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Searby A, Burr D, Abram MD. Stigma towards a nursing specialty: A qualitative analysis of the perceptions of the addiction nursing workforce. Int J Ment Health Nurs 2024. [PMID: 38661370 DOI: 10.1111/inm.13336] [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] [Received: 02/04/2024] [Revised: 03/12/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024]
Abstract
Addiction nurses are highly skilled providers of holistic care and ensuring workforce sustainability is key to providing quality care to a traditionally marginalised group of healthcare consumers. The aim of this study was to explore perceived stigma towards the addiction nursing speciality, addiction nursing (also known as alcohol and other drug nursing) and its impact on workforce sustainability, retention and recruitment. Secondary analysis of qualitative interview data with nurses (n = 50) and survey data (n = 337) was conducted as part of a workforce mapping exercise in 2019. COREQ reporting guidelines were used. After structural coding was applied, three themes emerged: stigma experienced by clients of alcohol and other drug treatment services, stigma experienced by addiction nurses and a lack of awareness of the specialty of addiction nursing itself. Participants overwhelmingly felt that these forms of stigma made addiction nursing less attractive to new entrants, particularly new nurses and posed a threat to the sustainability of the specialty. The findings from this study indicate that urgent attention is required to address stigma towards individuals who use alcohol and other drugs, and the nurses providing care for them. Furthermore, creating awareness of the addiction nursing specialty is paramount to ensure workforce sustainability and to improve care for individuals who use alcohol and other drugs. Beyond addiction nurses, our results indicate that stigma towards other specialties (such as mental health nursing) is a substantive barrier to workforce sustainability.
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Affiliation(s)
- Adam Searby
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Dianna Burr
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Marissa D Abram
- Duke University School of Nursing, Durham, North Carolina, USA
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Gupta S, Kumar A, Kathiresan P, Pakhre A, Pal A, Singh V. Mental health stigma and its relationship with mental health professionals - A narrative review and practice implications. Indian J Psychiatry 2024; 66:336-346. [PMID: 38778855 PMCID: PMC11107930 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_412_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 05/25/2024] Open
Abstract
The extent and magnitude of the mental health stigma are enormous, with substantial clinical and social implications. There is a complex relationship between mental health stigma and mental health professionals (MHPs); MHPs can be anti-stigma crusaders, victims of stigma, and even a source of stigma. Unfortunately, literature is scarce talking about the relationship between stigma and MHPs. Hence, the current review aims to bridge the existing gap in the literature on various aspects of stigma and the role of MHPs. For the current review, we ran a search in PubMed and Google Scholar databases; we restricted our study to records focusing on the interplay of mental health stigma and the MHPs, published during 2012-2022, in English, and having a full text available. We found that MHPs (psychiatrists, psychologists, and psychiatric nurses) can also be the recipients of the stigma. The stigma faced by the MHPs is determined by the negative stereotypes set by the media, or medical students, or other health professionals; the marginal position of psychiatry in the health system; difficult-to-treat mental disorders; MHPs' own experience of stigma; and the attitude or beliefs of various caders of the MHPs, their professional experience, and expertise in managing various mental health conditions. Notably, MHPs can also be a source of stigma (stigmatizers). MHPs need to be sensitized concerning this, and the anti-stigma interventions must incorporate this aspect of stigma. Novel interventions, such as digital-based programs, should be used instead of traditional anti-stigma programs in order to decrease stigma around mental health issues and make anti-stigma initiatives more appealing and scalable. To address the issues of stigma, there has to be more communication between MHPs, other health professionals, service users, and policymakers.
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Affiliation(s)
- Snehil Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Akash Kumar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Preethy Kathiresan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Pakhre
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Arghya Pal
- Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Vijender Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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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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Dalky HF, Alnajar M, Dalky AF, Mahmoud N, Al‐Ma'ani M, Mosleh S, Hamdan‐Mansour AM. Social cognitive elements of mental illness stigma among healthcare professionals currently working in general hospitals: A cross-sectional study from Jordan. Nurs Open 2023; 10:6980-6988. [PMID: 37515452 PMCID: PMC10495734 DOI: 10.1002/nop2.1953] [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: 10/12/2022] [Revised: 05/21/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
AIM To assess the social cognitive elements of the stigma of mental illness (knowledge, attitudes and behaviours) among healthcare professionals (HCPs) in Jordan. DESIGN A cross-sectional descriptive design. METHODS A total of 206 HCPs were conveniently recruited from general hospitals in Jordan. The mental attitude, knowledge and intended behaviours scales were used to measure stigma elements. RESULTS Participants reported a moderate level of knowledge, a moderate negative attitude and a moderate or not greater interest to deal with people with mental health illnesses. The bivariate correlation revealed a negative significant correlation between HCPs' knowledge and attitude, indicating that HCPs with more knowledge significantly have more positive attitude (lower average score) towards those suffering from the illness. A more significant correlation was found between HCPs' knowledge and behaviour. The HCPs who had more knowledge were holding more interest and willingness towards dealing with persons with mental illness. PATIENT OR PUBLIC CONTRIBUTION Negative attitudes among HCPs demand awareness programmes pertaining to the stigma of mental illness to afford higher standards of practice for patients with mental problems.
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Affiliation(s)
- Heyam F. Dalky
- Community/Mental Health Nursing Department, Faculty of NursingJordan University of Science & TechnologyIrbidJordan
| | - Malek Alnajar
- Graduate Research and Teaching Assistant College of NursingUniversity of UtahSalt Lake CityUtahUSA
| | - Ala'a F. Dalky
- Department of Health Management and Policy, Faculty of MedicineJordan University of Science and TechnologyIrbidJordan
| | - Naser Mahmoud
- Acute Inpatient Psychiatry UnitAl‐Rashid Hospital CenterAmmanJordan
| | | | - Sultan Mosleh
- Health Sciences Department‐Nursing ProgramHigher Colleges of TechnologyAl‐FujairahUnited Arab Emirates
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Napoli G, Autuori S, Ephraim KS. Attitudes of Italian mental health nurses towards mental illness and recovery: a cross-sectional study. AIMS Public Health 2023; 10:333-347. [PMID: 37304595 PMCID: PMC10251057 DOI: 10.3934/publichealth.2023025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/22/2023] [Accepted: 04/23/2023] [Indexed: 06/13/2023] Open
Abstract
Background Mental health nurses' (MHNs) stigma and discrimination against people with mental illnesses are obstacles to recovery and the development of effective care and treatment. Although many authors have been interested in exploring stigma among general health professionals, paradoxically, less and non-generalizable evidence is available on this phenomenon among MHNs. Understanding the factors associated with stigma and its relationship to recovery attitudes among MHNs could allow for more accurate interventions and improve patient care outcomes. Objective This study conducted on a sample of Italian psychiatric nurses had the objective of analyzing the aptitude for recovery and the tendency towards stigma of these professionals towards mental illness. Methodology A cross-sectional web survey was conducted on a sample of Italian MHNs, who were administered two validated tools, the RAQ-7 (assessment of recovery aptitude) and the WHO-HC-15 (assessment of stigma) respectively. Results A total of 204 MHNs were interviewed. The analysis showed positive overall scores (high recovery aptitude and low stigma levels) among participating MHNs. The attitude to recovery appeared to be directly related to a lower tendency to stigma towards mental illness. It has been observed that MHNs with advanced levels of education appear to be more predisposed to recovery, as well as generally less stigmatizing. There is evidence that the setting in which care is provided, marital status and age can play a significant role in the tendency to stigmatization. Conclusion Our manuscript could assist nursing executives, leaders or educators in making decisions about managing and preventing stigma among MHNs.
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Affiliation(s)
- Giovanni Napoli
- Dipartimento di Salute Mentale, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Simone Autuori
- UOC Psichiatria 2, Azienda Ospedale-Università Padova (AOUP), Padova, Italy
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Tzeng WC, Su PY, Yeh SH, Chang TW, Lin CH, Feng HP. Nurses' views on the provision of physical healthcare for individuals with comorbid mental illness and chronic disease. Int J Ment Health Nurs 2023; 32:199-211. [PMID: 36184847 DOI: 10.1111/inm.13076] [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] [Accepted: 09/14/2022] [Indexed: 01/13/2023]
Abstract
The prevalence of chronic diseases (such as diabetes, obesity, cancer, heart disease, and chronic obstructive pulmonary disease) continues to increase among patients with mental illness. This cross-sectional study investigated the factors affecting nurses' views on the provision of physical healthcare to patients with comorbid mental illness and chronic disease. In total, 369 nurses working in mental health were assessed for the physical healthcare attitudes and practices using the Physical Health Attitude Scale for Mental Health Nurses. The results of generalized linear modelling indicated that nurses' involvement in physical healthcare was associated with psychiatric mental health nurse credentials (B = 1.560, 95% CI = 0.292-2.828, P = 0.016) and their confidence in delivering physical healthcare was associated with prior physical healthcare training (B = 0.639, 95% CI = 0.104-1.174, P = 0.019). In addition, the frequency with which the nurses engaged in physical healthcare practices was associated with working in a community unit (B = -7.416, 95% CI = -9.652 to -5.180, P < 0.001), involvement in physical healthcare (B = 0.349, 95% CI = 0.162-0.535, P < 0.001), and confidence in delivering physical healthcare (B = 1.148, 95% CI = 0.776-1.519, P < 0.001). Our findings suggest that interventions aiming to help nurses assess and improve their own physical healthcare practices should consider nurses' background and patients' physical health needs in various settings and focus on cultivating an organizational culture that gives nurses confidence in providing physical healthcare.
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Affiliation(s)
- Wen-Chii Tzeng
- School of Nursing, National Defense Medical Center, Taipei City, Taiwan
| | - Pi-Yu Su
- Department of Nursing, Tri-Service General Hospital, Taipei City, Taiwan
| | - Shih-Hua Yeh
- Department of Nursing, Tri-Service General Hospital, Taipei City, Taiwan
| | - Tsu-Wei Chang
- Department of Nursing, Kaohsiung Armed Forces General Hospital Zuoying Branch, Kaohsiung City, Taiwan
| | - Chia-Huei Lin
- School of Nursing, National Defense Medical Center, Taipei City, Taiwan.,Department of Nursing, Tri-Service General Hospital, Taipei City, Taiwan
| | - Hsin-Pei Feng
- School of Nursing, National Defense Medical Center, Taipei City, Taiwan
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Kallai D, März V, de Timary P, De Mol J. Mental Health Nurses' Social Representations of People Who Experience Mental Illness: A Story of Paradoxes. Glob Qual Nurs Res 2023; 10:23333936231203818. [PMID: 37899770 PMCID: PMC10605669 DOI: 10.1177/23333936231203818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 10/31/2023] Open
Abstract
Public representations of people who experience mental illness (PEMI) have been well documented within the stigma literature. However, studies about mental health nurses' representations of PEMI are still scarce and characterized by contradictions. Using the theoretical concept of social representation instead of stigma, the current study aims to explore and understand mental health nurses' social representations of PEMI. Qualitative research was conducted based on 13 semi-structured interviews with nurses from two psychiatric units in general hospitals. Data were analyzed using interpretative phenomenological analysis. Results showed that nurses' social representations were characterized by paradoxes. They explicitly displayed positive social representations, while nuancing them from an implicit point of view. The nurses wanted to work toward a destigmatizing voice for PEMI while nuancing their assertions to sound honest and accurate, which led them to a state of cognitive dissonance.
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Affiliation(s)
| | - Virginie März
- UCLouvain, Louvain-la-Neuve, Walloon Brabant, Belgium
| | - Philippe de Timary
- UCLouvain, Louvain-la-Neuve, Walloon Brabant, Belgium
- UCLouvain, Woluwé-Saint-Lambert, Belgium
| | - Jan De Mol
- UCLouvain, Louvain-la-Neuve, Walloon Brabant, Belgium
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Lee MY, Choi YJ. Effects of a mental health nursing simulation for general ward nurses: A pilot study. Nurs Open 2022; 10:3432-3436. [PMID: 36564942 PMCID: PMC10077386 DOI: 10.1002/nop2.1568] [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: 11/27/2021] [Revised: 11/15/2022] [Accepted: 12/10/2022] [Indexed: 12/25/2022] Open
Abstract
This study aimed to develop a mental health nursing simulation education programme for non-psychiatric nurses and verify its effects on mental health care competence, burden, and anxiety. To verify the effects of the simulation, we applied a non-equivalent control group pre-posttest research design. We developed a mental health nursing simulation using a standardized patient who presented moderate levels of anxiety and depressive mood during chemotherapy after mastectomy. The participants were nurses working at non-psychiatric wards of a general hospital in Seoul, Korea. Participants' mental health care competency scores increased by 80% in the experimental group and 15% in the control group from pre-test to posttest. Burden scores decreased by 42% in the experimental group and 4% in the control group from pre-test to posttest, and anxiety scores decreased by 77% in the experimental group and 24% in the control group. This study demonstrated the nursing simulation education programme's effectiveness as a complementary tool to improve mental health nursing care for non-psychiatric nurses.
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Affiliation(s)
- Min-Yeong Lee
- Department of Nursing, Yeoungnam University Colleage, Daegu, South Korea
| | - Yun-Jung Choi
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
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Le Glaz A, Lemey C, Berrouiguet S, Walter M, Lemogne C, Flahault C. Physicians' and medical students' beliefs and attitudes toward psychotic disorders: A systematic review. J Psychosom Res 2022; 163:111054. [PMID: 36272378 DOI: 10.1016/j.jpsychores.2022.111054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 10/02/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to analyze physicians' and medical students' (MS) beliefs and attitudes toward people with psychotic disorders. METHODS This systematic review follows the PRISMA guidelines. It was conducted on 5 databases (Pubmed, PsycINFO, Pascal & Francis, Scopus and EMBASE) with a keyword string combining words for physicians' and students' professional status, attitudes toward people, and psychotic disorders. No limitations on publication dates were imposed. RESULTS This review includes 39 articles, among which quantitative studies are in the majority, and general practioners are mainly represented. Schizophrenia is the main condition used to illustrate psychotic disorders and measure stigmatizing attitudes. Physicians' and MS' beliefs toward people with psychotic disorders are mainly represented by dangerousness and unpredictability. They can be reinforced with socio-demographic criteria (age and female gender) or physicians' beliefs about the disease's etiology. The desire for social distance is higher toward patients with schizophrenia compared to other psychiatric disorders, and medical care could be impacted with a tendency to refer them at psychiatric specific care or to anticipate their difficulties and to modify their treatment plan. Stigma scores remain globally high during medical training. Even if specific anti-stigma trainings have a positive impact on beliefs and attitudes, these effects do not last in time. CONCLUSION This review highlights the importance to explore physicians' and medical students' representations about patient with psychosis to understand better their difficulties in the management of these patients.
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Affiliation(s)
- A Le Glaz
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France.
| | - C Lemey
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France.
| | - S Berrouiguet
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France; TIM, INSERM, UMR 1101, Brest, France.
| | - M Walter
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France.
| | - C Lemogne
- Department of Psychiatry and Addictology, AP-HP.Centre-Université de Paris, Paris, Île-de-France, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.
| | - C Flahault
- Université de Paris, LPPS, F-92100 Boulogne-Billancourt, France; U.F. de Psychologie et Psychiatrie de Liaison et d'Urgences DMU Psychiatrie et Addictologie, AP-HP Centre Université de Paris, France.
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Aşık E, Albayrak S. The effect of stigmatization education on the social distancing of nursing students toward patients with a diagnosis of schizophrenia. Arch Psychiatr Nurs 2022; 40:132-136. [PMID: 36064236 DOI: 10.1016/j.apnu.2022.07.005] [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] [Received: 11/15/2021] [Revised: 05/19/2022] [Accepted: 07/03/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the effect of a program designed to reduce nursing students' social distancing from individuals diagnosed with schizophrenia. METHOD This experimental study was designed using a pretest, a posttest, and a control group. All participants were nursing students, of which 25 were included in the intervention group and 23 were placed in the control group. A 13-week program was offered to the intervention group. The measuring instruments consisted of a personal information form and the Social Distance Scale. Data were analyzed using the two-way repeated measures analysis of variance. FINDINGS A significant difference was found between the two groups. CONCLUSION The Education Program on Stigmatization in Schizophrenia is an effective intervention that reduces the social distance of nursing students from individuals diagnosed with schizophrenia.
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Affiliation(s)
- Elif Aşık
- Kırıkkale University, Department of Mental Health and Psychiatric Nursing, Faculty of Health Sciences, Kırıkkale, Türkiye.
| | - Sevil Albayrak
- Sağlık Bilimleri University, Department of Midwifery, Faculty of Health Sciences, Ankara, Türkiye
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Chan JKN, Chu RST, Hung C, Law JWY, Wong CSM, Chang WC. Mortality, Revascularization, and Cardioprotective Pharmacotherapy After Acute Coronary Syndrome in Patients With Severe Mental Illness: A Systematic Review and Meta-analysis. Schizophr Bull 2022; 48:981-998. [PMID: 35786737 PMCID: PMC9434477 DOI: 10.1093/schbul/sbac070] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND HYPOTHESIS People with severe mental illness (SMI) may experience excess mortality and inequitable treatment following acute coronary syndrome (ACS). However, cardioprotective pharmacotherapy and SMI diagnoses other than schizophrenia are rarely examined in previous reviews. We hypothesized that SMI including bipolar disorder (BD) is associated with increased post-ACS mortality, decreased revascularization, and cardioprotective medication receipt relative to those without SMI. STUDY DESIGN We performed a meta-analysis to quantitatively synthesize estimates of post-ACS mortality, major adverse cardiac events (MACEs), and receipt of invasive coronary procedures and cardioprotective medications in patients with SMI, comprising schizophrenia, BD, and other nonaffective psychoses, relative to non-SMI counterparts. Subgroup analyses stratified by SMI subtypes (schizophrenia, BD), incident ACS status, and post-ACS time frame for outcome evaluation were conducted. STUDY RESULTS Twenty-two studies were included (n = 12 235 501, including 503 686 SMI patients). SMI was associated with increased overall (relative risk [RR] = 1.40 [95% confidence interval = 1.21-1.62]), 1-year (1.68 [1.42-1.98]), and 30-day (1.26 [1.05-1.51]) post-ACS mortality, lower receipt of revascularization (odds ratio = 0.57 [0.49-0.67]), and cardioprotective medications (RR = 0.89 [0.85-0.94]), but comparable rates of any/specific MACEs relative to non-SMI patients. Incident ACS status conferred further increase in post-ACS mortality. Schizophrenia was associated with heightened mortality irrespective of incident ACS status, while BD was linked to significantly elevated mortality only in incident ACS cohort. Both schizophrenia and BD patients had lower revascularization rates. Post-ACS mortality risk remained significantly increased with mild attenuation after adjusting for revascularization. CONCLUSIONS SMI is associated with increased post-ACS mortality and undertreatment. Effective multipronged interventions are urgently needed to reduce these physical health disparities.
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Affiliation(s)
- Joe Kwun Nam Chan
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ryan Sai Ting Chu
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Chun Hung
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Jenny Wai Yiu Law
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Corine Sau Man Wong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Wing Chung Chang
- To whom correspondence should be addressed; Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong; tel: (852) 22554486, fax: (852) 28551345, e-mail:
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Werremeyer A, Strand MA, Eukel H, Skoy E, Steig J, Frenzel O. Longitudinal evaluation of pharmacists’ social distance preference and attitudes toward patients with opioid misuse following an educational training program. Subst Abuse 2022; 43:1051-1056. [DOI: 10.1080/08897077.2022.2060449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Amy Werremeyer
- Department of Pharmacy Practice, North Dakota State University, Fargo, ND, USA
| | - Mark A. Strand
- Department of Pharmacy Practice, North Dakota State University, Fargo, ND, USA
| | - Heidi Eukel
- Department of Pharmacy Practice, North Dakota State University, Fargo, ND, USA
| | - Elizabeth Skoy
- Department of Pharmacy Practice, North Dakota State University, Fargo, ND, USA
| | - Jayme Steig
- Quality Health Associates of North Dakota, Minot, ND, USA
| | - Oliver Frenzel
- Department of Pharmacy Practice, North Dakota State University, Fargo, ND, USA
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Fursa O, Mocroft A, Lazarus JV, Amele S, Lundgren J, Matulionyte R, Rasmussen LD, Rockstroh JK, Parczewski M, Jilich D, Moreno S, Vassilenko A, Lacombe K, Wandeler G, Borodulina E, Brännström J, Wiese L, Orkin C, Behrens GMN, Mansinho K, Portu JJ, Peters L. The hepatitis C cascade of care in HIV/hepatitis C virus coinfected individuals in Europe: regional and intra-regional differences. AIDS 2022; 36:423-435. [PMID: 34690281 DOI: 10.1097/qad.0000000000003112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Following the introduction of direct-acting antiviral therapy in 2013, WHO launched the first Global Health Sector Strategy on Viral Hepatitis. We describe a hepatitis C virus (HCV) cascade of care in people with HIV (PWH) across Europe in terms of reaching the WHO elimination targets of diagnosing 90% and treating 80% of HCV-infected individuals. METHODS HIV/HCV-coinfected participants in the EuroSIDA cohort under prospective follow-up at October 1, 2019, were described using a nine-stage cascade of care. Care cascades were constructed across Europe, on a regional (n = 5) and country (n = 21) level. RESULTS Of 4773 anti-HCV positive PWH, 4446 [93.1%, 95% confidence interval (CI) 92.4-93.9)] were ever tested for HCV RNA, and 19.0% (95% CI 16.4-21.6) were currently HCV RNA positive, with the highest prevalence in Eastern and Central-Eastern Europe (33.7 and 29.6%, respectively). In Eastern Europe, 78.1% of the estimated number of chronic infections have been diagnosed, whereas this proportion was above 95% in the other four regions. Overall, 3116 persons have ever started treatment (72.5% of the ever chronically infected, 95% CI 70.9-74.0) and 2404 individuals (55.9% of the ever chronically infected, 95% CI 53.9-57.9) were cured. Cure proportion ranged from 11.2% in Belarus to 87.2% in Austria. CONCLUSION In all regions except Eastern Europe, more than 90% of the study participants have been tested for HCV-RNA. In Southern and Central-Western regions, more than 80% ever chronically HCV-infected PWH received treatment. The proportion with cured HCV infection did not exceed 80% in any region, with significant heterogeneity between countries. SUMMARY In a pan-European cohort of PWH, all regions except Eastern Europe achieved the WHO target of diagnosing 90% of chronic HCV infections, while the target of treating 80% of eligible persons was achieved in none of the five regions.
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Affiliation(s)
- Olga Fursa
- Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark
| | - Amanda Mocroft
- Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London, UK
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Sarah Amele
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London, UK
| | - Jens Lundgren
- Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark
| | - Raimonda Matulionyte
- Vilnius University, Faculty of Medicine, Department of Infectious Diseases and Dermatovenerology, Vilnius, Lithuania
| | - Line D Rasmussen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | | | - Milosz Parczewski
- Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Szczecin, Poland
| | - David Jilich
- Charles University in Prague and Na Bulovce Hospital, Prague, Czech Republic
| | - Santiago Moreno
- Servicio Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Karine Lacombe
- Sorbonne Université, IPLESP Inserm UMR-S1136, AP-HP, Paris, France
| | - Gilles Wandeler
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Switzerland
| | | | - Johanna Brännström
- Department of Infectious Diseases/Venhälsan, Södersjukhuset, Stockholm, Sweden
| | - Lothar Wiese
- Sjællands Universitetshospital, Roskilde, Denmark
| | | | - Georg M N Behrens
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | | | | | - Lars Peters
- Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark
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14
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Stigmatizing attitudes and social perception towards mental illness among Moroccan medical students. Encephale 2022; 49:275-283. [DOI: 10.1016/j.encep.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/29/2021] [Accepted: 01/05/2022] [Indexed: 11/20/2022]
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15
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Hill R. Nursing staff confidence and knowledge when caring for people with self-harm injuries: a service improvement study. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S42-S50. [PMID: 35220752 DOI: 10.12968/bjon.2022.31.4.s42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The knowledge and confidence of nursing staff can impact re-harming rates of patients with self-harm injury. This service improvement study sought to address the knowledge, confidence and practice issues for staff nurses and healthcare assistants (HCAs) caring for patients who had presented to the emergency department (ED) with self-harm injury. The knowledge and confidence of nursing staff was reported using Likert-style questionnaires in a longitudinal study, framed within one Plan, Do, Study, Act (PDSA) cycle. Attitudes and challenges to patient care were also sought to inform future practice. The findings, based on the responses of 10 nurses and 5 HCAs, showed an increase in knowledge and confidence among both staff groups following the education session. Of the 15 who participated, 5 provided feedback to a reflective questionnaire to assess their views 30 days after the intervention. Quantitative data revealed a perception in an increase in the standard of care. The study found that both knowledge and confidence in supporting individuals presenting with self-harm in the ED improved at 30 days post-educational intervention. The numbers in the study were small and challenge transferability, however, service improvement theory is concerned with identifying measures of success rather than statistical reliability.
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Affiliation(s)
- Rebecca Hill
- Senior Community Nurse, Cornwall Partnership Foundation Trust
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16
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Martínez-Martínez C, Esteve-Claramunt F, Prieto-Callejero B, Ramos-Pichardo JD. Stigma towards Mental Disorders among Nursing Students and Professionals: A Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031839. [PMID: 35162862 PMCID: PMC8835101 DOI: 10.3390/ijerph19031839] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 01/25/2023]
Abstract
Stigma is one of the main barriers to prevention, treatment and recovery from mental illness. However, bibliometric studies in this area are still scarce. Therefore, our aim was to quantify and analyze the scientific literature on the stigma of nursing students and professionals towards mental disorders. To this purpose, bibliometric indicators of scientific production, impact and collaboration were used. Among our results, it stands out that only 14.3% of the total number of studies analyzed measure the efficacy of the interventions carried out to reduce stigma. Furthermore, with exceptions such as Happell B and Byrne L, collaborations between authors and institutions are limited. “Service user involvement” appeared as a prominent keyword in 2018, coinciding with the increase in publications on the effectiveness of interventions. Interventions based on the involvement of people with psychiatric diagnoses in the design of nursing curricula seem to become a promising line of research. More studies measuring the efficacy of such interventions are needed. Knowledge of the lines of research that are being developed and of the researchers and institutions involved can contribute to creating synergy between the different researchers and to continue adding projects to the existing ones, thus contributing to the generation of more robust results that show the most indicated interventions to reduce the still present stigma and improve care for people with psychiatric diagnoses.
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Affiliation(s)
| | - Francisca Esteve-Claramunt
- Department of Nursing, Faculty of Health Sciences, Universidad Europea de Valencia, 46010 Valencia, Spain;
- Correspondence:
| | - Blanca Prieto-Callejero
- Nursing Department, University of Huelva, 21004 Huelva, Spain; (B.P.-C.); (J.D.R.-P.)
- Hospital Virgen de la Bella (Lepe), 21440 Huelva, Spain
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17
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Ghuloum S, Mahfoud ZR, Al-Amin H, Marji T, Kehyayan V. Healthcare Professionals' Attitudes Toward Patients With Mental Illness: A Cross-Sectional Study in Qatar. Front Psychiatry 2022; 13:884947. [PMID: 35651821 PMCID: PMC9148967 DOI: 10.3389/fpsyt.2022.884947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Negative attitudes toward mental illness by Health Care Professionals (HCP) have been reported in many countries across the world. Stigmatizing attitudes by HCP can have adverse consequences on people with mental illness from delays in seeking help to decreased quality of care provided. Assessing such attitudes is an essential step in understanding such stigma and, if needed, developing and testing appropriate and culturally adapted interventions to reduce it. AIMS To assess physicians and nurses attitudes toward mental illness and to determine associated factors with different levels of stigma. METHODS A cross-sectional survey was conducted among Physicians and Nurses. The Mental Illness Clinician's Attitudes (MICA) scale was used to assess attitudes toward mental illness. MICA scores range between 1 and 6 with higher values indicating higher stigmatizing attitudes. Demographic and work related information were also gathered. Descriptive statistics along with multivariate linear and multivariate logistic regression models were used. RESULTS A total of 406 nurses and 92 doctors participated in the study. The nurses' mean MICA score was significantly higher than that of the physicians. Among nurses, being Asian and working in a geriatric, rehabilitation and long-term care facility were associated with lower MICA scores. Among physicians, being female or graduating more than 1 year ago were also associated with lower MICA scores. CONCLUSION Stigmatizing attitudes toward people with mental illness by healthcare workers are present in Qatar. They are higher among nurses as compared to physicians. Factors associated with higher stigmatizing attitudes could be used in creating appropriate intervention to reduce the magnitude of the problem.
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Affiliation(s)
| | - Ziyad R Mahfoud
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States.,Department of Medical Education, Weill Cornell Medicine-Qatar, Al-Rayyan, Qatar
| | - Hassen Al-Amin
- Department of Medical Education, Weill Cornell Medicine-Qatar, Al-Rayyan, Qatar
| | - Tamara Marji
- Primary Health Care Corporation, Doha, Qatar.,Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar
| | - Vahe Kehyayan
- Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar
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18
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Sølvhøj IN, Kusier AO, Pedersen PV, Nielsen MBD. Somatic health care professionals' stigmatization of patients with mental disorder: a scoping review. BMC Psychiatry 2021; 21:443. [PMID: 34493245 PMCID: PMC8424966 DOI: 10.1186/s12888-021-03415-8] [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: 06/30/2021] [Accepted: 08/06/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Patients with mental disorders have an increased risk of developing somatic disorders, just as they have a higher risk of dying from them. These patients often report feeling devaluated and rejected by health professionals in the somatic health care system, and increasing evidence shows that disparities in health care provision contribute to poor health outcomes. The aim of this review was to map and synthesize literature on somatic health professionals' stigmatization toward patients with mental disorders. METHODS We conducted a scoping review using Arksey and O'Malley's framework and carried out a systematic search in three databases: Cinahl, MEDLINE, and PsycINFO in May-June 2019. Peer-reviewed articles published in English or Scandinavian languages during 2008-2019 were reviewed according to title, abstract and full-text reading. We organized and analyzed data using NVivo. RESULTS A total of 137 articles meeting the eligibility criteria were reviewed and categorized as observational studies (n = 73) and intervention studies (n = 64). A majority of studies (N = 85) focused on patients with an unspecified number of mental disorders, while 52 studies focused on specific diagnoses, primarily schizophrenia (n = 13), self-harm (n = 13), and eating disorders (n = 9). Half of the studies focused on health students (n = 64), primarily nursing students (n = 26) and medical students (n = 25), while (n = 66) focused on health care professionals, primarily emergency staff (n = 16) and general practitioners (n = 13). Additionally, seven studies focused on both health professionals and students. A detailed characterization of the identified intervention studies was conducted, resulting in eight main types of interventions. CONCLUSIONS The large number of studies identified in this review suggests that stigmatizing attitudes and behaviors toward patients with mental disorders is a worldwide challenge within a somatic health care setting. For more targeted interventions, there is a need for further research on underexposed mental diagnoses and knowledge on whether specific health professionals have a more stigmatizing attitude or behavior toward specific mental disorders.
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Affiliation(s)
- Ida Nielsen Sølvhøj
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark.
| | - Amalie Oxholm Kusier
- grid.10825.3e0000 0001 0728 0170National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455 Copenhagen, Denmark
| | - Pia Vivian Pedersen
- grid.10825.3e0000 0001 0728 0170National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455 Copenhagen, Denmark
| | - Maj Britt Dahl Nielsen
- grid.10825.3e0000 0001 0728 0170National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455 Copenhagen, Denmark
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19
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Aebi NJ, Caviezel S, Schaefert R, Meinlschmidt G, Schwenkglenks M, Fink G, Riedo L, Leyhe T, Wyss K. A qualitative study to investigate Swiss hospital personnel's perceived importance of and experiences with patient's mental-somatic multimorbidities. BMC Psychiatry 2021; 21:349. [PMID: 34253168 PMCID: PMC8274261 DOI: 10.1186/s12888-021-03353-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/28/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Mental-somatic multimorbidity in general hospital settings is associated with long hospital stays, frequent rehospitalization, and a deterioration of disease course, thus, highlighting the need for treating hospital patients more holistically. However, there are several challenges to overcome to address mental health conditions in these settings. This study investigated hospital personnel's perceived importance of and experiences with mental-somatic multimorbidities of patients in hospital settings in Basel, Switzerland, with special consideration of the differences between physicians and nurses. METHODS Eighteen semi-structured interviews were conducted with nurses (n = 10) and physicians (n = 8) in different hospitals located in Basel, Switzerland. An inductive approach of the framework analysis was used to develop the themes. RESULTS Four themes emerged from the data analysis: 1) the relevance of mental-somatic multimorbidity within general hospitals, 2) health professionals managing their emotions towards mental health, 3) knowledge and competencies in treating patients with mental-somatic multimorbidity, and 4) interprofessional collaboration for handling mental-somatic multimorbidity in hospital settings.The mental-somatic multimorbidities in general hospital patients was found to be relevant among all hospital professionals, although the priority of mental health was higher for nurses than for physicians. This might have resulted from different working environments or in efficient interprofessional collaboration in general hospitals. Physicians and nurses both highlighted the difficulties of dealing with stigma, a lack of knowledge of mental disorders, the emphasis place on treating somatic disorders, and competing priorities and work availability, which all hindered the adequate handling of mental-somatic multimorbidity in general hospitals. CONCLUSION To support health professionals to integrate mental health into their work, proper environments within general hospitals are needed, such as private rooms in which to communicate with patients. In addition, changes in curriculums and continuing training are needed to improve the understanding of mental-somatic multimorbidities and reduce negative stereotypes. Similarly, interprofessional collaboration between health professionals needs to be strengthened to adequately identify and treat mentally multimorbid patients. A stronger focus should be placed on physicians to improve their competencies in considering patient mental health in their daily somatic treatment care.
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Affiliation(s)
- Nicola Julia Aebi
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Seraina Caviezel
- grid.6612.30000 0004 1937 0642Department of Psychosomatic Medicine, University Hospital and University of Basel, Basel, Switzerland
| | - Rainer Schaefert
- grid.6612.30000 0004 1937 0642Department of Psychosomatic Medicine, University Hospital and University of Basel, Basel, Switzerland
| | - Gunther Meinlschmidt
- grid.6612.30000 0004 1937 0642Department of Psychosomatic Medicine, University Hospital and University of Basel, Basel, Switzerland ,grid.461709.d0000 0004 0431 1180Division of Clinical Psychology and Cognitive Behavioural Therapy, International Psychoanalytic University, Berlin, Germany ,grid.6612.30000 0004 1937 0642Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Matthias Schwenkglenks
- grid.6612.30000 0004 1937 0642Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland
| | - Günther Fink
- grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland
| | - Lara Riedo
- Department of Health Canton Basel-Stadt, Division of Prevention, Basel, Switzerland
| | - Thomas Leyhe
- grid.6612.30000 0004 1937 0642University of Basel, Geriatric Psychiatry, University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland ,grid.412556.10000 0004 0479 0775University of Basel, Center of Old Age Psychiatry, Psychiatric University Hospital, Basel, Switzerland
| | - Kaspar Wyss
- grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, Basel, Switzerland
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20
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Gordon SE, Kininmonth LA, Newton-Howes G, Purdie GL, Gardiner T. A comparative analysis of two alternative programmes to counter stigma and discrimination associated with mental illness delivered to medical students. Australas Psychiatry 2021; 29:357-360. [PMID: 33231093 DOI: 10.1177/1039856220971935] [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: 11/16/2022]
Abstract
OBJECTIVE To assess and compare attitudes of medical students in response to two service-user-led anti-stigma and discrimination education programmes. METHOD Two programmes, consistent with the key elements of effective contact-based anti-stigma and discrimination education programmes for healthcare providers, were delivered to medical students in their penultimate and final year: a more intensive version of the programme in 2015/2016 and a briefer programme in 2016/2017. Attitudes were assessed using the Recovery Attitudes Questionnaire (RAQ) and the Opening Minds Stigma Scale for Health Care Providers (OMS-HC-20) at the beginning and end of their final year. RESULTS There were no significant differences between the years in initial scores on either scale. Both cohorts showed statistically significant reductions in scores on both scales after completion of the programme, indicating overall improvements in students' attitudes with reductions in stigma, and more positive attitudes towards recovery of those in mental distress. The more intensive programme led to significantly greater improvement in reductions in stigma than the less intensive programme. CONCLUSION Findings support the need for contact-based anti-stigma and discrimination education programmes for medical students that are both intensive and repeated over time.
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Affiliation(s)
- Sarah E Gordon
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Leah A Kininmonth
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Giles Newton-Howes
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Gordon L Purdie
- Dean's Department, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Tracey Gardiner
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
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21
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Hung MS, Chow MC, Chien WT, Wong PY. Effectiveness of the Mental Health First Aid programme for general nursing students in Hong Kong: A randomised controlled trial. Collegian 2021. [DOI: 10.1016/j.colegn.2020.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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22
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Yildirim M, Balci B. Beliefs toward mental illness in Turkish physiotherapists. Physiother Theory Pract 2021; 38:1419-1425. [PMID: 33472490 DOI: 10.1080/09593985.2020.1870251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Physiotherapists (PTs) are responsible for the prevention and promotion of physical and mental health. Their beliefs toward mental illness (MI) are important to disclose stigmatization.Purpose: To investigate the beliefs of PTs toward MI.Methods: Beliefs toward Mental Illness Scale were sent to an e-mail network of Turkish Physiotherapy Association. The scale has three subscales: 1) Dangerousness; 2) Incurability and Poor Social and Interpersonal Skills (IPSIS); and 3) Shame. Total and subscale scores were used for analysis as higher scores indicated more negative beliefs.Results: In total, 155 PTs completed the questionnaires. The median total score was 45/105, while Dangerousness, IPSIS, and Shame scores were 20/40, 23/55, and 0/10, respectively. Dangerousness score was higher in PTs with a bachelor's degree compared to PTs with a postgraduate education (p = .049). IPSIS score was higher in PTs who did not consult a health professional in the presence of MI compared to PTs who consulted (p = .023). Total and IPSIS scores were higher in PTs exposed to an individual with MI during physiotherapy sessions compared to PTs having a family member with MI (p = .006 and p = .012, respectively).Conclusion: Postgraduate education may affect the positivity of the beliefs regarding the dangerousness of MI. Negative beliefs about the curability of MI, frustration in interpersonal relationships, and perception that the mentally ill are untrustworthy may hinder the health-seeking behavior, even the individual is a health-care professional. Having a family member with MI may positively affect the beliefs of PTs in case of an exposure to a patient with MI during physiotherapy sessions.
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Affiliation(s)
- Meriç Yildirim
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Birgül Balci
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
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23
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The Views of Non-psychiatric Medical Specialists About People with Schizophrenia and Depression. Community Ment Health J 2020; 56:1077-1084. [PMID: 32020387 DOI: 10.1007/s10597-020-00567-x] [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] [Received: 02/02/2019] [Accepted: 01/30/2020] [Indexed: 10/25/2022]
Abstract
This study explored the views of non-psychiatric medical specialists about people with schizophrenia and depression and examined whether specialists' approach to these clients, and their perception of dangerousness and social distance, differed by disorder. Non-psychiatric medical specialists working in community centers in Italy read either a schizophrenia or depression description and then completed a questionnaire on their views about people with that disorder. The schizophrenia-group (N = 114) was more sure than the depression-group (N = 97) that the patients should be approached differently in outpatient specialized clinics like those where the respondents worked; are incapable of caring for their own health; and are kept at distance by others. Perceived dangerousness did not significantly differ between the two groups. These findings highlight the potential effects of attitudes on medical practice and outline the need to educate non-psychiatric medical specialists on stigma as a strategy to reduce health discrepancies, particularly toward people diagnosed with schizophrenia.
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Werner P, Segel-Karpas D. Depression-related stigma: comparing laypersons' stigmatic attributions towards younger and older persons. Aging Ment Health 2020; 24:1149-1152. [PMID: 30836013 DOI: 10.1080/13607863.2019.1584791] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: A great amount of interest has been invested in the understanding of public stigma toward persons with depression. However, published studies were mostly restricted to the study of stigma toward a young person with depression. This study was aimed to compare public stigma towards a younger and an older person with depression among a sample of the Jewish adult population in Israel.Method: Computerized phone interviews were conducted with 393 participants (aged 18+) who were randomly presented with one of two vignettes describing a younger or an older person with depression.Results: Overall, the participants reported low levels of stigma towards a person with depression. With the exception of pity, the younger person elicited higher levels of stigmatic attributions in all dimensions (cognitive, emotional, and behavioral) in comparison to the older person. Regardless of the age of the person with depression, only emotional reactions - but not cognitive attributions-were associated with discriminatory attributions.Conclusion: Our findings stress the importance of paying attention to the age of the person with depression in anti-stigma campaigns and studies to better understand the meaning and consequences of depression-stigma.
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Affiliation(s)
- Perla Werner
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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25
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Dalky HF, Abu-Hassan HH, Dalky AF, Al-Delaimy W. Assessment of Mental Health Stigma Components of Mental Health Knowledge, Attitudes and Behaviors Among Jordanian Healthcare Providers. Community Ment Health J 2020; 56:524-531. [PMID: 31760548 PMCID: PMC10923396 DOI: 10.1007/s10597-019-00509-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 11/19/2019] [Indexed: 01/13/2023]
Abstract
Health care providers (HCPs)' stigma perception can determine their behaviors and attitudes toward providing mental health services. This study aimed to assess stigma components of knowledge, attitude, and behavior among HCPs in Jordan. A cross sectional descriptive study using a convenience sample of 541 HCPs utilized. The Mental Health Knowledge Schedule (MAKS), the Mental Illness: Clinicians' Attitudes Scale (MICA) and the Reported and Intended Behavior Scale (RIBS) were used to evaluate HCPs' perceived stigma. Mean scores on RIBS were lowest and at mid-point for MAKS and MICA. Results revealed significantly that HCPs perceived stigma demonstrated in greater negative attitudes correlated with less knowledge (r = .18, .17; p = .01, .009) for both physicians and nurses. And between attitudes and reported intended behavior (r = .13, p = .025) among nurses. This make them less likely to deal with mental health problems in primary healthcare centers. The reported stigma in this context is possibly due to lack of training, inadequate experience, and cultural dynamics. Indeed, awareness programs are important to prepare those HCPs to provide mental health care in these settings shall they are asked to.
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Affiliation(s)
- Heyam F Dalky
- Faculty of Nursing, Jordan University of Science & Technology, P.O Box 3030, Irbid, 22110, Jordan.
| | - Hana H Abu-Hassan
- School of Medicine, University of Jordan, Amman, Jordan
- Family Medicine Department, UCSD, San Diego, CA, USA
| | - Alaa Fawwaz Dalky
- Faculty of Medicine, Jordan University of Science & Technology, P.O Box 3030, Irbid, 22110, Jordan
| | - Wael Al-Delaimy
- Division of Global Health, Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
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Maier HB, Neyazi M, Neyazi A, Hillemacher T, Pathak H, Rhein M, Bleich S, Goltseker K, Sadot-Sogrin Y, Even-Chen O, Frieling H, Barak S. Alcohol consumption alters Gdnf promoter methylation and expression in rats. J Psychiatr Res 2020; 121:1-9. [PMID: 31710958 DOI: 10.1016/j.jpsychires.2019.10.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/07/2019] [Accepted: 10/28/2019] [Indexed: 11/17/2022]
Abstract
Alcohol use disorder is one of the most disabling diseases worldwide. Glial-cell derived neurotrophic factor (Gdnf) shows promising results concerning the inhibition of alcohol consumption in rodent models. We investigated the epigenetic regulation of Gdnf following ethanol consumption and withdrawal in a rat model. 32 Wistar rats underwent 7 weeks of intermittent access to alcohol in a 2-bottle choice (IA2BC). Whole blood, Nucleus Accumbens (NAc) and Ventral Tegmental Area (VTA) were collected immediately after the last 24 h of an alcohol-drinking session (alcohol group, AG) or 24 h after withdrawal (withdrawal group, WG). MRNA levels were measured using real-time quantitative PCR. Bisulfite-conversion of DNA and capillary sequencing was used to determine methylation levels of the core promoter (CP) and the negative regulatory element (NRE). The CP of the AG in the NAc was significantly less methylated compared to controls (p < 0.05). In the NAc, mRNA expression was significantly higher in the WG (p < 0.05). In the WG, mRNA expression levels in the VTA were significantly lower (p < 0.05) and showed significantly less methylation in the NRE in the VTA (p < 0.001) and the NAc (p < 0.01) compared to controls. Changes in the cerebral mRNA expression correspond to alterations in DNA methylation of the Gdnf promoter in a rodent model. Our results hold clinical relevance since differences in Gdnf mRNA expression and DNA methylation could be a target for pharmacological interventions.
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Affiliation(s)
- Hannah Benedictine Maier
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany.
| | - Meraj Neyazi
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Alexandra Neyazi
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Thomas Hillemacher
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany; Department of Psychiatry and Psychotherapy, Paracelsus Medical University, Nuremberg, Germany
| | - Hansi Pathak
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Mathias Rhein
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Koral Goltseker
- School of Psychological Sciences, The Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Yossi Sadot-Sogrin
- School of Psychological Sciences, The Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Oren Even-Chen
- School of Psychological Sciences, The Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Segev Barak
- School of Psychological Sciences, The Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Avery J, Schreier A, Swanson M. A complex population: Nurse's professional preparedness to care for medical-surgical patients with mental illness. Appl Nurs Res 2020; 52:151232. [PMID: 31937475 DOI: 10.1016/j.apnr.2020.151232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 01/05/2020] [Indexed: 10/25/2022]
Abstract
Globally, patients with the co-morbidity of physical and mental illness experience greater health complexities than the general population. Yet nurses caring for medical-surgical patients with a secondary diagnosis of mental illness are often unprepared for these complexities. This paper focuses on professional experiences from a more extensive parent study that evaluated components of nursing preparedness (nursing care self-efficacy and mental health care competency) to provide care for medical-surgical patients who also have mental illness. The parent study explored characteristics of variables (personal, educational and professional) more frequently associated with and more predictive of nursing preparedness. Discussed will be the findings from characteristics of professional experiences that best indicated nurse preparedness to care for medical-surgical patients with mental illness. A descriptive correlational design was used with a convenience sample of RNs (N = 260) from a tertiary health system in the south-eastern United States. Findings significantly indicated three characteristics of professional experiences - mentoring, frequency of care and continuing education - best prepare a registered nurse to care for this complex population. Further research is necessary to locate, grow and develop mentors and to construct accessible, affordable continuing education regarding care of this population for a prepared nursing workforce and work environment.
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Affiliation(s)
- Jeanette Avery
- East Carolina University College of Nursing, Greenville, NC 27858, USA.
| | - Ann Schreier
- East Carolina University College of Nursing, Greenville, NC 27858, USA
| | - Melvin Swanson
- East Carolina University College of Nursing, Greenville, NC 27858, USA
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Couto E Cruz C, Salom C, Parsell C, Dietze P, Burns L, Alati R. Social domains of discrimination against people who inject drugs: Links with health and wellbeing. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 77:102620. [PMID: 31931474 DOI: 10.1016/j.drugpo.2019.102620] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 11/10/2019] [Accepted: 12/03/2019] [Indexed: 11/27/2022]
Abstract
AIMS People who inject drugs frequently experience discrimination. However, little is known about how discrimination experienced in different social domains is linked to health and wellbeing. DESIGN We used data collected in 2016 from the Illicit Drug Reporting System (IDRS), an Australian survey of people who inject drugs. We used a modified version of the Discrimination Scale (DISC-12) to assess discriminatory behaviours in diverse social domains, including public institutions, neighbours, family and friends. We used the Kessler-10 scale, the Personal Wellbeing Index and specific items from the IDRS questionnaire to assess participants' health and wellbeing. FINDINGS Sixty three percent of participants who responded to the discrimination module included in the IDRS 2016 (N = 796) reported ever having experienced discrimination due to their injecting drug use and 53% reported having experienced discrimination in the past month. Discrimination in all social domains analysed was linked with poor health and wellbeing, except for housing. Self-reported mental health problems and poorer general health were most frequently associated with discrimination. Participants who experienced discrimination from friends were three times more likely to report mental health problems (AOR=3.0, CI95=1.5-6.0). CONCLUSIONS There are significant associations between the domains in which discrimination takes place and the health and wellbeing of people who inject drugs. Our findings highlighted the importance of assessing the social domains of discrimination in relation to mental health. Further research needs to assess not just whether a group or individual is discriminated against, but rather how they are likely to perceive this discrimination and how this experience can affect their life as a whole.
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Affiliation(s)
- Camila Couto E Cruz
- University of Queensland, Institute for Social Science Research, 80 Meiers Road, Indooroopilly, QLD 4068, Australia.
| | - Caroline Salom
- University of Queensland, Institute for Social Science Research, 80 Meiers Road, Indooroopilly, QLD 4068, Australia
| | - Cameron Parsell
- University of Queensland, Institute for Social Science Research, 80 Meiers Road, Indooroopilly, QLD 4068, Australia
| | - Paul Dietze
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Lucinda Burns
- University of New South Wales, National Drug and Alcohol Research Centre (NDARC), 22-32 King St, Randwick, NSW 2031, Australia
| | - Rosa Alati
- University of Queensland, Institute for Social Science Research, 80 Meiers Road, Indooroopilly, QLD 4068, Australia
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Simon R, Snow R, Wakeman S. Understanding why patients with substance use disorders leave the hospital against medical advice: A qualitative study. Subst Abus 2019; 41:519-525. [PMID: 31638862 DOI: 10.1080/08897077.2019.1671942] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Hospital discharges against medical advice (AMA) is associated with negative health outcomes and re-admissions. Patients with substance use disorders (SUD) are up to three times more likely to be discharged AMA as compared to those without SUD. Studies suggest that undertreated withdrawal and a perception of stigma may increase the risk, however, to date, there are no published qualitative studies exploring the specific reasons why patients with SUD leave prematurely. Methods: Semi-structured interviews with patients (n = 15) with SUD with documented AMA discharges from our hospital between 9/2017 and 9/2018. Maximum variation sampling was employed to display diversity across gender, race, age, and type of substance use disorder (alcohol vs opioids). Patients were interviewed until no new concepts emerged from additional interviews. Two coders separately coded all transcripts and reconciled code assignments. Results: Four core issues were identified as patients' reasons for leaving the hospital prematurely: undertreated withdrawal and ongoing craving to use drugs, uncontrolled acute and chronic pain, stigma and discrimination by hospital staff about their SUD, and hospital restrictions, including not being allowed to intermittently leave the hospital floor. For patients with histories of criminal involvement, being hospitalized reminded them of being incarcerated. Conclusion: These findings shed light on the reasons patients with SUD are discharged from the hospital AMA, an event that is associated with increased thirty-day mortality and hospital re-admission. AMA discharges represent missed opportunities for the health care system to engage with patients struggling with a SUD. Our findings support the need for inpatient addiction treatment, particularly for management of withdrawal and co-occurring pain, and the need to address health care provider associated stigma surrounding addiction.
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Affiliation(s)
- Rachel Simon
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Rachel Snow
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah Wakeman
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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