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认知行为团体辅导改善医学生临床共情能力的实验研究

【作者】 曹娜娜

【导师】 蔡翥;

【作者基本信息】 安徽医科大学, 发展与教育心理学, 2019, 硕士

【摘要】 目的:临床共情是医学人文教育的重要内容,指医务工作者能感同身受病患的情绪和内心情感状态,恰当予以回应,帮助患者克服困难的能力,是医护人员重要的心理特质之一,是医患关系的重要影响因素。在结合之前研究的基础上,首先,本研究以医学专业学生为研究对象,采用自填问卷调查的方式研究当前医学生临床共情能力现状及其影响因素;其次,使用认知行为团体辅导的方法进行实验研究,探讨认知行为团体辅导对医学生临床共情能力的干预效果。方法:研究一:采用杰弗逊共情量表医学生版(JSPE-S)、艾森克人格问卷简式量表中国版(EPQ-RSC)、中文版成人素质希望量表(ADHS)、心理弹性量表(CD-RISC)、大学生学业情绪问卷,对480名医学生进行问卷调查,就调查结果进行讨论分析。研究二:将50名被试随机分为人数相等的实验组和对照组,其中实验组进行8次认知行为团体辅导干预,对照组同期不做处理。使用杰弗逊共情量表医学生版对所有被试在干预前、后及干预3个月后进行测量,探究该干预方式对改善医学生临床共情能力的效果。结果:研究一:女生在观点采择(t=-2.770,p<0.01)、换位思考维度(t=-2.245,p<0.05)及临床共情总分(t=-2.492,p<0.05)上,均显著高于男生,有统计学意义。非独生子女在临床共情总分(t=-2.017,p<0.05),观点采择(t=-2.186,p<0.05)维度,得分显著高于独生子女,有统计学意义。不同生源地的学生在临床共情上得分差异无统计学意义,但在换位思考维度(t=-2.046,p<0.05)来自乡镇和农村的学生得分高于来自县城和市区的同学,有统计学意义。担任过学生干部的学生在观点采择(t=2.446,p<0.05)及临床共情总分(t=2.170,p<0.05)显著高于未担任过学生干部的同学,有统计学意义。父母亲中有人是医务工作者的学生在观点采择(t=2.348,p<0.05)、情感护理(t=2.141,p<0.05)及临床共情总分(t=2.265,p<0.05)上均显著高于父母亲中没有人是医务工作者学生的得分,有统计学意义。路径思维、希望特质总分均与观点采择、情感护理、换位思考、临床共情总分呈现正相关。力量性、心理弹性总分均与观点采择、情感护理、换位思考、临床共情总分呈现正相关。学业情绪的积极高唤醒维度及消极高唤醒维度与观点采择、情感护理、换位思考、临床共情总分相关。研究二:实验组在实施认知行为团体辅导干预后,观点采择维度(t=-4.884,p<0.01)、换位思考维度(t=3.420,p<0.01)及临床共情总分(t=-3.744,p<0.01)均有显著提高,有统计学意义。认知行为团体辅导可以有效提高医学生的临床共情能力,且这种提升具有一定的延续性。结论:1.医学生的临床共情能力在性别等因素方面存在差异。女生临床共情能力高于男生,来自乡镇和农村的学生临床共情能力高于来自县城和市区的同学,担任过学生干部的同学高于没有担任过学生干部的同学,父母亲中有医务工作者的学生临床共情能力高于父母亲中没有医务工作者的学生。2.医学生的临床共情能力与其希望特质和心理弹性呈正相关,与学业情绪的积极高唤醒维度、消极高唤醒维度及消极低唤醒维度存在相关。3.实验组在实施认知行为团体辅导干预后,医学生临床共情能力显著提高。认知行为团体辅导可以有效提高医学生的临床共情能力,且这种提升具有一定的延续性。

【Abstract】 Objective: Clinical empathy is an important part of medical humanities education.It refers to the fact that medical workers can timely sense the emotions and inner feelings of patients,give appropriate responses to patients,and help patients cope with problems.It is one of the important psychological characteristics of medical staff.It is an important factor influencing the relationship between doctors and patients.On the basis of previous research,firstly,this study takes medical students as the research object,and uses self-administered questionnaires to study the current status and influencing factors of clinical students’ clinical empathy ability.Secondly,using cognitive behavior group counseling Methods Experimental research was conducted to explore the effect of cognitive behavioral group counseling on the intervention of medical students’ clinical empathy ability.Method: Study 1: Using the Jefferson Sympathy Scale Medical Student Edition(JSPE-S),the Eysenck Personality Questionnaire Simple Scale China Edition(EPQ-RSC),the Adult Hope Quality Table(ADHS)and the Mental Resilience Scale(CD-RISC),College Students’ Academic Emotion Questionnaire,conducted a questionnaire survey of 480 medical students and discussed the results of the survey.Study 2: 50 subjects were randomly divided into experimental groups and control groups with equal numbers.Among them,the experimental group conducted 8 cognitive behavioral group counseling interventions,and the control group did not treat them at the same time.All subjects were measured before,after,and after 3 months of intervention using the Jefferson Sympathy Scale(Medical Health Edition)to explore the effect of this intervention on improving the clinical empathy of medical students.Results: Study 1: Girls’ opinions selection(t=-2.770,p<0.01),transposition thinking dimension(t=-2.245,p<0.05)and total clinical empathy score(t=-2.492,p<0.05)were significantly higher than boys’,with statistical significance.The total score of clinical empathy(t=-2.017,p<0.05),viewpoint selection(t=-2.186,p<0.05)of non-only children were significantly higher than that of only children,with statistical significance.There was no significant difference in the scores of clinical empathy among students from different places of origin,but in the dimension of transposition thinking(t=-2.046,p<0.05),the scores of students from villages and towns were higher than those from counties and districts,with statistical significance.The students who have served as student cadres have significantly higher opinions selection(t =2.446,p<0.05)and total clinical empathy score(t= 2.170,p<0.05)than those who have not served as student cadres,with statistical significance.The students whose parents were medical workers had significantly higher scores in viewpoint selection(t=2.348,p<0.05),emotional nursing(t= 2.141,p<0.05)and clinical empathy(t=2.265,p<0.05)than those whose parents were not medical workers,with statistical significance.The total scores of path thinking and hope trait were positively correlated with the total scores of viewpoint selection,emotional nursing,transposition thinking and clinical empathy.The total scores of strength and resilience were positively correlated with the total scores of viewpoint selection,emotional nursing,transposition thinking and clinical empathy.The positive high arousal dimension and negative high arousal dimension of academic emotion are related to the total scores of viewpoint selection,emotional nursing,transposition thinking and clinical empathy.Study 2: After the intervention of cognitive behavior group counseling,the dimensions of viewpoint selection(t=-4.884,p<0.01),transposition thinking(t=3.420,p<0.01)and total score of clinical empathy (t=-3.744,p<0.01)in the experimental group were significantly improved,with statistical significance.Cognitive behavior group counseling can effectively improve the clinical empathy ability of medical students,and this improvement has a certain continuity.Conclusion: 1.Medical students’ clinical empathy ability is different in gender and other factors.The clinical empathy ability of female students is higher than that of male students.The clinical empathy ability of students from villages and towns is higher than that of students from counties and districts.Students who have served as student cadres are higher than those who have not served as student cadres.The clinical empathy ability of students with medical workers in their parents was higher than that of students without medical workers in their parents.2.The clinical empathy ability of medical students is positively correlated with their hope traits and resilience,and with the positive high arousal dimension,the negative high arousal dimension and the negative low arousal dimension of academic emotion.3.In the experimental group,the clinical empathy ability of medical students was significantly improved after the implementation of cognitive behavior group counseling intervention.Cognitive behavior group counseling can effectively improve the clinical empathy ability of medical students,and this improvement has a certain continuity.

  • 【网络出版投稿人】 安徽医科大学
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