INTRODUCTION

Mental health is a topic that has become more prominent in recent decades¹. Its importance has emerged in different aspects of life and contexts, taking priority in the development of communities, families, and workplaces². Thus, stress, anxiety, and depression have become important in the development of policies of work and coexistence in different societies of the World³. In addition, the evolution in the importance of mental health has led to the emergence of laws, policies, and rights focused on the development of a balanced environment that seeks the protection of emotions and feelings^3-5Therefore, it has been understood that the elements of a healthy relationship are good interpersonal therapy and empathy^6,7.

On the other hand, Medical professions must include mental and psychological aspect as an important part in the development of its protocols and working mechanisms⁸. Training in psychological and empathic skills must accompany medical training during all its stages: undergraduate^9-11and postgraduate¹². In this context, medical schools should encourage the training of professionals who can handle stressful situations¹³, establish an empathetic medical patient relationship¹⁴and who can solve the mental health problems prevalent in society. According to this, the physician's role is not only to ensure the well-being of his patients but also to all areas involved in comprehensive care¹⁵. Therefore, it is important to implement the subject of mental health in the academic curriculum of pre-degree and post-degree programs of the human medicine career for the development of competent and empathetic professionals¹⁶. Therefore, the objective of this study is to determine the resident physician's perception of a mental health course during the last year of medical residency.

METHODS

RESULTS

All the 130 participants, 57.69% were women. The marital status of the participants was 61.54% single and 27.69% married. The medical specialty with the largest number of people was Pediatrics, representing 13.85% of the total sample. Residents who were trained in clinical specialties accounted for 57.69%, and 58.46% were free-standing. The general characteristics of the study sample are shown inTable 1.

Regarding the perception of the mental health course and according to the items of the data collection instrument, it was obtained that 60% considered interesting the concepts and problems contained in the Mental health course, while 7.69% of residents found the procedural aspects of the subject uninteresting. In addition, 58.46% had good acceptance of the mental health course during medical residency.Table 2details the results obtained from the measuring instrument applied to the resident physicians who participated in the study.

When performing the bivariate analysis on the relevance of the mental health course, it was found that 62.96% of respondents of ages 25 - 35 years considered the course interesting (p = 0.038). In addition, 53.7% of residents matched into a program described the course to be” interesting " and 64.47% of the free-standing residents considered it to be "interesting" (p = 0.005). The other data from the analysis are detailed inTable 3.

The bivariate analysis on the acceptance of the mental health course found that 72.2% of residents between 36 and 45 years of age had good acceptance of the mental health course during the medical resident (P = 0.021). 58.82% of those who performed a surgical specialty showed good disposition towards the subject of mental health (p = 0.053) adjusted according to age range, gender, marital status, type of residency, and mode of residency. The details of the analysis can be found intable 4.

DISCUSSION

In our study, we found that 62.96% of participants of the A group considered the contents of the mental health course important during medical residency. This contrasts with a study done with undergrad students who, after an internship in mental health understood that the human being is not only composed of biological aspects but also psychological, social, cultural, and spiritual¹⁷. It is interesting to mention the relevance of these findings. Chau and Vilela, a study conducted in 1024 university students from Lima and Huanuco showed that the mental health of the students was determined by variables such as perceived stress, feeling of self-efficacy, career, type of study, institution, among others¹⁸. Residents within this age group do not only face the job challenges that correspond to the needs of hospital service but also they are exposed to the common problems of their age group. It is for this reason that Ovalle-Peña et. at. tried to understand the most common problems in young adults that could lead them to severe depressive states. A qualitative study of 25 people of 25 - 40 years of age was done using the "The State-Trait Depression Scales" and concluded that at this age there is an emotional lack of control, personality problems, a tendency towards depression, and remarkable emotional instability¹⁹.

On the other hand, 64.47% of the residents who were in the free-standing modality considered as interesting the topics contained in the mental health course. This finding is relevant in the context of the job instability that many of these professionals experience especially at the end of their training years as specialists. Therefore, to affirm that a big interest of the participants is to be able to handle situations of stress or anxiety as a result of the finalization of residency and initiation in the labor field, which in many cases will be their first work experience, is not out of context²⁰. In addition, we must add that, among the participants, 27.69% were married. Therefore, in a situation of possible unemployment plus family burden the proper management of depressive or anxious situations takes a special interest in these professionals. This situation was seen by Ponce et al. in residents of a private hospital in the city of Córdoba, Argentina of 159 residents, a percentage of them had developed clinical Burnout syndrome and the others suffered from stress or some degree of anxiety²¹.

In the age range C (46-65 years) 46.15% of participants had a” very good " acceptance of the subject. These results show a reality less explored within the medical field. The acceptance of the course may be a result of the need for professionals of this age to be able to cope with continuous stressful situations in their work. The contact with younger professionals performing the same specialty, family burdens, and pressures of their work centers to obtain a specialty come into play in the emotional stability of this group²². For this reason, when Ortuño et. al. evaluated patients within this age group in a sample of 674 people found that 27.6% had depressive syndromes that required pharmacological treatment and 71% were women²³. Based on the findings of this study, it is important to implement strengthening programs of mental health. An example of this was done by The John A. Burns School of Medicine at the University of Hawaiʻi system which provides individual counseling services. This resulted in a significant decrease in depressive symptoms as well as reported suicidal thoughts in students²⁴. Similarly, a much larger program was instituted at The University of California, San Diego School of Medicine, focusing on the mental health of medical students, residents, and faculty physicians. The program was well accepted by faculty members²⁵.

Also, it has been reported that doctors with better mental health, are in a position to provide a better service to their patients and strengthen the physician-patient relationship. They do not only provide a more friendly and empathetic service but also, detect mental health problems that may interfere in the course of the disease, and take the necessary measures in a timely manner²⁶.

One of the limitations of our study was the selection bias as the sample was non-probability sampling and was taken for the convenience of a class of the subject of Mental Health. Also, the study did not consider specialists who had just graduated from the residencies. The problems of this population can be explored in future research.

CONCLUSION

Students in their last year of residency in medical school considered the subject of Mental Health important and relevant. It was concluded, that the youngest residents considered the content and procedure of the course to be “good” and “acceptable”.