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Campos L, Barreto JV, Bassetti S, Bivol M, Burbridge A, Castellino P, Correia JA, Durusu-Tanriöver M, Fierbinteanu-Braticevici C, Hanslik T, Heleniak Z, Hojs R, Lazebnic L, Mylona M, Raspe M, Melo JQE, Pietrantonio F, Gans R, Pálsson R, Montano N, Gómez-Huelgas R, Dicker D. Physicians' responsibility toward environmental degradation and climate change: A position paper of the European Federation of Internal Medicine. Eur J Intern Med 2022; 104:55-58. [PMID: 36055953 DOI: 10.1016/j.ejim.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022]
Abstract
The current data on climate change and environmental degradation are dramatic. The consequences of these changes are already having a significant impact on people's health. Physicians - as advocates of the patients, but also as citizens - have an ethical obligation to be involved in efforts to stop these changes. The European Federation of Internal Medicine (EFIM) strongly encourages the Internal Medicine societies and internists across Europe to play an active role in matters related to climate change and environmental degradation. At a national level, this includes advocating the adoption of measures that reduce greenhouse gas (GHG) emissions and environmental degradation and contributing to policy decisions related to these issues. At a hospital level and in clinical practice, supporting actions by the health sector to reduce its ecological footprint is vital. At the level of EFIM and its associated internal societies, promoting educational activities and developing a toolkit to prepare internists to better care for citizens who suffer from the consequences of climate change. In addition to advocating and implementing effective actions to reduce the ecological footprint of the health industry, recommending the introduction of these themes in scientific programs of Internal Medicine meetings and congresses and the pre- and postgraduate medical training. At a personal level, internists must be active agents in advocating sustainable practices for the environment, increasing the awareness of the community about the health risks of climate change and environmental degradation, and being role models in the adoption of environmentally friendly behaviour.
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Affiliation(s)
- Luís Campos
- Department of Internal Medicine, Hospital CUF Tejo, Lisbon, Portugal.
| | - J Vasco Barreto
- Internal Medicine Service, Medicine Department, Hospital Pedro Hispano, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Stefano Bassetti
- Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Monica Bivol
- Medical Division, Akershus University Hospital, Lorenskog, Norway
| | - Amie Burbridge
- Acute Medicine Department, University Hospitals Coventry and Warwickshire, Coventry, United Kingdom
| | - Pietro Castellino
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - João Araújo Correia
- Serviço de Medicina Interna, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Mine Durusu-Tanriöver
- Department of General Internal Medicine, Hacettepe University Hospital, Ankara, Turkey
| | - Carmen Fierbinteanu-Braticevici
- "Carol Davila" University of Medicine and Pharmacy Bucharest, Medical Clinic II and Gastroenterology, Department of Gastroenterology, University Hospital Bucharest, Bucharest, Romania
| | - Thomas Hanslik
- Service de Médecine Interne, Hôpital Ambroise Paré, Boulogne Billancourt, France
| | - Zbigniew Heleniak
- Department of Nephrology, Transplantology and Internal Medicine, Medical, University of Gdansk, Gdansk, Poland
| | - Radovan Hojs
- Clinic for Internal Medicine, University Clinical Centre Maribor, Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Leonid Lazebnic
- The Moscow State University of Medicine and Dentistry, Moscow, Russian Federation
| | - Maria Mylona
- 1st Department of Propaedeutic & Internal Medicine, Laiko General Hospital, Athens University Medical School, Athens, Greece
| | - Matthias Raspe
- Department of Internal Medicine, Infectious Diseases and Respiratory Medicine, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | | | | | - Reinold Gans
- Internal Medicine Department, University Medical Center, Groningen, The Netherlands
| | - Runólfur Pálsson
- Landspitali-The National University Hospital of Iceland and University of Iceland, Reykjavik, Iceland
| | - Nicola Montano
- University of Milan, UNIMI - Department of Clinical Sciences and Community Health, Milan, Italy
| | - Ricardo Gómez-Huelgas
- Department of Internal Medicine, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga, University of Málaga, Málaga, Spain
| | - Dror Dicker
- Internal Medicine D and Obesity Clinic, Hasharon Hospital, Rabin Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Strametz R, Koch P, Vogelgesang A, Burbridge A, Rösner H, Abloescher M, Huf W, Ettl B, Raspe M. Prevalence of second victims, risk factors and support strategies among young German physicians in internal medicine (SeViD-I survey). J Occup Med Toxicol 2021; 16:11. [PMID: 33781278 PMCID: PMC8005860 DOI: 10.1186/s12995-021-00300-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 03/15/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Second victims, defined as healthcare team members being traumatised by an unanticipated clinical event or outcome, are frequent in healthcare. Evidence of this phenomenon in Germany, however, is sparse. Recently, we reported the first construction and validation of a German questionnaire. This study aimed to understand this phenomenon better in a sample of young (<= 35 years) German physicians. METHODS The electronic questionnaire (SeViD-I survey) was administered for 6 weeks to a sample of young physicians in training for internal medicine or a subspecialty. All physicians were members of the German Society of Internal Medicine. The questionnaire had three domains - general experience, symptoms, and support strategies - comprising 46 items. Binary logistic regression models were applied to study the influence of various independent factors on the risk of becoming a second victim, the magnitude of symptoms and the time to self-perceived recovery. RESULTS The response rate was 18% (555/3047). 65% of the participants were female, the mean age was 32 years. 59% experienced second victim incidents in their career so far and 35% during the past 12 months. Events with patient harm and unexpected patient deaths or suicides were the most frequent key incidents. 12% of the participants reported that their self-perceived time to full recovery was more than 1 year or have never recovered. Being female was a risk factor for being a second victim (odds ratio (OR) 2.5) and experiencing a high symptom load (OR 2). Working in acute care was promoting a shorter duration to self-perceived recovery (OR 0.5). Support measures with an exceptionally high approval among second victims were the possibility to discuss emotional and ethical issues, prompt debriefing/crisis intervention after the incident and a safe opportunity to contribute insights to prevent similar events in the future. CONCLUSION The second victim phenomenon is frequent among young German physicians in internal medicine. In general, these traumatic events have a potentially high impact on physician health and the care they deliver. A better understanding of second victim traumatisations in Germany and broad implementation of effective support programs are warranted.
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Affiliation(s)
- Reinhard Strametz
- Wiesbaden Business School, RheinMain University of Applied Sciences, Bleichstraße 44, 65183, Wiesbaden, Germany
| | - Peter Koch
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Anja Vogelgesang
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Amie Burbridge
- Department of Acute Medicine, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX, England
| | - Hannah Rösner
- Wiesbaden Business School, RheinMain University of Applied Sciences, Bleichstraße 44, 65183, Wiesbaden, Germany
| | - Miriam Abloescher
- Karl Landsteiner Institute for Clinical Risk Management, Wolkersbergenstraße 1, 1130, Vienna, Austria.,Clinic Hietzing, Vienna Healthcare Group, Wolkersbergenstraße 1, 1130, Vienna, Austria
| | - Wolfgang Huf
- Karl Landsteiner Institute for Clinical Risk Management, Wolkersbergenstraße 1, 1130, Vienna, Austria.,Clinic Hietzing, Vienna Healthcare Group, Wolkersbergenstraße 1, 1130, Vienna, Austria
| | - Brigitte Ettl
- Karl Landsteiner Institute for Clinical Risk Management, Wolkersbergenstraße 1, 1130, Vienna, Austria.,Clinic Hietzing, Vienna Healthcare Group, Wolkersbergenstraße 1, 1130, Vienna, Austria
| | - Matthias Raspe
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Internal Medicine, Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany.
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