Abstract
Standardized residency training is a crucial component of medical education. However, residents commonly face heavy clinical workloads, occupational stress, and insufficient social support, contributing to a high prevalence of negative emotions such as depression, anxiety, and stress. These psychological issues significantly threaten personal well-being and the quality of medical care. International studies have documented prominent mental health challenges among medical residents; yet, empirical research within the Chinese context remains limited, particularly regarding the mechanisms involving social support, workload, and institutional design. This study aimed to evaluate the prevalence of negative emotions among residents undergoing standardized residency training, identify key influencing factors, and to provide a basis for developing targeted intervention strategies in the future. A cross-sectional study was conducted involving 514 residents from 3 general hospitals in Hunan Province. Data were collected using a general information questionnaire, the Depression Anxiety Stress Scales-21, and a residency training-specific questionnaire. Data analysis was performed using SPSS version 26.0 to assess the residents' mental health status and identify associated influencing factors. The prevalence rates for depression, anxiety, and stress among residents were 86.4%, 92.2%, and 90.7%, respectively. Moderate-to-severe cases accounted for 19.8% (depression), 29.6% (anxiety), and 13.0% (stress). Factors significantly associated with negative emotions included interpersonal stress (odds ratios [OR] = 2.20-2.87), emotional stress (OR = 3.89), frequent extra shifts (OR = 4.85-5.42), duration of training (OR = 1.36), and low satisfaction with residency training (OR = 2.17-3.11). Conversely, positive perceptions regarding the value of residency training were protective factors (OR = 0.21-0.54). Negative emotions are prevalent among medical residents and influenced by multiple factors. Our findings indicate that interventions should prioritize mitigating interpersonal and emotional stressors, reducing non-rostered workloads, and fundamentally enhancing trainees' satisfaction and sense of value within the training program to safeguard their mental well-being and, by extension, patient care quality.