Damuwa a cikin ɗaliban likita

Damuwa a cikin ɗaliban likitanci damuwa ce da shirye-shiryen likitanci masu wahala ke haifarwa, wanda zai iya yin tasiri ga lafiyar ɗaliban likitanci. Damuwa mai yawa a cikin horon likitanci yana sa ɗalibai su fuskanci matsaloli wajen warware rikice-rikicen da ke tsakanin mutane sakamakon damuwa da ta gabata. Kashi mai yawa na ɗaliban likitanci suna fama da matsalolin damuwa saboda tasirin damuwa na dogon lokaci akan alamun motsin rai da ɗabi'a. Ɗaliban likitanci suma suna fama da damuwa mai yawa musamman a shekarun asibiti. [1] [2] Wannan yanayin ya zama abin damuwa a ƙasa da duniya baki ɗaya, don haka layin farko na ganowa da kariya daga damuwa shine ɗaliban da kansu. Ya kamata a ba wa ɗalibai kayan aikin da za su gane da kuma magance damuwa, da kuma tabbatar musu cewa ba za su sha hukunci daga wasu ba saboda gane buƙatarsu ta neman taimako wajen magance damuwa. Malamai, masu ba da shawara da sauran membobin malamai waɗanda suka lura da alamun damuwa a cikin ɗalibi suna buƙatar kusantar ɗalibi ta hanyar da ba ta barazana ba, ba tare da hukunci ba, don ƙoƙarin taimaka wa ɗaliban likitanci su gane da kuma magance damuwarsu.

 Dalilai 
An bayyana damuwa a matsayin rashin daidaito tsakanin yanayin muhalli da ake buƙata don rayuwa da kuma ikon mutane na daidaitawa da waɗannan yanayi. An daɗe ana gane damuwa a cikin ɗaliban likitanci. Nazari da yawa sun binciki dalilai, sakamako da mafita. Akwai batutuwa uku da ake ganin sun fi dacewa, dangane da ci gaban damuwa a cikin ɗaliban likitanci. Ana buƙatar su koyi sabbin bayanai da yawa cikin ɗan gajeren lokaci kafin su yi jarrabawa da kimantawa. Saboda haka, ba su da lokacin yin bita kan abin da suka koya. 

Ɗaliban likitanci suna da tarin bayanai masu yawa. Suna da ɗan lokaci kaɗan don haddace duk bayanan da aka yi nazari a kansu. Yawan bayanai yana haifar da jin takaici saboda rashin iya sarrafa duk bayanan a lokaci guda da kuma samun nasara a lokacin jarrabawa. Da yawa daga cikin ɗaliban likitanci suna fama da ƙarfin kansu na biyan buƙatun manhajar likitanci. Yussof, M; Baba, A (2013). "Prevalence and associated factors of stress, anxiety and depression among prospective medical students". Asian Journal of Psychiatry. 6 (2): 128–133. doi:10.1016/j.ajp.2012.09.012. PMID 23466109.

Amsoshin damuwa ga yanayi daban-daban sun bambanta a matakai daban-daban na sani, damuwa ta tunani, da kuma damuwa ta jiki . Waɗannan wuraren damuwa na iya kasancewa da alaƙa, kuma kowannensu yana iya kasancewa a wani mataki daban.  Mutane da yawa sun yi imanin cewa lokacin da ya fi damuwa a cikin aikin ɗalibi na likitanci shine tazara tsakanin kammala karatunsa daga makarantar likitanci da kuma cancantar hukumar gudanarwa a fannin likitanci. Kwamitin Kula da Mazauna na Ƙungiyar Daraktocin Shirye-shirye a Magungunan Cikin Gida (APDIM) ya raba matsalolin zama a cikin rukuni uku: yanayi, na mutum, da na ƙwararru. 

Abubuwan da ke haifar da damuwa a yanayi sun haɗa da yawan sa'o'i, rashin barci,  yawan aiki, nauyin malamai da na gudanarwa, rashin isasshen tallafi daga ƙwararrun likitoci, adadi mai yawa na marasa lafiya masu wahala, da kuma yanayi na koyo wanda ba shi da kyau. Ray, I; Joseph, D (2010). "Stress in medical students" (PDF). JK Science. 12 (4): 163–164. Ɗaliban aji biyu suna fuskantar wasu yanayi na damuwa saboda sun fara mu'amala da marasa lafiya. Waɗannan mu'amala sun haɗa da yanayi masu damuwa, kamar isar da labarai marasa daɗi. VanDulmen, S; Trompb, F (2007). "The impact of assessing simulated bad news consultations on medical students stress response and communication performance". Psychoneuroendocrinology. 32 (6): 943–950. doi:10.1016/j.psyneuen.2007.06.016. hdl:1874/29376. PMID 17689196. S2CID 10381355.

Abubuwan da ke damun mutum sun haɗa da matsalolin iyali, abokai da dangantaka. Matsalolin kuɗi sun zama ruwan dare gama gari, domin mazauna da yawa suna da basussukan ilimi masu yawa, kuma suna jin dole su riƙe wani aiki na biyu domin biyan basussukansu. Sau da yawa keɓewa yakan tsananta ta hanyar ƙaura daga dangi da abokai. Sauran abubuwan da ke damun mutum sun haɗa da ɗan gajeren lokacin hutu don shakatawa ko haɓaka sabbin tsarin tallafi, damuwar zamantakewa da ta shafi tunanin ɗan adam da damuwar zama, da kuma rashin ƙwarewar jurewa. Abubuwan da ke damun mutum sun haɗa da alhakin kula da marasa lafiya, kula da ƙananan yara da ɗalibai, marasa lafiya masu wahala, yawan bayanai da kuma tsara aiki. Ray, I; Joseph, D (2010). "Stress in medical students" (PDF). JK Science. 12 (4): 163–164.

 Tasiri 
Yawan damuwa a horon likitanci yana sa ɗalibai su fuskanci matsaloli wajen magance rikice-rikicen da ke tsakanin mutane, matsalolin barci, raguwar hankali, raguwar maida hankali, jarabar yin zamba a jarrabawa, baƙin ciki, rashin daidaito, ƙaruwar yawan kurakurai, da kuma rashin ɗabi'u kamar sakaci.  Bugu da ƙari, damuwa a ɗaliban likitanci na iya lalata lafiyar ɗalibi kuma ya haifar da rashin lafiya. Wannan na iya haifar da ciwon kai, matsalolin ciki, cututtukan zuciya, rashin yanke hukunci, rashin zuwa makaranta, shan magunguna da barasa.  Abin lura ne cewa waɗannan haɗarin suna ci gaba a duk lokacin horo, suna shafar likitoci mazauna da waɗanda ke halarta ban da ɗaliban likitanci, musamman dangane da alamun damuwa.   

Wani bincike da aka yi kwanan nan tsakanin ɗaliban likitancin Jamus a jami'o'in ƙasa da ƙasa ya nuna cewa haɗarin kamuwa da cututtukan baƙin ciki ya fi na matsakaicin yawan jama'a sau 2.4. Kashi 23.5% na waɗannan ɗaliban likitancin Jamus sun nuna alamun baƙin ciki masu alaƙa da asibiti.  Wani bincike da aka yi a mujallar Amurka mai suna JAMA ya nuna alamun baƙin ciki a cikin kashi 21% zuwa 43% na dukkan ɗaliban likitanci. Douglas A. Mata; Marco A. Ramos; Narinder Bansal; Rida Khan; Constance Guille; Emanuele Di Angelantonio & Srijan Sen (2015). "Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis". JAMA. 314 (22): 2373–2383. doi:10.1001/jama.2015.15845. PMC 4866499. PMID 26647259.

Ɗaliban suna ƙoƙarin magance tasirin yanayi mai wahala ta hanyar amfani da dabarun jurewa daban-daban. Juriyar ta haɗa da ƙoƙarin fahimta da ɗabi'a don magance matsalar damuwa da ake fuskanta yayin jarrabawa.  Ɗaliban likitanci waɗanda suka kasa sarrafa matakan damuwa suna da halin rashin ƙwarewa a aikinsu. Ɗaliban da ba su iya sarrafa iyakokin lokacin jarrabawa ba suna da lokacin motsa jiki da hulɗa da jama'a saboda waɗannan batutuwa biyu sun fi damuwa fiye da wariya da ake gani a kan hanya ko mutuwar marasa lafiya. O'Rourke, M; Hammond, S (2010). "The Medical Student Stress Profile: a tool for stress audit in medical training". Medical Education. 27 (44): 1027–1037. doi:10.1111/j.1365-2923.2010.03734.x. PMID 20880372. S2CID 205358914.

Daliban likitanci sau da yawa suna yawan yin tururuwa kafin jarrabawa sai dai su manta da mafi yawansu bayan jarrabawa ko kuma su tsallake tsarin gabobin jiki gaba ɗaya domin ba lallai ne a sami cikakken ilimi ba don cin jarabawa.

 Tasirin jiki 
Matakan damuwa suna da alaƙa mai ƙarfi da yanayin jiki. O'Rourke, M; Hammond, S (2010). "The Medical Student Stress Profile: a tool for stress audit in medical training". Medical Education. 27 (44): 1027–1037. doi:10.1111/j.1365-2923.2010.03734.x. PMID 20880372. S2CID 205358914. Ɗaliban likitanci a lokacin jarrabawa na iya fuskantar rashin barci, gajiya, da tashin zuciya. Bugu da ƙari, gudawa ko maƙarƙashiya na shafar metabolism. Cututtukan fata, gami da kuraje, dermatitis, da psoriasis, sun zama ruwan dare a lokacin jarrabawa. Waɗannan alamun suna tasowa ne ta hanyar tsawon lokacin aiki da kuma tashin hankalin kammala kwasa-kwasan da kyakkyawan sakamako. 

An san ɗaliban likitanci suna shan abubuwan sha masu ɗauke da sinadarin caffein don su kasance masu aiki da kuma lura a lokacin karatu. Waɗannan ɗaliban suna shan kofi, shayi, cola, da abubuwan sha masu ƙarfi . Duk da cewa ƙaruwar shan maganin kafeyin na iya ƙara yawan adenosine, adrenaline, cortisol da dopamine a cikin jini, maganin kafeyin kuma yana hana shan wasu sinadarai masu gina jiki, yana ƙara yawan acidity na tsarin narkewar abinci da kuma rage yawan sinadarin calcium, magnesium, iron da sauran ma'adanai na jiki ta hanyar fitar da fitsari. Bugu da ƙari, maganin kafeyin yana rage kwararar jini zuwa kwakwalwa da kashi 30 cikin ɗari, kuma yana rage yawan insulin, wani sinadari da ke taimakawa wajen daidaita matakin sukari a cikin jini. Rizvi, A (2010). "Pre-examination stress in second year medical students in a government college". J Ayub Med Coll Abbottabad. 22 (2): 152–5. PMID 21702291.

Damuwa na iya haifar da yawan sinadarin hormones kamar haka: norepinephrine, leptin, NPY, nitrite, ACTH da adrenomedullin . Rizvi, A (2010). "Pre-examination stress in second year medical students in a government college". J Ayub Med Coll Abbottabad. 22 (2): 152–5. PMID 21702291. Yawan matakan adenosine, adrenaline, cortisol da dopamine a cikin jini na iya haifar da gajiya, damuwa, canje-canje a halaye, cututtukan zuciya, matsalolin nauyi, ciwon suga, da cututtukan fata. Hakanan yana rage amsawar garkuwar jiki, wanda zai iya haifar da ƙwannafi da ciwon ciki. An, H; Chunga, S (2012). "Novelty-seeking and avoidance of coping strategies are associated with academic stress in Korean medical students". Psychiatry Research. 200 (16): 464–468. doi:10.1016/j.psychres.2012.07.048. PMID 22901439. S2CID 16434292.

Sinadaran hormones na zagayowar jinin al'ada ( hormone mai motsa follicle (FSH) da luteinizing hormone (LH)) a lokacin gwajin suma suna da tasiri. Rizvi, A (2010). "Pre-examination stress in second year medical students in a government college". J Ayub Med Coll Abbottabad. 22 (2): 152–5. PMID 21702291. Dalibai mata na iya samun matsala a lokacin zagayowar jinin al'ada saboda matakan FSH da LH na al'ada suna canzawa sosai. Daliban likitanci kuma suna iya samun matsala a lokacin zagayowar barci a waɗannan lokutan. 

 Tasirin Ilimin Halayyar Dan Adam 
Ana ɗaukar matakin damuwa mafi kyau a matsayin mai kyau saboda ɗaliban likitanci suna haɓaka iyawar jurewa. Rizvi, A (2010). "Pre-examination stress in second year medical students in a government college". J Ayub Med Coll Abbottabad. 22 (2): 152–5. PMID 21702291. Duk da haka, yawan damuwa yana haifar da matsaloli. Nazarin da aka yi a baya ya ba da rahoton cewa kashi mai yawa na ɗaliban likitanci suna fama da matsalolin damuwa saboda damuwa tana da alaƙa mai ƙarfi da matsalolin motsin rai da ɗabi'a. O'Rourke, M; Hammond, S (2010). "The Medical Student Stress Profile: a tool for stress audit in medical training". Medical Education. 27 (44): 1027–1037. doi:10.1111/j.1365-2923.2010.03734.x. PMID 20880372. S2CID 205358914. Jin takaici a fannin ilimi ya fi yawa a cikin ɗaliban da ba su da aikin da ya dace da ilimi. Yussof, M; Baba, A (2013). "Prevalence and associated factors of stress, anxiety and depression among prospective medical students". Asian Journal of Psychiatry. 6 (2): 128–133. doi:10.1016/j.ajp.2012.09.012. PMID 23466109.

Manyan matsalolin motsin rai da aka lura sun haɗa da rashin jin daɗi, rashin barci, damuwa da yawa, jin damuwa akai-akai, jin rashin jin daɗi da baƙin ciki, rashin iya mai da hankali, rashin jin daɗin ayyukan yau da kullun, rashin amincewa da kai, rashin iya shawo kan matsaloli, rashin iya fuskantar matsaloli, rashin iya yanke shawara, rashin iya taka rawa mai amfani a cikin abubuwa, da kuma yarda cewa kai ba shi da amfani.  Ganin waɗannan matsalolin motsin rai, bincike ya kuma tabbatar da cewa ɗaliban likitanci sun fi fuskantar tunanin kashe kansu fiye da ɗaliban wasu makarantu.

Ɗaliban likitanci mata na iya mayar da martani ga damuwa da ƙarin bayyanar damuwa. An gano cewa abubuwan da ke haifar da damuwa ta jiki, ta tunani da kuma ta ɗabi'a suna da alaƙa da canje-canjen metabolism na jiki. Rizvi, A (2010). "Pre-examination stress in second year medical students in a government college". J Ayub Med Coll Abbottabad. 22 (2): 152–5. PMID 21702291.

Damuwa kuma na iya cutar da ingancin aiki. Yana rage hankali, yana rage maida hankali, yana shafar ƙwarewar yanke shawara, kuma yana rage ikon kafa dangantaka mai ƙarfi tsakanin likitoci da marasa lafiya.  Ɗaliban likitanci suma sun lura da canje-canje a halayensu lokacin da suke cikin damuwa. Fushi da baƙin ciki sun zama ruwan dare a cikin ɗalibai a zangon karatu na gaba, kuma waɗannan matsalolin tunani suna ƙaruwa lokacin da aka fara jarrabawa. Rizvi, A (2010). "Pre-examination stress in second year medical students in a government college". J Ayub Med Coll Abbottabad. 22 (2): 152–5. PMID 21702291.

 Magani 
Ganin cewa yawan damuwa yana haifar da matsaloli, yana da mahimmanci a tantance matakin damuwar da ɗalibi zai iya fuskanta. A yau,  akwai hanyoyin tantance matakin damuwar motsin rai da ɗaliban likitanci za su iya jurewa. Yana da kyau a sarrafa lokacin karatu kuma a haɗa da abinci mai kyau a duk tsawon yini. Bugu da ƙari, motsa jiki na yau da kullun na iya taimakawa wajen rage damuwa. O'Rourke, M; Hammond, S (2010). "The Medical Student Stress Profile: a tool for stress audit in medical training". Medical Education. 27 (44): 1027–1037. doi:10.1111/j.1365-2923.2010.03734.x. PMID 20880372. S2CID 205358914. Shige-tsage kan rashin gaskiya na ilimi kamar satar fasaha shi ma yana taimakawa wajen hana haɗarin damuwa da baƙin ciki a cikin ɗaliban likitanci. Yin karatu a cikin ƙaramin rukuni kuma yana ba ɗalibai damar koyo daga juna da rage damuwar koyo ta hanyar raba ra'ayoyi. Bugu da ƙari, wasu makarantun likitanci suna ba da ilimin halayyar ɗan adam don taimakawa ɗalibai wajen sarrafa damuwa. An, H; Chunga, S (2012). "Novelty-seeking and avoidance of coping strategies are associated with academic stress in Korean medical students". Psychiatry Research. 200 (16): 464–468. doi:10.1016/j.psychres.2012.07.048. PMID 22901439. S2CID 16434292.

Sadarwa tsakanin ɗaliban likitanci na shekara ta uku da ta huɗu tana shirya su don magance matsalolin da ke tattare da aikin asibiti na gaske. Wannan shiri na tunani yana ƙarfafa ɗaliban su rage yawan kurakurai a cikin shawarwarin likita. VanDulmen, S; Trompb, F (2007). "The impact of assessing simulated bad news consultations on medical students stress response and communication performance". Psychoneuroendocrinology. 32 (6): 943–950. doi:10.1016/j.psyneuen.2007.06.016. hdl:1874/29376. PMID 17689196. S2CID 10381355. Ɗaliban likitanci suna shirye don gano da kuma magance marasa lafiya, amma ƙila ba su da isasshen shiri don mu'amala da matsalolin majinyacinsu, ko magance mummunan labari da kuma damuwar motsin zuciyar majinyacin yayin shawarwari. 

Hankali na motsin rai (EI) na iya zama kariya daga tasirin damuwa ta tunani, kuma yana iya inganta walwala. Duk da haka, EI ana tsara shi ta hanyar hali kuma ba a lura cewa yanayi mai wahala ya shafe shi ba. O'Rourke, M; Hammond, S (2010). "The Medical Student Stress Profile: a tool for stress audit in medical training". Medical Education. 27 (44): 1027–1037. doi:10.1111/j.1365-2923.2010.03734.x. PMID 20880372. S2CID 205358914. Duk da haka, waɗannan ɗaliban da ke shiga ayyukan da ba na makaranta ba suna da ƙarancin damuwa fiye da waɗanda suka mai da hankali kan karatunsu kawai. An, H; Chunga, S (2012). "Novelty-seeking and avoidance of coping strategies are associated with academic stress in Korean medical students". Psychiatry Research. 200 (16): 464–468. doi:10.1016/j.psychres.2012.07.048. PMID 22901439. S2CID 16434292. Don magance waɗannan matsalolin, wasu makarantun likitanci sun yi canje-canje kamar rage mako na aiki, kafa gyare-gyaren manhaja kamar samun gajerun azuzuwa, ƙarancin haddacewa, da kuma samar da ayyukan tunani. Barikana, A (2007). "Stress in Medical Students". Journal of Medical Education. 11 (1): 41–44.

Damuwa a cikin ɗaliban likitanci ta zama abin damuwa a duk duniya, inda matakin farko na gano da kare damuwar shine ɗaliban da kansu. Wasu tsoma baki sun haɗa da halartar ƙungiyoyin tallafi, don haka matakin ƙyama ya yi ƙasa da wanda ke da alaƙa da halartar jiyya ta mutum ɗaya. Wannan yana ba da tallafi na dogon lokaci da taimako ga ɗalibai don sa ido kan ci gaba da shiri don ingantaccen aiki. O'Rourke, M; Hammond, S (2010). "The Medical Student Stress Profile: a tool for stress audit in medical training". Medical Education. 27 (44): 1027–1037. doi:10.1111/j.1365-2923.2010.03734.x. PMID 20880372. S2CID 205358914.

Sauran shirye-shiryen kula da damuwa suna ba wa ɗaliban horo dabarun magance matsalolin kamar su hypnosis, hotuna, da kuma shakatawar tsoka; alaƙa da takwarorinsu, damar bayyana motsin rai da kuma ƙarfafa dangantaka da malamai. Barikana, A (2007). "Stress in Medical Students". Journal of Medical Education. 11 (1): 41–44.

Shigowar mafi yawan shirye-shiryen suna amfani da tsarin rukuni inda ɗaliban ke haɗuwa da takwarorinsu, ko kuma tare da shugabanni. Babu wani "ma'auni na zinare" da ke akwai ga abubuwan da ke cikin shirye-shiryen rage damuwa ga ɗaliban likitanci. Wasu suna ba da shawarar tsarin ƙungiyoyin tallafi da aka tsara da waɗanda ba a tsara ba, horar da shakatawa (gami da tunani da hypnosis), dabarun sarrafa lokaci da jurewa, rage damuwa bisa ga tunani, da shirye-shiryen jagoranci. Barikana, A (2007). "Stress in Medical Students". Journal of Medical Education. 11 (1): 41–44. Kyakkyawan shiga tsakani ya haɗa da muhimman abubuwan shakatawa kamar numfashin ciki, koyon gano da kuma magance mummunan tunani, amfani da hotuna a cikin shakatawa, hanyoyin aiki don ƙara cin abinci mai kyau, gina juriya mai kyau, amfani da kalmomi masu kwantar da hankali ko kunna su yadda ya kamata, da kuma mayar da lokaci da kuzari zuwa ayyuka daban-daban bisa ga matakin mahimmanci. 

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 Pamela Wible

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