International Journal of Psychiatry in Medicine最新文献

{"title":"Thriving among Pakistani physicians: A qualitative study.","authors":"Malik Muhammad Sohail, Kinza Nawaz, Benjamin Doolittle","doi":"10.1177/00912174241272545","DOIUrl":"https://doi.org/10.1177/00912174241272545","url":null,"abstract":"<p><strong>Objective: </strong>Burnout among physicians negatively impacts the quality of patient care and provider's mental health. While many studies have evaluated burnout, factors associated with physician thriving are not well-defined. This study involved a qualitative exploration of thriving and career satisfaction among physicians in Pakistan.</p><p><strong>Methods: </strong>A snowball sampling technique was used to recruit participants who completed a measure of job satisfaction, life satisfaction, and burnout between December 2022 and February 2023. Semi-structured interviews were conducted to explore factors associated with burnout and thriving. Participants were physicians working in public and private hospitals in North Punjab.</p><p><strong>Results: </strong>Twenty-four physicians were interviewed. Six themes emerged that might help to explain factors involved in thriving: patient's affirmation, serving humanity, social support, spiritual connection, occupational prestige, and activities outside of work. Two themes were identified as challenges to thriving: excessive workload and lack of resources.</p><p><strong>Conclusion: </strong>Improving the well-being of primary care practitioners requires a multi-modal approach, which includes cultivating intrinsic virtues, such as resilience and spiritual resources, as well as improving social support and the workplace environment.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"912174241272545"},"PeriodicalIF":1.1,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between peripheral immune cell markers and cognitive functions in patients with schizophrenia.","authors":"Aykut Karahan, Işılay Manzak Saka, Demet Sağlam Aykut, Filiz Civil Arslan, Ezgi Selçuk Özmen, Evrim Özkorumak Karagüzel","doi":"10.1177/00912174241266059","DOIUrl":"https://doi.org/10.1177/00912174241266059","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to investigate the relationship between peripheral immune cell markers and cognitive functions in patients with schizophrenia and healthy controls.</p><p><strong>Methods: </strong>Thirty-five patients diagnosed with schizophrenia with a stable course and a control group of 35 individuals matched in terms of sex, education, and age were included in this cross-sectional study. The Wisconsin Card Sorting Test (WCST), the Rey Auditory Verbal Learning Test (RAVLT), and the Stroop Test were used for neuropsychological evaluation. Blood neutrophil and lymphocyte percentages, neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) values were calculated.</p><p><strong>Results: </strong>The female patients exhibited significantly higher NLR and neutrophil percentages than the female controls and higher NLR, neutrophil percentage, and SII than the male patients. The increased neutrophil percentages and NLR and decreased lymphocyte percentages in the female patients were significantly correlated with worsening Stroop interference and RAVLT 1 scores. Additionally, a longer duration of illness was significantly correlated with elevated NLR, SII, and neutrophil percentage and a decreased lymphocyte percentage. A higher number of previous hospitalizations was correlated with elevated SII and decreased lymphocyte percentages. Regression analysis showed a significant association between neutrophil percentages and Stroop interference scores used to evaluate attentional functions in patients with schizophrenia.</p><p><strong>Conclusions: </strong>These study results suggest that gender and the course of the illness may affect NLR and SII values. An elevated neutrophil percentage may be one of the factors affecting attentional dysfunction in patients with schizophrenia. Prospective studies are now needed to verify these findings.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"912174241266059"},"PeriodicalIF":1.1,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finding compassion when compassion fatigued.","authors":"Carlie Nikel, Limor Gildenblatt","doi":"10.1177/00912174231215923","DOIUrl":"10.1177/00912174231215923","url":null,"abstract":"<p><p><b>Objective:</b> The unrelenting turmoil of the COVID-19 pandemic has been especially hard on those in the healthcare field. This chronic stress has resulted in depleted compassion towards patients served and colleagues. Researchers have suggested that empathy is a finite resource that must be replenished. For physicians in residency training and those in practice, where finding meaning and purpose in their work is already a challenge, the spark for medicine and helping others may easily become extinguished.This article explores interventions implemented in two family medicine residency programs to address concerns about burnout and compassion fatigue exacerbated by the COVID-19 pandemic.<b>Methods:</b> A qualitative research approach is employed here through case studies of two family medicine programs, along with a description of several interventions intended to mitigate burnout and compassion fatigue during the pandemic.Participants were 36 family medicine residents from \"residency #1\" and 36 family medicine residents from \"residency #2.\"<b>Results:</b> The authors describe several interventions used in the two residency programs to reduce issues of compassion fatigue. These include meditation, gratitude practice, guided group support, and a focus on clinicians' physical health.Feedback from residents and program leaders suggest that these interventions were useful tools to help physicians navigate their new normal as they began to practice during a pandemic, thereby reducing burnout and challenges with compassion fatigue. A strategic plan is outlined to help other programs implement some of these strategies.<b>Conclusions:</b> It is imperative that training programs continue to implement interventions that emphasize resident and post-residency wellness to reduce compassion fatigue in order to navigate the new stressors that came with the COVID-19 pandemic and those that will come with pandemics in the future.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"447-454"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout, moral injury, and suicidal/self-harm ideation among healthcare professionals in Mainland China: Insights from an online survey during the COVID-19 pandemic.","authors":"Guangtian Liu, Yan Tong, Jinghong Li, Xiaoya Sun, Linlin Chen, Xiwei Zheng, Xinhui Zhang, Jufen Lv, Jinyan Wang, Bingfen Wei, Jianhua Wei, Ruixia Cheng, Zhizhong Wang","doi":"10.1177/00912174231219041","DOIUrl":"10.1177/00912174231219041","url":null,"abstract":"<p><strong>Objective: </strong>This survey explored the relationships between burnout, moral injury, and suicidal/self-harm ideation among Chinese health professionals in mainland China.</p><p><strong>Methods: </strong>Health professionals were surveyed online using the Maslach Burnout Inventory-Human Services Survey for Medical Personnel, Patient Health Questionnaire-9, and the Moral Injury Symptom Scale-Health Professional version.</p><p><strong>Results: </strong>A total of 6,146 health professionals participated in the study. The average age of participants was 34.9 ± 8.5 years, and suicidal/self-harm ideation was present in 2,338 participants (38.0%). The prevalence of suicidal/self-harm ideation was more common among those with severe burnout (vs. mild burnout), particularly in the dimensions of emotional exhaustion, depersonalization, and decreased personal accomplishment. The prevalence of suicidal/self-harm ideation among those with significant moral injury symptoms was higher than in those without moral injury. Unconditional logistic regression analysis demonstrated that those with moderate or severe emotional exhaustion, moderate or severe reduced sense of professional accomplishment, and moderate or severe depersonalization were at increased risk of suicidal/self-harm ideation.Structural equation modelling demonstrated that burnout significantly mediated the relationship between moral injury and suicidal/self-harm ideation. The proportion of mediation (PM) by burnout was 43.0%.</p><p><strong>Conclusions: </strong>This study found that burnout and moral injury were significant predictors of suicidal/self-harm ideation among health professionals in China. Both moral injury and burnout had positive and direct effects on suicidal/self-harm ideation, and burnout mediated the relationship between moral injury and suicidal/self-harm ideation. Interventions to address moral injury and subsequent burnout in Chinese healthcare workers may enhance the mental health of these healthcare professionals and increase the quality of care that they provide.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"487-502"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric anxiety disorders: Basic concepts for primary care.","authors":"Christopher M Haymaker, Stephanie Ellwood","doi":"10.1177/00912174231220239","DOIUrl":"10.1177/00912174231220239","url":null,"abstract":"<p><p>Anxiety disorders in children and adolescents often present in primary care, and many clinicians will need to guide families on treatment. The purpose of this article is to give a brief overview of assessment and treatment principles for clinicians in primary care. Anxiety and its expression are heavily influenced by children's developmental progression and capabilities. Anxiety disorders have multiple underlying etiologies including temperament, environmental exposure to stressors, and childhood trauma. All anxiety disorders are strengthened by an operant process known as escape conditioning. The most effective treatments for child and adolescent anxiety begin with behavioral-based interventions including exposure with response prevention (ERP) and cognitive behavioral therapy (CBT). Medication can be effective in combination with CBT and ERP, or as a standalone treatment when behavioral interventions are not available. Selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors have been evaluated by randomized clinical trials for the treatment of childhood anxiety, but most are not approved by the Food and Drug Administration. When anxiety is severe and functional impairment is high, referral for psychiatric care and multimodal treatment reduces the likelihood of poor outcomes.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"439-446"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening, brief intervention, and referral to treatment (SBIRT) implementation in urban underserved family medicine practices.","authors":"Hannah Bednar, Katherine Bergs, Mirsada Serdarevic","doi":"10.1177/00912174231215914","DOIUrl":"10.1177/00912174231215914","url":null,"abstract":"<p><p>Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice that provides early integrated intervention and treatment to patients with Alcohol Use Disorder (AUD) and/or Substance Use Disorders (SUD). Three Primary Care Medical Homes (PCMHs) in North Texas were selected as pilot sites for a SAMHSA grant designed to integrate SBIRT into existing services. The goal of this program is to support the stabilization and community reintegration of individuals who present with SUD by providing them with a continuum of care from screening, to brief intervention, to brief treatment, to referral for more advanced services. Specific aims of the grant included: provide SBIRT services to eligible participants, decrease substance and alcohol use at 6-month follow-up, improve patient physical and behavioral health measured at 6 months, and decrease in emergency department visits and costs for program participants. This brief report examines project design, outlines the implementation strategies, and provides preliminary results.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"432-438"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing lifestyle medicine into family medicine: Theory and applications.","authors":"Julie Brennan, Kevin Phelps, Angele McGrady, Paul Schultz","doi":"10.1177/00912174231215917","DOIUrl":"10.1177/00912174231215917","url":null,"abstract":"<p><p>\"Lifestyle medicine (LM) is an evidence-based therapeutic intervention delivered by clinicians trained and certified in this specialty to prevent, treat, and often reverse chronic disease\". Eighty percent of the conditions primary care physicians routinely encounter in their offices, e.g., diabetes mellitus, hypertension, COPD, cardiovascular disease, have root causes in poor lifestyle choices such as smoking, insufficient sleep, being sedentary, or eating highly processed foods. Lifestyle is the foundation of most chronic disease management guidelines aimed at reducing morbidity and mortality. Studies have shown that changes in lifestyle can be achieved and link almost directly to reduction in risk for chronic illness. Primary care physicians are ideally positioned to incorporate LM into their practices. It is important to recognize and find solutions to the many barriers to implementing LM at the patient, physician, and system level. There is an urgent need to increase opportunities for practicing physicians to increase their knowledge and skills related to LM and include this in medical school and residency curricula. Many resources exist that can provide the necessary training for seasoned physicians and students/residents to become competent in practicing LM and address barriers to implementing LM. LM has the potential to revolutionize clinical practice by placing a greater emphasis on disease prevention and the role of healthy lifestyle behaviors in disease management.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"415-423"},"PeriodicalIF":16.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Studying moral distress and moral injury among inpatient and outpatient healthcare professionals during the COVID-19 pandemic.","authors":"Phyllis B Whitehead, Carl E Haisch, Maria S Hankey, Ryan B Mutcheson, Sarah A Dewitt, Christi A Stewart, Jonathan D Stewart, Jennifer L Bath, Sherry M Boone, Ilona Jileaeva, Emily R Faulks, David W Musick","doi":"10.1177/00912174231205660","DOIUrl":"10.1177/00912174231205660","url":null,"abstract":"<p><p><b>Objective:</b> COVID-19 increased moral distress (MD) and moral injury (MI) among healthcare professionals (HCPs). The purpose of this study was to examine MD and MI among inpatient and outpatient HCPs during March of 2022.The study sought to examine (1) the relationship between MD and MI; (2) the relationship between MD/MI and pandemic-related burnout and resilience; and (3) the degree to which HCPs experienced pandemic-related MD and MI based on background characteristics.<b>Methods:</b> A survey was conducted to measure MD, MI, burnout, resilience, and intent to leave healthcare at two academic medical centers during a 4-week period. A convenience sample of 184 participants (physicians, nurses, residents, respiratory therapists, advanced practice providers) completed the survey. In this mixed-methods approach, researchers analyzed both quantitative and qualitative survey data and triangulated the findings.<b>Results:</b> A moderate association was found between MD and MI (r = .47, <i>P</i> < .001). Regression results indicated that burnout was significantly associated with both MD and MI (<i>P</i> = .02 and <i>P</i> < .001, respectively), while intent to leave was associated only with MD (<i>P</i> < .001). Qualitative results yielded eight sources of MD and MI: workload, distrust, lack of teamwork/collaboration, loss of connection, lack of leadership, futile care, outside stressors, and vulnerability.<b>Conclusions:</b> While interrelated conceptually, MD and MI should be viewed as distinct constructs. Many HCPs were significantly impacted by the COVID-19 pandemic, with MD and MI being experienced by those in all HCP categories. Understanding the sources of MD and MI among HCPs could help to improve well-being, work satisfaction, and the quality of patient care.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"469-486"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41135940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To the bone: Prevalence and correlates of depression and anxiety among orthopedic residents in Mexico.","authors":"Ana Fresán, Rebeca Robles-García, María Yoldi-Negrete, Diana Guízar-Sánchez, Carlos-Alfonso Tovilla-Zárate","doi":"10.1177/00912174231199216","DOIUrl":"10.1177/00912174231199216","url":null,"abstract":"<p><strong>Objective: </strong>Examining orthopedic residents in Mexico, researchers explore the relationship between the presence of depressive or anxious symptoms and the degree of perfectionism, perceived work-related distress, and involvement in the care of patient(s) who died.</p><p><strong>Methods: </strong>This was a cross-sectional online survey of 642 orthopedic residents from October 2019 to April 2021.</p><p><strong>Results: </strong>Of orthopedic residents contacted, 50.6% responded rate (70.9% male, average age 29.8 years). A total of 12.5% reported significant depressive symptoms and 18.4% reported significant anxious symptoms. On a scale from 0-100, the mean score of perceived work-related distress was 51.9. One-third (33.6%) reported being involved in the care of patient(s) who had died. Higher levels of work-related distress and higher scores on perfectionism were associated with depressive and anxiety symptoms. In particular, being involved in the care of patient(s) who had died was associated with anxious symptoms (OR = 1.79; 95%CI = 1.18-2.72).</p><p><strong>Conclusions: </strong>These results highlight the need for systematic monitoring of the mental health of orthopedic residents in Mexico, particularly those who report a high level of work-related distress or perfectionism or who have recently experienced the death of a patient.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"455-468"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Even one voice: Teaching legislative advocacy as a core competency in family medicine.","authors":"Alexander Brown, Terri N Wall, Grace Pratt, Mary R Talen, Clare O'Grady, Randall Reitz","doi":"10.1177/00912174231190136","DOIUrl":"10.1177/00912174231190136","url":null,"abstract":"<p><p>Credentialing bodies increasingly focus on advocacy as a competency to be developed by physicians during residency. The skills of advocacy are especially important with the increased attention on social determinants of health, as restrictive state and federal health policy decisions gain widespread attention in the national news media. This movement is reflected in the ACGME's recently revised statement on the training mission of family medicine residencies with the most recent update of milestones, which identifies advocacy as a core competency. Additionally, the major family medicine organizations and governing bodies all similarly identify advocacy as an important professional responsibility for family physicians. Advocacy is a broad term that can be applied across a range of settings and scenarios. For the purposes of this paper we focus primarily on legislative advocacy as a specific area for growing curricular emphasis in family medicine residency programs.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"424-431"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9837413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}