Barriers to consent taking in ECT

2011 ◽  
Vol 26 (S2) ◽  
pp. 1152-1152
Author(s):  
S.R. Pereira ◽  
A. Slattery ◽  
J. Beezhold
Keyword(s):  
Patient Participation ◽  
Consent Form ◽  
Convulsive Therapy ◽  
Nice Guidelines ◽  
Nice Guideline ◽  
Full Compliance ◽  
Study Case ◽  
The One ◽  
Electro Convulsive Therapy ◽  
Improve Patient

IntroductionThere were 16,482 administrations of Electro-convulsive Therapy (ECT) to 2835 individuals in England between January-March 1999. Controversy still surrounds the safety, ethics and necessity of ECT with some patients reporting severe adverse effects and feeling particularly strongly about it being administered without their consent. NICE guidelines along with the ECT accreditation service (ECTAS) sought to address these concerns and raise standards for ECT in UK.Aims and ObjectiveTo identify any barriers to compliance with NICE guidelines regarding consent for ECT.MethodsAll patients newly started on ECT during a 3 month period at Hellesdon Hospital were enrolled into this study. Case notes were analysed for 16 patients against the 21 standard ECTAS consent criteria.ResultsThe hospital rated good (70–89%) or excellent (90–100%) for all guidance except the one which requires patients to complete some sections of the consent form. Only 63% of the patients had completed these, however 100% went on to sign the consent form before every session. Guidance compliance was excellent for 15 (72%) of items examined.ConclusionsThere is good compliance with NICE guideline relating to consent for ECT. The only barrier to full compliance was inadequate documentation by patients in some sections. Steps to improve patient participation can now be implemented. This will provide assurance that ECT is used appropriately and that the process fully enables informed consent. Further research is required to discover the reasons for unsatisfactory patient participation in the consent process.

scholarly journals Understanding Treatment-Resistant Depression: A Missionary’s Autobiographical Case Report

2019 ◽  
Vol 6 (1) ◽  
pp. 43-50
Author(s):  
Hunter York
Keyword(s):  
Case Report ◽  
Depression Symptoms ◽  
Primary Concern ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Spiritual Discipline ◽  
Convulsive Therapy ◽  
Service Oriented ◽  
Resistant Depression ◽  
Electro Convulsive Therapy

As a career cross-cultural missionary in Southeast Asia, the author has seen first-hand and has personally experienced the devastating effects of colleagues, families, leaders, clinicians, and the sufferers themselves misunderstanding the symptoms and the reality of major depressive disorder, an increasing global health problem.  This autobiographical case report reflects on twenty years of treatment-resistant depression and a journey through pharmacological approaches, psychotherapy treatment, Christian prayer counselling, and electro convulsive therapy without improvement in this condition.  The primary concern is how to remain faithful and effective with this condition in a service-oriented occupation that requires regular emotional expenditure.  In lieu of effective conventional and non-conventional therapies, the remaining option is to find a way to manage chronic depression; identify personal trends, weaknesses, and triggers; and find a personalized way to live that minimizes the effects of the condition.  In any chronic, incurable disorder, the sufferer must inevitably come to terms with his or her reality and find peace in the acceptance of that reality.  By expressing the journey through treatment-resistant depression, the author encourages readers to persevere in ministry and to respond more appropriately to the afflicted with clearer understanding and empathy.  A companion article on mitigating depression symptoms through the spiritual discipline of identifying with Christ and His experience of human emotional pain during His passion is available.  

scholarly journals The NICE OECD countries’ geographic search filters: Part 2—validation of the MEDLINE and Embase (Ovid) filters

2021 ◽  
Vol 109 (4) ◽  
Author(s):  
Lynda Ayiku ◽  
Thomas Hudson ◽  
Ceri Williams ◽  
Paul Levay ◽  
Catherine Jacob
Keyword(s):  
Gold Standard ◽  
Oecd Country ◽  
Oecd Countries ◽  
Workplace Health ◽  
Nice Guidelines ◽  
Nice Guideline ◽  
Abortion Care ◽  
Flu Vaccination ◽  
Search Filters ◽  
Standard Sets

Objective: We previously developed draft MEDLINE and Embase (Ovid) geographic search filters for Organisation for Economic Co-operation and Development (OECD) countries to assess their feasibility for finding evidence about the countries. Here, we describe the validation of these search filters.Methods: We identified OECD country references from thirty National Institute for Health and Care Excellence (NICE) guidelines to generate gold standard sets for MEDLINE (n=2,065) and Embase (n=2,023). We validated the filters by calculating their recall against these sets. We then applied the filters to existing search strategies for three OECD-focused NICE guideline reviews (NG103 on flu vaccination, NG140 on abortion care, and NG146 on workplace health) to calculate the filters’ impact on the number needed to read (NNR) of the searches.Results: The filters both achieved 99.95% recall against the gold standard sets. Both filters achieved 100% recall for the three NICE guideline reviews. The MEDLINE filter reduced NNR from 256 to 232 for the NG103 review, from 38 to 27 for the NG140 review, and from 631 to 591 for the NG146 review. The Embase filter reduced NNR from 373 to 341 for the NG103 review, from 101 to 76 for the NG140 review, and from 989 to 925 for the NG146 review.Conclusion: The NICE OECD countries’ search filters are the first validated filters for the countries. They can save time for research topics about OECD countries by finding the majority of evidence about OECD countries while reducing search result volumes in comparison to no filter use.

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