您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (11): 93-99.doi: 10.6040/j.issn.1671-7554.0.2020.0073

• 医学心理学 • 上一篇    下一篇

医学生生命意义感与自杀意念的关系

张艺琳,王超,邹广顺,吕军城   

  1. 潍坊医学院公共卫生学院 “健康山东”重大社会风险预测与治理协同创新中心, 山东 潍坊 261053
  • 发布日期:2021-11-11
  • 通讯作者: 吕军城. E-mail:cheng_china@163.com
  • 基金资助:
    2019年山东省社科规划研究项目(19CJYJ24);2020年度山东省人文社会科学课题(2020-NDGL-30);山东省高等学校青创人才引育计划(2019-6-156,Lu-Jiao);《医学统计学》教学案例库构建(SDYAL20153)

Relationship between sense of meaning in life and suicidal ideation in medical students

ZHANG Yilin, WANG Chao, ZOU Guangshun, LYU Juncheng   

  1. School of Public Health, Weifang Medical University, Collaborative Innovation Center for Prediction and Management of Major Social Risks in “Healthy Shandong”, Weifang 261053, Shandong, China
  • Published:2021-11-11

摘要: 目的 对医学生的生命意义感及自杀意念进行调查研究,探讨医学生自杀意念的影响因素以及生命意义感与自杀意念的关系。 方法 于2020年5至10月采用随机分层整群抽样法选择某两医学院2 000名医学生,采用自编一般情况调查表、生命意义感量表(PIL)、Beck自杀意念量表中文版(BSI-CV)对其进行问卷调查;收集有效问卷1 847份。 结果 1 847名医学生平均(19.39±1.26)岁,过去一周自杀意念检出率为21.33%;生命意义感平均(53.73±17.18)分;有自杀意念的医学生生命意义得分低于无自杀意念的(t=-16.041,P<0.001);生命意义感与自杀意念呈负相关(rs=-0.390,P<0.001);多因素Logistic回归结果显示,与医学生自杀意念相关的因素有:生命意义感得分高(OR=0.521,95%CI=0.472~0.575),家庭教育方式为民主型(参考组为其他)(OR=0.583,95%CI=0.360~0.944),亲朋好友无自杀行为(OR=0.555,95%CI=0.382~0.806),遇到压力和困难时不能得到帮助(OR=1.527,95%CI=1.003~2.323),知心朋友的数量(参考组3个及以上)为0个(OR=2.494,95%CI=1.650~3.769)、1个(OR=1.955,95%CI=1.432~2.669),认为理想与现实(参考组为无差距)差距很大(OR=2.084,95%CI=1.220~3.559)、差距非常大(OR=2.235,95%CI=1.171~4.264)。 结论 医学生的自杀意念检出率不容乐观;生命意义感得分低的医学生更易产生自杀意念;生命意义感与自杀意念存在关联;医学院校应采取针对性措施如加强生命意义感教育从而降低医学生的自杀意念。

关键词: 医学生, 生命意义感, 自杀意念, 影响因素, 预防措施

Abstract: Objective To investigate the sense of meaning in life and suicidal ideation in medical students, so as to explore their relationship and influencing factors. Methods From May to October 2020, 2 000 medical students from Weifang Medical College and Binzhou Medical College were selected by random stratified cluster sampling method, and surveyed with a self-compiled general questionnaire, Purpose in Life Test(PIL)and Beck Suicidal Ideation Scale Chinese Version(BSI-CV). A total of 1 847 valid questionnaires were collected. Results The average age of medical students was(19.39±1.26)years, and the detection rate of suicidal ideation in the past week was 21.33%. The average score of the sense of meaning in life was 53.73±17.18. Medical students with low sense of meaning in life were more likely to develop suicidal ideation than those with high scores (t=-16.041, P<0.001). There was a negative correlation between sense of meaning in life and suicidal ideation(rs=-0.390, P<0.001). Multiple Logistic regression showed that the factors related to suicidal ideation were high sense of meaning in life(OR=0.521, 95%CI: 0.472-0.575), democratic child discipline(the reference group was other)(OR=0.583, 95%CI: 0.360-0.944), no friends or relatives committing suicide(OR=0.555, 95%CI: 0.382-0.806), unavailability of help under stress and difficulties(OR=1.527, 95%CI: 1.003-2.323), number of close friends(3 or more in the reference group)being 0(OR=2.494, 95%CI: 1.650-3.769)and 1(OR=1.955, 95%CI: 1.432-2.669), gap between ideal and reality(no gap in the reference group)being large(OR=2.084, 95%CI: 1.220-3.559)and very large(OR=2.235, 95%CI: 1.171-4.264). Conclusion The rate of suicidal ideation among medical students is high. Those with low sense of meaning in life are more likely to develop suicidal ideation. The sense of meaning in life is associated with suicidal ideation. Medical colleges and universities should take targeted measures such as strengthening the sense of meaning in life education so as to reduce suicidal ideation.

Key words: Medical students, Sense of meaning in life, Suicidal ideation, Influencing factors, Prevention measure

中图分类号: 

  • R179
[1] 陈玲玉,宋广文. 加强大学生生命意义感教育的必要性和实效性研究[J]. 河北大学成人教育学院学报, 2019, 21(2): 125-128. CHEN Lingyu, SONG Guangwen. Study on the necessity and effectiveness of strengthening college students sense of meaning of life education [J]. Journal of College of Adult Education, Hebei University, 2019, 21(2): 125-128.
[2] 何兆雄. 自杀病学简论[J]. 学术论坛, 1999(6): 44-48. HE Zhaoxiong. Brief introduction to the pathology of suicide [J]. Academic Forum, 1999(6): 44-48.
[3] 许二平, 姬旺华, 张会萍. 医学生生命意义感现状调查及对策探析[J]. 教育教学论坛, 2019(26): 68-70. XU Erping, JI Wanghua, ZHANG Huiping. Investigation and countermeasure analysis on the sense of life meaning of medical students [J]. Education Teaching Forum, 2019(26): 68-70.
[4] 李献云, 费立鹏, 张亚利, 等. Beck自杀意念量表中文版在大学学生中应用的信效度[J]. 中国心理卫生杂志, 2011, 25(11): 862-866. LI Xianyun, PHILLIPS Michael R, ZHANG Yali, et al. Reliability and validity of the Chinese version of Beck Scate for Suicide Ideation(BSI-CV)among university students [J]. Chinese Mental Health Journal, 2011, 25(11): 862-866.
[5] 关素珍, 刘向阳, 郑平, 等. 医学生自杀意念与家庭因素关系的研究[J]. 中国预防医学杂志, 2015, 16(1): 36-38. GUAN Suzhen, LIU Xiangyang, ZHENG Ping, et al. The influence of family factors on suicidal thoughts of medical students [J]. China Preventive Medicine, 2015, 16(1): 36-38.
[6] 陈秀珍, 贾珍荣, 杨晓娟. 生活事件、自尊和抑郁对大学生自杀意念的影响[J]. 中国健康心理学杂志, 2020, 28(10): 1557-1561. CHEN Xiuzhen, JIA Zhenrong, YANG Xiaojuan. Effects of life events, self-esteem and depression on suicidal ideation of college students [J]. China Journal of Health Psychology, 2020, 28(10): 1557-1561.
[7] 和红, 杨洋. 大学生抑郁自杀意念及影响因素的路径分析[J].中国学校卫生, 2015, 36(1): 80-83. HE Hong, YANG Yang. Path analysis on the influencing factors of suicide ideation among college students in Beijing [J]. Chinese Journal of School Health, 2015, 36(1): 80-83.
[8] 朱薏帆, 蓝媛美, 欧阳皓华, 等. 父母教养方式、生命价值观与大学生自杀意念的关系研究[J]. 中国健康教育, 2019, 35(8): 675-679. ZHU Yifan, LAN Yuanmei, OUYANG Haohua, et al. Study on the relationship between parental rearing style, life values and suicidal ideation of college students [J]. China Health Education, 2019, 35(8): 675-679.
[9] 刘畅, 赵群. 医学生自杀意念与孤独感的关系[J]. 中国健康心理学杂志, 2013, 21(11): 1747-1749. LIU Chang, ZHAO Qun. Relationship between suicidal ideation and loneliness in medical students [J]. Chinese Journal of Health Psychology, 2013, 21(11): 1747-1749.
[10] 吴玲, 王小丹, 田冶. 海南医学生自杀意念的现况调查[J].中国健康心理学杂志, 2013, 21(10): 1587-1588. WU Ling, WANG Xiaodan, TIAN Ye. A cross-sectional survey of suicidal ideation among medical students in Hainan [J]. Chinese Journal of Health Psychology, 2013, 21(10): 1587-1588.
[11] 叶有好, 高钰琳, 李婷. 医学生主观幸福感在生命意义感与学习动机关系中的中介作用研究[J]. 护理研究, 2019, 33(9): 1482-1485. YE Youhao, GAO Yulin, LI Ting. The mediating role of subjective well-being in the relationship between the sense of life meaning and learning motivation among medical students [J]. Chinese Nursing Research, 2019, 33(9): 1482-1485.
[12] 黄俊霞, 王婷婷, 史玉坤. 大学生总体幸福感与自杀意念的相关分析[J]. 宿州学院学报, 2017, 32(5): 45-48. HUANG Junxia, WANG Tingting, SHI Yukun. Correlation analysis between general well-being and suicidal ideation of college students [J]. Journal of Suzhou University, 2017, 32(5): 45-48.
[13] Feldman DB, Snyder CR. Hope and the meaningful life: theoretical and empirical associations between goal-directed thinking and life meaning[J]. J Soci Clin Psychol, 2005, 24(3): 401-421.
[14] Krause N. Thought suppression and meaning in life: a longitudinal investigation [J]. Int J Aging Hum Dev, 2007, 64(1): 67-82.
[15] 汤思尧, 肖蓉, 张瑞雪. 医学生物质主义价值观和抑郁: 生命意义感的中介作用[J]. 南方医科大学学报, 2019, 39(4): 495-499. TANG Siyao, XIAO Rong, ZHANG Ruixue. Materialistic values and depression in medical students: the mediating effect of meaning in life [J]. Journal of Southern Medical University, 2019, 39(4): 495-499.
[16] 罗婷, 张代敏, 陶亮桥. 医学新生生命价值观及心理健康水平对自杀意念的影响[J]. 重庆医学, 2020, 49(13): 2193-2196. LUO Ting, ZHANG Daimin, TAO Liangqiao. Effect of life values and mental health on suicidal ideation in medical freshmen [J]. Chongqing Medicine, 2020, 49(13): 2193-2196.
[17] 杨笑梅, 徐丽. 护生死亡态度及影响因素的研究进展[J]. 全科护理, 2019, 17(13): 1557-1561. YANG Xiaomei, XU Li. Research progress on death attitude and influencing factors of nursing students [J]. General Nursing, 2019, 17(13): 1557-1561.
[18] 田雪, 吕世欣, 徐耀辉, 等. 医学生死亡态度与自杀意念的关系: 自我效能感的中介效应[J]. 中国健康心理学杂志, 2016, 24(6): 932-935. TIAN Xue, LV Shixin, XU Yaohui, et al. The relationship between attitudes toward death and suicide ideation in medical students: mediating effect of self-efficacy [J]. China Journal of Health Psychology, 2016, 24(6): 932-935.
[19] 黄香琴, 耿浩宇. 大学生生活事件与自杀意念、死亡态度的关系[J]. 现代交际, 2020(7): 191-192. HUANG Xiangqin, GENG Haoyu. Relationship between life events, suicidal ideation and death attitude of college students [J]. Modern Communication, 2020(7): 191-192.
[20] 陶涛, 史玉坤, 袁锦, 等. 大学生自杀意念与死亡态度的相关分析[J]. 中国健康心理学杂志, 2016, 24(7): 1073-1076. TAO Tao, SHI Yukun, YUAN Jin, et al. The relationship between suicide ideation and attitude towards death among college students [J]. China Journal of Health Psychology, 2016, 24(7): 1073-1076.
[21] 茹福霞, 黄秀萍, 詹文韵, 等. 中国大陆大学生自杀计划检出率Meta分析[J]. 中国学校卫生, 2019, 40(1): 42-45. RU Fuxia, HUANG Xiuping, ZHAN Wenyun, et al. Prevalence of suicidal plans among college students in mainland China: a Meta-analysis [J]. Chinese Journal of School Health, 2019, 40(1): 42-45.
[22] Holly C, Amelia M, Kimberly M, et al. Prevalence and predictors of persistent suicide ideation, plans, and attempts during college [J]. Effect Discord, 2010, 127(3): 287-294.
[23] 陈君, 耿仁文. 心理健康与自杀行为的影响因素: 基于对三所高校10 340名医学生的调查[J]. 南方医科大学学报, 2020, 40(11): 1689-1692. CHEN Jun, GENG Renwen. Factors affecting psychological health and suicidal behavior: based on a survey of 10340 medical students from three universities [J]. Journal of Southern Medical University, 2020, 40(11): 1689-1692.
[24] 吴传莉, 留秀丽, 游文鋆, 等. 医学研究生人格特质与心理健康状况典型相关分析[J]. 中国卫生统计, 2017, 34(3): 421-423. WU Chuanli, LIU Xiuli, YOU Wenjun, et al. Canonical correlation analysis of relationship between personality characteristics and mental health status among medical postgraduate students [J]. Chinese Journal of Health Statistics, 2017, 34(3): 421-423.
[25] Tang WJ, Kang YK, Xu JP, et al. Associations of suicidality with adverse life events, psychological distress and somatic complaints in a Chinese medical student sample [J]. Community Ment Health J, 2020, 56(4): 635-644.
[26] 刘肖莉, 刘照佩, 房晓萌, 等. 青少年情绪障碍的影响因素分析[J]. 中国妇幼保健, 2019, 34(12): 2822-2824. LIU Xiaoli, LIU Zhaopei, FANG Xiaomeng, et al. Analysis of influencing factors of emotional disorder in adolescents [J]. Maternal and Child Health Care of China, 2019, 34(12): 2822-2824.
[27] 文建, 况利. 医学生自杀意念影响因素的研究进展[J]. 现代医药卫生, 2020, 36(20): 3252-3255. WEN Jian, KUANG Li. Research progress on influencing factors of suicidal ideation in medical students [J]. Modern Medicine and Health, 2020, 36(20): 3252-3255.
[28] 张平, 张兰鸽, 涂翠平. 大学生自杀行为的保护性因素分析[J]. 中国学校卫生, 2020, 41(6): 939-942. ZHANG Ping, ZHANG Lange, TU Cuiping. Analysis of protective factors of suicidal behavior among college students [J]. China School Health, 2020, 41(6): 939-942.
[1] 许小芬,朱晓,马伟,李娜. 123例癌症患者癌性疼痛管理障碍的影响因素[J]. 山东大学学报 (医学版), 2022, 60(9): 119-124.
[2] 胥凯,韩超,丁守銮,丁璇,邢德广,王成伟. 181例高分级动脉瘤性蛛网膜下腔出血患者术前再出血的影响因素[J]. 山东大学学报 (医学版), 2022, 60(9): 97-101.
[3] 侯茹男,邵頔,秦廷廷,尚美美,申玉珍,孙晓杰. 山东省癌症患者烟草使用情况及影响因素分析[J]. 山东大学学报 (医学版), 2022, 60(6): 102-106.
[4] 申雨霏,赵美,胡宓. 有自杀意念中学生的求助意愿、求助行为现状及其相关因素[J]. 山东大学学报 (医学版), 2022, 60(4): 99-106.
[5] 况利,徐小明,曾琪. 机器学习用于自杀研究的综述[J]. 山东大学学报 (医学版), 2022, 60(4): 10-16.
[6] 赵思博,彭立,凌鸿翔. 农村老年人医疗保险参与和自杀风险的关系[J]. 山东大学学报 (医学版), 2022, 60(4): 113-118.
[7] 韩璇,孙秀彬,刘铱,王淑康,刘静,袁中尚,张涛,李秀君,薛付忠,刘云霞. 预防医学专业学生《卫生统计学》学习满意度评价[J]. 山东大学学报 (医学版), 2022, 60(3): 109-113.
[8] 苏永刚,王睿,杨同卫. 健康中国视域下老年人群自杀的影响因素及预防对策[J]. 山东大学学报 (医学版), 2022, 60(2): 8-13.
[9] 邹丽萍,贺玉静,谢元忠,赵建云,许春华,马永胜,李传彬,刘晓雪,刘翀,赵小冬,孙红云. 济南市1 614名HBsAg阳性产妇新生儿首针乙肝疫苗接种时间分布及影响因素[J]. 山东大学学报 (医学版), 2022, 60(11): 113-120.
[10] 于书卷,王美娟,陈丽,曹英娟,吕晓燕,刘雪燕,林鹏,颜景政. 老年2型糖尿病患者轻度认知功能障碍的影响因素[J]. 山东大学学报 (医学版), 2022, 60(11): 108-112.
[11] 王春霞,贺梦璐,王海鹏,李慧. 山东省农村地区多重慢病患者多重用药现状及影响因素分析[J]. 山东大学学报 (医学版), 2022, 60(1): 93-100.
[12] 王超,张艺琳,邹广顺,吕军城. 686名医学生有无自杀意念调查及影响因素分析[J]. 山东大学学报 (医学版), 2022, 60(1): 78-85.
[13] 毕凤英,闫冬勤,陈曦,罗丹. HIV感染者/艾滋病患者自杀死亡危险因素理论框架构建——基于扎根理论的定性研究[J]. 山东大学学报 (医学版), 2022, 60(1): 109-117.
[14] 王清,周淼,赵迪,厉萍. 医学生心理控制源在正念水平与平静心境间的中介作用[J]. 山东大学学报 (医学版), 2021, 59(5): 104-109.
[15] 秦艺文,杨晓帆,魏艳欣,刘宝鹏,Bob Lew,贾存显. 大学生生命意义感在心理扭力和自杀行为风险间的中介作用[J]. 山东大学学报 (医学版), 2021, 59(11): 76-83.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 吕龙飞,李林,李树海,亓磊,鲁铭,程传乐,田辉. 腔镜下细针导管空肠造瘘在微创McKeown食管癌切除术中的应用[J]. 山东大学学报 (医学版), 2020, 1(7): 77 -81 .
[2] 邵海港, 王璇, 王青. 山东地区人下颌第一前磨牙根管系统解剖研究[J]. 山东大学学报(医学版), 2014, 52(9): 85 -89 .
[3] 姜保东,马祥兴,王青,王茜,冯晓源,李克,于富华 . 脑CT静脉造影扫描时相及重建层厚的选择[J]. 山东大学学报(医学版), 2008, 46(11): 1084 -1086 .
[4] 史爽,李娟,米琦,王允山,杜鲁涛,王传新. 胃癌miRNAs预后风险评分模型的构建与应用[J]. 山东大学学报 (医学版), 2020, 1(7): 47 -52 .
[5] 李玉亮,王永正,王晓华,张福君,朱立东,张万明,李 征,李振家,张开贤 . 动脉灌注吉西他滨联合125I粒子胰腺内植入治疗进展期胰腺癌[J]. 山东大学学报(医学版), 2007, 45(4): 393 -396 .
[6] 黄飞,王怀经,邢毅,高薇,李永刚,邢子英,李振中. NGF和GM1联合应用对坐骨神经损伤大鼠初级传入神经元的保护作用[J]. 山东大学学报(医学版), 2006, 44(4): 332 -335 .
[7] 王晓菊1 ,汪明明2 ,徐皖苏2 ,赵胜梅3 ,崔速南2 ,李晓迎2 ,刘春华1
. 慢性HBV活动性感染者外周血淋巴细胞
泛素mRNA的表达及临床意义

[J]. 山东大学学报(医学版), 2009, 47(02): 58 -61 .
[8] 马立新 李刚 苏雨行 张彩 张建. NKG2D在颅内肿瘤中的表达[J]. 山东大学学报(医学版), 2009, 47(5): 88 -91 .
[9] 唐芳1,2 ,张颖倩3 ,王志强4 ,康殿民4 ,王洁贞1 ,薛付忠1 . 自然疫源性疾病疫源地空间结构的二维
最小生成树模型及其应用
[J]. 山东大学学报(医学版), 2009, 47(01): 106 -110 .
[10] 刘海春 张剑锋 陈允震. 骨质疏松大鼠股骨生物力学特性与骨胶原质量变化的相关研究[J]. 山东大学学报(医学版), 2009, 47(5): 42 -45 .