PDF(Pubmed)
Abstract：
BACKGROUND Clinical training for allied health trainees (AHTs) and postgraduate-year (PGY) doctors needed to go online during the outbreak of coronavirus disease 2019 (COVID-19), which may have caused academic stress and consequent outcomes among this cohort. MATERIAL AND METHODS To evaluate academic-related stress, clinical confidence, psychological distress, and insomnia, an online survey-based study was conducted among Taiwanese AHTs and PGY doctors between July and December, 2022, during the COVID-19 pandemic. The survey included the 21-item Depression, Anxiety, and Stress Scale (DASS-21), the Insomnia Severity Index (ISI), and self-designed questions. It was distributed using convenience sampling and snowball sampling and was completed by 522 participants. RESULTS Structural equational modelling showed that academic stress was negatively associated with clinical confidence (standardized coefficient [ß]=-0.382, p<0.001). Clinical confidence was negatively associated with psychological distress (ß=-0.397, p<0.001), which was associated with insomnia (ß=0.648, p<0.001). Additionally, clinical confidence and psychological distress were the significant mediators. Results indicated that higher academic stress was associated with higher level of insomnia via the mediation of clinical confidence and psychological distress. CONCLUSIONS Academic stress related to changes in clinical training may have led to insomnia among AHTs and PGY doctors during the pandemic. Factors to reduce academic stress should be investigated to promote good mental health while providing sufficient clinical training, especially during events that can cause increased stress (eg, epidemics, pandemics).
摘要：
背景在2019年冠状病毒病（COVID-19）爆发期间，需要对专职卫生受训人员（AHTs）和研究生（PGY）医生进行临床培训，这可能会导致该队列中的学术压力和随之而来的结果。材料和方法评估学术相关压力，临床信心，心理困扰,失眠，7月至12月期间，台湾AHTs和PGY医生进行了一项基于在线调查的研究，2022年，在COVID-19大流行期间。调查包括21项抑郁症，焦虑,和应力标度（DASS-21），失眠严重程度指数（ISI），和自行设计的问题。它使用便利采样和滚雪球采样进行分发，由522名参与者完成。结果结构方程模型显示，学业压力与临床置信度呈负相关（标准化系数[β]=-0.382，p<0.001）。临床信心与心理困扰呈负相关（β=-0.397，p<0.001），与失眠相关（β=0.648，p<0.001）。此外,临床信心和心理困扰是重要的中介因素.结果表明，通过临床信心和心理困扰的调解，较高的学业压力与较高的失眠水平相关。结论与临床培训变化相关的学术压力可能导致大流行期间AHTs和PGY医生失眠。应调查减少学业压力的因素，以促进良好的心理健康，同时提供足够的临床培训，尤其是在可能导致压力增加的事件中(例如，流行病,流行病)。
