Strengthening coping among psychiatry residents: A theory of planned behavior-based mental health promotion model

Abstract

Psychiatry residency is a high-stress period characterized by significant psychological strain, often exacerbated by limited use of effective coping strategies, which impacts resident well-being and patient care. This study examined the relationship between psychopathological symptoms and coping mechanisms among psychiatry residents, identified influencing factors, and developed a Theory of Planned Behavior (TPB)-based mental health intervention. A sequential exploratory mixed-methods design was employed. Seventy-three residents completed the Symptom Checklist-90 (SCL-90) and the Brief COPE Inventory. Statistical analyses explored associations and predictors. A TPB-based intervention module was developed and evaluated through qualitative interviews with 11 residents and 3 academic supervisors. High levels of depression, somatization, and anxiety were observed. Residents utilized both adaptive (e.g., acceptance) and maladaptive (e.g., venting, self-blame) coping strategies. Psychopathology was strongly correlated with coping style (r = 0.957, p < 0.001). Financial burden (p = 0.008) and lack of intrinsic motivation (p = 0.009) were significant predictors. The TPB module demonstrated strong content validity (κ > 0.75). Psychopathological symptoms are linked to maladaptive coping and influenced by external stressors. TPB-based interventions show potential in improving coping mechanisms and reducing psychological symptoms. TPB-guided modules may enhance coping strategies and can be integrated into psychiatric training.