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Michael K, Schujovitzky D, Karnieli-Miller O. The associations between resilience, self-care, and burnout among medical students. PLoS One 2024; 19:e0309994. [PMID: 39298395 DOI: 10.1371/journal.pone.0309994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 08/22/2024] [Indexed: 09/21/2024] Open
Abstract
Burnout is a work-related stress syndrome with substantial consequences for patients, physicians, and medical students. Personal resilience, i.e., the ability to bounce back and thrive despite challenging circumstances, and certain practices, such as self-care, may protect individuals from burnout. However, limited information exists on the complex relationships between resilience, different self-care practices, and burnout. Understanding these associations is important for designing efficient interventions within medical schools. Therefore, the present study examined the direct and indirect associations through a cross-sectional study among 95 fourth-year medical students. Self-reported questionnaires measured resilience, self-care dimensions (stress management, spiritual growth, interpersonal relations, health responsibility), and burnout dimensions (emotional exhaustion, depersonalization, personal accomplishment). Data were analyzed via IBM-SPSS and PROCESS-macro. The main results demonstrated that self-care mediated the associations between resilience and burnout: stress management and interpersonal relations mediated the associations with emotional exhaustion, while spiritual growth mediated the association with personal accomplishment. These results highlight that medical students' resilience may encourage self-care behaviors, thus decreasing levels of the burnout dimensions of emotional exhaustion and personal accomplishment. Developing curricula that enhance students' resilience through applying self-care techniques in stressful situations may reduce the negative impact of burnout in healthcare.
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Affiliation(s)
- Keren Michael
- Department of Human Services, Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Dana Schujovitzky
- Faculty of Medical and Health Sciences, Department of Medical Education, Tel Aviv University, Tel Aviv, Israel
- Department of Pediatrics, Meir Medical Center, Kfar Saba, Israel
| | - Orit Karnieli-Miller
- Faculty of Medical and Health Sciences, Department of Medical Education, Tel Aviv University, Tel Aviv, Israel
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Vries C, Flurey CA. 'Do I cry or just carry on?' A story completion study of healthcare professionals' anticipated responses to experiencing chest pain. J Health Psychol 2024; 29:1138-1149. [PMID: 38282370 PMCID: PMC11344965 DOI: 10.1177/13591053231221400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
Healthcare professionals may experience barriers to seeking healthcare that differ from the general population. We explored healthcare professionals' anticipated responses to experiencing chest pain following a period of stress using qualitative story completion method with healthcare professionals (n = 44). Data were analysed using reflexive thematic analysis, which identified three themes: '"Do I cry or just carry on?": A Culture of Suffering in Silence' identified worries that expressing health concerns would be perceived as weakness, with potential impact on career opportunities. Participants also described self-diagnosis and self-medication rather than help-seeking. '"Me? Have a panic attack?": Psychosomatic Shame' suggested mental health issues may be ignored due to stigma. '"We definitely don't take care of ourselves": Prioritising Pressures of Multiple Responsibilities over Self-care' identified real or perceived pressures to de-prioritise their health. Future research should explore the design of confidential, time efficient support for healthcare professionals that tackle cultural norms and barriers to self-care.
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He G, Ren J, Chen X, Pan Q, Pan T. GP's GP, general practitioner's health and willingness to contract family doctors in China: a national cross-sectional study. BMC PRIMARY CARE 2024; 25:253. [PMID: 38997659 PMCID: PMC11245823 DOI: 10.1186/s12875-024-02492-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 06/26/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVES General practitioners are trained to care for patients with a high level of responsibility and professional competency. However, there are few reports on the physical and mental health status of general practitioners (GPs) in China, particularly regarding help seeking and self-treatment. The primary aims of this study were to explore GPs' expectations of their own family doctors and their reflection on role positioning, and to explore the objective factors that hinder the system of family doctors. STUDY DESIGN Cross-sectional study. METHODS We conducted an online survey of Chinese GPs. Descriptive statistics were used to summarize the findings. RESULTS More than half of the participants (57.20%) reported that their health was normal over the past year. A total of 420 participants (23.35%) reported having chronic diseases. For sleep duration, 1205 participants (66.98%) reported sleeping 6-8 h per day; 473 participants (26.29%) reported chronic insomnia. Two hundred thirty-one participants (12.84%) had possible depression. A total of 595 (33.07%) participants reported that they had contracted a fixed family doctor. In terms of preventing themselves from contracting for a family doctor, the following factors were identified: lack of sufficient time (54.81%), could solve obstacles themselves (50.97%), and embarrassment (24.24%). The proportion of the contract group (12.44%) taking personal relationship as a consideration was higher than that of the non-contract group (7.64%) (χ2 = 10.934 P = 0.01). Most participants (79.90%) in the non-signed group reported never having seen a family doctor. In terms of obstacles, more than half of the signed group thought that they could solve obstacles themselves, while the non-signed group (39.20%) was less confident in the ability of family doctors than the signed group (29.75%) (χ2 = 15.436, P < 0.01). CONCLUSIONS GPs work under great pressure and lack of self-care awareness, resulting in an increased prevalence of health conditions. Most GPs did not have a regular family doctor. Having a family doctor with a fixed contract is more conducive to the scientific management of their health and provides a reasonable solution to health problems. The main factors hindering GPs from choosing a family doctor were time consumption, abilities to solve obstacles themselves, and trust in the abilities of GPs. Therefore, simplifying the process of family doctor visits, Changing the GPs' medical cognition, and strengthening the policy of GP training would be conducive to promoting a family doctor system that enhances hierarchical diagnosis and treatment. International collaboration could integrate GP health support into global healthcare system.
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Affiliation(s)
- Guoshu He
- Department of General Practice, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China
| | - Jingjing Ren
- Department of General Practice, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China.
| | - Xiaoyang Chen
- Department of General Practice, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China
| | - Qi Pan
- Department of General Practice, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China
| | - Tianyuan Pan
- Department of General Practice, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China
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Li Q, Wu J, Chen Z, Wang J, Gong Y, Yin X. Prevalence of self-medication with antibiotics and its related factors among the general public and health professionals during the COVID-19 pandemic: A cross-sectional study in China. Am J Infect Control 2024; 52:759-764. [PMID: 38401644 DOI: 10.1016/j.ajic.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Self-medication with antibiotics (SMA) is a common public health concern. This study aimed to assess the prevalence of SMA in the general public and health professionals during the COVID-19 pandemic and identify the associated factors. METHODS A cross-sectional study was conducted from October 28, 2022, to November 6, 2022. Logistics regression analysis was used to examine the associated factors. RESULTS The rate of SMA was 10.25% in the general public and 12.69% in health professionals. For the public, those who perceived themselves as average or good health, had moderate antibiotic knowledge, and had easy access to nearby health facilities were less likely to SMA; while those who live in rural areas, found it easy to purchase antibiotics without prescriptions, and those who frequently encountered antibiotics recommended by pharmacy staff were more likely to SMA. For health professionals, those who were female, perceived themselves as good health, had moderate or high antibiotic knowledge, and had easy access to health facilities were less likely to SMA; while those who found it easy to purchase antibiotics without prescriptions were more likely to SMA. CONCLUSIONS SMA is prevalent in both the general public and health professionals. Promoting the rational use of antibiotics requires joint participation and effort.
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Affiliation(s)
- Qinnan Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianxiong Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhenyuan Chen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Lemey G, Larivière Y, Osang'ir BI, Zola T, Kimbulu P, Milolo S, Danoff E, Tchuma Y, Maketa V, Mitashi P, Ravinetto R, Van Damme P, Van Geertruyden JP, Muhindo-Mavoko H. An ancillary care policy in a vaccine trial conducted in a resource-constrained setting: evaluation and policy recommendations. BMJ Glob Health 2024; 9:e015259. [PMID: 38857947 PMCID: PMC11168174 DOI: 10.1136/bmjgh-2024-015259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/22/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION Clear guidelines to implement ancillary care (AC) in clinical trials conducted in resource-constrained settings are lacking. Here, we evaluate an AC policy developed for a vaccine trial in the Democratic Republic of the Congo and formulate policy recommendations. METHODS To evaluate the AC policy, we performed a longitudinal cohort study, nested in an open-label, single-centre, randomised Ebola vaccine trial conducted among healthcare personnel. Participants' demographic information, residence distance to the study site and details on the financial and/or medical support provided for any (serious) adverse events ((S)AE) were combined and analysed. To assess the feasibility of the AC policy, an expenditure analysis of the costs related to AC support outcomes was performed. RESULTS Enrolment in this evaluation study started on 29 November 2021. The study lasted 11 months and included 655 participants from the Ebola vaccine trial. In total, 393 participants used the AC policy, mostly for AE management (703 AE and 94 SAE) via medication provided by the study pharmacy (75.3%). Men had a 35.2% (95% CI 4.0% to 56.6%) lower likelihood of reporting AE compared with women. Likewise, this was 32.3% lower (95% CI 5.8% to 51.4%) for facility-based compared with community-based healthcare providers. The daily AE reporting was 78.8% lower during the passive vs the active trial stage, and 97.4% lower during unscheduled vs scheduled visits (p<0.001). Participants living further than 10 km from the trial site more frequently reported the travel distance as a reason for not using the policy (p<0.04). In practice, only 1.1% of the operational trial budget was used for AC policy support. CONCLUSION The trial design, study population and local health system impacted the use of the AC policy. Nonetheless, the AC policy implementation in this remote and resource-constrained setting was feasible, had negligible budgetary implications and contributed to participants' healthcare options and well-being.
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Affiliation(s)
- Gwen Lemey
- Global Health Institute, University of Antwerp, Antwerpen, Belgium
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium
| | - Ynke Larivière
- Global Health Institute, University of Antwerp, Antwerpen, Belgium
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium
| | - Bernard Isekah Osang'ir
- Global Health Institute, University of Antwerp, Antwerpen, Belgium
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium
| | - Trésor Zola
- Global Health Institute, University of Antwerp, Antwerpen, Belgium
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Primo Kimbulu
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Solange Milolo
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Engbu Danoff
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Yves Tchuma
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Vivi Maketa
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Patrick Mitashi
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Raffaella Ravinetto
- Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium
| | | | - Hypolite Muhindo-Mavoko
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
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McNeill K, Vaillancourt S, Choe S, Yang I, Sonnadara R. "I don't know if I can keep doing this": a qualitative investigation of surgeon burnout and opportunities for organization-level improvement. Front Public Health 2024; 12:1379280. [PMID: 38799682 PMCID: PMC11116672 DOI: 10.3389/fpubh.2024.1379280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Burnout is a pressing issue within surgical environments, bearing considerable consequences for both patients and surgeons alike. Given its prevalence and the unique contextual factors within academic surgical departments, it is critical that efforts are dedicated to understanding this issue. Moreover, active involvement of surgeons in these investigations is critical to ensure viability and uptake of potential strategies in their local setting. Thus, the purpose of this study was to explore surgeons' experiences with burnout and identify strategies to mitigate its drivers at the level of the organization. Methods A qualitative case study was conducted by recruiting surgeons for participation in a cross-sectional survey and semi-structured interviews. Data collected were analyzed using reflexive thematic analysis, which was informed by the Areas of Worklife Model. Results Overall, 28 unique surgeons participated in this study; 11 surgeons participated in interviews and 22 provided responses through the survey. Significant contributors to burnout identified included difficulties providing adequate care to patients due to limited resources and time available in academic medical centers and the moral injury associated with these challenges. The inequitable remuneration associated with education, administration, and leadership roles as a result of the Fee-For-Service model, as well as issues of gender inequity and the individualistic culture prevalent in surgical specialties were also described as contributing factors. Participants suggested increasing engagement between hospital leadership and staff to ensure surgeons are able to access resources to care for their patients, reforming payment plans and workplace polities to address issues of inequity, and improving workplace social dynamics as strategies for addressing burnout. Discussion The high prevalence and negative sequalae of burnout in surgery necessitates the formation of targeted interventions to address this issue. A collaborative approach to developing interventions to improve burnout among surgeons may lead to feasible and sustainable solutions.
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Affiliation(s)
- Kestrel McNeill
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Sierra Vaillancourt
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
- Department of Biology, McMaster University, Hamilton, ON, Canada
| | - Stella Choe
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Ilun Yang
- Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Ranil Sonnadara
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
- Department of Surgery, McMaster University, Hamilton, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
- Vector Institute for Artificial Intelligence, Toronto, ON, Canada
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Mortier P, Vilagut G, García-Mieres H, Alayo I, Ferrer M, Amigo F, Aragonès E, Aragón-Peña A, Asúnsolo Del Barco Á, Campos M, Espuga M, González-Pinto A, Haro JM, López Fresneña N, Martínez de Salázar AD, Molina JD, Ortí-Lucas RM, Parellada M, Pelayo-Terán JM, Pérez-Gómez B, Pérez-Zapata A, Pijoan JI, Plana N, Polentinos-Castro E, Portillo-Van Diest A, Puig T, Rius C, Sanz F, Serra C, Urreta-Barallobre I, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J. Health service and psychotropic medication use for mental health conditions among healthcare workers active during the Spain Covid-19 Pandemic - A prospective cohort study using web-based surveys. Psychiatry Res 2024; 334:115800. [PMID: 38387166 DOI: 10.1016/j.psychres.2024.115800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/30/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
Little is known about healthcare workers' (HCW) use of healthcare services for mental disorders. This study presents data from a 16-month prospective cohort study of Spanish HCW (n = 4,809), recruited shortly after the COVID-19 pandemic onset, and assessed at four timepoints using web-based surveys. Use of health services among HCW with mental health conditions (i.e., those having a positive screen for mental disorders and/or suicidal thoughts and behaviours [STB]) was initially low (i.e., 18.2 %) but increased to 29.6 % at 16-month follow-up. Service use was positively associated with pre-pandemic mental health treatment (OR=1.99), a positive screen for major depressive disorder (OR=1.50), panic attacks (OR=1.74), suicidal thoughts and behaviours (OR=1.22), and experiencing severe role impairment (OR=1.33), and negatively associated with being female (OR = 0.69) and a higher daily number of work hours (OR=0.95). Around 30 % of HCW with mental health conditions used anxiolytics (benzodiazepines), especially medical doctors. Four out of ten HCW (39.0 %) with mental health conditions indicated a need for (additional) help, with most important barriers for service use being too ashamed, long waiting lists, and professional treatment not being available. Our findings delineate a clear mental health treatment gap among Spanish HCW.
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Affiliation(s)
- Philippe Mortier
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Gemma Vilagut
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Helena García-Mieres
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Itxaso Alayo
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Biosistemak Institute for Health Systems Research, Barakaldo, Bizkaia, Spain
| | - Montse Ferrer
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Franco Amigo
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Enric Aragonès
- Institut d'Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain; Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - Andrés Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain; Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - Ángel Asúnsolo Del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain; Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain; Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, United States
| | - Mireia Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - Meritxell Espuga
- Occupational Health Service. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ana González-Pinto
- BIOARABA, Hospital Universitario Araba-Santiago, UPV/EHU, Vitoria-Gasteiz, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep M Haro
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | | | - Juan D Molina
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain; Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain; Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Rafael M Ortí-Lucas
- Service of Preventive Medicine and Quality of Attention, University Clinical Hospital of Valencia, Valencia, Spain
| | - Mara Parellada
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José Maria Pelayo-Terán
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Servicio de Psiquiatría y Salud Mental. Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI). Gerencia Regional de Salud de Castilla y Leon (SACYL). Ponferrada, León, Spain; Area de Medicina Preventiva y Salud Pública. Universidad de León, León, Spain
| | - Beatriz Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; National Center of Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | | | - José Ignasio Pijoan
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Clinical Epidemiology Unit-Hospital Universitario Cruces/ OSI EEC, Bilbao, Spain/ Biocruces-Bizkaia Health Research Institute, Spain
| | - Nieves Plana
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Elena Polentinos-Castro
- Research Unit Primary Care Management, Madrid Health Service, Madrid, Spain; Department of Medical Specialities and Public Health. King Juan Carlos University, Madrid, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud RICAPPS-(RICORS). Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Ana Portillo-Van Diest
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Teresa Puig
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Cristina Rius
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Ferran Sanz
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain; Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute, MELIS, Universitat Pompeu Fabra, Barcelona, Spain; Instituto Nacional de Bioinformatica - ELIXIR-ES, Barcelona, Spain
| | - Consol Serra
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain; CiSAL-Centro de Investigación en Salud Laboral, Hospital del Mar Research Institute/UPF, Barcelona, Spain
| | - Iratxe Urreta-Barallobre
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain; Biodonostia Health Research Institute, Clinical Epidemiology, San Sebastián, Spain
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eduard Vieta
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Víctor Pérez-Solá
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Jordi Alonso
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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McFarland DC, Lee HB. Preventing Physician Suicide-A Role for Consultation-Liaison Psychiatry? J Acad Consult Liaison Psychiatry 2023; 64:489-491. [PMID: 37890786 DOI: 10.1016/j.jaclp.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Affiliation(s)
- Daniel C McFarland
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY; Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY.
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Schulz S, Meissner F, Wolf F, Freytag A. Health Care Utilization and Self-Treatment by Primary Care Physicians and Specialist Physicians. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:688-689. [PMID: 37970669 PMCID: PMC10666256 DOI: 10.3238/arztebl.m2023.0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Sven Schulz
- Institute of General Practice and Familiy Medicine, Jena University Hospital, Friedrich-Schiller-University,
| | - Franziska Meissner
- Institute of General Practice and Familiy Medicine, Jena University Hospital, Friedrich-Schiller-University,
| | - Florian Wolf
- Institute of General Practice and Familiy Medicine, Jena University Hospital, Friedrich-Schiller-University,
| | - Antje Freytag
- Institute of General Practice and Familiy Medicine, Jena University Hospital, Friedrich-Schiller-University,
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10
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Mark Anderson D, Diris R, Montizaan R, Rees DI. The effects of becoming a physician on prescription drug use and mental health treatment. JOURNAL OF HEALTH ECONOMICS 2023; 91:102774. [PMID: 37451143 DOI: 10.1016/j.jhealeco.2023.102774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 05/16/2023] [Accepted: 05/26/2023] [Indexed: 07/18/2023]
Abstract
There is evidence that physicians disproportionately suffer from substance use disorder and mental health problems. It is not clear, however, whether these phenomena are causal. We use data on Dutch medical school applicants to examine the effects of becoming a physician on prescription drug use and the receipt of treatment from a mental health facility. Leveraging variation from lottery outcomes that determine admission into medical schools, we find that becoming a physician increases the use of antidepressants, anxiolytics, opioids, and sedatives. Increases in the use of antidepressants, anxiolytics, and sedatives are larger among female physicians than among their male counterparts.
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Affiliation(s)
- D Mark Anderson
- Department of Agricultural Economics and Economics, Montana State University, NBER, United States; IZA - Institute of Labor Economics, Bonn, Germany.
| | - Ron Diris
- Department of Economics, Leiden University, the Netherlands; IZA - Institute of Labor Economics, Bonn, Germany
| | - Raymond Montizaan
- Research Centre for Education and the Labour Market, Maastricht University, the Netherlands; IZA - Institute of Labor Economics, Bonn, Germany
| | - Daniel I Rees
- Department of Economics, Universidad Carlos III de Madrid, Spain
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Born J, Frank C. Direct and indirect barriers to hypothetical access to care among Canadian forces health services personnel. RESEARCH IN HEALTH SERVICES & REGIONS 2023; 2:11. [PMID: 39177892 PMCID: PMC11281741 DOI: 10.1007/s43999-023-00026-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/13/2023] [Indexed: 08/24/2024]
Abstract
BACKGROUND Though research among Canadian Forces Health Services (CFHS) personnel is limited, the literature suggests formal healthcare is underused. Though much research has been conducted on particular barriers (e.g., stigma), examining a breadth of barriers could better inform behavioral interventions. Furthermore, work has yet to examine the indirect effects of barriers through their impact on intentions to access care. METHODS CFHS participants were randomly assigned to complete either a mental health (N = 503) or physical health (N = 530) version of the survey. The survey included questions on the perceived impact of barriers, health-related information (e.g., past access to care), intention to seek care, and two hypothetical scenarios (i.e., pneumonia and back injury or post-traumatic stress disorder and depression) as a proxy of access to care. Multiple regressions using Hayes PROCESS macro were conducted to assess the direct and indirect effects (through intentions) of the barriers on hypothetical access to care. RESULTS Results show conflict with career goals barriers were indirectly linked to all health outcomes, and directly linked to mental health outcomes. Treatment preference barriers were directly and indirectly linked to care seeking only for mental health, while resource barriers were directly linked to care seeking only for physical health. Knowledge and ability to access care barriers were directly linked to care seeking for depression and pneumonia. IMPLICATIONS Interventions to improve treatment-seeking should be developed only after the behavioural antecedents are understood, and should focus on combining evidence-based techniques to simultaneously target multiple aspects of the behaviour.
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Affiliation(s)
- Jennifer Born
- Department of National Defence and the Canadian Armed Forces, Director General Military Personnel Research and Analysis, Ottawa, Ontario, Canada.
| | - Christine Frank
- Department of National Defence and the Canadian Armed Forces, Director General Military Personnel Research and Analysis, Ottawa, Ontario, Canada
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Schulz S, Meissner F, Wolf F, Freytag A. The Utilization of Medical Services by Doctors in Outpatient Practice. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:505-506. [PMID: 37981820 PMCID: PMC10511011 DOI: 10.3238/arztebl.m2023.0053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 11/23/2022] [Accepted: 02/21/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Sven Schulz
- Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - Franziska Meissner
- Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - Florian Wolf
- Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - Antje Freytag
- Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
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Jonsson P, Christiansen F, Brulin E. The association between self-treatment and mental health among Swedish physicians. Occup Med (Lond) 2023; 73:243-248. [PMID: 37210591 PMCID: PMC10292679 DOI: 10.1093/occmed/kqad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Despite a high prevalence of mental health problems among physicians, the rate of help-seeking behaviour is low. Instead, physicians tend to self-treat. This can have a negative impact on individual physicians and society. AIMS The aim was to explore the relationship between self-rated depression, the use of psychotropic medication, and the extent of self-treatment across gender and hierarchical position among Swedish physicians. In addition, the aim was to investigate whether social support can buffer against self-treatment. METHODS This study draws on data from the Longitudinal Occupational Health for Health Care in Sweden 2021 study, comprising a representative sample of physicians. Descriptive statistics and logistic regressions were carried out. RESULTS The present study showed that approximately 60% of the physicians using narcotic or non-narcotic psychotropic medication were self-prescribing. Male and more senior physicians self-treated to a greater extent. Physicians without depression were self-treating to a greater extent than those with depression. Those who used non-narcotic psychotropic medication intermittently were more likely to self-treat than those who used these medications regularly. The frequency of use was insignificant in relation to self-treatment with narcotic psychotropic medication. No buffering effect from social support at work was found. CONCLUSIONS Self-treatment was common among physicians in Sweden, particularly among those who reported mild or no symptoms of depression. This may have negative long-term effects on an individual level and for Swedish health care at large.
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Affiliation(s)
- P Jonsson
- Institute of Environmental Medicine, Unit of Occupational Medicine, Karolinska Institutet, Stockholm 113 65, Sweden
| | - F Christiansen
- Institute of Environmental Medicine, Unit of Occupational Medicine, Karolinska Institutet, Stockholm 113 65, Sweden
| | - E Brulin
- Institute of Environmental Medicine, Unit of Occupational Medicine, Karolinska Institutet, Stockholm 113 65, Sweden
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Al-Qerem W, Bargooth A, Jarab A, Akour A, Abu Heshmeh S. Information sources, attitudes, and practices of Self-Medication by Jordanian patients: A cross-sectional study. Saudi Pharm J 2023; 31:482-491. [PMID: 37063441 PMCID: PMC10102443 DOI: 10.1016/j.jsps.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Background and Objective Self-medication (SM) has significantly increased worldwide in the past decades, which may have detrimental health consequences including antimicrobial resistance, adverse drug reactions, drug-drug interaction, and dependency. Although several studies have evaluated the extent of SM, such studies are still limited in Jordan. The aim of this study was to explore sources of SM information, attitudes toward SM and the practice of SM and its associated factors. Methods The data of this cross-sectional study was collected between February and July 2022. A validated questionnaire was distributed to patients attending pharmacies from different locations in Jordan. The survey evaluated sources of information and attitudes toward SM, extent of SM practice, and attitudes towards SM, symptoms that the participants treat with SM and those that usually requires medical doctor consolation, followed by questions about the classes of medications mostly used for SM and the reasons for SM. Results and Discussion The study enrolled 695 Jordanian adults. The most reported indications for SM included headache (86.9 %), flu (76.4 %), and fever (69.6 %). The most common causes for SM included previous knowledge about the diseases and its treatments (84.2 %), and full knowledge of the medicine to be purchased (55.2 %). Results of the ordinal regression showed that physician counseling frequency was positively and significantly associated with "not being on chronic medication" (p-value = 0.001), and having a positive SM attitude level (p-value = 0.019), while negatively correlated with being in medical field (p-value < 0.001), having no children (p-value = 0.009), and relaying on non-scientific sources to obtain information for SM (p-value = 0.014). The frequency of SM practice was positively associated with being in medical field (p-value < 0.001, having no insurance (p-value < 0.001), and relaying on nonscientific sources (p-value = 0.017). Lastly, having a positive SM attitude level (p-value < 0.001) and not being on chronic medications (p-value = 0.007) were associated with decreased SM practice. Conclusion The study participants demonstrated increased SM practice due to the wrong perceptions toward SM and the reliance on non-scientific source of information about SM practice.
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Affiliation(s)
- Walid Al-Qerem
- Department of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan
| | - Afnan Bargooth
- Department of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan
| | - Anan Jarab
- Collage of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology. P.O. Box 3030. Irbid 22110, Jordan
| | - Amal Akour
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Jordan
| | - Shrouq Abu Heshmeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology. P.O. Box 3030. Irbid 22110, Jordan
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Solms L, van Vianen AEM, Koen J, Kan KJ, de Hoog M, de Pagter APJ. Physician exhaustion and work engagement during the COVID-19 pandemic: A longitudinal survey into the role of resources and support interventions. PLoS One 2023; 18:e0277489. [PMID: 36724165 PMCID: PMC9891506 DOI: 10.1371/journal.pone.0277489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 10/27/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Physicians increasingly show symptoms of burnout due to the high job demands they face, posing a risk for the quality and safety of care. Job and personal resources as well as support interventions may function as protective factors when demands are high, specifically in times of crisis such as the COVID-19 pandemic. Based on the Job Demands-Resources theory, this longitudinal study investigated how monthly fluctuations in job demands and job and personal resources relate to exhaustion and work engagement and how support interventions are associated with these outcomes over time. METHODS A longitudinal survey consisting of eight monthly measures in the period 2020-2021, completed by medical specialists and residents in the Netherlands. We used validated questionnaires to assess job demands (i.e., workload), job resources (e.g., job control), personal resources (e.g., psychological capital), emotional exhaustion, and work engagement. Additionally, we measured the use of specific support interventions (e.g., professional support). Multilevel modeling and longitudinal growth curve modeling were used to analyze the data. RESULTS 378 medical specialists and residents were included in the analysis (response rate: 79.08%). Workload was associated with exhaustion (γ = .383, p < .001). All job resources, as well as the personal resources psychological capital and self-judgement were associated with work engagement (γs ranging from -.093 to .345, all ps < .05). Job control and psychological capital attenuated the workload-exhaustion relationship while positive feedback and peer support strengthened it (all ps < .05). The use of professional support interventions (from a mental health expert or coach) was related to higher work engagement (estimate = .168, p = .032) over time. Participation in organized supportive group meetings was associated with higher exhaustion over time (estimate = .274, p = .006). CONCLUSIONS Job and personal resources can safeguard work engagement and mitigate the risk of emotional exhaustion. Professional support programs are associated with higher work engagement over time, whereas organized group support meetings are associated with higher exhaustion. Our results stress the importance of professional individual-level interventions to counteract a loss of work engagement in times of crisis.
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Affiliation(s)
- Lara Solms
- Department of Work and Organizational Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Department of Pediatrics, Erasmus MC-Sophia Children’s Hospital, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- * E-mail:
| | - Annelies E. M. van Vianen
- Department of Work and Organizational Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Jessie Koen
- Department of Work and Organizational Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Department of Sustainable Productivity and Employability, Netherlands Organization for Applied Scientific Research, Leiden, The Netherlands
| | - Kees-Jan Kan
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Matthijs de Hoog
- Department of Pediatrics, Erasmus MC-Sophia Children’s Hospital, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anne P. J. de Pagter
- Department of Pediatrics, Erasmus MC-Sophia Children’s Hospital, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
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Zahavi E, Lev-Shalem L, Yehoshua I, Adler L. Methylphenidate use and misuse among medical residents in Israel: a cross-sectional study. HUMAN RESOURCES FOR HEALTH 2023; 21:5. [PMID: 36721145 PMCID: PMC9890881 DOI: 10.1186/s12960-023-00792-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Methylphenidate (MPH) and other stimulants may be misused, mainly as cognitive enhancers and recreational drugs. Data regarding misuse among medical residents are scarce. This study aimed to evaluate the prevalence of and main reasons for methylphenidate (MPH) use and misuse among Israeli medical residents. METHODS In this cross-sectional study, we sent an online questionnaire to medical residents who had completed their first residency exam and specialists with up to 2 years of experience. We asked about the use of MPH before and during residency and attitudes toward the use of MPH as a cognitive enhancer. We also added the Adult ADHD Self-Report Scale (ASRS) questionnaire, a validated tool used to screen for the presence of attention deficit hyperactivity disorder (ADHD). Users and misusers were classified based on self-report of use and formal ADHD diagnosis. Logistic regression analysis was used to evaluate factors associated with MPH misuse. RESULTS From March 2021 to August 2021, 370 physicians responded to our questionnaire (response rate 26.4%). Twenty-eight met the exclusion criteria and were not included. The respondents' average age was 36.5 years. Women comprised 63.5% of the respondents. Of the participants, 16.4% were classified as users and 35.1% as misusers. The prevalence of misusers was 45.6% among surgery and OB/GYN physicians, 39.4% among pediatricians and internists, and 24% among family physicians (P < 0.001). Misusers had a more liberal approach than others to MPH use as a cognitive enhancer. Factors associated with misuse of MPH included not being a native-born Israeli (OR-1.99, 95% CI 1.08, 3.67) and type of residency (OR-2.33, 95% CI 1.22, 4.44 and OR-4.08, 95% CI 2.06, 8.07 for pediatrics and internal medicine and surgery, respectively). CONCLUSION Very high levels of MPH misuse during residency may be related to stress, long working hours, night shifts, and the academic burden of the residency period. We believe that our findings should be considered by healthcare policymakers as they make decisions regarding the conditions of medical residencies. The use of MPH as a cognitive enhancer should be further studied and discussed.
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Affiliation(s)
- Eden Zahavi
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel
- Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Liat Lev-Shalem
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel
| | - Ilan Yehoshua
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel
- Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Limor Adler
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel.
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv, Israel.
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Cezar-Vaz MR, Xavier DM, Bonow CA, Vaz JC, Cardoso LS, Sant’Anna CF, da Costa VZ, Nery CHC, Alves AS, Vettorello JS, de Souza JL, Loureiro HMAM. Musculoskeletal Pain in the Neck and Lower Back Regions among PHC Workers: Association between Workload, Mental Disorders, and Strategies to Manage Pain. Healthcare (Basel) 2023; 11:365. [PMID: 36766940 PMCID: PMC9914445 DOI: 10.3390/healthcare11030365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/01/2023] Open
Abstract
Scientific evidence indicates that workers in the health sector are commonly exposed to work-related musculoskeletal pain. OBJECTIVES We aimed to identify the relationship between the presence and intensity of musculoskeletal pain in the neck and lumbar regions reported by Primary Health Care (PHC) workers with workloads and occupational risks, analyze musculoskeletal pain in the presence and absence of self-reported mental disorders based on a medical diagnosis, and identify workers' strategies to manage pain. METHOD This cross-sectional study addressed 338 health professionals working in PHC outpatient services in the extreme South of Brazil. One questionnaire addressed sociodemographic questions concerning occupation, occupational risks, and mental disorders. The Nordic Musculoskeletal Questionnaire was used to assess self-reported musculoskeletal pain. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) measured the workload. A descriptive and inferential analysis was performed using SPSS version 21.0. RESULTS Most (55.3%) participants reported neck and (64.5%) lower back pain in the previous 12 months, and 22.5% and 30.5% reported intense neck and lower back pain, respectively, in the previous 12 months. The results showed different independent associations with increased musculoskeletal pain among health workers. Dentists presented the highest prevalence of neck pain, while female workers presented the highest prevalence of lower back pain. Furthermore, the perception of ergonomic risk and virtually all self-reported mental disorders (except panic syndrome for neck pain) were associated with pain in the neck and lower back regions and a higher frustration level (mental demand). Additionally, professionals with graduate degrees, nurses, and professionals working the longest in PHC services reported seeking complementary therapies more frequently, while physicians and those with self-reported mental disorders self-medicated more frequently.
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Affiliation(s)
| | | | - Clarice Alves Bonow
- Faculty of Nursing, Federal University of Pelotas, Pelotas 96010-610, Brazil
| | - Jordana Cezar Vaz
- Institute of Dermatology Professor Rubem David Azulalay (Medical Residency), Rio de Janeiro 20020-020, Brazil
| | | | | | | | - Carlos Henrique Cardona Nery
- Institute of Human and Information Sciences—ICHI, Federal University of Rio Grande—Santa Vitória do Palmar Campus, Santa Vitória do Palmar 96230-000, Brazil
| | - Aline Soares Alves
- School of Nursing (Ph.D. Program), Federal University of Rio Grande, Rio Grande 96203-900, Brazil
| | | | - Jociel Lima de Souza
- School of Nursing (Ph.D. Program), Federal University of Rio Grande, Rio Grande 96203-900, Brazil
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Geuijen P, Schellekens A, Schene A, Atsma F. Substance use disorder and alcohol consumption patterns among Dutch physicians: a nationwide register-based study. Addict Sci Clin Pract 2023; 18:4. [PMID: 36639645 PMCID: PMC9837897 DOI: 10.1186/s13722-022-00356-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 12/09/2022] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Problematic substance use and Substance Use Disorders (SUD) are common in all layers of the population. Several studies suggest higher prevalence rates of problematic substance use among physicians compared to the general population, which is harmful for themselves and potentially impairs quality of care. However, nationwide comparison with a highly educated reference group is lacking. Using nationwide register data, this study compared the prevalence of clinical SUD diagnoses and alcohol consumption patterns between physicians and a highly educated reference population. METHODS A retrospective study was performed using registry data from 2011 up to and including 2019, provided by Statistics Netherlands. From the data, a highly educated reference group was selected and those with an active medical doctor registration were identified as "physicians". Clinical SUD diagnoses were identified by DSM-IV codes in mental healthcare registries. Benchmark analyses were performed, without statistical testing, to compare the prevalence of SUD diagnoses and alcohol consumption patterns between physicians and the reference population. RESULTS Clinical SUD diagnoses were found among 0.3% of the physicians and 0.5% of the reference population, with higher proportions of sedative use disorder among physician patients. Among drinkers, the prevalence rates of heavy and excessive drinking were respectively 4.0% and 4.3% for physicians and 7.7% and 6.4% for the reference population. CONCLUSION Prevalence rates of SUD diagnoses were fairly comparable between physicians and the highly educated reference population, but physicians displayed more favorable alcohol consumption patterns. The use of sedatives by physicians might deserve attention, given the relatively higher prevalence of sedative use disorder among physicians. Overall, we observed relatively low prevalence rates of SUD diagnoses and problematic alcohol use, which may reflect a treatment gap and social desirable answers.
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Affiliation(s)
- Pauline Geuijen
- grid.10417.330000 0004 0444 9382Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Department of Psychiatry, Radboud University Medical Center, Reinier Postlaan 4, 6525 GC Nijmegen, The Netherlands ,grid.491352.8Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, The Netherlands
| | - Arnt Schellekens
- grid.10417.330000 0004 0444 9382Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Department of Psychiatry, Radboud University Medical Center, Reinier Postlaan 4, 6525 GC Nijmegen, The Netherlands ,grid.491352.8Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, The Netherlands
| | - Aart Schene
- grid.10417.330000 0004 0444 9382Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Department of Psychiatry, Radboud University Medical Center, Reinier Postlaan 4, 6525 GC Nijmegen, The Netherlands
| | - Femke Atsma
- grid.10417.330000 0004 0444 9382Scientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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Tounsi AA, Alnowaiser A, Alsuhibani A, Alsadhan L, Hamdan HM. Dental students' attitude towards propranolol non-medical use: A multi-institutional cross-sectional study in Riyadh, Saudi Arabia. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:787-793. [PMID: 34951731 DOI: 10.1111/eje.12761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 09/29/2021] [Accepted: 12/19/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The lives of college students are full of various stressors. Students seek a number of stress-relieving modalities as self-prescribed beta-blockers to improve their academic performance. The aim of this study was to assess the extent of beta-blockers (propranolol) usage amongst Saudi dental students and their attitude towards its use to enhance academic performance. METHODS A cross-sectional study involving a convenient sample was conducted on a group of undergraduate dental students enrolled in Riyadh dental schools during the academic year of 2019/2020. A paper format closed-ended questionnaire was used. RESULTS A sample of 680 students participated in the survey (43% response rate). Approximately 12% of dental students used propranolol for non-medical reasons. The prevalence did not differ significantly with the gender or year of study. A significantly higher percentage of students from private dental schools reported using propranolol for non-medical reasons (odds ratio (OR), 3.1; 95% confidence interval (CI), 1.7-5.4; p < .001). Propranolol users were significantly more likely to connect with other students using the medication. Both students, those who used and those who did not use propranolol, similarly, highly endorsed the need for being informed about the risk of using propranolol. Compared with non-users, there was more disagreement amongst propranolol users on the necessity for placing school regulations controlling medication use. CONCLUSION The use of propranolol to enhance academic performance amongst dental students in Saudi Arabia should not be disregarded. The study findings emphasise the importance of regulating students' usage of beta-blockers to promote a fair academic environment.
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Affiliation(s)
- Abrar A Tounsi
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Hebah M Hamdan
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
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Sachdev C, Anjankar A, Agrawal J. Self-Medication With Antibiotics: An Element Increasing Resistance. Cureus 2022; 14:e30844. [PMID: 36451647 PMCID: PMC9704507 DOI: 10.7759/cureus.30844] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/29/2022] [Indexed: 04/04/2023] Open
Abstract
Self-medication refers to the consumption of drugs such as antibiotics by individuals based on their own experience and knowledge, without consulting a doctor either for diagnosis or prescription. The inappropriate use of antibiotics is the primary source of antibiotic resistance (AR) development in microorganisms. As a result, some specific types of microorganisms that are naturally resistant to antibiotics have become considerably more common. Self-medication poses a danger to the advantages of antibiotics since it results in financial burdens on low and middle-income countries (LMICs), management failures, the evolution of antibiotic-resistant bacterial serotypes, and a higher risk of contamination of the general population by such tensions. Antibiotic misuse puts patients at risk for adverse drug reactions, false symptom relief, and the rise of drug-resistant microorganisms. It carries many health risks, chiefly in LMICs. These risks are linked to various factors, including a shortage of medical experts, low-level healthcare facilities, unregulated medication delivery, and negative public perceptions of doctors. The primary issue with self-medication is that majority of the population is uninformed of the harmful consequences of antibiotic resistance and how they might donate to it by self-diagnosing and self-treating with antibiotics. Antibiotic self-medication remains a common practice in society, and educational attainment significantly affects the frequency of this behavior. The article aims to educate the people by showing the development and plausible future to decrease antibiotic misuse. It also tells about the various challenges and prevention of this preceding problem.
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Affiliation(s)
- Chetna Sachdev
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Ashish Anjankar
- Biochemistry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Jayesh Agrawal
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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Schulz S, Hecker F, Sauerbrey U, Wolf F. Illness behaviour and influencing aspects of general practitioners in Germany and their use of the health care system: a qualitative study. BMJ Open 2022; 12:e051404. [PMID: 36180120 PMCID: PMC9528620 DOI: 10.1136/bmjopen-2021-051404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of this study was to explore aspects that play a role when general practitioners (GPs) become ill and thus gain a more comprehensive understanding of the overall illness behaviour of GPs and their use of the healthcare system. SETTING Primary care practices in Thuringia, Germany. PARTICIPANTS Convenience sample of 16 GPs. DESIGN Qualitative study design with semistructured interviews and content analysis. RESULTS Using our approach of having participants report their own episodes of illness, we found that self-treatment was practised and accepted by all 16 participants. The widespread use of naturopathy and complementary methods seems to be a special feature of German GPs. Formal use of the healthcare system mainly took place through direct consultation with specialists.Our study revealed various aspects influencing the illness behaviour of the GPs and their use of the healthcare system. Some aspects also apply to lay patients, but it became clear how strongly illness behaviour is influenced by participants' activities as physicians. Noteworthy and less described aspects are especially the influence of patients and practice staff, the influence of biographical and professional imprint and the attitudes and values of the physicians.Complex inter-relationships were found between illness behaviour and influencing aspects; these are subjected to a dynamic and recursive process. CONCLUSIONS The illness behaviour of German GPs seems to be comprehensively influenced by their activities as responsible healthcare providers. The ability to perceive and reflect in this regards should already be actively promoted in studies and further education. Further research is needed for a better understanding of the inter-relationships.
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Affiliation(s)
- Sven Schulz
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
| | - Friederike Hecker
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
| | - Ulf Sauerbrey
- Department of Social Work and Education, Jena University Hospital, Jena, Germany
- Department of Social Work and Education, Neubrandenburg University of Applied Sciences, Neubrandenburg, Germany
| | - Florian Wolf
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
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22
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Cohidon C, Mahler L, Broers B, Favrod-Coune T, Moussa A, Sebo P. Primary Care Physicians’ Personal and Professional Attributes Associated With Forgoing Own Care and Presenteeism: A Cross Sectional Study. Int J Public Health 2022; 66:1604442. [PMID: 35242001 PMCID: PMC8886613 DOI: 10.3389/ijph.2021.1604442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of this study was to describe the prevalence of forgoing care and forgoing sick leave among primary care physicians (PCPs) in Switzerland and to investigate associated factors.Methods: A random sample of 1,000 PCPs in French-speaking regions of Switzerland (participation rate: 50%) was asked whether they had forgone care and sick leave during the last year. Sociodemographic, personal and occupational characteristics were recorded. Logistic regressions were performed to study these behaviours.Results: 37% of respondents reported at least one episode of forgoing care and 29% reported an episode of forgoing sick leave. No associations were found between individual characteristics and forgoing care. A heavy workload was the most common reason evoked for forgoing care. Coming to work when sick (presenteeism) was associated with female sex, younger age, having a chronic illness, working in a suburban area and working full-time.Conclusion: A high proportion of PCPs in Switzerland is forgoing own care and continues to work despite sickness. New generations of PCPs should require careful monitoring, and specific solutions should be sought to reduce these harmful behaviours.
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Affiliation(s)
- Christine Cohidon
- Family Medicine Department, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- *Correspondence: Christine Cohidon,
| | - Liv Mahler
- Primary Care Division, Geneva University Hospitals, Geneve, Switzerland
| | - Barbara Broers
- Primary Care Division, Geneva University Hospitals, Geneve, Switzerland
| | | | - Amir Moussa
- Primary Care Unit, University of Geneva, Geneva, Switzerland
| | - Paul Sebo
- Primary Care Unit, University of Geneva, Geneva, Switzerland
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23
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Self-Medication Perceptions and Practice of Medical and Pharmacy Students in Serbia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031193. [PMID: 35162213 PMCID: PMC8834465 DOI: 10.3390/ijerph19031193] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 12/03/2022]
Abstract
Background. Attitudes towards conventional and complementary medicine among future healthcare professionals can impact their future pharmacotherapy practice. This study aimed to determine the prevalence and predisposing factors related to self-medication among medical and pharmacy students. Methods. This cross-sectional questionnaire-based study was performed at the Faculty of Medicine, University of Novi Sad, Serbia, on first- and final-year students of medicine and pharmacy. The multivariate Poisson regression model with robust variance was used to identify the main predictors of self-medication. Results. The overall self-medication prevalence in the past year was 81.3%. Independent risk factors for self-medication identified in the regression analysis were the final study year, housing condition, i.e., living in a leased apartment or in a student dormitory in comparison to living with parents, and cigarette consumption. The conventional drugs were the most frequently used, mostly for the symptoms of cold and pain. Final-year students had more confidence in conventional medicines than in herbal drugs and were more aware of the risks of their concomitant use. Conclusion. Self-medication is highly prevalent among students of medical sciences, especially among final-year students. Increased medical knowledge led to the higher awareness of the drug interaction risks.
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Vilovic T, Bozic J, Zuzic Furlan S, Vilovic M, Kumric M, Martinovic D, Rusic D, Rada M, Tomicic M. Mental Health Well-Being and Attitudes on Mental Health Disorders among Family Physicians during COVID-19 Pandemic: A Connection with Resilience and Healthy Lifestyle. J Clin Med 2022; 11:438. [PMID: 35054130 PMCID: PMC8778288 DOI: 10.3390/jcm11020438] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/16/2022] Open
Abstract
Family physicians (FPs) are exposed to high amounts of stress, and could be susceptible to the development of mental health disorders (MHD), especially after the emergence of the COVID-19 pandemic. The aim of the current study was to assess MHD history, attitudes toward MHDs and stress-coping strategies in FPs. An additional goal was to estimate their comprehensive well-being and investigate connections with resilience and a healthy lifestyle. A total of 483 FPs submitted their responses via online survey. MHD attitudes were assessed with the according questionnaires, while burnout levels, healthy lifestyle, resilience, job and life satisfaction were estimated with validated scales. Results have shown that 32.5% of FPs disclosed positive MHD history, while 68.7% used professional help. Resilience and healthy lifestyle levels were significantly higher in MHD negative FPs (p < 0.001), while burnout levels were lower (p < 0.001). Moreover, healthy lifestyle (β = 0.03, p < 0.001) was an independent correlate of resilience, while healthy lifestyle (β = -0.35, p < 0.001, and resilience (β = -1.82, p < 0.001) were of burnout levels. Finally, resilience (OR = 0.387, p < 0.001) and healthy lifestyle (OR = 0.970, p = 0.021) were shown as independent predictors of positive MHD history status. Strong promotion and education of FP population regarding resilience and healthy lifestyle should be utilized in practice in order to alleviate the possibility of mental health disturbances and the according consequences.
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Affiliation(s)
- Tina Vilovic
- Department of Family Medicine, University of Split School of Medicine, 21000 Split, Croatia; (T.V.); (S.Z.F.); (M.R.)
- Department of Family Medicine, Split-Dalmatia Health Center, 21000 Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.B.); (M.V.); (M.K.); (D.M.)
| | - Sanja Zuzic Furlan
- Department of Family Medicine, University of Split School of Medicine, 21000 Split, Croatia; (T.V.); (S.Z.F.); (M.R.)
- Department of Family Medicine, Split-Dalmatia Health Center, 21000 Split, Croatia
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.B.); (M.V.); (M.K.); (D.M.)
| | - Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.B.); (M.V.); (M.K.); (D.M.)
| | - Dinko Martinovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.B.); (M.V.); (M.K.); (D.M.)
| | - Doris Rusic
- Department of Pharmacy, University of Split School of Medicine, 21000 Split, Croatia;
| | - Marko Rada
- Department of Family Medicine, University of Split School of Medicine, 21000 Split, Croatia; (T.V.); (S.Z.F.); (M.R.)
- Department of Family Medicine, Split-Dalmatia Health Center, 21000 Split, Croatia
| | - Marion Tomicic
- Department of Family Medicine, University of Split School of Medicine, 21000 Split, Croatia; (T.V.); (S.Z.F.); (M.R.)
- Department of Family Medicine, Split-Dalmatia Health Center, 21000 Split, Croatia
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Sar-El R, Angel Y, Fire G, Avni A, Tene O. The price of internship through COVID-19: 1st year physicians report substantial mental health symptoms during the pandemic. Gen Hosp Psychiatry 2022; 78:111-116. [PMID: 36029557 PMCID: PMC9388293 DOI: 10.1016/j.genhosppsych.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine the prevalence of mental health symptoms among medical interns working for the first time as physicians in a large tertiary hospital in Israel during the 1st COVID year. METHODS All interns who worked for at least 2 months during the 1st COVID year (March 2020-February 2021) at the Tel-Aviv Sourasky Medical Center (TASMC), a large tertiary general hospital in Israel were approached simultaneously during April-May 2021, and were requested to fill in an online survey. In each questionnaire, the interns were asked to refer to the worst time they endured the symptoms described. Included were all medical. Depression and anxiety symptoms, post-traumatic stress symptoms and Burnout measures were evaluated using validated questionnaires. Depressive/anxiety symptoms were defined as primary end measures. We assessed the association between depression and anxiety symptoms, and demographic, post-traumatic and burnout measures. RESULTS 145 out of 188 interns completed the study (77% overall response rate). The mean age was 30.36 ± 2.97. Almost half the interns (47%) reported depression/anxiety symptoms. The high depression/anxiety group was characterized by a lower mean age (29.87 ± 2.93 vs. 30.92 ± 2.91, p = 0.041), higher post-traumatic symptoms (15.62 ± 13.32 vs. 3.63 ± 5.59, p < 0.0001) and higher scores in 2/3 burnout subscales - emotional exhaustion (5.09 ± 1.29 vs. 3.61 ± 1.38, p = 0.000001) and depersonalization (3.83 ± 1.71 vs. 2.94 ± 1.46, p = 0.002). 11.4% of interns in the full sample reported they used cannabis or alcohol as "self-medication". CONCLUSIONS medical interns serving for their first year as physicians during the COVID pandemic, developed mental symptoms in alarming numbers. The findings point to a crucial need to implement active interventions to protect these doctors, so that they can safely embark on their medical careers, specifically in times of global health crises.
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Affiliation(s)
- Roy Sar-El
- Psychiatric Division, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
| | - Yoel Angel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel,Department of Physician Affairs, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel,Division of Anesthesia, Pain Management and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Gil Fire
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel,Faculty of Medicine, Ariel University, Ariel, Israel,Department of Physician Affairs, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Aviv Avni
- Psychiatric Division, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Oren Tene
- Psychiatric Division, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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26
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Kassa T, Gedif T, Andualem T, Aferu T. Antibiotics self-medication practices among health care professionals in selected public hospitals of Addis Ababa, Ethiopia. Heliyon 2022; 8:e08825. [PMID: 35128109 PMCID: PMC8803584 DOI: 10.1016/j.heliyon.2022.e08825] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/08/2021] [Accepted: 01/20/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Self-medication is the first option and response to most illness episodes. Use of antimicrobials without health care professionals' guidance may result in greater probability of inappropriate use, missed diagnosis, delays in appropriate treatment, pathogen resistance and increased morbidity. There is no sector in the health care community which is immune to drug abuse or misuse of which the worst offenders include physicians, nurses and pharmacy professionals. Self-medication among health care professionals may be an indicator that the health professional is neglecting his or her own health. This represents serious issues for both patients and the professionals. OBJECTIVE To assess self-medication practices with antibiotics among health care professionals in selected hospitals of Addis Ababa, Ethiopia. METHOD Facility based cross-sectional study was conducted from April to May, 2017 among 317 health care professionals. Convenient sampling technique was used to select study participants. Data were collected through self-administered questionnaire and analyzed using Statistical Package for Social Sciences software version 20. Binary logistic regression analysis was done to check the relationship between the dependent variable (antibiotic self-medication) and selected independent variables (sex, age, marital status, income, professional qualification and work experience). RESULTS The prevalence of self-medication with antibiotics among health care professionals in one month recall period was found to be 72 (22.7%). The main reasons given for this practice were being familiar with the treatment options, 31 (43.1%) and need for rapid relief, 25 (34.7%). Respiratory problems, 29 (40.3%) and gastro intestinal problems, 28 (38.9%) were the most common illnesses for which self-medication with antibiotics was practiced while penicillins, 30 (41.6%) and fluoroquinolones, 29 (40.3%) constituted the two most commonly used antibiotics for the same. None of the variables had significant association with the practice of self-medication with antibiotics. CONCLUSION Self-medication with antibiotics was common among the study participants. Efforts should be made by health authorities including Drug and Therapeutics Committee, Drugs Regulatory Authority, Hospitals' management and other stakeholders to ensure safe usage of antibiotics.
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Affiliation(s)
- Tsehay Kassa
- Teklehaimanot Health Center, Addis Ababa, Ethiopia
| | - Teferi Gedif
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Temesgen Aferu
- School of Pharmacy, College of Medicine and Health Sciences, Mizan Tepi University, Mizan- Aman, Ethiopia
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27
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Perceptions and Practice of Self-Medication among Undergraduate Medical Students of a Tertiary Care Teaching Hospital in South India. JOURNAL OF CLINICAL AND BASIC RESEARCH 2021. [DOI: 10.52547/jcbr.5.3.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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28
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McFarland DC, Hlubocky F. Therapeutic Strategies to Tackle Burnout and Emotional Exhaustion in Frontline Medical Staff: Narrative Review. Psychol Res Behav Manag 2021; 14:1429-1436. [PMID: 34552358 PMCID: PMC8450185 DOI: 10.2147/prbm.s256228] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/02/2021] [Indexed: 12/30/2022] Open
Abstract
Burnout and emotional exhaustion in frontline healthcare workers and their implications for the health of patients, individual clinicians, and organizations are increasingly described among various healthcare settings. Yet therapeutic strategies to address burnout and other work-related conditions are outpaced by innumerable descriptions of burnout prevalence across healthcare disciplines. This review provides a framework that should be helpful in beginning the process of addressing burnout and its related conditions. It begins with an elucidation of key inter-related concepts of work-related conditions that should be considered in the differential diagnosis along with other mental health conditions that are concomitantly elevated in healthcare clinicians (eg, depression and substance abuse) but require a different approach to treatment. Factors that lead to increased resilience, engagement, and thriving in clinical workplaces are considered. While strategies are dichotomized between organizational level interventions and individual or personal interventions to address burnout, the idea of identifying and addressing root causes of burnout and related conditions is highlighted. The efficacy and feasibility of interventions that incorporate mindfulness-based stress reduction, cognitive behavioral strategies, meaning-centered therapy, and compassion training are highlighted as interventions with proven efficacy and durability that should be considered based on work-related stressors and appeal to clinicians.
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Affiliation(s)
- Daniel C McFarland
- Department of Medicine, Northwell Health Cancer Institute, Lenox Hill Hospital, New York, NY, USA
| | - Fay Hlubocky
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, MacLean Center for Clinical Medical Ethics, and the Cancer Research Center, Chicago, IL, USA
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29
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Sciolla AF, Haskins J, Chang CH, Kirshnit C, Rea M, Uppington J, Yellowlees P. The Suicide Prevention, Depression Awareness, and Clinical Engagement Program for Faculty and Residents at the University of California, Davis Health. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:272-278. [PMID: 33797017 PMCID: PMC8016615 DOI: 10.1007/s40596-021-01439-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/15/2021] [Indexed: 05/07/2023]
Abstract
OBJECTIVE The objective of the study is to present results of a depression and suicide screening and treatment referral program for physicians at an academic medical center. METHODS An anonymous web-based screening questionnaire was sent to all physicians at a large academic center. Responses were classified as indicating either high, moderate, or low risk for depression and suicide. Physicians at high and moderate risk were contacted by a counselor through a messaging system. The counselor's message contained information on risk level and an invitation to meet in person. High-risk respondents who did not reply to the message or declined to meet received mental health resources. Respondents who met with the counselor were offered individualized treatment referrals and to participate in a 1-year follow-up of self-reports every 3 months. RESULTS The questionnaire was sent to approximately 1800 residents, fellows, and faculty from February 2013 through March 2019. A total of 639 questionnaires were received, 100 were excluded for various reasons, and 539 were used to conduct analyses (14.4% response rate). The majority of respondents were classified at moderate (333 [62%]) or high (193 [36%]) risk for depression or suicide. Eighty-three respondents were referred for mental health care, and 14 provided data for the follow-up study. CONCLUSIONS Results of screening physicians for depression and suicide at one academic medical center highlight the challenges of engaging most of them in this activity and the satisfaction of the minority who successfully engaged in a treatment referral program.
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Affiliation(s)
| | | | - Celia H Chang
- University of California, Davis, Sacramento, CA, USA
| | | | - Margaret Rea
- University of California, Davis, Sacramento, CA, USA
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30
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Khan SDAA, Al-Garni M, Alalhareth FA, Al Touk AA, Al-Ajmi HA, Alyami SA, Alalyani HH. Data on self-medication among healthcare students at Najran University, KSA. Bioinformation 2021; 17:599-607. [PMID: 35095234 PMCID: PMC8770411 DOI: 10.6026/97320630017599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/29/2021] [Accepted: 05/29/2021] [Indexed: 11/30/2022] Open
Abstract
The prevalence of self-medication (SM) has increased in health professionals due to awareness of disease and symptoms. Incorrect use of medication caused harmful effects. To assess the knowledge, attitude and practice of health professionals, this survey was conducted. A cross-sectional study was carried out among health professionals of different specialities. Knowledge, attitude and practice-based questions were asked through an electronically distributed questionnaire. Data were statistically tested using the Chi-square test with SPSS. Most of the health professionals were aware with the term of self-medication; however the knowledge about related questions was not satisfactory. Almost half of the participants practiced self-medication. The prevalence of self-medication among participants was high. They need to be trained and educate about the incorrect use of self-medication.
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Affiliation(s)
- Siraj DAA Khan
- Department of Preventive Dental Sciences, Faculty of Dentistry, Najran University, KSA
| | - Musleh Al-Garni
- Department of Preventive Dental Sciences, Faculty of Dentistry, Najran University, KSA
| | - Faisal Ali Alalhareth
- Department of Preventive Dental Sciences, Faculty of Dentistry, Najran University, KSA
| | | | | | - Saeed Ali Alyami
- Department of Preventive Dental Sciences, Faculty of Dentistry, Najran University, KSA
| | - Hamzah Hamed Alalyani
- Department of Preventive Dental Sciences, Faculty of Dentistry, Najran University, KSA
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31
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Brower KJ. Professional Stigma of Mental Health Issues: Physicians Are Both the Cause and Solution. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:635-640. [PMID: 33885412 PMCID: PMC8078109 DOI: 10.1097/acm.0000000000003998] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
After a medical student prompted medical faculty to tell their stories of depression and related mental health issues, the author wrote this article with the aim of decreasing the stigma of mental illness and encouraging treatment, as needed, in the medical profession. The professional culture of the house of medicine not only mimics society in attributing stigma to people with mental health issues but may also contribute to high rates of suicide in the ranks of health care professionals by leading to a delay in seeking treatment. Acculturation accelerates in the first year of medical school such that medical students experience an increase in burnout and depressive symptoms from prematriculation levels. It follows that faculty have a responsibility to improve the learning environment. Survey data from medical faculty at the author's institution showed that depression decreased respondents' willingness to seek mental health treatment because of the stigma and issues of access to help. Faculty attitudes toward mental health issues, including reluctance to admit having such issues, may be conveyed to medical students in the hidden curriculum that teaches them to keep depression hidden. Moreover, the fear of mental disorders is manifested in licensing and privileging applications under the guise of patient safety, contributing to a culture of shame and silence. As creators and guardians of this professional culture, medical faculty and other physicians must be the ones who change it. The same faculty who play a part in causing and perpetuating stigma related to mental health issues have the power to derive and enact some of the solutions. In addition to giving voice to a personal experience of mental health issues, this article offers suggestions for normalizing moderate to severe depression as a medical disorder, decreasing the stigma of mental health issues, and encouraging faculty to seek treatment.
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Affiliation(s)
- Kirk J. Brower
- K.J. Brower is professor, Department of Psychiatry, and chief wellness officer, University of Michigan Medical School, Ann Arbor, Michigan
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Zacay G, Baron-Epel O, Malatskey L, Heymann A. Preferences and barriers to the utilization of primary health care by sick physicians: a nationwide survey. Fam Pract 2021; 38:109-114. [PMID: 32839825 DOI: 10.1093/fampra/cmaa090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Physicians are often dissatisfied with their own medical care. Self-prescribing is common despite established guidelines that discourage this practice. From a pilot study, we know primary care physicians' (PCP) preferences, but we lack information regarding other specialties and work places. OBJECTIVES The goal of this study was to examine whether physicians are satisfied with their personal primary care and how this could be improved. METHODS We distributed an electronic survey to all physicians registered with the Israeli Medical Association. The questionnaire examined satisfaction with medical care, preferences for using formal care versus informal care, self-prescribing and barriers to using formal care. RESULTS Two thousand three hundred and five out of 24 360 invited physicians responded. Fifty-six per cent of the respondents were satisfied with their personal primary care. Fifty-two per cent reported initiating self-treatment with a medication during the last year. Five and four per cent initiated treatment with a benzodiazepine and an antidepressant, respectively, during the last year. This was despite the fact that most physicians did not feel competent to treat themselves. Having a personal PCP was correlated with both a desire to use formal care and self-referral to formal care in practice. Regression analysis showed that the highest odds ratio (OR) for experiencing a large gap between desired and actual care were for physicians who had no personal PCP (OR = 1.92). CONCLUSIONS Physicians frequently engage in self-treatment and in informal medical care. Whether the root cause is the health care system structure that does not meet their needs or the convenience of self-treatment is not known.
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Affiliation(s)
- Galia Zacay
- Department of Family Medicine, Meuhedet Health Fund, Tel Aviv.,The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | | | - Lilach Malatskey
- Israeli Society of Lifestyle Medicine, Israeli Association of Family Physicians, Tel Aviv.,Azrieli Faculty of Medicine, Bar Ilan University, Ramat-Gan, Israel
| | - Anthony Heymann
- Department of Family Medicine, Meuhedet Health Fund, Tel Aviv.,The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
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Huang WT, Lin HJ, Feng IJ, Hsu CC, Wang JJ, Huang CC, Su SB. Comparison of the Risk for Peripheral Vertigo between Physicians and the General Population. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:180-187. [PMID: 34178777 PMCID: PMC8213624 DOI: 10.18502/ijph.v50i1.5085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Because of the limited information available regarding peripheral vertigo (PV) in physicians, we conducted this study to clarify this issue. Methods: We used Taiwan National Health Insurance Research Database to identify 26,309 physicians and an identical number of general population matched by age and sex. All the participants who had PV before 2007 and residents were excluded. By tracing their medical histories between 2007 and 2013, comparisons of PV risk between physicians and general population and among physicians were performed. Results: Physicians had a significantly lower PV risk than the general population (adjusted odds ratio [AOR]: 0.811; 95% confidence interval [CI]: 0.662–0.994). In comparison among physicians, otolaryngologists had a significantly higher PV risk than other specialties. Physicians who were older or served in local hospitals or clinics had a significantly higher PV risk than physicians in medical centers. Conclusion: Physicians had a significantly lower PV risk than the general population. Better medical knowledge in physicians than in the general population may explain the findings; however, further studies are warranted for elucidating the detailed mechanisms.
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Affiliation(s)
- Wei-Ta Huang
- Department of Emergency Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Hung-Jung Lin
- Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.,Department of Emergency Medicine, Taipei Medical University, Taipei, Taiwan
| | - I-Jung Feng
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Chien-Chin Hsu
- Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.,Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Chien-Cheng Huang
- Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.,Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department Senior Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi Mei Medical Center, Tainan, Taiwan.,Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan
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Bitencourt MR, Silva LL, Alarcão ACJ, Dutra ADC, Bitencourt MR, Garcia GJ, de Andrade L, Nickenig Vissoci JR, Pelloso SM, Carvalho MDDB. The Impact of Violence on the Anxiety Levels of Healthcare Personnel During the COVID-19 Pandemic. Front Psychiatry 2021; 12:761555. [PMID: 34803769 PMCID: PMC8602572 DOI: 10.3389/fpsyt.2021.761555] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/05/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction: The COVID-19 pandemic stressed the importance of healthcare personnel. However, there is evidence of an increase in violence against them, which brings consequences, such as anxiety. The aim of this study was to analyze the anxiety levels of health professionals who have or not suffered violence during the COVID-19 pandemic, and verify the variables associated with the risk of starting to take medication for anxiety. Methods: We assessed the anxiety profile of health professionals in Brazil through an online questionnaire, using the Generalized Anxiety Disorder 7-item Scale (GAD-7), in relation to groups of participants who have or not suffered violence during the COVID-19 pandemic. We used Cronbach's alpha reliability coefficient to check the consistency of the responses, and the effect size using the r coefficient. Principal Component Analysis was used to verify the differences in anxiety scores between the two groups. Logistic regression analysis was also used to verify the variables associated with the risk of starting medication for anxiety and considered statistically significant when p < 0.05. Results: A total of 1,166 health professionals participated in the study, in which 34.13% had a normal anxiety profile, 40.14% mild, 15.78% moderate, and 9.95% severe. The mean score of the sum of the GAD-7 was 7.03 (SD 5.20). The group that suffered violence had a higher mean (8.40; SD 5.42) compared to the group that did not (5.70; SD 4.60). In addition, the median between both groups was significantly different (7.0 vs. 5.0; p < 0.01). Approximately 18.70% of the participants reported having started taking medication to treat anxiety during the pandemic. The factors that increased the chances of these professionals starting medication for anxiety p < 0.05 were having suffered violence during the pandemic (OR 1.97; 95% CI 1.42-2.77), being nurses (OR 1.61; 95% CI 1.04-2.47) or other types of health professionals (OR 1.58; 95% CI 1.04-2.38), and having a mild (OR 2.11; 95% CI 1.37-3.34), moderate (OR 4.05; 95% CI 2.48-6.71) or severe (OR 9.08; 95% CI 5.39-15.6) anxiety level. Conclusion: Brazilian healthcare professionals who have suffered violence during the pandemic have higher anxiety scores and higher risk to start taking anxiety medication.
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Affiliation(s)
| | - Lincoln Luís Silva
- Graduation Program in Biosciences and Physiopathology, State University of Maringá, Maringá, Brazil
| | | | | | | | | | - Luciano de Andrade
- Graduation Program in Health Sciences, State University of Maringá, Maringá, Brazil
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Does the problem begin at the beginning? Medical students' knowledge and beliefs regarding antibiotics and resistance: a systematic review. Antimicrob Resist Infect Control 2020; 9:172. [PMID: 33143746 PMCID: PMC7607835 DOI: 10.1186/s13756-020-00837-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 10/22/2020] [Indexed: 11/19/2022] Open
Abstract
Background Studies have detected that prescribers display gaps in knowledge and inappropriate attitudes regarding antibiotics and resistances, but it is not known whether these are generated during professional practice or derive from the undergraduate stage of their education. Accordingly, the aim of this study was to identify medical students’ knowledge, beliefs and attitudes regarding antibiotic use and antibiotic resistance, and whether these change over the course of their time at medical school.
Methods We conducted a search of the MEDLINE and EMBASE databases, and included studies that measured knowledge and/or beliefs and/or attitudes regarding antibiotic prescribing and/or resistance, among medical students. Results Of the 509 studies retrieved, 22 met the inclusion criteria. While medical students perceived resistance as posing a major public health problem, both worldwide and in their own countries, students in the last two course years were more aware of overprescription of antibiotics in general, and of broad-spectrum antibiotics, at their teaching hospital. There was a considerable lack of knowledge about the treatment of high-incidence infections, and upper respiratory tract infections in particular (41–69% of participants believed antibiotics to be useful for treating these), without any differences by course year. Students were conscious of their personal shortcomings and thus showed willing to improve their education. Conclusions Future physicians display important gaps in knowledge, particularly in terms of treatment of high-incidence infections. This finding may be of use when it comes to designing more effective training in antibiotic stewardship for undergraduates.
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Abukhalaf AA, Alomar AA, Alsalame NM, Sumaya OY, Alessa OM, Alasbali MM, Alaska YA. Inappropriate use of beta-blockers among medical and dental students at King Saud University, Riyadh. J Family Med Prim Care 2020; 9:4391-4395. [PMID: 33110866 PMCID: PMC7586521 DOI: 10.4103/jfmpc.jfmpc_696_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/10/2020] [Accepted: 07/01/2020] [Indexed: 12/13/2022] Open
Abstract
Aim: Self-medication and inappropriate beta-blocker use have been commonly reported among students. This study aimed to determine the prevalence of inappropriate self-prescription of beta-blockers among medical and dental students. Methods: We conducted a cross-sectional study using a validated self-administered questionnaire distributed via online Google document to all undergraduate medical and dental students, including interns, of King Saud University, Riyadh, Saudi Arabia. Results: Out of 1,240 emails sent, 885 students (627 [70.8%] medical students and 258 [59.2%] dental students) responded to the survey (response rate, 71.4%). Beta-blockers were used by 198 students (22.4%) during their college years, of which 147 (16.6%) used it ≤5 times. The most common reason of using beta-blockers was to relieve stress and anxiety. The most common sources of information for use were their colleagues/fellow students. Self-prescribed beta-blockers were used by 123 students (13.9%). The usual dose consumed was 20 mg in 84 students (9.5%), while 15 (1.7%) experienced side effects. Although male students used beta-blockers more than females, females used beta-blockers at significantly higher doses (>20 mg). Medical students consumed more beta-blockers than dental students did (33.7% versus 0%, P = 0.001). Students in their senior years continued self-prescription and beta-blocker use longer than their juniors. Continued use was associated with their current academic level, who prescribed the drug, their usual dose, and awareness of complications. Conclusion: Two in ten students inappropriately used beta-blockers to relieve their anxiety and stress during examinations, and most of them were self-prescribed.
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Affiliation(s)
| | - Ali Abdullah Alomar
- Department of Emergency, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nayef Mosleh Alsalame
- Department of Emergency, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Omar Yassin Sumaya
- Department of Emergency, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Omar Mohammed Alessa
- Department of Emergency, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Yasser A Alaska
- Department of Emergency, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Chambe J, Kobayashi Frisk M, Charton L, Lefebvre F, Will S, Rat C, Bourgin P. Hypnotic prescription by GPs is associated with their personal drug consumption but not by their insomnia status. J Sleep Res 2020; 29:e12993. [DOI: 10.1111/jsr.12993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 09/27/2019] [Accepted: 01/20/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Juliette Chambe
- General Medicine Department Faculty of Medicine University of Strasbourg Strasbourg France
- Sleep Disorders Center‐CIRCSom University Hospital of Strasbourg Strasbourg Strasbourg France
- Institute for Cellular and Integrative Neurosciences CNRS UPR 3212 Strasbourg France
| | - Mio Kobayashi Frisk
- Sleep Disorders Center‐CIRCSom University Hospital of Strasbourg Strasbourg Strasbourg France
- Institute for Cellular and Integrative Neurosciences CNRS UPR 3212 Strasbourg France
| | - Lea Charton
- General Medicine Department Faculty of Medicine University of Strasbourg Strasbourg France
| | - François Lefebvre
- Public Health Department Faculty of Medicine University of Strasbourg Strasbourg France
| | - Sandrine Will
- General Medicine Department Faculty of Medicine University of Strasbourg Strasbourg France
| | - Cédric Rat
- General Medicine Department Faculty of Medicine INSERM U892‐CNRS U6299‐CRCNA Nantes France
| | - Patrice Bourgin
- Sleep Disorders Center‐CIRCSom University Hospital of Strasbourg Strasbourg Strasbourg France
- Institute for Cellular and Integrative Neurosciences CNRS UPR 3212 Strasbourg France
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Simegn W, Dagnew B, Dagne H. Self-Medication Practice and Associated Factors Among Health Professionals at the University of Gondar Comprehensive Specialized Hospital: A Cross-Sectional Study. Infect Drug Resist 2020; 13:2539-2546. [PMID: 32801792 PMCID: PMC7399467 DOI: 10.2147/idr.s257667] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/05/2020] [Indexed: 11/23/2022] Open
Abstract
Background Self-medication is the use of medication to treat self-diagnosed disorders or symptoms. In the current time, there has been an increasing tendency in self-medication in pharmacies and retail outlets in our country Ethiopia and alarmingly high in healthcare professionals. In spite of the adverse impacts, there were scarcity of data on self-medication practice among health professionals in Ethiopia. Therefore, this study aimed to determine the practice of self-medication and its determinant factors among health professionals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Methods A Cross-sectional study design was employed using a simple random sampling technique to recruit the study participants. We used self-administered questionnaires to collect the data. Epi Info 7 and SPSS 20 were used for data entry and statistical analysis, respectively. Frequencies and mean with standard deviation were computed. Measure of association between self-medication and independent factors was determined using logistic regression. Variables with a p<0.05 were declared as determinant factors of self-medication practice. Results Four hundred and twelve health professionals were involved in the study with a mean age of 29.9 years (±5.43, range=20–60). In this study, self-medication practice was 54.6% (95% CI: 49.8–59.4). Health professionals who had worked less than 3 years after last graduation (AOR=1.67, 95% CI (1.02, 2.76)), those with 44–55 working hours per week (AOR=2.44, 95% CI: 1.07,5.57), and who knew over-the-counter classification of drugs (AOR=1.75, 95% CI: 1.03,2.99) had significantly higher self-medication practice. Conclusion Self-medication practice was remarkably high in the current study which is a major public health problem. The findings suggest a cooperative implementation of pharmaceutical regulations particularly focusing on those health professionals with high working hours per week.
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Affiliation(s)
- Wudneh Simegn
- Department of Pharmaceutics, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Henok Dagne
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Susilo C, Qomaruddin MB, Fahrera MP. Acute Coronary Syndrome and patient behavior factors in overcoming the event of chest pain in pre hospital phase. J Public Health Res 2020; 9:1810. [PMID: 32728556 PMCID: PMC7376453 DOI: 10.4081/jphr.2020.1810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/13/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Acute coronary syndrome (ACS) is a complex disease induced by thrombosis, which causes unstable angina (UA), acute myocardial infarction (AMI) or sudden cardiac death. It is important to rapidly detect the presence of chest pain to conduct the pre-hospital phase. This study aims to analyze the behavioral factors of patients suffering from ACS in overcoming the incidence of chest pain in the prehospital phase. Design and Methods: The consecutive sampling technique and cross-sectional method were used to obtain data from a sample of 110 outpatient respondents at the Community- Integrated Health Center Results: After the logistic regression test, a significant relationship was found between the occurrence of chest pain (Pvalue = 0.040), with compressive behavior factors, buying over the counter drugs (P-value = 0.001), massaging and rubbing with oil (P-value = 0.046). Conclusions: In conclusion, the significant behavioral factors associated with ACS sufferers in dealing with the occurrence of chest pain in the pre-hospital phase are due to the act of buying OTC drugs and the habit of massaging or rubbing with oil. Significance for public health One of the causes of delay in handling Acute Coronary Syndrome (ACS) has been attributed to patient behavior. Most times, patients hesitate to seek health services. This delay is because myocardial infarction attacks are not accompanied by severe signs and symptoms and patients usually look healthy. Improving the behavior of patients with ACS while dealing with the incidence of chest pain in the prehospital phase is very important to prevent delays in the prehospital phase. This study aims to explain the behavioral factors of ACS sufferers in dealing with the incidence of chest pain in the prehospital phase.
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Affiliation(s)
- Cipto Susilo
- Doctoral Program of Public Health, Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya Indonesia.,Faculty of Health Sciences, University of Muhammadiyah Jember, Jember, Indonesia
| | - Mochammad Bagus Qomaruddin
- Department of Health Promotion and Behavioral Sciences, Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya Indonesia
| | - Mellani Puji Fahrera
- Faculty of Health Sciences, University of Muhammadiyah Jember, Jember, Indonesia
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Greco L, Gindi M, Yusupov E, Niwagaba L, Pino MA. Are Medical Students Prepared to Model Healthy Behaviors for Their Future Patients? A Survey Comparing Aged-Matched Peers. MEDICAL SCIENCE EDUCATOR 2020; 30:843-848. [PMID: 34457740 PMCID: PMC8368412 DOI: 10.1007/s40670-020-00960-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Osteopathic medical students (OMS) who establish healthy behaviors for themselves are more likely to counsel their future patients on appropriate self-care. This study compared the lifestyle habits of OMS with those of age-matched peers in other areas of study, which served as the control group. METHOD In the fall of 2018, a survey was administered to OMS of the New York Institute of Technology College of Osteopathic Medicine (NYIT-COM) (group I) and graduate programs from the same school (group II), to assess their lifestyle habits. Questions on demographics were additionally included. RESULTS There were 398 total responses: 83.2% (N = 331) from group I and 16.9% (N = 67) from group II, with 25 being the mean age of the respondents. Group I (53.2%) reported to studying at least 5-10 h per day, while 20.1% reported to studying more than 10 h. Group II reported 37.3% and 9.0%, respectively, of study time. Group I exercised more times per week (2-3 times) than group II and for a longer duration (30-60 min). Group I slept more than group II (6-8 h), yet reported to using more substances to stay awake. CONCLUSIONS OMS studied, exercised, and slept more than age-matched peers, but used more substances to stay awake. Aspects of this study are encouraging, but suggest that further evaluation is needed for schools to assist students establish lifelong habits to encourage the wellness of their future patients.
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Affiliation(s)
- Lisa Greco
- New York Institute of Technology College of Osteopathic Medicine (NYITCOM), Northern Blvd, P.O. Box 8000, Old Westbury, NY 11568-8000 USA
| | - Michael Gindi
- New York Institute of Technology College of Osteopathic Medicine (NYITCOM), Northern Blvd, P.O. Box 8000, Old Westbury, NY 11568-8000 USA
| | - Eleanor Yusupov
- New York Institute of Technology College of Osteopathic Medicine (NYITCOM), Northern Blvd, P.O. Box 8000, Old Westbury, NY 11568-8000 USA
| | - Lillian Niwagaba
- New York Institute of Technology College of Osteopathic Medicine (NYITCOM), Northern Blvd, P.O. Box 8000, Old Westbury, NY 11568-8000 USA
| | - Maria A. Pino
- New York Institute of Technology College of Osteopathic Medicine (NYITCOM), Northern Blvd, P.O. Box 8000, Old Westbury, NY 11568-8000 USA
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McFadden T, Simon C, Kobeissi B, Gerin-Lajoie C. Physicians' access to primary care: results from the Canadian Medical Association National Physician Health Survey. Can J Ophthalmol 2020; 55:27-28. [PMID: 32386785 DOI: 10.1016/j.jcjo.2020.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/13/2020] [Accepted: 03/18/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Taylor McFadden
- Canadian Medical Association, Ottawa, Ont.; University of Ottawa, Ottawa, Ont..
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Hartnett Y, Drakeford C, Dunne L, McLoughlin DM, Kennedy N. Physician, heal thyself: a cross-sectional survey of doctors' personal prescribing habits. JOURNAL OF MEDICAL ETHICS 2020; 46:231-235. [PMID: 31796545 DOI: 10.1136/medethics-2018-105064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/26/2019] [Accepted: 10/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Self-prescribing and prescribing to personal contacts is explicitly discouraged by General Medical Council guidelines. AIMS This study examines how widespread the practice of self-prescribing and prescribing to personal contacts is. METHODS A 16-item questionnaire was distributed via an online forum comprising 4445 young medical doctors (representing 20% of all Irish registered doctors), which asked respondents about previous prescribing to themselves, their families, friends and colleagues, including the class of medication prescribed. Demographic details were collected including medical grade and specialty. RESULTS A total of 729 responses were obtained, the majority of which were from young non-consultant hospital doctors from a range of specialties. Two-thirds of respondents had self-prescribed, over 70% had prescribed to family, and nearly 60% had prescribed to a friend or colleague. Older doctors were more likely to self-prescribe (χ2=17.51, p<0.001). Interns being less likely to self-prescribe was not unexpected (χ2=69.55, p<0.001), while general practitioners (GPs) and paediatricians were more likely to self-prescribe (χ2=13.33, p<0.001; χ2=11.35, p<0.001). GPs, paediatricians and hospital medicine specialties were more likely to prescribe to family (χ2=5.19, p<0.05; χ2=8.38, p<0.05; χ2=6.17, p<0.05) and surgeons were more likely to prescribe to friends (χ2=15.87, p<0.001). Some 3% to 7% who had self-prescribed had prescribed an opiate, benzodiazepine or psychotropic medication. Male doctors, anaesthetists and surgeons were more likely to self-prescribe opioids (χ2=7.82, p<0.01; χ2=7.31, p<0.01; χ2=4.91, p<0.05), while those in hospital medicine were more likely to self-prescribe psychotropic medications (χ2=5.47, p<0.05). CONCLUSION Prescribing outside the traditional doctor-patient relationship is widespread despite clear professional guidance advising against it.
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Affiliation(s)
- Yvonne Hartnett
- Department of Psychiatry, St Patrick's University Hospital, Dublin, Ireland
- Department of Psychiatry, University of Dublin Trinity College, Dublin, Ireland
| | - Clive Drakeford
- School of Medicine, University of Dublin Trinity College, Dublin, Ireland
| | | | - Declan M McLoughlin
- Department of Psychiatry, St Patrick's University Hospital, Dublin, Ireland
- Department of Psychiatry, University of Dublin Trinity College, Dublin, Ireland
| | - Noel Kennedy
- Department of Psychiatry, St Patrick's University Hospital, Dublin, Ireland
- Department of Psychiatry, University of Dublin Trinity College, Dublin, Ireland
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Fekadu G, Dugassa D, Negera GZ, Woyessa TB, Turi E, Tolossa T, Fetensa G, Assefa L, Getachew M, Shibiru T. Self-Medication Practices and Associated Factors Among Health-Care Professionals in Selected Hospitals of Western Ethiopia. Patient Prefer Adherence 2020; 14:353-361. [PMID: 32110001 PMCID: PMC7040189 DOI: 10.2147/ppa.s244163] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 02/07/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Even though the type, extent and reasons for self-medication practice (SMP) vary, globally self-medication (SM) is rising to relieve burdens on health services. However, inappropriate SMP results in economic wastes, damage of vital organs, incorrect therapy selection, risk of adverse drug reactions and development of antimicrobial-resistant pathogens. These consequences have severe implications including legal, ethical and quality of health-care delivery. Temporal increment and high prevalence of SM among health professionals is also a major bottleneck for Ethiopia. Hence, the study aimed to assess the SM among health-care professionals (HCPs) in selected governmental hospitals of Western Ethiopia. METHODS An instiution-based cross-sectional study was conducted among 338 HCPs using a pre-tested and self-adminstered questionnaries from March 1 to 25, 2018. Simple random sampling was used to select study participants and SMP (yes or no) was the outcome of the study variable. Data were entered and analyzed using SPSS version 20. Crude and adjusted odds ratios (95% CI) were calculated and all results were deemed to be statistically significant when p < 0.05. RESULTS Among the 338 participants, 184 (54.4%) were females and the mean age of the study participants was 25±3.23 years. About 154 (45.6%) of them had work experience of less than 5 years and 49.7% were nurses by profession. The prevalence of SM was 73.4% with 3 months of recall for SM. Familiarity with medicines and ailments (46.8%) and mildness of illness (40.7%) were the most common reasons to self-medicate. The most frequently reported ailments were headache (37.1%) and gastric pain (29.8%). Analgesics (44.4%) and antibiotics (42.7%) were the most commonly used self-medicated categories of drugs. Female sex (Adjusted odds ratio [AOR] =2.13, 95% CI: 1.43-8.66), age 20-29 years (AOR=4.53, 95% CI: 1.01-14.45) and work experience of <5 years (AOR= 3.01, 95% CI: 1.32-11.71) were significantly associated with SMPs. CONCLUSION The study revealed a high prevalence of SMP among HCPs. Sex, age, and work experience were significantly associated with SMPs. Hence, the use of prescription drugs without prescription should be discouraged and appropriate health education should be provided by all concerned bodies on the proper use of drugs.
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Affiliation(s)
- Ginenus Fekadu
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
- Correspondence: Ginenus Fekadu Clinical Pharmacy Unit Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Oromia, EthiopiaTel +251-917137145Fax +251576617980 Email
| | - Dinka Dugassa
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | | | - Tilahun Bakala Woyessa
- Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tadesse Tolossa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Getahun Fetensa
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Lemessa Assefa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Motuma Getachew
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tesfaye Shibiru
- Department of Pediatrics and Child Health, Wollega University Referral Hospital, Nekemte, Ethiopia
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Doctors' experience of becoming patients and its influence on their medical practice: A literature review. Explore (NY) 2019; 16:145-151. [PMID: 31843394 DOI: 10.1016/j.explore.2019.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/14/2019] [Accepted: 10/20/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE Doctors' illness experiences can deeply influence not only their perceptions of illness and roles but also their medical practice. Researchers and doctors have sought to understand what happens when doctors become patients. However, currently, literature reviews focused exclusively on their illness experiences are lacking. This review examines academic literature and combines it with illness narratives (i.e., pathographies) written by doctors to elucidate the unknown about doctors' experiences and its subsequent influence on medical practice. METHODS An electronic search of the databases Academic Search Complete, Google Scholar, PubMed, ProQuest, and Ichushi-Web was conducted using relevant keywords. The literature reviewed included studies that described doctors' illness experiences or doctors' perspectives on their experiences of being patients. RESULTS Previous studies showed that doctors' disease prognoses are generally better than or similar to those of patients belonging to the general population. However, doctors' documented illness experiences are multi-dimensional and have several common themes. These include the concept of the 'medical self' (behaving as a doctor despite being a patient) and 'role reversal' (the doctor adjusting to the patient role). The other elements of their experiences include barriers to health care, self-treatment and self-doctoring, presenteeism, and 'wounded healers' (those who can heal others using the wisdom from their illness experiences). Most previous literature has omitted the sociocultural and historical dispositions of doctors and their biomedical perspectives of their own afflictions, even though these strongly impact their illness experiences. CONCLUSION Further research that re-contextualises the meaning of illness for doctors is necessary.
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Ko DT, Chu A, Austin PC, Johnston S, Nallamothu BK, Roifman I, Tusevljak N, Udell JA, Frank E. Comparison of Cardiovascular Risk Factors and Outcomes Among Practicing Physicians vs the General Population in Ontario, Canada. JAMA Netw Open 2019; 2:e1915983. [PMID: 31755946 PMCID: PMC6902820 DOI: 10.1001/jamanetworkopen.2019.15983] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Although cardiovascular disease is the leading cause of death in most developed countries, little is known about current physicians' cardiovascular health and outcomes. OBJECTIVE To compare cardiac risk factor burden, health services use, and major cardiovascular event incidence between physicians and the general population. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from practicing physicians and nonphysicians without cardiovascular disease aged 40 to 75 years in Ontario, Canada. Cohorts were assembled beginning January 1, 2008, and were followed up to December 31, 2015. Data analysis was performed between November 2017 and September 2019. EXPOSURE Being a practicing physician. MAIN OUTCOMES AND MEASURES The primary outcome was 8-year incidence of a major cardiovascular event (ie, cardiovascular death or hospitalization for myocardial infarction, stroke, heart failure, or coronary revascularization). Secondary outcomes included health services used, such as physician assessments and guideline-recommended tests. RESULTS The cohort comprised 17 071 physicians (mean [SD] age, 53.3 [8.8] years; 11 963 [70.1%] men) and 5 306 038 nonphysicians (mean [SD] age, 53.7 [9.5] years; 2 556 044 [48.2%] men). Physicians had significantly lower baseline rates of hypertension (16.9% vs 29.6%), diabetes (5.0% vs 11.3%), and smoking (13.1% vs 21.6%), while having better cholesterol profiles (total cholesterol levels >240 mg/dL, 13.3% vs 16.5%; low-density lipoprotein cholesterol >130 mg/dL, 33.2% vs 36.8%); age- and sex-adjusted differences were even larger. Physicians also had lower rates of periodic health examinations (58.9% [95% CI, 57.5%-60.4%] vs 67.9% [95% CI, 67.8%-67.9%]), hyperlipidemia screening (76.3% [95% CI, 74.7%-78.0%] vs 83.8% [95% CI, 83.7%-83.9%]), and diabetes screening (79.0% [95% CI, 77.3%-80.8%] vs 85.3% [95% CI, 85.2%-85.4%]), but higher rates of cardiologist consultations (25.2% [95% CI, 24.2%-26.3%] vs 19.5% [95% CI, 19.4%-19.5%]). The 8-year age- and sex-standardized primary outcome incidence was 4.4 major cardiovascular events per 1000 person-years for physicians and 7.1 major cardiovascular events per 1000 person-years for the general population. After adjusting for age, sex, socioeconomic status, and cardiac risks and comorbidities, physicians had a 22% lower hazard (hazard ratio, 0.78; 95% CI, 0.72-0.85) of experiencing the primary outcome compared with the general population. CONCLUSIONS AND RELEVANCE Practicing physicians in Ontario had fewer cardiovascular risk factors, underwent less preventive testing, and were less likely to experience major adverse cardiovascular outcomes than the general population.
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Affiliation(s)
- Dennis T Ko
- ICES, Toronto, Ontario, Canada
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Sharon Johnston
- Bruyère Research Institute, Ottawa, Ontario, Canada
- Departmentof Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Brahmajee K Nallamothu
- Division of Cardiovascular Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor
| | - Idan Roifman
- ICES, Toronto, Ontario, Canada
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Jacob A Udell
- ICES, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Hospital, Toronto, Ontario, Canada
| | - Erica Frank
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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Abstract
PURPOSE OF REVIEW To highlight an emerging understanding of burnout and physician mental health. This review will provide a discussion of conceptual and diagnostic issues of the burnout syndrome with its relevance to psychiatry, and how psychiatry may interface with other medical disciplines to provide support in creating burnout prevention and treatment programs. RECENT FINDINGS Descriptive data of burnout correlations and risk factors are available while an understanding of burnout best practices is lacking but growing. Two recent meta-analyses provide efficacy data along with key subgroup analyses that point to greater efficacy among systemic/organizational over individual level interventions. Among individual interventions, groups work better than individual therapy and the incorporation of Mindfulness-Based Stress Reduction and/or Cognitive Behavioral Therapy modalities provide greater efficacy over other therapies. Ultimately, addressing burnout will be an iterative process specific to institutional cultures and therefore should be thought of as quality improvement initiatives involving leadership to adopt the quadruple aim of physician wellness and to seek institution-specific collaboration and feedback. Psychiatry is uniquely positioned to help change institutional cultures regarding the burnout syndrome, which has been labeled a national crisis. Combinatorial strategies that combine efficacious individual-level interventions with systemic-level interventions that enhance workflow will likely provide the most sustainable model for preventing and treating burnout. Psychiatry should be involved, especially at the level of the liaison psychiatrist to assist with how these types of interventions may be best implemented in specific institutions.
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Levy AB, Nahhas RW, Sampang S, Jacobs K, Weston C, Cerny-Suelzer C, Riese A, Munetz MR, Shaw J. Characteristics Associated with Depression and Suicidal Thoughts Among Medical Residents: Results from the DEPRESS-Ohio Study. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:480-487. [PMID: 31290011 DOI: 10.1007/s40596-019-01089-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 05/13/2023]
Abstract
OBJECTIVE This study describes the characteristics that are associated with depression in residents and also examines resident perception of available mental health support. METHODS Residents and their program directors from each of 10 specialties across all academic training institutions in Ohio were electronically surveyed over a 2-month period. Generalized logistic regression was used to test for association between risk factors and depression and, among depressed residents, with suicidal thoughts. RESULTS Using the PHQ-9, 19% of residents met criteria for at least moderate depression and 31.1% of depressed residents had suicidal thoughts. Over 70% of depressed residents were not receiving treatment, including 70% of depressed residents with suicidal thoughts. Residents who were unaware of wellness programming or did not believe their program director would be supportive of a depressed resident were significantly more likely to be depressed. Residents who believed depression treatment would negatively impact medical licensure were significantly more likely to be depressed. Male program directors and those in their position for fewer than 5 years were significantly more likely to have depressed residents in their program. CONCLUSIONS A substantial proportion of depressed residents have suicidal thoughts, and most are not receiving treatment. Depressed residents may perceive the availability of support from their program director differently than their non-depressed colleagues, and may perceive greater risk to medical licensure if they seek treatment.
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Affiliation(s)
- Alan B Levy
- The Ohio State University, Columbus, OH, USA.
| | | | | | | | | | | | - Amy Riese
- University of Toledo, Toledo, OH, USA
| | - Mark R Munetz
- Northeast Ohio Medical University College of Medicine, Rootstown, OH, USA
| | - Janet Shaw
- Ohio Psychiatric Physicians Association, Columbus, OH, USA
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DeChant PF, Acs A, Rhee KB, Boulanger TS, Snowdon JL, Tutty MA, Sinsky CA, Thomas Craig KJ. Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systematic Review. Mayo Clin Proc Innov Qual Outcomes 2019; 3:384-408. [PMID: 31993558 PMCID: PMC6978590 DOI: 10.1016/j.mayocpiqo.2019.07.006] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
To assess the impact of organization-directed workplace interventions on physician burnout, including stress or job satisfaction in all settings, we conducted a systematic review of the literature published from January 1, 2007, to October 3, 2018, from multiple databases. Manual searches of grey literature and bibliographies were also performed. Of the 633 identified citations, 50 met inclusion criteria. Four unique categories of organization-directed workplace interventions were identified. Teamwork involved initiatives to incorporate scribes or medical assistants into electronic health record (EHR) processes, expand team responsibilities, and improve communication among physicians. Time studies evaluated the impact of schedule adjustments, duty hour restrictions, and time-banking initiatives. Transitions referred to workflow changes such as process improvement initiatives or policy changes within the organization. Technology related to the implementation or improvement of EHRs. Of the 50 included studies, 35 (70.0%) reported interventions that successfully improved the 3 measures of physician burnout, job satisfaction, and/or stress. The largest benefits resulted from interventions that improved processes, promoted team-based care, and incorporated the use of scribes/medical assistants to complete EHR documentation and tasks. Implementation of EHR interventions to improve clinical workflows worsened burnout, but EHR improvements had positive effects. Time interventions had mixed effects on burnout. The results of our study suggest that organization-directed workplace interventions that improve processes, optimize EHRs, reduce clerical burden by the use of scribes, and implement team-based care can lessen physician burnout. Benefits of process changes can enhance physician resiliency, augment care provided by the team, and optimize the coordination and communication of patient care and health information.
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Montgomery A, Panagopoulou E, Esmail A, Richards T, Maslach C. Burnout in healthcare: the case for organisational change. BMJ 2019; 366:l4774. [PMID: 31362957 DOI: 10.1136/bmj.l4774] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - E Panagopoulou
- Hygiene Laboratory, Aristotle Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Esmail
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | | | - C Maslach
- University of California, Berkeley, CA, USA
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50
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Pandey SK, Sharma V. Doctor, heal thyself: Addressing the shorter life expectancy of doctors in India. Indian J Ophthalmol 2019; 67:1248-1250. [PMID: 31238485 PMCID: PMC6611328 DOI: 10.4103/ijo.ijo_656_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Suresh K Pandey
- SuVi Eye Institute and Lasik Laser Center, Kota, Rajasthan, India
| | - Vidushi Sharma
- SuVi Eye Institute and Lasik Laser Center, Kota, Rajasthan, India
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