Study Effect Factors And Intervene Trialk Of Sleep Quality About Medical Students In Hainan Provrnce

[Objective] To explore the baseline level of sleep quality in students of Hainan medical college, analyze the impact factors and evaluate the effect of group consulting intervention on sleep quality in medical students.[Method] Using cluster sampling method, 551 students of 5 classes in Hainan medical college were selected from each of the 5 grades, and cross-sectional survey were conducted in October 10, 2006 with self-designed scale for sleep related factors and PSQI,SCL-90,EPQ scales. the impact factors and their effect on quality of sleep were analyzed using stepwise multiple regression and path analysis methods based on the cross-sectional data. We sampled 150 students from grade one,grade three and grade five, 50 each, from the original sample and conducted the same survey in November 23, 2007 and January 10, 2007. Then we evaluated the trends of sleep quality change in different time points using mixed effect linear model method based on repeat measurement data. On the same time, we also sample 108 students in grade one from department of preventive medicine, who did not participate the previous study, for the intervention study of sleep quality. They were investigated using the self-designed scale for sleep factors and PSQI,SCL-90,EPQ scales in December 15,2006, those who got an PSQI score more than 7(21 students) were intervened by group counseling for 30 days. Paired t-test or Signed-ranks test were used to evaluate the effect according to the data distribution.[Result] The mean of PSQI score was 5.74±2.78, 21.42% of subjects in this study had problem in sleep. No statistically significant difference was found between different genders. Path analysis showed that among all factors we explored, the personality of "nervousness" play the most important role in the sleep quality of medical students with an effect value of 0.3575, " mental disorder disposition" and " frequency of sleep delay " were main factors subsequently with effect value of 0.2650 and 0.2351, respectively. "mental disorder disposition" and "dormitory's environment" were direct impact factors of sleep quality, while study burden and stress were inducement factors, but did not played main role. Personality, "frequency of sleep delay "and grade factors can affect sleep quality both by direct influence and intermediate impact. Repeat measurement analysis with mixed effect linear method showed a stable level of sleep quality in the first half of term followed by a decrease in the later term. Sleep quality were different between grades(F=3.86, P=0.0232). the main impact factors to sleep quality were personality dimension of "extraversion" (beta =-0.111, P=0.0013) and nervousness (beta =0.0951, P=0.0031), mental disorder disposition (beta =0.0075, P=0.0023),frequency of sleep delay (beta =0.4280, P<0.0001), dormitory's environment (beta =-0.2680, P=0.0043) and study burden(beta =0.3905, P=0. 0004). There were significant difference between pre-evaluation and post-evaluation of sleep quality after group counseling intervention (t=-8.72,P<0.0001) , most students (80.95%) got better sleep quality.[Conclusion] The sleep quality of medical students is worthy of worrying about, especially for the grade 1 students. Psychological Consulting and group activities should be strengthened to help the students to fit into college life effectively. Based on the results that study burden was an objective factor, stress does a small effect but acting as a trigger, mental disorder disposition was the direct factor, personality was the bases factor to sleep quality, and the fact that college students are on the stage of personality construct and thus impressionable, we conclude that psychological consulting,psychology induction,group counseling,should be effective method to improve the sleep quality by personality trait adjustment and psycho-quality improvement. At the same time, good environment in dormitory and regular bedtime and rising time can also help. It was obviously that sleep quality in end-of-term stage was worst, so intervention in the period is more important.