后疫情时期医学生心理弹性在压力与焦虑症状关系中的中介作用
Mediating role of psychological resilience in relationship between stress and anxiety symptoms of medical students in post COVID-19 period
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摘要:
背景 后疫情时期，不同阶段各类人群心理变化的研判引起重视。在疫情应激压力下，医学生如何控制焦虑症状等负性情绪，将对其职业认同与未来职业胜任能力产生重要影响。
目的 探讨后疫情时期不同阶段医学生压力与焦虑症状的特征，心理弹性在压力与焦虑症状关系间的中介作用。
方法 于2020年9—11月期间，采用方便抽样法，选取陕西省3所医学院校医学生3000名，运用焦虑自评量表（SAS）、大学生压力量表（SSCS）、成人心理弹性量表（RSA）进行网络问卷调查，评定医学生压力、心理弹性和焦虑症状。采用SPSS 25.0软件进行独立样本
t 检验、方差分析、Pearson相关分析和中介作用检验（分层回归分析）。结果 本次调查回收有效问卷2 894份，有效率96.5%。后疫情时期医学生压力、心理弹性和焦虑症状总体得分分别为（56.61±17.17）、（166.88±28.55）和（40.45±9.67）分。高压力检出率72.2%，焦虑症状检出率16.0%。高、低压力水平组间医学生焦虑症状得分（42.16±9.92、35.99±7.30）差异有统计学意义（
P < 0.01）。不同年级组间医学生压力、心理弹性、焦虑症状得分差异有统计学意义（P < 0.01）。Pearson相关分析结果显示，压力得分与焦虑症状得分呈正相关（r =0.417，P < 0.01），与心理弹性得分呈负相关（r =-0.344，P < 0.01）；心理弹性得分与焦虑症状得分呈负相关（r =-0.495，P < 0.01）。分层回归分析发现，压力对焦虑症状有正向作用（b =0.280，P < 0.01），对心理弹性有负向作用（b =-0.344，P < 0.01）；心理弹性对焦虑症状有负向作用（b =-0.398，P < 0.01）；心理弹性在压力与焦虑症状的关系中，具有部分中介作用（作用值为0.137），中介效应占32.8%。结论 后疫情时期医学生存在高压力与高焦虑症状叠加现象。心理弹性是焦虑症状的保护性因素，并在压力与焦虑症状的关系中起部分中介作用。
Abstract:Background In the post-pandemic period, attention has been paid to the study of psychological stage changes in various groups. Under the stress of pandemics, how to control negative emotions such as anxiety symptoms will have an important impact on medical students' professional identity and future professional competence.
Objective This study is designed to explore the characteristics of stress and anxiety symptoms of medical students in different stages of the post COVID-19 period, and potential mediating role of psychological resilience in the relationship between stress and anxiety symptoms.
Methods By convenience sampling method, 3 000 medical students from three medical colleges in Shaanxi Province were selected and completed an online survey reporting the SelfRating Anxiety Scale (SAS), Stress Scale for College Student (SSCS), and Resilience Scale of Adults (RSA) to assess their stress, psychological resilience, and anxiety symptoms in September and November 2020. SPSS 25.0 software was used to perform dependent-sample
t test, variance analysis, Pearson correlation analysis, and mediating effect test (hierarchical regression analysis).Results A total of 2 894 valid questionnaires were recovered and the valid recovery rate was 96.5%. The overall scores of stress, psychological resilience, and anxiety symptoms of selected medical students were 56.61±17.17, 166.88±28.55, and 40.45±9.67, respectively in the post COVID-19 period. The positive rate of high stress was 72.2%, and the positive rate of anxiety symptoms was 16.0%. There were significant differences in anxiety symptoms scores between the high and the low stress level groups (42.16±9.92, 35.99±7.30) (
P < 0.01). There were significant differences in scores of stress, psychological resilience, and anxiety symptoms among different grade groups (P < 0.01). The pearson correlation analysis results showed that the stress score was positively correlated with the anxiety symptom score (r =0.417,P < 0.01) and negatively correlated with the psychological resilience score (r =-0.344,P < 0.01); the psychological resilience score was negatively correlated with the anxiety symptom score (r =-0.495,P < 0.01). The hierarchical regression analysis results found that stress had a positive effect on anxiety symptoms (b =0.280,P < 0.01), and a negative effect on psychological resilience (b =-0.344,P < 0.01); psychological resilience negatively affected anxiety symptoms (b =-0.398,P < 0.01), and played a partial mediating role in the relationship between stress and anxiety symptoms (effect value was 0.137) that accounted for 32.8% of the total effect.Conclusion In the post COVID-19 period, medical students have a superposition of high stress and high anxiety symptoms. Psychological resilience is a protective factor for anxiety symptoms and plays a partial mediating role in the relationship between stress and anxiety symptoms.
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