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Bauer AG, Bellot J, Bazan C, Gilmore A, Kideys K, Cameron A. Cultural considerations for substance use and substance use disorders among Black men. Bull Menninger Clin 2024; 88:108-127. [PMID: 38836848 DOI: 10.1521/bumc.2024.88.2.108] [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] [Indexed: 06/06/2024]
Abstract
There are complex cultural considerations for understanding, assessing, and treating substance use disorders (SUD) among Black men, from the initiation of substance use through SUD-related outcomes. This narrative review provides insight into some of these factors, including the individual, interpersonal, and community-level risk and protective factors (e.g., family and social roles, religiosity, racism and discrimination, exposure to trauma and adversity) underlying relative risk for substance use and disparities in SUD-related outcomes. This article also highlights the ways that public attitudes and policies related to substance use have contributed to ongoing inequities in SUD treatment access for Black men. Recommendations for clinical research and practice include increasing focus on measurement equivalence, creating pathways for access to community-based and specialty treatment, and providing services that are culturally affirming, relevant, and appropriate. Comprehensive efforts are needed to reduce SUD-related inequities and promote positive well-being among Black men and their communities.
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Affiliation(s)
- Alexandria G Bauer
- Center of Alcohol & Substance Use Studies and the Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey
| | - Jahnayah Bellot
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey
| | - Carolyn Bazan
- School of Health Professions, Rutgers University, Piscataway, New Jersey
| | - Ayanna Gilmore
- New York State Psychiatric Institute, New York, New York
| | - Kaan Kideys
- Center of Alcohol & Substance Use Studies, Rutgers University, Piscataway, New Jersey
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2
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Cazalis A, Lambert L, Auriacombe M. Stigmatization of people with addiction by health professionals: Current knowledge. A scoping review. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 9:100196. [PMID: 38023342 PMCID: PMC10656222 DOI: 10.1016/j.dadr.2023.100196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023]
Abstract
Background Stigma of people with substance and non-substance use disorders (SNSUD) is a long-known phenomenon. The aim of this review was to assess the stigmatization, by health professionals, of people with SNSUD, its characteristics and change over time. Methods A scoping review of literature reviews was conducted with systematic search of PubMed, Scopus and PsycINFO databases. Results From the 19 selected reviews, all focused on people with SUD (PWSUD) only and 20 % to 51 % of health professionals had negative attitudes/beliefs about SUD. Addiction training and clinical experience with PWSUD were associated with a less negative attitude. Health professionals' negative beliefs, lack of time or support were associated with less involvement in addiction care. Tobacco use disorder, SUDs other than alcohol and tobacco, relapse, psychiatric comorbidity or criminal records were associated with a more negative attitude. The influence of several variables potentially related to stigmatization was inconsistent across selected reviews. The evolution of stigmatization over time was not systematically assessed and showed mixed results. Conclusions The stigmatization of PWSUD has an impact on their care, and a change in some variables could reduce its importance: moral model of addiction, health professionals' negative beliefs, lack of training, time, and role support. Teaching what addiction is according to the medical chronic disease model, and developing stigma-focused training could improve caregivers' attitudes and further reduce stigma. Further studies are needed to determine whether stigma of PWSUD by health professionals has changed over time and to characterize stigma for people with non-substance use disorders.
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Affiliation(s)
- Anthony Cazalis
- University of Bordeaux, Bordeaux, France
- Addiction Team, Sleep, Addiction and Neuropsychiatry, (Sanpsy), Centre National de la Recherche Scientifique (CNRS) Unité mixte de recherche (UMR) 6033, University of Bordeaux, Bordeaux, France
- Pôle interétablissement d'Addictologie, CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
| | - Laura Lambert
- University of Bordeaux, Bordeaux, France
- Addiction Team, Sleep, Addiction and Neuropsychiatry, (Sanpsy), Centre National de la Recherche Scientifique (CNRS) Unité mixte de recherche (UMR) 6033, University of Bordeaux, Bordeaux, France
- Pôle interétablissement d'Addictologie, CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
| | - Marc Auriacombe
- University of Bordeaux, Bordeaux, France
- Addiction Team, Sleep, Addiction and Neuropsychiatry, (Sanpsy), Centre National de la Recherche Scientifique (CNRS) Unité mixte de recherche (UMR) 6033, University of Bordeaux, Bordeaux, France
- Pôle interétablissement d'Addictologie, CH Charles Perrens and CHU de Bordeaux, Bordeaux, France
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Alarifi AM, Alshahrani NZ, Albali NH, Aljalajel KM, Alotaibi NM, Fallatah AA, Zeitounie MR, Alghamdi KA, Alsaaid MA, Alshehri A. Exploration of Psychiatry Residents' Attitudes toward Patients with Substance Use Disorder, Bipolar Disorder and Schizophrenia in Saudi Arabia. Behav Sci (Basel) 2023; 13:642. [PMID: 37622782 PMCID: PMC10451806 DOI: 10.3390/bs13080642] [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: 05/22/2023] [Revised: 07/15/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
Stigmatizing attitudes of psychiatry professionals toward patients with various mental disorders may negatively impact treatment-seeking behaviors. However, in Saudi Arabia, little is known about psychiatry residents' attitudes toward individuals with a specific disease/disorder. Therefore, the purpose of this study was to assess psychiatry residents' attitudes toward patients with substance use disorder (SUD), bipolar disorder and schizophrenia in Saudi Arabia. Data for this cross-sectional study were collected from psychiatry residents (N = 79) in Saudi Arabia with a structured questionnaire containing sociodemographic and attitude-related variables. The 11-item Medical Condition Regard Scale (MCRS) for individuals with three conditions was used to assess participants' attitudes. A linear regression model was fitted to investigate the association. Based on the MCRS (on a scale of 11 to 66), participants' mean attitude scores were 41.59 (SD: 8.09), 54.53 (SD: 5.90) and 54.20 (SD: 6.60) for SUD, bipolar disorder and schizophrenia, respectively. Adjusted regression analysis demonstrated that senior residents, an age ≥ 27 years and a high confidence level were significantly associated with psychiatry residents' positive attitudes toward patients with the three conditions. Psychiatry residents' attitude scores were relatively lower (i.e., negative attitudes) for patients with SUD than for those with bipolar disorder and schizophrenia. Future longitudinal studies are recommended to explore the factors behind psychiatry residents' negative attitudes toward patients with addictive behaviors and mental illnesses.
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Affiliation(s)
- Abdullah M. Alarifi
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh 13316, Saudi Arabia
| | - Najim Z. Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia
| | - Nawaf H. Albali
- Department of Epidemiology, Biostatistics and Public Health, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
| | - Khalid M. Aljalajel
- Mental Health Department, King Faisal Specialist Hospital & Research Center, Riyadh 23433, Saudi Arabia
| | - Nourh M. Alotaibi
- Department of Psychiatry, Ministry of Health, Riyadh 12613, Saudi Arabia
| | - Anan A. Fallatah
- Eradah Complex for Mental Health, Ministry of Health, Riyadh 12613, Saudi Arabia
| | | | - Khalid A. Alghamdi
- Department of Psychiatry, Ministry of Health, Riyadh 12613, Saudi Arabia
| | - Maan A. Alsaaid
- Department of Psychiatry, Ministry of Health, Riyadh 12613, Saudi Arabia
| | - Ahmed Alshehri
- Adult Mental Health Department, King Abdulaziz Medical City, National Guard, Riyadh 11426, Saudi Arabia
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4
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Paroz S, Monnat M, Panese F, Saraga M, Daeppen JB. Caring for patients with substance use disorders: a qualitative investigation of difficulties encountered by hospital-based clinicians. J Addict Dis 2023:1-12. [PMID: 37369578 DOI: 10.1080/10550887.2023.2227307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Background: Caring for patients with substance use disorders (SUD) is held in low regard and many clinicians resist treating them. To address this situation, numerous research projects assessed training program gaps and professional attitudes. In contrast, this study explored the actual clinical difficulties that a variety of hospital-based professionals encounter when treating patients with SUD. Methods: Qualitative multiple method design including: (1) individual semi-structured interviews with SUD experts and educators; (2) video-elicited, cross self-confrontation interviews with clinicians working in a specialist addiction unit; (3) paired semi-structured interviews with clinicians working in non-specialist units. Participants were recruited within one university hospital. Data collected at stages (1) and (3) relied on an interview guide and were analyzed using conventional content analyses. Data collected at stage (2) consisted of discussions of video recorded clinical interviews and were analyzed based on a participatory approach. Results: Twenty-three clinicians from seven hospital units participated. Forty-four difficulties were reported that we classified into six categories: knowledge-based; moral; technical; relational; identity-related; institutional. We identified seven cross-category themes as key features of SUD clinical complexity: exacerbation of patient characteristics; multiplication of medical issues; hybridity and specificity of medical discipline; experiences of stalemate, adversity, and role reversal. Conclusions: Our study, providing a comprehensive analysis of the difficulties of caring for patients with SUD, reveals a highly challenging clinical practice for a diversity of healthcare providers. They represent a complementary approach to addressing resistance as an important feature of a complex clinical system, and valuable material to discussing professional preparedness.
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Affiliation(s)
- Sophie Paroz
- Service of Addictions Medicine, Lausanne University Hospital and University of Lausanne, Canton of Vaud, Switzerland
| | - Martine Monnat
- Service of Community Psychiatry, Lausanne University Hospital and University of Lausanne, Canton of Vaud, Switzerland
- Public Health Service of Canton de Vaud, Department of Health and Social Action, Canton of Vaud, Lausanne, Switzerland
| | - Francesco Panese
- Institute of Humanities in Medicine, Lausanne University Hospital and University of Lausanne, Canton of Vaud, Switzerland
- Institute of Social Sciences, University of Lausanne, Canton of Vaud, Switzerland
| | - Michael Saraga
- Service of General Psychiatry, Lausanne University Hospital and University of Lausanne, Canton of Vaud, Switzerland
| | - Jean-Bernard Daeppen
- Service of Addictions Medicine, Lausanne University Hospital and University of Lausanne, Canton of Vaud, Switzerland
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5
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Brown PCM, Button DA, Bethune D, Kelly E, Tierney HR, Nerurkar RM, Nicolaidis C, Harrison RA, Levander XA. Assessing Student Readiness to Work with People Who Use Drugs: Development of a Multi-disciplinary Addiction Educational Survey. J Gen Intern Med 2022; 37:3900-3906. [PMID: 35419741 PMCID: PMC9640533 DOI: 10.1007/s11606-022-07494-5] [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: 09/14/2021] [Accepted: 03/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND As health profession schools implement addiction curricula, they need survey instruments to evaluate the impact of the educational interventions. However, existing measures do not use current non-stigmatizing language and fail to capture core concepts. OBJECTIVE To develop a brief measure of health profession student readiness to work with people who use drugs (PWUDs) and establish its content validity. METHODS We conducted a literature review of existing instruments and desired clinical competencies related to providing care to PWUD and used results and expert feedback to create and revise a pool of 72 items. We conducted cognitive interviews with ten pre-clinical health profession students from various US schools of nursing, pharmacy, and medicine to ensure the items were easy to understand. Finally, we used a modified Delphi process with twenty-four health professions educators and addiction experts (eight each from nursing, pharmacy, and medicine) to select items for inclusion in the final scale. We analyzed expert ratings of individual items and interdisciplinary agreement on ratings to decide how to prioritize items. We ultimately selected 12 attitudes and 12 confidence items to include in the REadiness to Discuss Use, Common Effects, and HArm Reduction Measure (REDUCE-HARM). Experts rated their overall assessment of the final scale. RESULTS Twenty-two of twenty-four experts agreed or strongly agreed that the attitudes scale measures student attitudes that impact readiness to work with PWUDs. Twenty-three of twenty-four experts agreed or strongly agreed that the confidence scale measures student self-efficacy in competencies that impact readiness to work with PWUDs. Seven of 72 initial items and none of the 24 selected items had statistically significant differences between disciplines. CONCLUSIONS The REDUCE-HARM instrument has strong content validity and may serve as a useful tool in evaluating addiction education. Additional research is needed to establish its reliability, construct validity, and responsiveness to change.
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Affiliation(s)
- Patrick C M Brown
- School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Dana A Button
- School of Medicine, Oregon Health & Science University, Portland, OR, USA.
| | - Danika Bethune
- School of Medicine, University of Washington, Seattle, WA, USA
| | - Emily Kelly
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Hannah R Tierney
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | - Christina Nicolaidis
- School of Social Work, Portland State University, Portland, OR, USA
- Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland, OR, USA
| | - Rebecca A Harrison
- Division of Hospital Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Ximena A Levander
- Division of General Internal Medicine & Geriatrics, Addiction Medicine Section, School of Medicine, Oregon Health & Science University, Portland, OR, USA
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6
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Howard S, Akhlaghi H, Watson T, O'Reilly GM, Karro J. Attitudes and regard for specific medical conditions among Australian emergency medicine clinicians. Emerg Med Australas 2022; 34:812-817. [DOI: 10.1111/1742-6723.14004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 03/28/2022] [Accepted: 04/10/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Stuart Howard
- Emergency Department St Vincent's Hospital Melbourne Melbourne Victoria Australia
| | - Hamed Akhlaghi
- Emergency Department St Vincent's Hospital Melbourne Melbourne Victoria Australia
- Faculty of Medicine, Dentistry and Health Sciences The University of Melbourne Melbourne Victoria Australia
| | - Tess Watson
- Emergency Department St Vincent's Hospital Melbourne Melbourne Victoria Australia
| | - Gerard M O'Reilly
- Emergency and Trauma Centre Alfred Health Melbourne Victoria Australia
- School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
- National Trauma Research Institute Alfred Health Melbourne Victoria Australia
| | - Jonathan Karro
- Emergency Department St Vincent's Hospital Melbourne Melbourne Victoria Australia
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7
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Appel G, Avery JJ, Ho K, Livshits Z, Rao RB, Avery J. Improved Emergency Medicine Physician Attitudes Towards Individuals with Opioid Use Disorder Following Naloxone Kit Training. Am J Emerg Med 2020; 38:1039-1041. [DOI: 10.1016/j.ajem.2019.11.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 11/09/2019] [Accepted: 11/12/2019] [Indexed: 01/07/2023] Open
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8
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Orsolini L, Rojnić Palavra I, Papanti GD, Potočan M, Quattrone D, Martens M, Sklenářová S, Levola J, Grichy L, Naughton S, Grinevičiene IK, Kuiters JP, Gondek TM, Panfil AL, Borovcanin MM, San Roman Uria A, Biskup E, Sönmez Güngör E, Casanova Dias M, Tomori S, Banjac V, Marinova-Djambazova P, Pinto da Costa M. Psychiatry Trainees' Attitudes, Knowledge, and Training in Addiction Psychiatry-A European Survey. Front Psychiatry 2020; 11:585607. [PMID: 33488419 PMCID: PMC7820719 DOI: 10.3389/fpsyt.2020.585607] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/29/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Although psychoactive substance use disorders (PSUDs) are a domain of mental health, addiction psychiatry is only formally recognized as a subspecialty in a few European countries, and there is no standardized training curriculum. Methods: A 76-item questionnaire was developed and disseminated through an online anonymous data-collecting system and hand-to-hand amongst psychiatric trainees from the 47 European countries of the Council of Europe plus Israel and Belarus. Results: 1,049/1,118 psychiatric trainees from 30 European countries completed the questionnaire. Fifty-nine-point nine percent of trainees stated to have training in addictions. Amongst the trainees who described having training in addictions, 43% documented a not well-structured training and 37% an unsatisfactory training, mainly due to poor acquired knowledge. Overall, 97% of trainees stated that addiction represents a core curriculum for their training. Overall, general adult psychiatric trainees reported a better knowledge in addictions, compared to trainees in child and adolescent psychiatry. Conclusion: Despite a growing spread of PSUDs in European countries, addiction psychiatry is a relatively poorly trained field within psychiatry training programs. Further research should investigate reasons for poor training and timings of the educational activities to optimize experiential education training in addiction psychiatry.
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Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, School of Medicine, Polytechnic University of Marche, Ancona, Italy.,Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | | | | | - Matej Potočan
- Psychiatric Hospital Begunje, Begunje na Gorenjskem, Slovenia
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Matis Martens
- Vaasa Central Hospital, Psychiatry Outpatient Clinic, Vaasa, Finland
| | - Sandra Sklenářová
- Department of Child Psychiatry, Charles University Second Faculty of Medicine, Motol University Hospital, Prague, Czechia.,Institute of Neuropsychiatric Care, Prague, Czechia
| | - Jonna Levola
- Psychiatry, Hospital District of Helsinki and Uusimaa, Helsinki, Finland
| | - Leslie Grichy
- Adult Partial Hospitalization Program, Department of Psychiatry, Universitary Hospital Louis Mourier, Colombes, France
| | | | | | | | - Tomasz M Gondek
- European Psychiatric Association-Early Career Psychiatrists Committee, Wroclaw, Poland
| | - Anca-Livia Panfil
- County Emergency Clinical Hospital, Pius Brînzeu, Liaison Psychiatry, Timisoara, Romania
| | - Milica M Borovcanin
- Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Alberto San Roman Uria
- Psychiatric Inpatient Unit, Department of Psychiatry, Hospital Universitario Nuestra Señora de Valme, Seville, Spain
| | - Ewelina Biskup
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.,School of Clinical Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Ekin Sönmez Güngör
- University of Health Sciences, Erenköy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
| | - Marisa Casanova Dias
- National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom.,Section of Women's Mental Health, King's College, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Sonila Tomori
- University Hospital Center "Mother Theresa", Tirana, Albania
| | - Visnja Banjac
- Clinic of Psychiatry, University Clinical Center of the Republic of Srpska, Banjaluka, Bosnia and Herzegovina
| | - Petra Marinova-Djambazova
- Department of Psychiatry in Medical University, University Hospital "Aleksandrovska", Sofia, Bulgaria
| | - Mariana Pinto da Costa
- Unit for Social and Community Psychiatry, World Health Organization (WHO) Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, United Kingdom.,Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,Hospital de Magalhães Lemos, Porto, Portugal
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9
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Hanafi E, Siste K, Kurniawan A, Nasrun MWS, Kusumadewi I. Perception of internet addiction among psychiatric residents in an urban area in Indonesia. MEDICAL JOURNAL OF INDONESIA 2019. [DOI: 10.13181/mji.v28i4.3316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND In the last two years, many suspected cases of internet addiction have been reported by the media. However, many physicians do not have comprehensive knowledge of internet addiction. Currently, there has been no study conducted among psychiatric residents. This study was aimed to determine the perception of internet addiction among psychiatric residents.
METHODS This cross-sectional study was done from April to May 2018. Subjects were recruited by a total sampling method consisting of all psychiatric residents of the Faculty of Medicine, Universitas Indonesia. Perceptions of internet addiction were measured using the illness perception questionnaire revised version for addiction. The calculation of subscales was based on the algorithms available for this instrument. The Mann–Whitney U test was used to determine the association of different years of psychiatric education and the perception of internet addiction.
RESULTS Fifty-two subjects completed the survey, and 85% of them reported feeling that they did not have adequate knowledge of internet addiction. They believed that their current knowledge was not sufficient to make diagnosis and management decisions. Junior residents had significantly lower consequence scale scores, with mean (standard deviation) scores of 4.1 (0.54) for juniors and 4.4 (0.48) for seniors (p = 0.021).
CONCLUSIONS Psychiatric residents perceived internet addiction as emotionally stressful, understandable, and cyclical, but difficult to control. Senior psychiatric residents had a better perception internet addiction consequences compared with their juniors, who have received only basic knowledge about addiction without clinical exposure, but the perceptions could still be improved.
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10
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Green C, Walkup JT, Bostwick S, Trochim W. Advancing the Agenda in Pediatric Mental Health Education. Pediatrics 2019; 144:peds.2018-2596. [PMID: 31383816 PMCID: PMC6856785 DOI: 10.1542/peds.2018-2596] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is an urgent need to advance mental health (MH) education and/or training in pediatric residency programs, yet no consensus on how to achieve this. We created an operational framework from ideas provided by a diverse group of stakeholders on how to advance MH education. METHODS Concept-mapping methodology was used, which involves brainstorming ideas by completing a focus prompt, sorting ideas into groups, and rating them for importance and feasibility. Multidimensional scaling and hierarchical cluster analysis grouped ideas into clusters. Average importance and feasibility were calculated for each statement and cluster and compared statistically in each cluster and between subgroups. RESULTS Ninety-nine ideas were generated. Sorted ideas yielded a 7-cluster concept map: (1) modalities for MH training, (2) prioritization of MH, (3) systems-based practice, (4) self-awareness and/or relationship building, (5) training in clinical assessment of patients, (6) training in treatment, and (7) diagnosis-specific skills. Two hundred and sixteen participants rated ideas for importance and 209 for feasibility. Four clusters had a statistically significant difference between their importance and feasibility ratings (P < .001). Suburban and rural area respondents (versus urban) rated clusters higher in importance and feasibility (P < .004), trainees rated all clusters higher in feasibility than practicing clinicians, and MH professionals rated prioritization of MH higher in feasibility (3.42 vs 2.98; P < .001). CONCLUSIONS This comprehensive set of ideas, especially those rated highly in both importance and feasibility, should inform curricular and policy initiatives. Differences between importance and feasibility may explain why there has been little progress in this field.
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Affiliation(s)
- Cori Green
- Department of Pediatrics, Weill Cornell Medicine, New York, New York;
| | - John T. Walkup
- Department of Psychiatry and Behavioral Health, Ann
& Robert H. Lurie Children’s Hospital of Chicago and Feinberg School
of Medicine, Northwestern University, Chicago, Illinois
| | - Susan Bostwick
- Department of Pediatrics, Weill Cornell Medicine, New
York, New York
| | - William Trochim
- Department of Policy Analysis and Management, Cornell
University, Ithaca, New York; and
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11
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Williams JM, Poulsen R, Chaguturu V, Tobia A, Palmeri B. Evaluation of an Online Residency Training in Tobacco Use Disorder. Am J Addict 2019; 28:277-284. [DOI: 10.1111/ajad.12885] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 02/07/2019] [Accepted: 03/09/2019] [Indexed: 11/28/2022] Open
Affiliation(s)
- Jill M. Williams
- Department of PsychiatryRutgers Robert Wood Johnson Medical SchoolPiscataway New Jersey
| | - Raul Poulsen
- Department of Psychiatry, Miller School of MedicineJackson Memorial Hospital, University of MiamiMiami Florida
| | - Vamsee Chaguturu
- Department of PsychiatryRutgers Robert Wood Johnson Medical SchoolPiscataway New Jersey
| | - Anthony Tobia
- Department of PsychiatryRutgers Robert Wood Johnson Medical SchoolPiscataway New Jersey
| | - Barbara Palmeri
- Department of PsychiatryRutgers Robert Wood Johnson Medical SchoolPiscataway New Jersey
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12
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Barlati S, Buoli M, Di Giorgio A, Di Lorenzo G, Gramaglia C, Gattoni E, Aguglia A, Monteleone AM, Dell'Osso B. Assessing Learning Needs and Career Attitudes of Italian Psychiatry Residents: Results from a National Survey Conducted by the Italian Society of Psychopathology Young Psychiatrists Section (SOPSI-GG). Clin Pract Epidemiol Ment Health 2019; 15:21-29. [PMID: 30972139 PMCID: PMC6407657 DOI: 10.2174/1745017901915010021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 11/16/2018] [Accepted: 01/23/2019] [Indexed: 11/22/2022]
Abstract
Objective: No data are available about learning needs and career attitudes of Italian Psychiatry Residents (IPRs). Authors aimed to assess such needs through a survey to generate insight for implementing educational programs close to IPRs’ perceived learning needs. Methods: A 54-item questionnaire was developed in order to investigate career information, educational preference and learning needs of IPRs. A sample of 298 IPRs participated to the survey and was divided into four subgroups according to their location (North, Centre, South and Islands). The subgroups were compared through ANOVA for age and chi-square tests for qualitative variables (including gender and all sub-items of the survey), with Bonferroni post-hoc analysis. Results: IPRs were found to pursue, along with traditional and theoretical training, a quite practical approach, characterized by working groups, discussions on clinical cases and practical interactive sessions. The topics of major interest included: clinical psychiatry, psychopharmacology, psychiatric emergencies, communication and relationship skills (97%, 98.0%, 98.3% and 95.7% of the total sample, respectively). Indeed, a strong need for interaction with healthcare professionals emerged (97% of the total sample). North and Centre IPRs were more involved in Day Hospital activities than residents from South Italy and Islands (p<.001). South IPRs appeared to be more prone to invest for their education than residents from other areas (p<.01). Conclusion: Reported findings should be taken into account as a starting point for planning and developing future targeted packages of educational proposals for IPRs and they should stand as a useful pilot study for further investigation in the field.
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Affiliation(s)
- Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Milan, Italy
| | | | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Psychiatry and Clinical Psychology Unit, Department of Neurosciences, Fondazione Policlinico "Tor Vergata", Rome, Italy
| | - Carla Gramaglia
- Department of Translational Medicine, Institute of Psychiatry, Università del Piemonte Orientale, Novara, Italy.,Institute of Psychiatry, Maggiore della Carità Hospital of Novara, Novara, Italy
| | - Eleonora Gattoni
- Department of Translational Medicine, Institute of Psychiatry, Università del Piemonte Orientale, Novara, Italy.,Institute of Psychiatry, Maggiore della Carità Hospital of Novara, Novara, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics Maternal and Child Health, University of Genoa, Psychiatry Unit, "IRCCS Policlinico San Martino" Hospital, Genoa, Italy.,"Rita Levi Montalcini" Department of Neuroscience, Turin, Italy
| | | | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, ASST Fatebenefratelli-Sacco, Milan, Italy.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
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13
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Avery J, Knoepflmacher D, Mauer E, Kast KA, Greiner M, Avery J, Penzner JB. Improvement in Residents' Attitudes Toward Individuals with Substance Use Disorders Following an Online Training Module on Stigma. HSS J 2019; 15:31-36. [PMID: 30863230 PMCID: PMC6384210 DOI: 10.1007/s11420-018-9643-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/27/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Resident physicians have been shown to possess negative attitudes toward individuals with substance use disorders (SUDs), even if the residents believe they have adequate knowledge and skills to care for these patients. Residents' negative attitudes may have an adverse impact on patient engagement, treatment, and outcomes. QUESTIONS/PURPOSES The goal of this study was to examine the impact of an online training module on residents' attitudes toward people with SUDs. We hypothesized that residents who received the educational intervention would show improved attitudes toward people with alcohol and opioid use disorders. METHODS A web-based questionnaire, including demographic information and the Medical Condition Regard Scale (MCRS) about individuals with alcohol and opioid use disorders, was sent to internal medicine and psychiatry residents before and 6 months after they took an online training module on stigma toward individuals with SUDs. RESULTS A total of 46 residents completed the initial questionnaire and 29 completed the follow-up questionnaire 6 months later. Attitudes toward individuals with SUDs, as reflected by an increase in MCRS scores, were improved 6 months after the online training module. CONCLUSION Residents' attitudes toward individuals with SUDs improved after taking an online training module. This is encouraging, as studies have shown that attitudes toward individuals with SUDs tend to decline during residency training and negatively affect patient care. Larger studies are needed to determine if such online modules can improve attitudes of other groups of clinicians, result in sustained change over time, and improve patient outcomes.
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Affiliation(s)
- Jonathan Avery
- Weill Cornell Medicine, 525 East 68th Street, Box 140, New York, NY 10065 USA
| | | | - Elizabeth Mauer
- Weill Cornell Medicine, 525 East 68th Street, Box 140, New York, NY 10065 USA
| | - Kristopher A. Kast
- Weill Cornell Medicine, 525 East 68th Street, Box 140, New York, NY 10065 USA
| | - Miranda Greiner
- Weill Cornell Medicine, 525 East 68th Street, Box 140, New York, NY 10065 USA
| | | | - Julie B. Penzner
- Weill Cornell Medicine, 525 East 68th Street, Box 140, New York, NY 10065 USA
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14
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Patil D, Andry T. Molding young minds: The importance of residency training in shaping residents’ attitudes toward substance use disorders. Am J Addict 2016; 26:80-82. [DOI: 10.1111/ajad.12484] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 12/05/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Dustin Patil
- Department of Psychiatry; Boston University Medical Center; Boston Massachusetts
| | - Tiffany Andry
- Menninger Department of Psychiatry and Behavioral Sciences; Baylor College of Medicine; Houston Texas
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15
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Avery J, Han BH, Zerbo E, Wu G, Mauer E, Avery J, Ross S, Penzner JB. Changes in psychiatry residents’ attitudes towards individuals with substance use disorders over the course of residency training. Am J Addict 2016; 26:75-79. [DOI: 10.1111/ajad.12406] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 06/04/2016] [Accepted: 07/05/2016] [Indexed: 12/01/2022] Open
Affiliation(s)
| | | | - Erin Zerbo
- Rutgers New Jersey Medical School; Newark New Jersey
| | - Guojiao Wu
- Weill Cornell Medical College; New York New York
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16
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Avery J, Zerbo E, Ross S. Improving Psychiatrists' Attitudes Towards Individuals with Psychotic Disorders and Co-Occurring Substance Use Disorders. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2016; 40:520-522. [PMID: 25977100 DOI: 10.1007/s40596-015-0361-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 04/30/2015] [Indexed: 06/04/2023]
Affiliation(s)
| | - Erin Zerbo
- Rutgers New Jersey Medical School, Newark, NJ, USA
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