| 张明辉,张欣梦,叶文静,张晓涛,宋红涛,姚高峰.住培医师压力知觉对睡眠质量的影响：自我控制和焦虑情绪的链式作用路径[J].四川精神卫生杂志,2026,(2):165-170.Zhang Minghui,Zhang Xinmeng,Ye Wenjing,Zhang Xiaotao,Song Hongtao,Yao Gaofeng,Influence of perceived stress on sleep quality among resident physicians： the chain mediating role of self-control and anxiety emotions[J].SICHUAN MENTAL HEALTH,2026,(2):165-170 |
| 住培医师压力知觉对睡眠质量的影响：自我控制和焦虑情绪的链式作用路径 |
| Influence of perceived stress on sleep quality among resident physicians： the chain mediating role of self-control and anxiety emotions |
| 投稿时间：2025-12-20 |
| DOI：10.11886/scjsws20251220001 |
| 中文关键词: 住培医师 压力知觉 自我控制 焦虑情绪 睡眠质量 |
| 英文关键词:Resident physician Perceived stress Self-control Anxiety emotions Sleep quality |
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| 中文摘要: |
| 背景 住院医师规范化培训（住培）医师是睡眠质量问题的高风险人群，其睡眠质量问题发生率高于普通人群，严重影响其身心健康。压力知觉可能通过消耗自我控制资源、引发焦虑情绪等心理路径影响睡眠质量，此机制有待验证。目的 探讨自我控制和焦虑情绪在住培医师压力知觉与睡眠质量之间的中介作用，揭示压力知觉影响住培医师睡眠质量的具体心理机制，为制订有针对性的心理干预方案提供参考。方法 采用横断面调查，于2025年4月，选取阜阳市某医院第一至第三学年全体在培住培医师为研究对象（n=372）。采用中文版压力知觉量表（CPSS）、自我控制双系统量表（DMSC-S）中文版、匹兹堡睡眠质量指数量表（PSQI）和广泛性焦虑障碍量表（GAD-7）进行团体施测。使用Process 4.1宏程序中的模型6考查自我控制和焦虑情绪在压力知觉与睡眠质量之间的作用路径。结果 共回收有效问卷322份，有效问卷回收率为86.56%。检出146名（45.34%）住培医师存在睡眠质量问题。住培医师CPSS评分和GAD-7评分与PSQI评分均呈正相关（r=0.727、0.784，P均<0.01），DMSC-S评分与PSQI评分呈负相关（r=-0.615，P<0.01）。住培医师压力知觉可直接正向预测睡眠质量（B=0.124，P<0.01），直接效应占总效应的31.39%；压力知觉可通过自我控制或焦虑情绪的中介作用影响睡眠质量，间接效应值分别为0.053（95% CI：0.019~0.091）、0.192（95% CI：0.141~0.249），效应量分别为13.42%、48.61%；压力知觉也可以通过自我控制和焦虑情绪的链式中介作用影响睡眠质量，间接效应值为0.026（95% CI：0.005~0.049），效应量为6.58%。结论 住培医师的压力知觉可通过降低自我控制、升高焦虑情绪以及二者的链式作用路径影响睡眠质量。 |
| 英文摘要: |
| Background Resident physicians represent a high-risk group for sleep disorders， exhibiting a significantly higher prevalence of such conditions compared with the general population， which severely impairs their physical and mental health. It is hypothesized that perceived stress negatively impacts sleep quality through psychological mechanisms， such as depleting self-control resources and triggering anxiety. However， this pathway warrants empirical validation.Objective To explore the mediating role of self-control and anxiety emotions in the association between perceived stress and sleep quality among resident physicians， and to elucidate the underlying psychological mechanisms， aiming at providing theoretical basis for developing targeted psychological interventions.Methods A cross-sectional survey was conducted in April 2025. First- to third- year resident physicians at a hospital in Fuyang City were recruited as participants （n=372）. The Chinese Perceived Stress Scales （CPSS）， the Chinese version of the Dual-Mode of Self-Control Scale （DMSC-S）， the Pittsburgh Sleep Quality Index （PSQI）， and the Generalized Anxiety Disorder Scale-7 item （GAD-7） were used for group testing. The model 6 of the Process macro version 4.1 was ultilized to examine the mediating pathway of self-control and anxiety emotions between perceived stress and sleep quality.Results A total of 322 valid questionnaires were collected， yielding an effective responsive rate of 86.56%. Among the respondents， 146 （45.34%） reported poor sleep quality. The CPSS score and GAD-7 score of resident physicians were positively correlated with the PSQI score （r=0.727， 0.784， P<0.01）， while the DMSC-S score was negatively correlated with the PSQI score （r=-0.615， P<0.01）. Perceived stress directly and positively predicted poor sleep quality （B=0.124， P<0.01）， with the direct effect accounting for 31.39% of the total effect. Furthermore， perceived stress indirectly affected sleep quality through the independent mediating effects of self-control and anxiety emotions. The indirect effect values of 0.053 （95% CI： 0.019 - 0.091） and 0.192 （95% CI： 0.141 - 0.249）， accounting for 13.42% and 48.61% of the total effect， respectively. Perceived stress also impact sleep quality through the serial mediating effect of self-control and anxiety， with the indirect effect value of 0.026 （95% CI： 0.005 - 0.049）， accounting for 6.58% of the total effect.Conclusion The perceived stress of resident physicians can influence sleep quality by impairing self-control， exacerbating anxiety， and through the serial mediation of both factors. |
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