“Empathize with me, Doctor!” Medical Undergraduates Training Project: Development, Application, Six-months Follow-up

The aim of the study was to assess the effectiveness of specially designed, empathy training for medical undergraduates, based on the principles of Person-Centered Approach.Within the context of the humanistic person-centered patient care, the experiential, 60-hour “Empathize with me, Doctor!” training program contains theory, personal development and skills development. Role plays, experiential exercises, self-awareness exercises, active listening practice and conduction of a person-centered interview constituted the training.Forty-two medical undergraduates (66% females; 29% fourth year of study, 40% fifth, 31% sixth) from the University of Ioannina in Greece applied and all of them completed the empathy training. Forty-five medical students comprised a similar according to age and year of studies control group.The Jefferson Scale of Physician Empathy (JSPE) was used to assess the empathic performance, and Cohen’s d to assess the practical importance of any statistical difference.The JSPE mean score (and standard deviation) before, after and six months follow-up was 109.3(12.7), 121.1(9.0), 121.1(9.5), respectively. The before–after and before–follow-up difference was highly significant (CI95%, p<0.001 in both cases), and of great practical importance (d=1.072, d=1.052, respectively), while no decrease was observed six-months later (CI 95%, p=0.999, d<0.001). Control group reached a JSPE 108.7(10.5), similar to intervention group before training (CI95%, p=0.832), and highly different and important compared to after (CI 95%p<0.001; d=1.268) and follow-up (CI 95%, p<0.001; d=1.238) intervention scores.The “Empathize with me, Doctor!” improved significantly and importantly medical undergraduates’ empathic performance, which was maintained intact for at least six months

General hospital staff worries, perceived sufficiency of information and associated psychological distress during the A/H1N1 influenza pandemic

<p>Abstract</p> <p>Background</p> <p>Health care workers (HCWs) presented frequent concerns regarding their health and their families' health and high levels of psychological distress during previous disease outbreaks, such as the SARS outbreak, which was associated with social isolation and intentional absenteeism. We aimed to assess HCWs concerns and anxiety, perceived sufficiency of information, and intended behavior during the recent A/H1N1 influenza pandemic and their associations with psychological distress.</p> <p>Method</p> <p>Between September 1^stand 30^th, 2009, 469 health-care workers (HCWs) of a tertiary teaching hospital completed a 20-item questionnaire regarding concerns and worries about the new A/H1N1 influenza pandemic, along with Cassileth's Information Styles Questionnaire (part-I) and the GHQ-28.</p> <p>Results</p> <p>More than half of the present study's HCWs (56.7%) reported they were worried about the A/H1N1 influenza pandemic, their degree of anxiety being moderately high (median 6/9). The most frequent concern was infection of family and friends and the health consequences of the disease (54.9%). The perceived risk of being infected was considered moderately high (median 6/9). Few HCWs (6.6%) had restricted their social contacts and fewer (3.8%) felt isolated by their family members and friends because of their hospital work, while a low percentage (4.3%) indented to take a leave to avoid infection. However, worry and degree of worry were significantly associated with intended absenteeism (p < 0.0005), restriction of social contacts (p < 0.0005), and psychological distress (p = 0.036). Perceived sufficiency of information about several aspects of the A/H1N1 influenza was moderately high, and the overall information about the A/H1N1 influenza was considered clear (median 7.4/9). Also, perceived sufficiency of information for the prognosis of the infection was significantly independently associated with the degree of worry about the pandemic (p = 0.008).</p> <p>Conclusions</p> <p>A significant proportion of HCWs experienced moderately high anxiety about the pandemic, and their degree of worry was an independent correlate of psychological distress. Since perceived sufficiency of information about the A/H1N1 influenza prognosis was associated with reduced degree of worry, hospital managers and consultation-liaison psychiatry services should try to provide for HCWs' need for information, in order to offer favourable working conditions in times of extreme distress, such as the current and future pandemics.</p

Treatment implications of predominant polarity and the polarity index: a comprehensive review.

Background: Bipolar disorder (BD) is a serious and recurring condition that affects approximately 2.4% of the global population. About half of BD sufferers have an illness course characterized by either a manic or a depressive predominance. This predominant polarity in BD may be differentially associated with several clinical correlates. The concept of a polarity index (PI) has been recently proposed as an index of the antimanic versus antidepressive efficacy of various maintenance treatments for BD. Notwithstanding its potential clinical utility, predominant polarity was not included in the DSM-5 as a BD course specifier. Methods: Here we searched computerized databases for original clinical studies on the role of predominant polarity for selection of and response to pharmacological treatments for BD. Furthermore, we systematically searched the Pubmed database for maintenance randomized controlled trials (RCTs) for BD to determine the PI of the various pharmacological agents for BD. Results: We found support from naturalistic studies that bipolar patients with a predominantly depressive polarity are more likely to be treated with an antidepressive stabilization package, while BD patients with a manic-predominant polarity are more frequently treated with an antimanic stabilization package. Furthermore, predominantly manic BD patients received therapeutic regimens with a higher mean PI. The calculated PI varied from 0.4 (for lamotrigine) to 12.1 (for aripiprazole). Conclusions: This review supports the clinical relevance of predominant polarity as a course specifier for BD. Future studies should investigate the role of baseline, predominant polarity as an outcome predictor of BD maintenance RCTs. Keywords

Psychological and self-management support for people with vasculitis or connective tissue diseases: UK health professionals' perspectives

© The Author(s) 2020. Objectives. CTD and systemic vasculitis impact on health-related quality of life. Treatment can be complex, involving multiple medical specialities. The aim of this study was to investigate psychological and self-management support for patients in secondary care. Methods. An online survey of health professionals in the UK, including 45 multiple-choice and freetext questions, was analysed descriptively. Free-text survey responses were analysed thematically to identify health professionals' perceptions of best practice and unmet needs. Results. The online survey included 120 health professionals (34% specialist nurses, 51% doctors and 12% allied health professionals), predominantly working in rheumatology (52.9%) and nephrology (21.5%) departments. Access to self-management programmes or clinics for people with CTD or vasculitis was available in 23% of rheumatology and 8% of nephrology departments. In response to 'How well is your team providing self-management support to people with CTD or vasculitis?', 38% of respondents reported 'not very well' or 'not well at all'. Direct access to psychological support was available in 76.9% of nephrology and 32.8% of rheumatology departments. More than 80% of respondents would like additional training. Key themes from the qualitative data (free-text survey responses) included the importance of: Dedicated psychological support and self-management programmes for people with CTD and vasculitis, a whole-team approach (specialist teams empowering people to manage their own care), staff training (e.g. brief psychological interventions) and signposting to resources, including patient charities. Conclusion. People with CTD and vasculitis have complex needs, and improvements in selfmanagement and psychological support are required in UK rheumatology and nephrology departments