑤The score of Social Avoidance And DistressScale (SAD) is (79.13±12.18) lower than theoretical average84.(2) Comparative and analysis in different grades①The scores of SCL-90of junior students are higher than senior studentsexcept the factor of hostile, and there are obvious differences between them (P<0.001).②The score of Self-rating Anxiety Scale (SAS) between them havenot obvious differences (P>0.05).③The score of Depression Status Inventory(DSI) between them have significant difference (P<0.001).④The score ofInterpersonal Trust Scale (DSI) between them have significant difference(P<0.05).⑤The score of Social Avoidance and Distress Scale (SAD) betweenthem have significant difference (P<0.001).(3) Comparative and analysis in different educational levels①The results for all of SCL-90factors revealed a significant main effect forlevel of education (P<0.001). When compared with the different subject groups,the SCL-90scores indicate that technical secondary school students are the highest of the four educational levels, and suffered with more psychologicalproblems compared with the junior college students (P<0.01), and the juniorcollege students had more psychological problems when compared with theundergraduate students (P<0.01), and the undergraduate students had morepsychological problems when compared with the graduate students (P<0.01).②The results for Self-rating Anxiety Scale (SAS) among them have significantdifference(P<0.01). When compared with the different subject groups, the SASresults suggest that score was the highest for technical secondary school studentsbetween different educational levels and had significant difference (P<0.01). Inaddition the results for the SAS indicate that the score was higher for the juniorcollege students than undergraduates (P<0.01) and higher for undergraduatescompared to the graduates (P<0.01).③The results for Depression StatusInventory (DSI) among them have significant difference(P<0.01). Whencompared with the different subject groups, the score of Depression StatusInventory (DSI) show that technical secondary school students was the lowestamong them and have significant difference (P<0.001). In addition the resultsfor the DSI indicate that depression was lower for the junior college studentsand undergraduates when compared with the graduates (P<0.01). Otherwise, thescore of DSI between the junior college students and undergraduates have notobvious differences (P>0.05).④The results for Interpersonal Trust Scale(ITS)among them have significant difference(P<0.01). The score of InterpersonalTrust Scale(ITS) show that technical secondary school students was the highestamong them and have significant difference (P<0.01). Furthermore, the resultsfor the ITS indicate that interpersonal trust was higher for the junior collegestudents than undergraduates (P<0.01) and higher for undergraduates comparedto the graduates (P<0.01).⑤The results for Social Avoidance and Distress Scale (SAD) among them have significant difference (P<0.01). When comparedwith the different subject groups, the score of Social Avoidance and DistressScale (SAD) show that technical secondary school students was the highestamong them and have significant difference (P<0.01). In addition, the results forthe SAD indicate that social avoidance and distress was higher for theundergraduates than junior college students (P<0.01) and higher for juniorcollege students compared to the graduates (P<0.01). The score of SocialAvoidance Scale was higher for technical secondary school students whencompared with the junior college students and undergraduates the graduates (P<0.01). Furthermore, the results for Social Avoidance Scale was higher forundergraduates than the junior college students (P<0.01) and higher for thejunior college students compared to the graduates (P<0.01), but there have notobvious differences between the junior college students and undergraduates(P>0.05). The score of Social Distress Scale was the highest for technicalsecondary school students (P<0.01), and higher for the junior college studentsand undergraduates when compared with the graduates (P<0.01), but there havenot obvious differences between the junior college students and undergraduates(P>0.05).3. The results of qualitative research(1) The psychological pressure of medical studentsEight points of their psychological pressure sources were obtained: learningpressure, further education and employment pressure, adaptation to theenvironment, interpersonal communication， school management, emotionalstress, family and personality traits.(2)The stress coping styles of medical studentsFour points of coping style are explained: communication and have talk with someone, find information and seek help, self-guidance and self-catharsis,blame incompetence and to evade the issue.Conclusion:1. The anxiety and depression of medical students in serious condition andmental health status is not optimistic.2. There were significant differences on the mental health status of themedical students in different grades. And we can conclude that the mental healthstatus of junior students was bad than senior grade students，but the condition ofdepression and Social Avoidance and Distress on senior grade students wasserious.3. There were significant differences on the mental health status of themedical students in different grades educational levels. Overall, the higher thestudent’s level of education, the better their mental health, whereas the conditionof interpersonal trust and depression revealed that senior grade students wasserious than junior students.4. It is concluded that the stress source of medical students tends to beinfluenced by factors of themselves and the external factors and the coping styleinclined to be positive.