| Background and aimIn the last few years,the psychological health of medical students is concerned by the whole world.As the important part of the university students and concerned about the work they will be engaged in after their graduate,medical students'psychological health is more important,and their psychological health is a social problem which can't be ignored.There are many factors can influence the medical students' psychological health,and the family factor is definitely one of the most important factors.Comprehensively,family environment affects the students'behavior and psychology mainly from these four aspects:family emotional atmosphere,parents' parenting style,family structure and family economic condition.We conduct the research in order to achieve the following objectives:(1)find the problem:find the psychological health problems in medical students;(2)find out the reason:to understand the reasons for the formation of medical students' psychological health problems,and discusses the family factor's impact on the medical students'psychological health problems;(3)provide scientific basis for solving the problem:to provide basis for psychological counseling and countermeasures for medical students'psychological health,provide references of studying the medical students'psychological health for other researchers;provide reference basis for formulating health policy for the relevant authorities.Object and methodStudents of grade one and two in three provincial medical universities respectively in the south,north and center of a province were chosen as our objective.Based on the situation of fully informed consent,we use the self-made questionnaire to collect the information of medical students.Use EpiData 3.1 to establish database,use SPSS13.0 to analyze the data,?=0.05.Frequency and frequency distribution were used to describe the character of enumeration data,if measurement data obey the normal distribution,the mean(standard deviation)or median(interquartile range)were used to describe their characters.Use the chi-square test,correction chi-square test or Fisher's exact test,t test,one-way ANOVA or nonparametric test methods and so on to statistical inference.Use the multivariable logistic regression analysis and multivariable linear regression analysis to analyze the influences between psychological health and its factors.Result11270 medical students joined the research,10340 effective questionnaires had been taken back.After analyzing the returned questionnaires,we got effective statistics about medical students' family situation and their psychological health.The results are as follows:Comparison of psychological health among medical students in different economic family:there's no statistically difference in aggression among medical students in different economic family(F=2.72,P=0.07).Statistically difference exists in impulsiveness among medical students in different economic family(F ? 5.16,P=0.01),medical students with the moderate economic family have the most obvious character of impulsiveness.The incidence of anxiety in medical students with a good economic family(10.42%)is lower(?2=65.94,P<0.001)than the one with a moderate economic family(12.87%)and poor economic family(16.70%).The incidence of depression in medical students with a poor economic family(21.09%)is higher(?2 = 85.98,P<0.001)than the one with a good economic family(11.98%)and moderate economic family(14.59%).The incidence of attempted suicide in good economic,moderate,and poor medical students' family are 1.56%,1.48%and 1.45%respectively,and the incidence of suicide ideation are 13.02%,16.34%and 17.05%respectively in three different levels family.The situation of attempted suicide and suicide ideation among medical students in different economic family have no statistically difference(?2=0.03,P=0.98;?2=2.56,P=0.28).Comparison of psychological health among medical students in different structure of family type:the score of AQ-CV in medical students with an incomplete family structure(28.78±13.33)is higher(F=6.99,P=0.008)than the one with complete family structure(27.37±12.82).The score of BIS-11 in medical students with complete and incomplete family structure is 36.76±11.90 and 36.87±11.49 respectively;the incidence of anxiety with two above family structure is 14.01%and 15.14%respectively;the incidence of depression is 16.77%and 17.87%respectively;and the incidence of attempted suicide is 1.42%and 2.25%respectively.There's no statistically difference among medical students in different structure of family type in score of BIS-11(F=0.05,P=0.83),anxiety(?2=5.15,P=0.16),depression(?2=2.43,P=0.49)and attempted suicide(?2=2.81,P=0.09).The incidence of suicide ideation in medical students with an incomplete family structure(20.93%)is higher(?2=9.39,P=0.002)the one with complete family structure(16.23%).Comparison of psychological health among medical students with different stay-at-home in childhood:there's statistically difference in the score of AQ-CV(F=63.90,P<0.001)and in the score of BIS-11(F=21.06,P<0.001)among medical students with different stay-at-home in childhood.And medical students with stay-at-home in childhood have more obvious character of aggression and impulsiveness.The incidence of anxiety in medical students with stay-at-home in childhood(17.74%)is higher than(?2=34.85,P<0.001)the one without stay-at-home in childhood(13.02%).The incidence of depression in medical students with stay-at-home in childhood(19.71%)is higher than(?2=18.10,P<0.001)the one without stay-at-home in childhood(16.00%).There's no statistically difference in attempted suicide among medical students with different stay-at-home in childhood(?2=2.89,P=0.09).The incidence of suicide ideation in medical students with stay-at,home in childhood(22.41%)is higher than(?2=76.11,P<0.001)the one without stay-at-home in childhood(14.79%).Comparison of psychological health among medical students with different violence between parents in childhood:there's statistically difference in the score of AQ-CV(F=324.96,P<0.001)and BIS-11(F=139.25,P<0.001)among medical students with different violence between parents in childhood.And medical students with violence between parents in childhood have more obvious character of aggression and impulsiveness.The incidence of anxiety,depression,attempted suicide and suicide ideation in medical students with violence between parents in childhood and without violence between parents in childhood are 19.74%,23.04%,2.53%,26.81%and 11.22%,13.69%,0.93%,11.29%respectively.There's statistically difference in anxiety(?2=139.74,P<0.001),depression(?2=437.44,P<0.001),attempted suicide(?2=40.74,P<0.001)and suicide ideation(?2=403.33,P<0.001).Comparison of psychological health among medical students with different assault by parents/guardians:there's statistically difference in the score of AQ-CV(F=377.37,P<0.001)and BIS-11(F=82.34,P<0.001)among medical students with different assault by parents/guardians.Those medical students with assault by parents/guardians have more obvious character of aggression and impulsiveness.The incidence of anxiety,depression,attempted suicide and suicide ideation in medical students with and without assault by parents/guardians is 20.41%,23.73%,3.56%,30.11%and 12.09%?14.67%.0.81%.12.23%respectively.There's statistically difference in anxiety(?2=118.86,P<0.001),depression(?2=132.30,P<0.001),attempted suicide(?2=97.79,P<0.001)and suicide ideation(?2=436.69,P<0.001).Comparison of psychological health among medical students with different family function:there's statistically difference in the score of AQ-CV(F=223.93,P<0.001)and BIS-11(F=314.38,P<0.001)among medical students with different family function.And those medical students with serious disorders in family function have most obvious character of aggression and impulsiveness.There's statistically difference in anxiety(?2=118.86,P<0.001),depression(?2=559.81,P<0.001),attempted suicide(?2=84.30,P<0.001)and suicide ideation(?2=504.04,P<0.001)among medical students with serious disorders in family function.Medical students with serious disorders in family function have more obvious character in anxiety,depression,attempted suicide and suicide ideation than those with moderate disorders in family function and those with normal family function.Multivariable logistic regression analysis of anxiety:family economic condition,stay-at-home in childhood,violence between parents,assault by parents/guardians,family function,gender,grade,the level of specialty satisfaction,religion and so on are the influence factors of anxiety in medical students.Medical students with a poor economic family(OR(95%C.I)=1.050-1.326,P=0.005),with stay-at-home in childhood(OR(95%C.I.)=1.053-1.377,P=0.007),with violence between parents in childhood(OR(95%C.I.)=1.228-1.579,P<0.001),with assault by parents/guardians(OR(95%C.I.)=1.088-1.433,P=0.002),with serious disorders in family function(OR(95%C.I.)=1.279-1.554,P<0.001)are more vulnerable to anxiety.Students who are female,in grade two,unsatisfied with their specialty and have religion are more vulnerable to anxiety(P<0.05).Multivariable logistic regression analysis of depression:family economic condition,violence between parents,family function,gender,grade,the level of specialty satisfaction,religion and so on are the influence factors of depression in medical students.Medical students with a poor economic family(OR(95%C.I)=1.281-1.596,P<0.001),with violence between parents in childhood(OR(95%C.I.)=1.184-1.503,P<0.001),with serious disorders in family function are more vulnerable to depression(OR(95%C.I.)=1.645-1.972,P<0.001).Students who are female,in grade two,unsatisfied with their specialty or have religion are more vulnerable to depression(P<0.05).Multivariable logistic regression analysis of attempted suicide:assault by parents/guardians,family function,anxiety,depression,gender,religion,etc are the influence factors of attempted suicide in medical students.Medical students with assault by parents/guardians(OR(95%C.I.)=2.005-4.158,P<0.001),with serious disorders in family function(OR(95%C.I.)=1.135-1.837,P=0.003),with anxiety(OR(95%C.I.)=1.400-3.039,P<0.001)and depression(OR(95%C.I.)=1.291-2.823,P=0.001)symptoms are more vulnerable to attempted suicide.Medical students of female or have religion are more vulnerable to attempted suicide(P<0.05).Multivariable logistic regression analysis of suicide ideation:violence between parents,stay-at-home in childhood,assault by parents/guardians,family function,anxiety,depression,gender,the level of specialty satisfaction,religion and so on are the influence factors of suicide ideation in medical students.Medical students with violence between parents in childhood(OR(95%C.I.)?1.602-2.035,P<0.001),with assault by parents/guardians(OR(95%C.I.)=1.861-2.405,P<0.001),with stay-at-home in childhood(OR(95%C.I.)=2.176-1.520,P<0.001),with serious disorders in family function(OR(95%C.I.)=1.531-1.846,P<0.001),with anxiety and depression symptoms(P<0.001)are more vulnerable to suicide ideation.Students who are female,in grade two,unsatisfied with their specialty or have religion are more vulnerable to suicide ideation(P<0.05).Multivariable linear regression analysis of aggression:aggression is related to family structure,violence between parents,stay-at-home in childhood,assault by parents/guardians,family function,anxiety,depression,gender,grade,the level of specialty satisfaction,religion,mental problems and so on.Students who are male,in grade two,unsatisfied with their specialty and have religion are more vulnerable to aggression(P<0.05).Medical students with an incomplete family structure(t=1.991,P=0.046),with stay-at-home in childhood(t=4.220,P<0.001),with violence between parents(t=7.615,P<0.001),with assault by parents/guardians(t=8.846,P<0.001),with serious disorders in family function(t=8.919,P<0.001),with anxiety and depression symptoms are more vulnerable to aggression.Medical students' anxiety,depression and insomnia have a positive correlation with aggression and those who have severer above symptoms have more obvious character of aggression.Multivariable linear regression analysis of impulsiveness:impulsiveness is related to the violence between parents,assault by parents/guardians,family function,anxiety,depression,gender,grade,the level of specialty satisfaction and so on.Medical students with violence between parents(t=3.799,P<0.001),with assault by parents/guardians(t=2.541,P=0.011),with serious disorders in family function(t=16.455,P<0.001),with anxiety and depression are more vulnerable to impulsiveness.Female,grade two and unsatisfied with their specialty are more vulnerable to impulsiveness(P<0.05).Medical students,who have anxiety,depression and can't engaged in the daily activities and study,have a positive correlation(P<0.05)with impulsiveness.And those who have severer above symptoms have more obvious character of impulsiveness(P<0.05).ConclusionMedical students have many psychological health problems such as aggression,impulsiveness,insomnia,mental problems,anxiety,depression,suicide(including attempted suicide and suicide ideation)and son on,and the incidence rates of psychological health problems are little higher.Family factors such as family economic status,family structure,family emotional atmosphere,parenting style and family function are the influence factors of medical students' psychological health,a good family environment is conducive to the psychological health of medical students.Therefore,we should strengthen the attention of the medical students' psychological health,especially the parents should pay attention to improve the family environment,build a harmonious family atmosphere,to promote the psychological health of medical students. |
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