Study On The Mental Health Of Medical School Students In Yunnan Border Areas And Education Intervention For Them

Objective:With unbalanced economic and cultural development, border areas are very remote, gathering ethnic minorities and presenting differences in the aspect of local ethnic custom and culture. Paying attention to the mental health of all ethnic groups in border areas is of great significance to maintain the security and stability of China’s border areas and the harmonious development of all ethnic groups. Also known as secondary vocational school students and medical students, medical school students belong to a special group. They are young with poor ability in adaptation, anti-pressure and self-regulation. In adolescence, they are experiencing quick and unbalanced physical and psychological development. A number of contradictions and conflicts exist between a strong sense of being an adult and independence and the educational concepts and modes of families and schools, which thus leads to too much negative emotional experience. Medical school students in border areas are a high-risk group with psychological problems. Therefore, probing into the intervention measures for the mental health and education of medical school students in border areas is of important significance to promote the development of the mental health of students, to improve the quality of personnel training and to maintain the security and stability of border areas, national unity and the comprehensive development of society. According to previous studies, medical school students were significantly lower than the average level in the aspect of mental health, whose detection rate of psychological problems was from 12.66% to 63.38%. However, samples were taken mainly from inland and coastal areas; few research tools were adopted; many investigations were conducted on the small samples of the cross section of mental health; few empirical studies were conducted on educational intervention. This research takes the special group of medical school students in border areas as objects, probing into the current situation, development characteristics and influence factors of psychological health, personality and anxiety-depressive mood of medical school students in border areas, combining with the demand characteristics of mentalal health service on this basis, constructing the schemes for the psychological health education of medical school students, conducting empirical studies on psychological education in school education and providing data reference for carrying out psychological health education for medical school students in border areas.Methods:Firstly, a cluster sampling of 3,277 students in a medical school of Yunnan border areas were selected as research objects. Symptom Checklist 90(SCL-90), Eysenck Personality Questionnaire(EPQ), Self-rating Depression Scale(SDS), State-Trait Anxiety Inventory(STAI-Form Y), Self-rating Anxiety Scale(SAS) were taken as evaluation tools to probe into the mental health, the development characteristics of personality and mood, influence factors and mutual relationship of medical school students, providing data support for constructing the schemes for the intervention into the mental health education of medical school students. Secondly, a total of 514 medical school students were selected at random and the self-made questionnaires about the mental health needs of medical school students were adopted to investigate the mental health needs of medical school students, providing the basis for constructing the schemes for the intervention into the mental health education of medical school students. Thirdly, a cluster sampling of 121 medical school students were divided into the intervention group and the control group to conduct empirical studies on the intervention of mental health education. Mental Health Inventory of Middle-school Students(MMHI-60), Coping Style for Secondary School Students(CSS), General Self-efficacy(GSES) and the self-made subjective evaluation form of the educational effect on the mental health of medical school students were selected as evaluation tools to evaluate intervention effects.Results:1. The Characteristics of the Mental Health, Personality and Anxiety- Depressive Mood of Medical school Students(1) Overall characteristics: The detection rate of medical school students with psychological problems was 57.40%. Each factor score of SCL-90 was significantly higher than that of national norm(P<0.01); the scores of SAI and TAI were remarkably higher than those of general population(P<0.01); the scores of SDS and SAS were notably higher than those of Chinese norm(P<0.01); the scores of psychoticism and concealment factors of EPQ were markedly lower than those of national norm(P<0.05); the scores of introversion-extroversion and neuroticism factors were prominently higher than those of national norm(P<0.01).(2) Gender characteristics: Each factor score and total mean score of SCL-90 and the scores of SAI, TAI, SAS and SDS were significantly higher in female students than in male students(P<0.05); the scores of psychoticism and introversion-extroversion factors of EPQ were dramatically higher in male students than in female students(P<0.01); while the scores of neuroticism and concealment factors were noticeably lower in male students than female student(P<0.05).(3) Characteristics in the aspect of grade: The scores and the total mean score of somatization, force, interpersonal sensitivity, depression, anxiety and horror factors of SCL-90 and the scores of SAI, TAI and SAS for medical school students presented significant differences in grade groups(P<0.05); the scores of psychoticism, neuroticism and concealment factors of EPQ showed remarkable differences in grades(P<0.05).(4) Professional characteristics: The scores and total mean score of interpersonal sensitivity, depression, hostility, paranoid and psychoticism factors of SCL-90 for medical school students presented marked differences in professional groups(P<0.05); the score of psychoticism factor of EPQ in nursing specialty was significantly lower than that in the specialty of rural medicine, medicament and medical laboratory(P<0.01).(5) Family structure characteristics: the scores of interpersonal sensitivity, horror factors of SCL-90 and the scores of SAI, TAI and SAS for only children were noticeably lower than those for non-only children(P<0.05); while the score of psychoticism and introversion-extroversion factors of EPQ for only children was markedly higher than that for non-only children(P<0.01);the scores of concealment factor for only children were noticeably lower than those for non-only children(P<0.01).(6) The characteristics of the source of students: The scores and total mean score of interpersonal sensitivity, depression, anxiety and horror factors of SCL-90 and the scores of SAI, TAI, SAS and SDS in rural students were signally higher than those in urban students(P<0.05); the scores of psychoticism and introversion-extroversion factors of EPQ in rural students were dramatically lower than those in urban students(P<0.01); the scores of concealment factors in rural students were remarkably higher than those in urban students(P<0.01). 2. The Relationship among Personality, Mood Level and Mental Health of Medical school Students Each factor score and total mean score of SCL-90 in medical school students presented a significant positive correlation with the scores of EPQ-N, EPQ-P, SAI, TAI, SAS and SDS(P<0.01) and a significant negative correlation with the scores of EPQ-E and EPQ-L(P<0.01). Six factors including anxiety, neuroticism, trait anxiety, psychoticism, depression and state anxiety could explain 54.5% of the variation amount of psychological health status and play a good role in predicting mental health. 3. The Current Situation of Mental Health Needs of Medical school Students Medical school students with more than 3 psychological problems accounted for 84.63%. The most common psychological problems included learning stress, graduation destination, emotional disturbance, interpersonal communication and self-worth. The primary influence factors of psychological problems involved a lot of difficult learning content, poor self-regulation ability, economic problems, great employment pressure and unclear self-awareness. Setting a high requirement on mental health service, medical school students thinking that schools should carry out mental health education took up 84.24%. Their favorite ways of psychological service included exchanging with mental health professionals, attending the lectures on mental health education, the teaching of psychological courses, network consulting, books, newspapers, films and television programs and so on. The mental health content which was anticipated to conducted most covered stress and emotion management, interpersonal ability, the common psychological contradictions and conflicts for secondary vocational school students and common sense of psychology. 4. Empirical Studies on the Intervention into the Mental Health Education of Medical school Students(1) Before intervention, the score of MMHI-60 in the experimental group had no significant differences with that in the control group(P>0.05);after intervention, the score of hostile factor of MMHI-60 in the experimental group decreased obviously(P<0.05); the scores of force, paranoid, depression, anxiety, maladaptation and psychological imbalance factors of MMHI-60 evidently increased in the control group(P<0.05); after intervention, the scores of force, paranoid, hostility, depression, anxiety, maladaptation and psychological imbalance factors of MMHI-60 in the experimental group were significantly lower than those in the control group(P<0.05).(2) Before intervention, no significant differences were showed in the score of CSS between the experimental group and the control group(P>0.05); after intervention, each factor score of coping with pointed problems of CSS in the experimental group remarkably increased(P<0.05); the scores of escape and vent factors apparently decreased(P<0.05); each factor score of coping with pointed problems and the score of patience factor of CSS in the control group witnessed a marked decline(P<0.05); after intervention, each factor score of coping with pointed problems and the score of patience factor of CSS in the experimental group were noticeably higher than those in the control group(P<0.05).(3) Before intervention, the score of self-efficacy in the experimental group showed no significant differences with that in the control group(P>0.05); after intervention, the score of self-efficacy in the experimental group and the control group presented no marked differences(P>0.05); after intervention, the score of self-efficacy in the experimental group was obviously higher than that in the control group(P<0.05).Conclusion:1. Medical school students are lower than general population in the aspect of mental health level with outgoing personality, emotional instability and high simplicity. It is supposed to pay special attention to the mental health of students who are female, studying in graduating class, coming from rural areas, living in a poor family environment and having parents with low education level, poor ability in adapting to the environment, poor interpersonal relationship and introverted personality. 2. Carrying out mental health education should fully consider the mental health, the development characteristics of personality and mood of medical school students and the differences in the needs of mental health service. 3. Mental health education can effectively improve the mental health level, coping capacity and self-efficacy of medical school students.