IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.
1. Define and identify the purposes of a nursing diagnosis.
2. Know what NANDA means and where to find more information.
3. Differentiate between the types of nursing diagnosis and be able to provide an example of each.
4. Differentiate a nursing diagnosis from a medical diagnosis.
5. Identify the three segments of a diagnostic statement and give examples of a comprehensive diagnostic statement.
- What is the nursing diagnosis?
- What is NANDA?
- Types of nursing diagnosis and examples of each.
- Criteria of nursing diagnosis.
- What is the difference(s) between a medical diagnosis and nursing diagnosis?
- Example: Pneumonia
- Possible nursing diagnosis:
o Altered gas exchange,
o Ineffective airway clearance,
o Activity intolerance,
o Risk for imbalanced nutrition,
o Risk for infection transmission,
o Discomfort.
- Refer to Maslow’s needs again
- Exercise
o Nursing diagnosis for Bronchitis
o Nursing diagnosis for Hypertension
Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.
1. Define and identify the purposes of a nursing diagnosis.
2. Know what NANDA means and where to find more information.
3. Differentiate between the types of nursing diagnosis and be able to provide an example of each.
4. Differentiate a nursing diagnosis from a medical diagnosis.
5. Identify the three segments of a diagnostic statement and give examples of a comprehensive diagnostic statement.
- What is the nursing diagnosis?
- What is NANDA?
- Types of nursing diagnosis and examples of each.
- Criteria of nursing diagnosis.
- What is the difference(s) between a medical diagnosis and nursing diagnosis?
- Example: Pneumonia
- Possible nursing diagnosis:
o Altered gas exchange,
o Ineffective airway clearance,
o Activity intolerance,
o Risk for imbalanced nutrition,
o Risk for infection transmission,
o Discomfort.
- Refer to Maslow’s needs again
- Exercise
o Nursing diagnosis for Bronchitis
o Nursing diagnosis for Hypertension
Compliance, concordance and empowerment in patients with type two diabetes me...NiyotiKhilare
This presentation compares the traditional model that focuses on compliance of the patient, with the new model which focuses on empowering the patient. The presentation will also focus elaborately on empowerment as an intervention for improved medical adherence in diabetic patients.
Explore and analyse concordance as a concept and empowerment as a strategic intervention to improve patient outcomes in diabetes.
This report was published by the Center for Information Therapy (IxCenter) prior to its dissolution in November of 2009.
I authored this report and am sharing it as a writing sample as well as a resource for discussions around meaningful use and patient access to health information.
Evidence based practice (EBP) in physiotherapy Saurab Sharma
This presentation is the classroom lecture for undergraduate physiotherapy students whom I teach at Kathmandu University School of Medical Sciences in Nepal. This is an introductory lecture. Students carry on with steps of EBP in the years to come during the student life and use it for their presentations and clinical learning placement.
Other students too may benefit. I highly encourage other students, especially in some parts of India where EBP is not taught, and is reserved for Master's degree program. I completely disagree with this concept, as EBP is the pillar of a responsible physiotherapy practice. Early it starts, better it is.
A Descriptive Study to Assess the Level of Knowledge and Attitude Regarding A...ijtsrd
ADHD attention deficit hyperactive disorder is a condition of the brain that makes it difficult for children to control their behavior .It is one of the most common chronic conditions of childhood. It affects 4 12 of school aged children about 3 times more boys than girls are diagnosed with attention deficit hyperactive disorder. ADHD attention deficit hyperactive disorder is a disorder make by an ongoing pattern of inattention and hyperactivity impulsivity that interferes with functioning or development. In this study a descriptive research design was used to assess the level of knowledge and attitude regarding attention deficit hyperactive disorder among 3rd year nursing students in a selected college of nursing in Lucknow with a view to develop an information booklet. Study result revealed that the majority of the subjects had good knowledge i.e. 50 , 30 of the subjects had average knowledge and 20 had poor knowledge regarding ADHD. Majority of the subjects 28 70 belong to the age group of 19 21 years, followed by 12 30 of the student belong to the age group of 22 24 year. In this study 5 12.50 were male and remaining 35 87.50 were female. The mean of knowledge score is 11.4 with SD 3.20415.The chi square test depict that education status of father and gender is associated with knowledge score, else no demographic variable shows any significant association with their demographic variable. In attitude score majority of the student 65 belong to the attitude score 21 40 had average attitude, 30 student belong to the attitude score 41 50 had good attitude and 5 student belong to the attitude score 1 20 had poor attitude regarding ADHD.The study results conclude that majority of the student has good knowledge and average attitude regarding ADHD. This study shows that there is a significant association between the level of knowledge with their demographic variables i.e. gender and father education .In attitude score there is a significant association between the level of knowledge and gender and age of 3rd year nursing student and there is no significant association between other demographic variables. Hence the curriculum needs to include behavior therapy for the health benefit of the students. The benefits of this study are that, by participating in the study, the students become aware of their existing knowledge and attitude regarding ADHD. Rajesh Singh | Adarsh Yadav | Basanti Kumari | Jyoti Patel | Khushi Verma | Rupal Gautam "A Descriptive Study to Assess the Level of Knowledge and Attitude Regarding Attention Deficit Hyperactive Disorder (ADHD)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46482.pdf Paper URL : https://www.ijtsrd.com/medicine/nursing/46482/a-descriptive-study-to-assess-the-level-of-knowledge-and-attitude-regarding-attention-deficit-hyperactive-disorder-adhd/rajesh-singh
Impact of Family Role on Patients Psychological Aspect Post Spinal Cord Injur...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Knowledge, Attitude and Practice of Self-Medication among Medical Studentsiosrjce
Self-medication is a common practice worldwide and the irrational use of the drugs is a major
cause of concern. Self-medication is an issue with serious global implication. The current study aimed to
determine the Knowledge, Attitude and Behavior of self-medication by medical students. A descriptive crosssectional
study was conducted among medical students currently studying first year to assess knowledge,
attitude and practice regarding self-medication in Chitwan Medical College, Bharatpur, Nepal. Seventy five
students studying in first year were selected for the study using stratified random sampling technique and data
was collected using a semi-structured self-administered questionnaire. The study finding revealed, the mean age
of 75 enrolled students was 20 years, 65.3% were in the age group of 17-20 years. Most of them were female
(72%). Seventy three point three percent belong to urban area. Prevalence rate of self-medication of one year
period seems high i.e. 84% and 68.25% in were females. The most common sources of information used by the
respondent were pharmacist (60.31%) and text book (46.03%). More than half of the respondent found to have
a good knowledge about self-medication regarding definition, adverse effect and different types of drug. The
attitude was positive towards self-medication and favored self-medication saying that it was acceptable. The
principal morbidities for seeking self-medication include cold and cough as reported by 85.7% followed by pain
76.2%, fever 73%, diarrhea 47.6% and dysmenorrheal 46%. Drugs / drugs group commonly used for selfmedication
included analgesics 75.8%, and anta-acids 53.2% and antipyretic 46.3%. Among reasons for
seeking self-medication, 79.2% felt that their illness was minor while 61.9% preferred as it is due to previous
experience. This study shows that self-medication is widely practiced among first year students of this medical
institution. There is dire need to make them aware about the pros and cons of self-medication in order to ensure
safe usage of drugs.
Assessment of Health Professionals’ Views and Beliefs about Mental Illnesses:...inventionjournals
Negative beliefs and prejudices might lead to stigmatization, violation of basic human rights and discriminatory behaviors. To determine health professionals’ views and beliefs about mental illnesses. The sample of this descriptive study comprised 317 health professionals working in Sivas Numune Hospital. Data were collected with the Personal Information Form, Stigma Assessment Questionnaire and Beliefs toward Mental Illness (BMI) Scale. For the statistical analysis, percentage distribution, t-test, ANOVA and Tukey test were used. Of the participants, 18.6% had a relative with a mental illness, and 63.7% stated that people with a mental illness. Whereas half of the health professionals stated favorable opinion about patients with schizophrenia, 41% of them said that patients with schizophrenia might be dangerous and cause other people harm. The mean scores obtained from the subscales of the BMI scale were as follows: 23.74±6.66 (min-max:6- 40) for the dangerousness subscale, 29.55±9.88 (min-max:0-55) for the helplessness and poor interpersonal relationships subscale, and 1.76±2.30 (min-max: 0-10) for the shame subscale. The mean total score of the BMI scale was 55.06±16.06 (min-max: 6-100). Of the health care professionals, the nurses/midwives, high school graduates, those with income equal to expenditure and those who had negative opinions about patients with schizophrenia obtained significantly higher total scores from the BMI Scale (p<0.05). Although the majority of the health care professionals had positive opinions of patients with schizophrenia, nearly, half of them thought that patients with schizophrenia could be dangerous and cause harm to other people.
Compliance, concordance and empowerment in patients with type two diabetes me...NiyotiKhilare
This presentation compares the traditional model that focuses on compliance of the patient, with the new model which focuses on empowering the patient. The presentation will also focus elaborately on empowerment as an intervention for improved medical adherence in diabetic patients.
Explore and analyse concordance as a concept and empowerment as a strategic intervention to improve patient outcomes in diabetes.
This report was published by the Center for Information Therapy (IxCenter) prior to its dissolution in November of 2009.
I authored this report and am sharing it as a writing sample as well as a resource for discussions around meaningful use and patient access to health information.
Evidence based practice (EBP) in physiotherapy Saurab Sharma
This presentation is the classroom lecture for undergraduate physiotherapy students whom I teach at Kathmandu University School of Medical Sciences in Nepal. This is an introductory lecture. Students carry on with steps of EBP in the years to come during the student life and use it for their presentations and clinical learning placement.
Other students too may benefit. I highly encourage other students, especially in some parts of India where EBP is not taught, and is reserved for Master's degree program. I completely disagree with this concept, as EBP is the pillar of a responsible physiotherapy practice. Early it starts, better it is.
A Descriptive Study to Assess the Level of Knowledge and Attitude Regarding A...ijtsrd
ADHD attention deficit hyperactive disorder is a condition of the brain that makes it difficult for children to control their behavior .It is one of the most common chronic conditions of childhood. It affects 4 12 of school aged children about 3 times more boys than girls are diagnosed with attention deficit hyperactive disorder. ADHD attention deficit hyperactive disorder is a disorder make by an ongoing pattern of inattention and hyperactivity impulsivity that interferes with functioning or development. In this study a descriptive research design was used to assess the level of knowledge and attitude regarding attention deficit hyperactive disorder among 3rd year nursing students in a selected college of nursing in Lucknow with a view to develop an information booklet. Study result revealed that the majority of the subjects had good knowledge i.e. 50 , 30 of the subjects had average knowledge and 20 had poor knowledge regarding ADHD. Majority of the subjects 28 70 belong to the age group of 19 21 years, followed by 12 30 of the student belong to the age group of 22 24 year. In this study 5 12.50 were male and remaining 35 87.50 were female. The mean of knowledge score is 11.4 with SD 3.20415.The chi square test depict that education status of father and gender is associated with knowledge score, else no demographic variable shows any significant association with their demographic variable. In attitude score majority of the student 65 belong to the attitude score 21 40 had average attitude, 30 student belong to the attitude score 41 50 had good attitude and 5 student belong to the attitude score 1 20 had poor attitude regarding ADHD.The study results conclude that majority of the student has good knowledge and average attitude regarding ADHD. This study shows that there is a significant association between the level of knowledge with their demographic variables i.e. gender and father education .In attitude score there is a significant association between the level of knowledge and gender and age of 3rd year nursing student and there is no significant association between other demographic variables. Hence the curriculum needs to include behavior therapy for the health benefit of the students. The benefits of this study are that, by participating in the study, the students become aware of their existing knowledge and attitude regarding ADHD. Rajesh Singh | Adarsh Yadav | Basanti Kumari | Jyoti Patel | Khushi Verma | Rupal Gautam "A Descriptive Study to Assess the Level of Knowledge and Attitude Regarding Attention Deficit Hyperactive Disorder (ADHD)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46482.pdf Paper URL : https://www.ijtsrd.com/medicine/nursing/46482/a-descriptive-study-to-assess-the-level-of-knowledge-and-attitude-regarding-attention-deficit-hyperactive-disorder-adhd/rajesh-singh
Impact of Family Role on Patients Psychological Aspect Post Spinal Cord Injur...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Similar to A cross sectional and comparative study of attitudes in undergraduate medical students towards Psychiatric illness, Cancer and Diabetes Mellitus.
Knowledge, Attitude and Practice of Self-Medication among Medical Studentsiosrjce
Self-medication is a common practice worldwide and the irrational use of the drugs is a major
cause of concern. Self-medication is an issue with serious global implication. The current study aimed to
determine the Knowledge, Attitude and Behavior of self-medication by medical students. A descriptive crosssectional
study was conducted among medical students currently studying first year to assess knowledge,
attitude and practice regarding self-medication in Chitwan Medical College, Bharatpur, Nepal. Seventy five
students studying in first year were selected for the study using stratified random sampling technique and data
was collected using a semi-structured self-administered questionnaire. The study finding revealed, the mean age
of 75 enrolled students was 20 years, 65.3% were in the age group of 17-20 years. Most of them were female
(72%). Seventy three point three percent belong to urban area. Prevalence rate of self-medication of one year
period seems high i.e. 84% and 68.25% in were females. The most common sources of information used by the
respondent were pharmacist (60.31%) and text book (46.03%). More than half of the respondent found to have
a good knowledge about self-medication regarding definition, adverse effect and different types of drug. The
attitude was positive towards self-medication and favored self-medication saying that it was acceptable. The
principal morbidities for seeking self-medication include cold and cough as reported by 85.7% followed by pain
76.2%, fever 73%, diarrhea 47.6% and dysmenorrheal 46%. Drugs / drugs group commonly used for selfmedication
included analgesics 75.8%, and anta-acids 53.2% and antipyretic 46.3%. Among reasons for
seeking self-medication, 79.2% felt that their illness was minor while 61.9% preferred as it is due to previous
experience. This study shows that self-medication is widely practiced among first year students of this medical
institution. There is dire need to make them aware about the pros and cons of self-medication in order to ensure
safe usage of drugs.
Assessment of Health Professionals’ Views and Beliefs about Mental Illnesses:...inventionjournals
Negative beliefs and prejudices might lead to stigmatization, violation of basic human rights and discriminatory behaviors. To determine health professionals’ views and beliefs about mental illnesses. The sample of this descriptive study comprised 317 health professionals working in Sivas Numune Hospital. Data were collected with the Personal Information Form, Stigma Assessment Questionnaire and Beliefs toward Mental Illness (BMI) Scale. For the statistical analysis, percentage distribution, t-test, ANOVA and Tukey test were used. Of the participants, 18.6% had a relative with a mental illness, and 63.7% stated that people with a mental illness. Whereas half of the health professionals stated favorable opinion about patients with schizophrenia, 41% of them said that patients with schizophrenia might be dangerous and cause other people harm. The mean scores obtained from the subscales of the BMI scale were as follows: 23.74±6.66 (min-max:6- 40) for the dangerousness subscale, 29.55±9.88 (min-max:0-55) for the helplessness and poor interpersonal relationships subscale, and 1.76±2.30 (min-max: 0-10) for the shame subscale. The mean total score of the BMI scale was 55.06±16.06 (min-max: 6-100). Of the health care professionals, the nurses/midwives, high school graduates, those with income equal to expenditure and those who had negative opinions about patients with schizophrenia obtained significantly higher total scores from the BMI Scale (p<0.05). Although the majority of the health care professionals had positive opinions of patients with schizophrenia, nearly, half of them thought that patients with schizophrenia could be dangerous and cause harm to other people.
The issue of medical aliteracy has drawn both scholars and medical practitioners’ attention in the recent years. The negative cost of medical aliteracy has continued to constitute major threats to health related issue which has resulted in high mortality rate, high medical expenditure and medical underperformance among others. On this premise the study examined the influence of medical aliteracy among senior medical personnel. The study employed descriptive research design and Chi-Square to test the research hypotheses. A total number of 50 questionnaires were designed to collect information from the sampled population through a random sampling. From the result of the analysis it was revealed that factors such as ineffective supervision of medical personnel, low patient literacy level, lack of personnel-patients engagement could lead to medical aliteracy among senior medical personnel. Senior medical personnel have the knowledge of medical aliteracy and its implications on for medical personnel and the public. Medical aliteracy has an implication on health sector performance which includes increase in mortality rate, increase health expenditure, widening of the gap between patients – medical personnel communication among others. Perception of medical aliteracy has significant influence on medical personnel performance. The study concluded that, medical aliteracy is prevalent among medical personnel and patients and is associated with many poor medical outcomes in the health sector. It was however recommended that medical literacy training, schemes and programmes should be designed according to the needs of the different medical personnel and should therefore be included in medical professional training programs.
Telaah jurnal Prevalence of hypochondriac symptoms among health science stude...Rindang Abas
Hypochondriac symptoms are commonly reported in health science students. With their incomplete medical knowledge, they may compare their own bodily symptoms with disease symptoms during the process of learning, which can lead to mental distress and the need for repeated medical reassurance.
the importance of epidemiological studies, important historical research on mental health, techniques and processes, and epidemiological research findings on mental health during covid 19 are included.
10 STRATEGIC POINTS
2
10 STRATEGIC POINTS
2
Factors that Influence Utilization of Public Mental Health Services
RSD-851: Residency: Dissertation
Grand Canyon University
October 5, 2020
10 Strategic Points
My Degree: Ph.D.
Program Emphasis: Industrial Organizational Psychology
Ten Strategic Points
Comments or Feedback
Broad Topic Area
Factors that Influence Utilization of Public Mental Health Services
Lit Review
(Theoretical Framework (Theory)
Gaps
Themes
All Citations
Gaps
A. Basu, Rehkopf, Siddiqi, Glymour, & Kawachi (2016). According to the authors, there is a gap here in the changes being experienced in social policies in recent years. It has created a gap among women with low income in South Texas. Accordingly, the authors used the determination of the differences in income to understand the relationships between health outcomes and welfare reforms as it impacts the less privileged women in comparison to the most affected women.
B. Ly, A. (2019). This study focused on the factors that influence the utilization of mental health among Vietnamese Americans and the barriers to seeking help in Texas. The study had 12 participants including providers and community leaders who were familiar with the target population. The findings of the study indicated that there is a gap here in cultural acceptance of mental health treatment. Hence the need to culturally specify mental health intervention to improve mental health utilization in the community. However, the study was limited by the small sample size; therefore, the findings cannot be generalized. Further studies should include more cultural groups to validate the findings of this research.
C. Kwan, P. P., Soniega-Sherwood, J., Esmundo, S., Watts, J., Pike, J., Sabado-Liwag, M., & Palmer, P. H. (2020). The authors of this study aimed to evaluate the facilitators and barriers to mental health utilization among Pacific Islanders. Semi structure interviews were used to collect information from 12 pacific islanders. Trained community leaders recruited eligible candidates for the study. The study was limited by the small sample size. Five themes arose from the study. There is a gap here in regard to cost of healthcare, mental health stigma and language and culture barriers, which were the themes that emerged concerning barriers affecting the utilization of mental health services. The researchers indicated the need for future studies to include a larger sample size to enable generalization of the findings.
D. Volkert, J., Andreas, S., Härter, M., Dehoust, M. C., Sehner, S., Suling, A., . . . Schulz, H. (2018). The aim of this study was to evaluate various aspects of the utilization of mental health services among the elderly. The study had 3,142 participants aged between 65-84 years. Logic regression approach was used to analyze predisposing, enabling, and need factors among the participants. Similarly, the study found that there is ...
10 STRATEGIC POINTS
2
10 STRATEGIC POINTS
2
Factors that Influence Utilization of Public Mental Health Services
RSD-851: Residency: Dissertation
Grand Canyon University
October 5, 2020
10 Strategic Points
My Degree: Ph.D.
Program Emphasis: Industrial Organizational Psychology
Ten Strategic Points
Comments or Feedback
Broad Topic Area
Factors that Influence Utilization of Public Mental Health Services
Lit Review
(Theoretical Framework (Theory)
Gaps
Themes
All Citations
Gaps
A. Basu, Rehkopf, Siddiqi, Glymour, & Kawachi (2016). According to the authors, there is a gap here in the changes being experienced in social policies in recent years. It has created a gap among women with low income in South Texas. Accordingly, the authors used the determination of the differences in income to understand the relationships between health outcomes and welfare reforms as it impacts the less privileged women in comparison to the most affected women.
B. Ly, A. (2019). This study focused on the factors that influence the utilization of mental health among Vietnamese Americans and the barriers to seeking help in Texas. The study had 12 participants including providers and community leaders who were familiar with the target population. The findings of the study indicated that there is a gap here in cultural acceptance of mental health treatment. Hence the need to culturally specify mental health intervention to improve mental health utilization in the community. However, the study was limited by the small sample size; therefore, the findings cannot be generalized. Further studies should include more cultural groups to validate the findings of this research.
C. Kwan, P. P., Soniega-Sherwood, J., Esmundo, S., Watts, J., Pike, J., Sabado-Liwag, M., & Palmer, P. H. (2020). The authors of this study aimed to evaluate the facilitators and barriers to mental health utilization among Pacific Islanders. Semi structure interviews were used to collect information from 12 pacific islanders. Trained community leaders recruited eligible candidates for the study. The study was limited by the small sample size. Five themes arose from the study. There is a gap here in regard to cost of healthcare, mental health stigma and language and culture barriers, which were the themes that emerged concerning barriers affecting the utilization of mental health services. The researchers indicated the need for future studies to include a larger sample size to enable generalization of the findings.
D. Volkert, J., Andreas, S., Härter, M., Dehoust, M. C., Sehner, S., Suling, A., . . . Schulz, H. (2018). The aim of this study was to evaluate various aspects of the utilization of mental health services among the elderly. The study had 3,142 participants aged between 65-84 years. Logic regression approach was used to analyze predisposing, enabling, and need factors among the participants. Similarly, the study found that there is ...
ADVANCED NURSING RESEARCH
1
ADVANCED NURSING RESEARCH 2
Evidence Based Practice Grant Proposal
Table of Contents
31.Purpose
42.Background
5Research objectives
6Theoretical framework
63.EBP Model
74.Proposed Change
85.Outcomes
86.Evaluation Plan
97.Dissemination Plan
9Tools to be Used
9Peer review tools for the proposal
11Grant Request
11Proposed Tasks
11Task 1: Case study- Reviewing existing literature on stigma around mental health complications
11Task 2: Interviewing clinicians that have dealt with the study topic
12Task 3: Interviewing patients of mental health
12Schedule
13Budget
148.Appendices
14a.Informed Consent
19Certificate of Consent
19Signature or Date
21b.Literature Matrix
32c.Tools and equipment to be used
34References
Grant Proposal-Assessing the role of stigma towards mental health patients in help seeking
Study problem
There are several studies that have shown that stigmatization towards mental health patients have been present throughout history and even despite the evolution in modern medicine and advanced treatment. For example, Verhaeghe et al., (2014), captures in a publication in reference to a study that he conducted that stigmatization towards mental health patients has been there even as early is in the 18th Century. People were hesitant to interact with people termed or perceived to have mental health conditions.
Stigmatization has resulted from the belief that those with mental problem are aggressive and dangerous creating a social distance (Szeto et al., 2017). Also, mental health-related stigma has become of major concern as it creates crucial barriers to access treatment and quality care since it not only influences the behaviour of the patients but also the attitude of the providers hence impacting help-seeking. Timmermann, Uhrenfeldt and Birkelund (2014), have identified stigma as a barrier that is of significance to care or help seeking while the extent to which it still remains a barrier have not been reviewed deeply. Therefore, this study will assess the role contributed by stigma in help seeking in depth. 1. Purpose
The intention of the research study is to review the association between stigma, mental illness and help seeking in order to formulate ways in which the stigma that is around mental health is done away with to enable as many people suffering from mental health complications to seek medical help.2. Background
Mental health is crucial in every stage of life. It is defined as the state of psychological well-being whereby the individual realizes a satisfactory integration instinctual drive acceptable to both oneself and his or her social setting (Ritchie & Roser, 2018). The status of mental health influences physical health, relationships, and most importantly day-to-day life. Mental health problems arise when there is a ...
Clinical issue of interestSilifat Jones-ibrahimWalden univer.docxbartholomeocoombs
Clinical issue of interest
Silifat Jones-ibrahim
Walden university
Clinical issue of interest
Psychiatric interventions focus on effectively engaging patients through improving the level of interaction. Integration of evidence based practices provide a better environment where it is possible to outline specific measures that can be used to handle different patients conditions.
There is need to create a strong outline which help define important changes which help maintain an improved level of focus.
Psychiatric services provide a detailed understanding on specific concepts which help create a better emphasis on important concepts which can help improve individual physical and psychological wellbeing.
Violent behavior is associated with different factors including lack of therapeutic interventions as well as groups.
Therefore the research aims at determining whether lack of therapeutic activities and presence of groups increase violent behavior over a two week period.
Formulation of picot question
The Picot question focused on understanding the key interventions that can help improve inpatient psychiatric hospitals because of the increasing violent behavior among patients.
Aggressive behaviour in patients with psychiatric disorders has many possible causes.
Different psychiatric patients have different mental and psychological concerns which require a strong emphasis on specific aspects which can help improve quality of care.
Thus the research sought to understand the causes of violent behavior where two aspects were investigated within a two week period.
Formulation of picot question
Therapeutic activities have been associated with different factors which provide a detailed emphasis important changes which help outline a strong emphasis on violent behavior among psychiatric patients.
Therefore understanding the effect of therapeutic activities and or group will provide a detailed focus on the development of psychiatric patients behavioral development.
The picot question development focused on these factors which help outline specific aspects which help understand psychiatric patients behavior.
Research databases
Choosing database provide a detailed emphasis on important changes which help outline a strong understanding on the underlying research literature based on the picot question. The databases that were included in the study are:-
PLOS One peer reviewed journal database
Physiology & behavior database
Aggression and Violent Behavior database
Neuropsychiatric disease and treatment database
References
Hallett, N., Huber, J. W., & Dickens, G. L. (2014). Violence prevention in inpatient psychiatric settings: Systematic review of studies about the perceptions of care staff and patients. Aggression and Violent Behavior, 19(5), 502-514.
Iozzino, L., Ferrari, C., Large, M., Nielssen, O., & De Girolamo, G. (2015). Prevalence and risk factors of violence by psychiatric acute inpatients: a systematic review and meta-anal.
ADVANCED NURSING RESEARCH
1
ADVANCED NURSING RESEARCH 2
Evidence Based Practice Grant Proposal
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Grant Proposal-Assessing the role of stigma towards mental health patients in help seeking
Study problem
There are several studies that have shown that stigmatization towards mental health patients have been present throughout history and even despite the evolution in modern medicine and advanced treatment. For example, Verhaeghe et al., (2014), captures in a publication in reference to a study that he conducted that stigmatization towards mental health patients has been there even as early is in the 18th Century. People were hesitant to interact with people termed or perceived to have mental health conditions.
Stigmatization has resulted from the belief that those with mental problem are aggressive and dangerous creating a social distance (Szeto et al., 2017). Also, mental health-related stigma has become of major concern as it creates crucial barriers to access treatment and quality care since it not only influences the behaviour of the patients but also the attitude of the providers hence impacting help-seeking. Timmermann, Uhrenfeldt and Birkelund (2014), have identified stigma as a barrier that is of significance to care or help seeking while the extent to which it still remains a barrier have not been reviewed deeply. Therefore, this study will assess the role contributed by stigma in help seeking in depth. 1. Purpose
The intention of the research study is to review the association between stigma, mental illness and help seeking in order to formulate ways in which the stigma that is around mental health is done away with to enable as many people suffering from mental health complications to seek medical help.2. Background
Mental health is crucial in every stage of life. It is defined as the state of psychological well-being whereby the individual realizes a satisfactory integration instinctual drive acceptable to both oneself and his or her social setting (Ritchie & Roser, 2018). The status of mental health influences physical health, relationships, and most importantly day-to-day life. Mental health problems arise when there is a disruption in mental well-being.
The risk factors to mental health problems are not limited and therefore everyone is entitled to the problem irrespective of gender, economic status, and ethnic group. For example, data shows that in America one out of five individuals experience mental health problems annually; with mental disorders being recognized as the leading cause of disability not only in the United States but also globally (Ritchie & Roser, 2018). Mental health disorders are seen to be complex and of many forms such as anxiety, mood, and schizophren.
Relationship between Perceived Social Support and Readiness for Treatment in ...iosrjce
Patients having Conversion disorder receives and reinforced by attention and social support thus
they assume sick role unintentionally. Present study aims to examine the characteristics and symptoms of
patients with conversion disorder while find out the relationship of perceived social support and readiness for
treatment. This study was conducted in Lahore, Pakistan. Fifty Conversion patients diagnosed by
psychologist/psychiatrist from different psychiatric departments of hospitals of Lahore were selected and were
required to complete the questionnaires. To assess the perceived social support and readiness for treatment,
Multidimensional Perceived Social Support scale (MPSS) and Client Motivation for Therapy Scale (CMOTS)
was administered respectively. Pearson Product Movement Correlation and t-test was applied for statistical
analysis. Results showed significant relationship between perceived social support and Readiness for treatment.
No significant differences were found in both genders. Perceived social support is related with readiness for
treatment in patients with conversion disorder. No significant gender differences have been found in perceived
social support and readiness for treatment in conversion patients. The result can facilitate psychologist and
other professionals to design the psychotherapy based on increasing sense of perception toward social support
and motivational strategies for patients with conversion disorder.
15_Program Elective course - I (Psychology in Health care).pdfVamsi kumar
This course, "Psychology in Health Care," aims to provide an understanding of the psychological factors that influence health and illness, promote effective communication in healthcare settings, and incorporate mental health care into general healthcare practice. By exploring these areas through the lens of theoretical concepts and practical case studies, students will develop a nuanced understanding of the important role psychology plays in health care.
Created by: Mr. Attuluri Vamsi Kumar, Assistant Professor, Department of MLT, UIAHS, Chandigarh University, Mohali, Punjab. For more details website: https://www.mltmaster.com
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Recomendamos muito.
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Introduction
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Childhood and Athletic Beginnings
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Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
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Importance of Flexibility and Mobility
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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A cross sectional and comparative study of attitudes in undergraduate medical students towards Psychiatric illness, Cancer and Diabetes Mellitus.
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 11 Ver. VII (Nov. 2015), PP 82-88
www.iosrjournals.org
DOI: 10.9790/0853-141178288 www.iosrjournals.org 82 | Page
A cross sectional and comparative study of attitudes in
undergraduate medical students towards Psychiatric illness,
Cancer and Diabetes Mellitus.
Lanka V.R.Usha1
, Srinivasa rao Sireesha2
, C Siva Kumar3
1
Associate Professor Psychiatry Department,Osmania Medical College, India
2
Associate Professor Psychiatry Department,Osmania Medical College, India
3
Assistant Professor Psychiatry Department,Osmania Medical College, India
Abstract:
Background: Stigmatizing attitudes of Undergraduate (UG) medical students towards psychiatric illnesses can
compromise patient care.
Aims:To study the impact of clinical postings on attitude of UG medical students towards Psychiatric
illness,Cancer and Diabetes Mellitus(DM).
Methods: A total of 120 UG medical students(60-1st
year and 60 Internees) constituted the study
population.Sociodemographic data was collected.All students rated on Medical Condition Regards
Scale(MCRS) for the three conditions separately.Results were analysed on SPSS 20.
Results: The mean MCRS scores of first year medical students for psychiatric illness was found to be
46.38±10.5SD,for cancer 51.4±7.2SD and for DM it was 50.45±6.8SD.The mean MCRS scores of internee
medical students for Psychiatric illness, Cancer and DM were 52.33±6.34,53.28±6.13 and 54.77±6.2
respectively. MCRS scores for psychiatric illness improved significantly after attending psychiatric posting but
remained less than that for Cancer and DM scores. The association between MCRS scores of psychiatric illness
and diabetes of first year and internee students were statistically significant. There was statistically significant
improvement on items 6, 7, 8,9,10 and 11 for Psychiatric illness on MCRS.There was also a significant
improvement on items 7&8 for Cancer and 7, 10 and 11 for Diabetes Mellitus on MCRS scores of study subjects
Conclusions: There was only a partial improvement in regard, for all three conditions which needs to be
further strengthened by improving training for undergraduates.
Key words: attitudes,internees,MCRS , medical student, psychiatry posting
I. Introduction:
Psychiatry has undergone several developments in the past 50 years. Neurobiological research has
improved our understanding of mental illnesses like schizophrenia and depression .Recent advances in
psychopharmacology has led to development of newer drugs and has revolutionised the treatment of psychiatric
disorders .With better understanding of mental illnesses and several newer drugs being available in the
armamentarium of Psychiatrists, it might be expected that there should be improvement in attitudes of doctors
towards mental illness. But unfortunately stigmatising attitudes continue to exist among not only general
population[1] but also doctors[2] .
An attitude is a hypothetical construct that represents a person‟s degree of like or dislike for a place,
person, thing, item or event. The term „attitudes‟ is used to describe the pattern of feelings, beliefs, and reactions
that an individual holds regarding particular people, objects, or ideas and are often formed based on an
individual‟s past experiences.[3,4] Pre-existing negative attitudes have the potential to lead people to become
close-minded and biased in their interactions with the person for which the attitudes are held .[5]Stigma,
detracting stereotypes, and negative attitudes toward medical conditions are a major impediment in the provision
of healthcare, with research showing that such attitudes can have a direct impact on patient‟s well-being and the
type of health care they receive .[6]Understanding the attitudes and beliefs towards different medical conditions
amongst undergraduate students is a fundamental step in addressing the issue of negative attitudes so often
reported in studies.[6,7,8]
There are many reasons for these negative attitudes specially towards psychiatric illness[9]:
a.Lack of accurate information about mental illness.
b.Lack of contact with individuals with mental illness.
c.Lack of familiarity with mental illness.
Such negative attitudes are detrimental not only to patients but also to society especially if they are present in
health professionals.
2. A cross sectional and comparative study of attitudes in undergraduate medical students towards...
DOI: 10.9790/0853-141178288 www.iosrjournals.org 83 | Page
Attitude development towards mental illness takes place during initial undergraduate(UG) medical
training. Therefore understanding attitudes of medical students is very important. Studies looking into effect of
education, [10] information and UG psychiatry training, [11] have shown positive influence on attitudes of
medical students. These attitudes have important implications for planning of mental health policy and mental
health programmes for a country.[12]
A previous study which assessed the degree to which medical students enjoy treating patients with
twelve types of medical conditions , found that straightforward medical conditions rated highest ,somatoform
condition rated lowest.[13] In another longitudinal study authors studied attitude of paramedics and nursing
students towards four medical conditions ,(chronic medical conditions, intellectual disability, attempted suicide
and acute psychosis).Empathy was more towards medical conditions .[14]. All these studies indicate that
medical students are having less regard for psychiatric patients than other medical patients.
With the available sparse literature from lndian studies about the attitude of medical students towards
mental illness, majority have shown that there are negative attitudes prevailing.[15,16] Others have found that
psychiatric posting is only partially successful in improving negative attitudes,[17,18,19,20] and have
recommended changes in current teaching practices to bring about effective change in attitudes .[21] While a
few studies have concluded that attending psychiatric postings had brought about positive change in
attitude.[22] Author of one study recommended use of experimental and practical methods than didactic
methods for improvement of standards of undergraduate students ; thereby decreasing stigma and instilling
positive attitudes among them.[23] Another Indian author recommended that theory classes and psychiatric
postings should be held simultaneously to generate interest among UG medical students for increasing
awareness among them.[24]
However there is a paucity of Indian studies comparing attitudes of medical students across medical
and psychiatric illnesses. Hence this comparative study was carried out to assess attitude of medical students
towards medical and mental illnesses across different medical years.
II. Aims:
(a) To study the attitudes of first year medical student towards Psychiatric disorders, Cancer and Diabetes
mellitus.
(b) To study the attitudes of internee medical students towards Psychiatric disorders, Cancer and Diabetes
mellitus.
(c) To compare the attitudes between the two study groups.
(d) To compare the attitudes towards Medical and Psychiatric disorders across both
study groups
III. Materials and Methods-
This study was conducted in an urban medical college. Appropriate permission was obtained from the
authorities to conduct this study.
3.1 Study Universe-1st
year and Internee medical students of an urban medical college.
3.2 Study design-Cross sectional and comparative study.
3.3 Sampling design-Simple random sampling
3.4 Sample size-120(60 each from 1st
year and Interns)
3.5 Study Period-September 2015
3.6 Data Collection-Sixty 1st year and Internee medical students each were selected for study by simple random
sampling. All the students were explained about the purpose of our study .Students were ensured that
participation in the study was voluntary and non participation will not affect their grades. Confidentiality
matters were also taken care of. The inclusion criterion for first group was first year students who have not
attended psychiatry training yet. The inclusion criterion for 2nd group was internees who had undergone theory
and clinical postings in psychiatry. Theory classes included 20 didactic lectures on important psychiatry topics.
Clinical postings included bedside teaching, case presentation, lectures and seminars for two weeks. Each
student filled up a self reported intake proforma including sociodemographic data. They then rated the items on
medical condition regard scale (MCRS)[13] for Psychiatric illness; for Diabetes mellitus and for Cancer on
separate scoring sheets. The students were explained that they should not discuss the questions amongst
themselves and to give the first spontaneous response that strikes them after reading the statement. Consent was
implied by completion of the questionnaire.
3.7Rating scales used in the study:
1. Semistructured questionnaire consisted of sociodemographic data like gender
, age background, parental education and occupation.
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2. Medical Condition Regard Scale (MCRS). [13]This was developed to provide a measure of attitudes that
could be applied to any medical condition and allow for comparison between them. The MCRS is considered
valid and reliable and its authors found the scale to have a Cronbach coefficient alpha of 0.87 and a test re-test
reliability of 0.84. It is, however, a self-report questionnaire and this needs to be kept in mind in the
interpretation of the results as it measures what students report rather than what are necessarily their actual
attitudes. The eleven items on the MCRS were rated on a 6-point Likert scale (1 = strongly disagree, 6 =
strongly agree). To reduce the confounding effect of acquiescent responding, five of the eleven items are
worded negatively, which are later reverse-scored for analysis (Items 3, 5, 7,8and 11). Item 7 which is “treating
patients like this is a waste of medical Dollars” was changed to “treating patients like this is a waste of medical
Rupees” to make it relevant for our Indian study. The closer a mean score (for an item) is to six, the more
indicative it is of positive regard/attitude toward that medical condition being measured. A score of 3.5 and
below for any item is indicative of a negative attitude.
3.8Statistical methods-
Descriptive statistics like means, percentages and standard deviation were used to summarise
sociodemographic data and MCRS scores. Inferential statistics (t -test) was used to compare the differences
between attitude scores for the three conditions across the two groups. The level of significance was set at
p≤0.05. Data was analysed using SPSS version 20.
IV. Results
Table no. 1 Comparison between groups on mean MCRS†
scores.(Independent t-test)
Medical Condition Student Mean(SD) t-Value Significance
Psychiatric Illness 1st
Year(60) 46.38(10.5) -3.758
0.0*
Intern(60) 52.33(6.3)
Diabetes Mellitus 1st
Year(60) 50.45(6.8) -3.651
0.0*
Intern(60) 54.77(6.2)
Cancer 1st
Year(60) 51.40(7.2) -1.543
0.12
Intern(60) 53.28(6.1)
*Significant
†Medical condition regard scale
A total of 60 1st
year medical students and 60 internee students participated in the study. The mean
MCRS score of 1st
year students was found to be least for psychiatric illness (46.38±10.5SD); and maximum
for Cancer (51.4±7.2 ) .The 1st
year student‟s mean score was 50.45±6.8 SD for Diabetes Mellitus. The mean
MCRS score of Internee students was least for Psychiatric illness(52.33±6.34) and maximum for Diabetes
Mellitus(54.77±6.2) .Their mean score for Cancer was 53.28±6.13 SD .Even after attending clinical posting
,Psychiatry scores were less than other two conditions.(Table no.1)
The association between MCRS scores for Psychiatric illness and Diabetes Mellitus of 1st
year and
Internee students was statistically significant on Independent t-test(p=0.00 and 0.00).This suggests
improvement of regard amongst medical students after attending psychiatry posting.(Table no.1)
Table no. 2. Comparison between groups on individual item scores of MCRS†
for Psychiatric illness
MCRS Items Student Mean scores(SD) t-value Significance
1 1st
year(60) 4.27(1.5)
-1.768 .080
Intern(60) 4.68(1.0)
2 1st
year(60) 4.48(1.6)
-1.802 .074
Intern(60) 4.93(1.1)
3 1st
year(60) 3.15(1.7)
-1.520 .131
Intern(60) 3.62(1.7)
4 1st
year(60) 4.12(1.5)
-1.516 .132
Intern(60) 4.48(1.1)
5 1st
year(60) 4.58(1.6)
-1.237 .219
Intern(60) 4.92(1.4)
6 1st
year(60) 4.37(1.4)
-2.368 .020*
Intern(60) 4.95(1.2)
7 1st
year(60) 5.28(1.4)
-3.248 .002*
Intern(60) 5.90(0.3)
8 1st
year(60) 3.75(1.5)
-3.332 .001*
Intern(60) 4.62(1.3)
9 1st
year(60) 4.12(1.3)
-3.380 .001*
Intern(60) 4.77(0.7)
10 1st
year(60) 3.85(1.5)
-2.201 .030*
Intern(60) 4.38(1.0)
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11. 1st
year(60) 4.42(1.6) -2.502
.014*
Intern(60) 5.02(1.0)
*Significant
†Medical condition regard scale
Table no.3 Comparison between groups on individual item scores of MCRS†
for Cancer
MCRS Items Student Mean scores(SD) t-value Significance
1 1st
year(60) 5.02(1.1)
1.473 .143
Intern(60) 4.70(1.3)
2 1st
year(60) 5.18(1.2)
-.324 .747
Intern(60) 5.25(1.0)
3 1st
year(60) 3.15(1.5)
.000 1.000
Intern(60) 3.15(1.6)
4 1st
year(60) 4.98(1.1)
1.196 .234
Intern(60) 4.73(1.1)
5 1st
year(60) 4.80(1.5)
-1.483 .141
Intern(60) 5.18(1.3)
6 1st
year(60) 4.55(1.7)
-1.366 .174
Intern(60) 4.93(1.3)
7 1st
year(60) 5.20(1.3)
-2.337 .021*
Intern(60) 5.65(0.8)
8 1st
year(60) 4.27(1.6)
-2.677 .008*
Intern(60) 4.95(1.1)
9 1st
year(60) 4.70(1.0)
-.589 .557
Intern(60) 4.80(0.8)
10 1st
year(60) 4.50(1.1)
-.248 .805
Intern(60) 4.55(1.0)
11 1st
year(60) 5.03(1.3)
-1.652 .101
Intern(60) 5.40(1.2)
*Significant
†Medical condition regard scale
Table no.4 Comparison between groups on individual item scores of MCRS†
for Diabetes Mellitus
MCRS Items Student Mean scores(SD) t-value Signifiance
1 1st
year(60) 5.00(1)
-1.370 .173
Intern(60) 5.23(0.9)
2 1st
year(60) 4.72(1.5)
-.535 .594
Intern(60) 4.85(1.3)
3 1st
year(60) 3.72(1.8)
-.515 .607
Intern(60) 3.88(1.8)
4 1st
year(60) 4.25(1.6)
-1.096 .275
Intern(60) 4.50(1.2)
5 1st
year(60) 4.95(1.6)
-1.866 .065
Intern(60) 5.42(1.2)
6 1st
year(60) 4.42(1.7)
-1.311 .192
Intern(60) 4.78(1.4)
7 1st
year(60) 4.98(1.6)
-3.316 .001*
Intern(60) 5.72(0.7)
8 1st
year(60) 4.77(1.3)
-1.727 .087
Intern(60) 5.15(1.1)
9 1st
year(60) 4.55(1.1)
-1.865 .065
Intern(60) 4.88(0.8)
10 1st
year(60) 4.13(1.3)
-2.968 .004*
Intern(60) 4.73(0.9)
11 1st
year(60) 4.98(1.4)
-3.127 .002*
Intern(60) 5.63(0.8)
*Significant
†Medical condition regard scale
Individual items of MCRS for Psychiatric illness; Cancer and Diabetes Mellitus across both study
groups were analysed using Independent t- test.(Table no. 2,3 and 4)
There was a statistically significant difference on items 6,7,8,9,10 and 11 of MCRS scale for
Psychiatric illness.(p=0.02;0.002;0.00;0.00;0.03;0.01) There was a statistically significant difference on items 7
and 8 of MCRS for Cancer(p=0.02;0.00).MCRS scores for Diabetes were significant on items 7,10 and
11(p=0.00;0.00;0.00).This suggests that attending Psychiatry posting has brought about a significant change in 6
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out of 11 items of MCRS in attitude of medical students towards Psychiatric illness. The same was also reflected
in 3 items of MCRS scores of Diabetes and 2 items of Cancer.
Scores for Item 3 of MCRS showed negative attitude for Psychiatric illness and Cancer in 1st
year
group (mean score 3.15 for both).After attending clinical postings none of the internees rated any item below 3.5
except on item 3 for Cancer (3.15).Internee medical students showed lowest regard for item 3 and highest regard
for item 7 across all three conditions.
V.Discussion
The medical students in the first year group of the study sample did not have a favourable attitude
towards Psychiatric illness (mean score 46) when compared with that for Cancer (mean score 51) and Diabetes
(mean scores 50.4) as shown by mean MCRS scores. This could be because they were not exposed to
psychiatric posting in their first year of MBBS .After Psychiatry posting Interns showed significant
improvement in the attitude scores for Psychiatric illness and Diabetes mellitus..This was also reflected in an
earlier study where there was improvement of scores after a clinical exposure. [25].
Our study showed improvement of attitudes of internees for mental illness (52.3), Diabetes Mellitus
(54.7) and Cancer (53.2) after attending psychiatric postings with the scores improving most for Diabetes
followed by Cancer and least improvement was seen for Psychiatric illness. .This is in line with a similar study
from Canada in which attitudes towards mental illness were compared with those towards type2 diabetes
(T2DM) using MCRS .[26]This study also examined the impact of a contact based educational intervention .
Stigmatizing attitudes towards mental illness remained greater than T2DM after attending educational
intervention.[26] One study was done on 1st,2nd
and 3rd year students of six different groups of health related
courses (paramedics, nursing,midwifery,physiotherapy, medical and occupational therapists) on three different
Psychiatric disorders namely intellectual disability of medical aetiology, substance abuse and acute mental
illness using MCRS at Melbourne .[27]Authors analysed individual items of MCRS and found that out of three
disorders studied, highest regard was shown for intellectual disability, lowest for substance abuse, and moderate
regard for acute mental illness.[27]We studied attitudes for psychiatric illness as a whole and did not compare
the attitudes for different psychiatric illness. Another study compared attitudes towards five conditions namely
pneumonia, depression, psychotic symptoms ,intravenous drug abuse and long standing abdominal complaints
.[28] They reported improvement of scores for respiratory conditions whereas attitudes for unexplained
abdominal pain worsened amongst final year students when compared with first year students suggesting least
empathy for somatisation disorders.
Many studies concluded that negative attitudes towards mental illness are difficult to control; the
reason being ,concerns people have about mentally ill are partially true .[8] As one author pointed out, such
patients are not easy to engage with and that better knowledge is required to treat them effectively without
stigma.[29]
1st
years scored particularly low on Item 3-“there is little I can do to help patients like this” for
Psychiatric illness and Cancer( 3.15 each ) when compared to Diabetes Mellitus(3.72).This could be due to the
preformed negative attitudes towards psychiatric illness. The diagnosis “Cancer”is associated with utmost dread
amongst the lay public because of the high morbidity and mortality associated with it. Diabetes with
comparatively less morbidity and mortality must have been perceived as less dangerous with the symptoms and
signs not being so overt and treatment with lifestyle modification being readily available. Interns after
Psychiatric posting showed more positive scores on item 3 for MCRS psychiatry scores though not statistically
significant. However for Cancer, Interns did not show any improvement on item 3 of MCRS , with the negative
attitude persisting(mean 3.15). The same student however was not followed up longitudinally.
MCRS scores for psychiatric illness amongst 1st
year students was particularly low on items 4,8,9 and
10.Item 4 was “I feel especially compassionate towards patients like this(4.12);item 8,“Treating patients like this
are particularly difficult for me to work with (3.75);Item 9,“I can usually find something that helps patients feel
better”(4.12) and item 10 was “I enjoy giving extra time to patients like this”(3.85).This suggests that students
were not willing to go one step beyond the level of expected care to help mentally ill patients. However interns
showed significant improvement on the scores for items 8,9 and 10 after their Psychiatric posting. Item
7,“treating patients like this is a waste of medical rupees” was scored favourably amongst interns across the 3
conditions suggesting that training has made them realise the efficacy of medical management of these
conditions.
Items 6-11 of MCRS showed significant improvement for psychiatric illness. Item 6 was “I would not
mind getting up on call nights to care for patients like this”;Item 7 was “treating patients like this is a waste of
medical Rupees”;Item 8 was “ treating Patients like this are particularly difficult for me to work with”;item 9
was “I can usually find something that helps patients like this feel better”;Item 10 was “I enjoy giving extra time
to patients like this” and Item 11 was “Patients like this irritate me”. In another study also items 7 and 11 were
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answered favourably across all three conditions studied namely intellectual disability, substance abuse and acute
mental illness. [28]
These changes may be due to the result of training which made Internees realise that patient‟s
symptoms are not intentionally produced and that their erratic behaviour is because of their illness which has
bio- psychosocial causes. Observing the patients improve with proper management may have made them realise
the important role of health care professionals in treating these patients hence dispelling the preformed myths
and society and culture bound distorted cognitions about Psychiatric illness. The Hippocrates oath reminds them
to be fair and responsible towards every patient without any prejudice.
Items 1-5 of MCRS score of internee on psychiatric illness did not show any improvement. Item 5 was
“I prefer not to work with patients like this”. The reason for this might be that these medical students had
negative experiences with mentally ill in the past like aggressive behaviour and carried forward the same
opinion which was reported by another study. [30] .But this aspect of past negative experiences was not
included in our questionnaire.
VI.Conclusions
With the present curriculum there was an improvement in the scores after training in certain aspects
only indicating that training needs to be more rigorous to bring about a complete change. There is also an urgent
need to dispel the myths about mental illness which is held by the lay public and society which is reflected in the
preformed negative attitudes towards mental illness by the students. Psychiatry classes and stress on mental
health and mental illness needs to be started right from preclinical years. The bio psycho social model to explain
the aetiology of various medical conditions will make them more psychologically minded. This may help in
bringing about a positive attitude towards the mentally ill patients whom they will be managing across all
clinical conditions at one stage or the other.
6.1 Implications- In India the prevalence of serious mental illness is 6.5% (roughly 11 million
people)[31] and increasing by the day with increase in stress of day to day living.. In India as such the patient to
psychiatrist ratio is poor. The negative attitudes and ignorance of the available health care givers towards mental
illness will further worsen the situation. There are just 0.4psychiatrists and 0.02 psychologists /100000 people as
per WHO.[32]In India with less than 0.5 psychiatrists per lakh people it is still lower.[33]The responsibility of
care of mentally ill lies in the hands of General Physicians and Practitioners especially in a limited resource
setting like India. Training should start from UG level for reducing stigma and negative attitudes because these
UG medical students are the ones who are going to be involved in the care of patients directly or indirectly
during their future careers. Results of this study will go a long way to improve education and change negative
attitude of budding General Practitioners and Physicians.
6.2 Limitations- This was a cross sectional study with limited number of students from a single urban
medical college. The same student was not followed up longitudinally. Psychiatric illness as a whole was
studied .Regard for different diagnosis of Psychiatry was not studied.
6.3 Future recommendations-A longitudinal study with a larger sample from different medical colleges
is recommended to study various factors influencing negative attitudes towards psychiatric illness.
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