scholarly journals Do Junior Doctors feel confident using Emergency Detention Certificates?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S60-S61
Author(s):  
Sarah Wordie ◽  
Alice Troup ◽  
Giovana Klefti ◽  
Cinzia Giuntoli
Keyword(s):  
Mental Health ◽  
Legal Aspects ◽  
Junior Doctors ◽  
Educational Materials ◽  
Educational Tools ◽  
Electronic Survey ◽  
Self Confidence ◽  
Health Officer ◽  
Pro Forma ◽  
Source Of Information

AimsTo assess junior doctors understanding of the law surrounding the use of The Mental Health (Care and Treatment) (Scotland) Act 2003 (MHA) with a focus on assessing confidence and knowledge of the use of the emergency detention certificate (EDC). A secondary aim was to use these findings to develop a variety of educational tools to subsequently improve junior doctors understanding in using the MHA.MethodWe created and distributed a comprehensive electronic survey to 152 Foundation Year Two Doctors working in NHS Lothian, Fife and Borders in December 2020. We subsequently interviewed 20 respondents to enquire about additional resources needed to improve knowledge of the MHA. Following on, we completed worked EDC exemplars, created an easily accessible guide with step-by-step instructions on implementing an EDC and devised a checklist pro-forma that can be accessed and inserted into a patient's electronic notes to ensure all necessary steps are completed for the EDC.Result51 doctors (34%) responded to our survey, of which 10 (19%) had previously worked in psychiatry and 16 (31%) had previously completed an EDC. 27 respondents (52%) reported a lack of self-confidence and knowledge and 26 (51%) reported a lack of understanding in the legal processes as barriers faced when putting an EDC in place. 23 (45%) respondents were unaware that a Mental Health Officer (MHO) must be contacted to grant an EDC. Respondents who had experience of working in psychiatry reported greater awareness of the MHA. From the focused interviews held, colleagues requested for worked EDC examples, an easily accessible checklist with relevant contact details and an electronic pro-forma for patients notes to assist with completing the relevant legal steps when implementing an EDC.ConclusionOur study identified a lack of confidence in understanding the MHA and completing an EDC. Our educational materials will provide an invaluable source of information for junior doctors, in particular those with little experience of the MHA. Importantly, our resources will ensure the legal aspects of implementing an EDC are both complied with and documented appropriately.

scholarly journals An audit of admission clerking of patients in Heddfan, Adult Mental Health Unit in BCUHB - north Wales

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S75-S75
Author(s):  
Asha Dhandapani ◽  
Sathyan Soundararajan ◽  
Manjula Simiyon ◽  
Vinila Zachariah ◽  
Rajvinder Sambhi
Keyword(s):  
Mental Health ◽  
Physical Examination ◽  
Junior Doctors ◽  
Physical And Mental Health ◽  
Improvement Project ◽  
North Wales ◽  
History Of ◽  
Mental Health Unit ◽  
State Examination ◽  
Source Of Information

AimsTo ensure admission clerking includes salient features needed for the management of both physical and mental health of the patient and also to aid in administrative purposes.MethodThe audit included a team of doctors reviewing the admission clerking notes for 50 patients in the General Adult Psychiatric unit in-patient ward.We created a standard questionnaire-based on Intended learning outcome of core training in psychiatry CT1-CT3 from Royal College of Psychiatry and standard textbooks.Our aim is to achieve 100 % compliance in clerkingResultIt was noted that only 30% wrote their GMC number, 4% added route of admission of the patient and a mere 8% filled the Consultants name. Though almost everyone had written the presenting complaints, the other aspects such as history of presenting illness, medical and family history, Allergy status and substance misuse history were missing in many clerking notes. None of them had filled in details of personal history and very few did a risk assessment.Further lacuna was noted with Mental state examination. Physical examination was also noted to be incomplete. While more than 50% had completed the Blood investigations and ECG, half of them had not documented it and that meant searching in the entire file. A mere 20% filled the nursing observation level whilst none had completed the formulation in the notes.ConclusionAdmission clerking is a vital source of information that would be needed for the formulation of patients diagnosis and future management.Apart from this, it also is needed for further continuity of care.Hence this vital source of information will need to be shared with the junior doctors who will be clerking the patient and seeing them in the first instance.We, therefore, intend to create a complete clerking proforma along with physical health proforma to aid us in this respect.We will audit initially in the first round and then plan to introduce a proforma for Clerking and physical examination based on the findings.We will re-audit to see if the standards are achieved after using the proforma and will consider a Quality improvement project based on this topic

Prawne regulacje pobierania i transplantacji narządów oraz tkanek w ujęciu europejskiej konwencji bioetycznej

2016 ◽  
pp. 52-65
Author(s):  
Patryk Kołodyński ◽  
Paulina Drab
Keyword(s):  
Ex Vivo ◽  
Legal Aspects ◽  
European Convention ◽  
The Public ◽  
Additional Protocol ◽  
The Past ◽  
Reliable Source ◽  
International Legal Order ◽  
Definition Of ◽  
Source Of Information

Over the past several years, transplantology has become one of the fastest developing areas of medicine. The reason is, first and foremost, a significant improvement of the results of successful transplants. However, much controversy arouse among the public, on both medical and ethical grounds. The article presents the most important concepts and regulations relating to the collection and transplantation of organs and tissues in the context of the European Convention on Bioethics. It analyses the convention and its additional protocol. The article provides the definition of transplantation and distinguishes its types, taking into account the medical criteria for organ transplants. Moreover, authors explained the issue of organ donation ex vivo and ex mortuo. The European Convention on Human Rights and Biomedicine clearly regulates the legal aspects concerning the transplantation and related basic concepts, and therefore provides a reliable source of information about organ transplantation and tissue. This act is a part of the international legal order, which includes the established codification of bioethical standards.

The Coronavirus Disease 2019 Pandemic in Taiwan: An Facebook Online study on Concern/Fear Regarding the Disease and General Anxiety and Relevant Factors (Preprint)

2020 ◽  
Author(s):  
Peng-Wei Wang ◽  
Wei-Hsin Lu ◽  
Yi-Lung Chen ◽  
Dian-Jeng Li ◽  
Yu-Ping Chang ◽  
...  
Keyword(s):  
Mental Health ◽  
Environmental Factors ◽  
Online Survey ◽  
Psychological Impact ◽  
Health Resources ◽  
World Health ◽  
Regional Government ◽  
General Anxiety ◽  
Self Confidence ◽  
Health Organization

BACKGROUND The World Health Organization (WHO) declared COVID-19 a ‘public health emergency of international concern. Both worry and anxiety are the common psychological impact during the pandemic. The level of and determinants for worry and anxiety during COVID-19 are not well explored. OBJECTIVE The present study aimed to explore the associations of demographic and environmental factors with worry toward COVID-19 and general anxiety among people in Taiwan. METHODS In total, 1970 respondents were recruited through a Facebook advertisement and completed an online survey on worry toward COVID-19, general anxiety during the pandemic, and individual and environmental factors. RESULTS In total, 51.7% and 43.4% of respondents reported high levels of worry toward COVID-19 and general anxiety, respectively. Worse self-rated mental health, lower self-confidence in COVID-19 management, and insufficient mental health resources were significantly associated with high levels of both worry toward COVID-19 and general anxiety. Lower perceived confidence in COVID-19 management by the regional government was significantly associated with a higher level of worry toward COVID-19. Lower perceived social support was significantly associated with a higher level of general anxiety during the COVID-19 pandemic. CONCLUSIONS The results showed that high levels of worry toward COVID-19 and general anxiety were prevalent during the disease outbreak. Multiple individual and environmental factors related to worry toward COVID-19 and general anxiety were identified. CLINICALTRIAL

Development of the Shift Smartphone App to Support the Emotional Wellbeing of Junior Doctors: Design of a Prototype and Results of Usability and Acceptability Testing (Preprint)

2020 ◽  
Author(s):  
Isabelle Counson ◽  
Alexandra Bartholomew ◽  
Joanna Crawford ◽  
Katherine Petrie ◽  
Geetanjali Basarkod ◽  
...  
Keyword(s):  
Mental Health ◽  
User Experience ◽  
Help Seeking ◽  
Pilot Trial ◽  
User Involvement ◽  
Health Behaviours ◽  
Junior Doctors ◽  
User Centered Design ◽  
Emotional Wellbeing ◽  
Prototype Development

BACKGROUND Junior doctors report higher levels of psychological distress than more senior doctors and report several barriers to seeking professional mental health support, including concerns about confidentiality and career progression. Mobile health applications (mHealth apps) may be utilised to help overcome these barriers to assist the emotional wellbeing of this population and encourage help-seeking. OBJECTIVE We describe the development and pilot trial of the Shift mHealth app to provide an unobtrusive avenue for junior doctors to seek information about, and help for, wellbeing and mental health concerns that is sensitive to workplace settings. METHODS A 4-phase iterative development process was undertaken to create the content and features of Shift involving junior doctors, using principles of user-centered design. These four phases were: I) Needs assessment, based on interviews with 12 junior doctors; II) Prototype development with user experience feedback from two junior doctors; III) Evaluation, consisting of a pilot trial with 22 junior doctors to assess usability and acceptability of the initial prototype; and IV) Redesign, including user experience workshops with 51 junior doctors. RESULTS Qualitative results informed the content and design of Shift to ensure the app was tailored to junior doctors’ needs. The Shift app prototype contained cognitive-behavioural, mindfulness, value-based actions, and psychoeducational modules, as well as a tracking function visualising patterns of daily variations in mood and health behaviours. Pilot testing revealed possible issues with the organisation of the app content, which were addressed in a thorough restructuring and redesign of Shift with the help of junior doctors across three user experience workshops. CONCLUSIONS The current research demonstrates the importance of ongoing end-user involvement in the creation of a specialised mHealth app for a unique working population experiencing profession-specific stressors and barriers to help-seeking. The development and pilot trial of this novel Shift mHealth app are first steps in addressing the mental health and support-seeking needs of junior doctors, although further research is required to validate its effectiveness and appropriateness on a larger scale.

Reproductive rights: Legal aspects of the right to sterilisation

Stanovnistvo ◽  
2001 ◽  
Vol 39 (1-4) ◽  
pp. 119-130 ◽  
Author(s):  
Hajrija Mujovic-Zornic
Keyword(s):  
Mental Health ◽  
Free Choice ◽  
Reproductive Rights ◽  
German Law ◽  
Legal Aspects ◽  
Penal Policy ◽  
Abortion Law ◽  
Legal Questions ◽  
The Right ◽  
Voluntary Sterilization

In this paper the author discusses the nature and importance of the right to reproduce, in particular the right to sterilisation. In the time past sterilization has been practiced only as a measure of penal policy or the prevention of mental health diseases. Today, mostly we can speak about the right to sterilization (especially reversible sterilization). The patient have a free choice to decide any method of contraception and that could be a voluntary sterilization (also called human, contraceptive, non-therapeutical in French law, and obliging in German law). Various legal questions about this right can be raised, in accordance of state of reproductive rights (how they are regulated by the law) and the protection of reproductive rights (especially the right of pregnant woman as a patient). Yugoslav law not yet has a complete regulation and adequate solutions in this area, except the abortion law. The primary gynecology care has contraceptive counseling, but concrete measures and education are insufficient. It cannot begin to give consistent answers to all of these questions without a coherent conception of the right to reproduce, which is the primary duty of legal experts.

scholarly journals Producing a new website for a paediatric liaison mental health team with our service users

2020 ◽  
Vol 9 (4) ◽  
pp. e001128
Author(s):  
Alexander Adams ◽  
Virginia Davies ◽  
Bethany Stubbs
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Patient Experience ◽  
Service Users ◽  
Health Issues ◽  
Web Page ◽  
Mental Health Team ◽  
Children And Young People ◽  
Specific Feedback ◽  
Source Of Information

IntroductionOnline resources are an important source of information about mental health issues and services for children and young people. Our service’s website had an out-of-date appearance and was aimed at professionals. More importantly, comments in our routinely collected patient experience data indicated that service users did not know what to expect when coming to our service.MethodsWe followed the model for improvement by testing out changes in plan, do, study and act cycles that included a review of recently updated child and adolescent mental health services’ and youth charities’ websites, designing a new web page for our service and then testing out the website in focus groups. We used routinely collected patient experience data to assess impact on wider patient satisfaction.ResultsFocus groups involving patients, parents and professionals judged the new website to be clearer, more attractive and easier to understand. Routine patient experience data did not reveal any website-specific feedback.ConclusionThis study demonstrates that it is easy and possible to create an attractive and accessible website for a mental health service using quality improvement methodology. In order to capture and integrate ongoing feedback about a service’s website from service users, routinely collected patient experience measures would need to ask specific questions related to this area. In this study, preproject and postproject patient experience data did not generate any specific comments.

scholarly journals Medical Studies during the COVID-19 Pandemic: The Impact of Digital Learning on Medical Students’ Burnout and Mental Health

2021 ◽  
Vol 18 (1) ◽  
pp. 349
Author(s):  
Panagiotis Zis ◽  
Artemios Artemiadis ◽  
Panagiotis Bargiotas ◽  
Antonios Nteveros ◽  
Georgios M. Hadjigeorgiou
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Emotional Exhaustion ◽  
Short Form ◽  
Maslach Burnout Inventory ◽  
Junior Doctors ◽  
Digital Learning ◽  
Student Survey ◽  
Medical Studies ◽  
The Impact

Objectives: The aim of this ecological study was to investigate what the impact of digital learning due to the COVID-19 pandemic was on the burnout and overall mental health (MH) of medical students. Background: During the unprecedented era of the COVID-19 pandemic, the majority of countries worldwide adopted very strong measures. Universities closed their doors, and education continued through digital learning lectures. Methods: An anonymous questionnaire was administered to all 189 eligible candidates before and during the COVID-19 pandemic. Mental health was assessed via the MH domain of the 36-item Short Form Health Survey (SF-36) and burnout with the Maslach Burnout Inventory—Student Survey (MBI-SS). Results: The overall response rate was 81.5%. The overall burnout prevalence did not differ significantly between the two periods (pre-COVID-19 18.1% vs. COVID-19 18.2%). However, the burnout prevalence dropped significantly in year 4 (pre-COVID-19 40.7% vs. COVID-19 16.7%, p = 0.011), whereas it increased significantly in year 6 (pre-COVID-19 27.6% vs. COVID-19 50%, p = 0.01). When looking at each MBI-SS dimension separately, we found that emotional exhaustion decreased significantly in year 4 but increased in year 6, and cynicism increased in all years. The overall MH deteriorated significantly between the two periods (pre-COVID-19 58.8 ± 21.6 vs. COVID-19 48.3 ± 23, p < 0.001). Conclusions: Digital learning in medical studies carries significant risks. Not only does the MH deteriorate, but cynicism levels also increase. Emotional exhaustion was found to increase particularly in final year students, who struggle with the lack of clinical experience just before they start working as qualified junior doctors.

scholarly journals Acceptance Commitment Therapy Intervention for Custodial Grandfamilies

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 928-928
Author(s):  
Manuela E Faulhaber ◽  
Amie Zarling ◽  
Jeongeun Lee
Keyword(s):  
Mental Health ◽  
Well Being ◽  
Web Based ◽  
Acceptance Commitment Therapy ◽  
Self Confidence ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Time Period ◽  
Biological Parents ◽  
American Children

Abstract Millions of American children under the age of 18 are being cared for by their grandparents and without the presence of the biological parents. The number of custodial grandfamilies has significantly increased over the last five years. Recent studies have shown that custodial grandparents (CPGs) are often facing specific challenges in life, such as lower emotional well-being, higher parenting burden and stress related to this unique situation. Despite these findings, few interventions take a strengths based approach to improve their mental health and resilience. We describe our efforts to address these issues by proposing intervention anchored in the Acceptance and Commitment Therapy (ACT), emphasizing the importance of acceptance of challenging circumstances outside of one’s control and promoting resilience among participants. The program consists of a web based ACT program with online coaching meetings, six common core sessions and six separate sessions for each age group over a time period of six months. This program is unique in the sense that it utilizes both individual and group session techniques to facilitate the learning process. Main active ingredients of this program are to promote effective coping strategies, to reduce parenting stress among grandparents and to increase life skills (i.e., decision-making, proactivity) among grandchildren. We are hypothesizing that participating in the ACT program will help CGPs to improve self-efficacy, emotional well-being, higher self-confidence, social competence, lower depressive symptoms, and parenting distress, thereby leading to positive outcomes such as improved mental health and higher resilience.

Parental alienation: the impact on men’s mental health

2015 ◽  
Vol 29 (3) ◽  
Author(s):  
Leo Sher
Keyword(s):  
Mental Health ◽  
Separation Anxiety ◽  
Self Esteem ◽  
Long Term Effects ◽  
Parental Alienation ◽  
Adult Men ◽  
Self Confidence ◽  
High Conflict ◽  
The Impact

Abstract Parental alienation is defined as a mental state in which a child, usually one whose parents are engaged in a high-conflict separation or divorce, allies himself strongly with one parent (the preferred parent) and rejects a relationship with the other parent (the alienated parent) without legitimate justification. Parental alienation may affect men’s mental health: a) parental alienation negatively influences mental health of male children and adolescents who are victims of parental alienation. Alienated children/adolescents display guilt, sadness, and depressed mood; low self-esteem and lack of self-confidence; distress and frustration; lack of impulse control, substance abuse and delinquent behavior; separation anxiety, fears and phobias; hypochondria and increased tendency to develop psychosomatic illness; suicidal ideation and suicide attempt; sleep and eating disorders; educational problems; enuresis and encopresis; b) parental alienation negatively affects the mental health of adult men who were victims of parental alienation when they were children and/or adolescents. Long-term effects of parental alienation include low self-esteem, depression, drug/alcohol abuse, lack of trust, alienation from own children, divorce, problems with identity and not having a sense of belonging or roots, choosing not to have children to avoid being rejected by them, low achievement, anger and bitterness over the time lost with the alienated parent; c) parental alienation negatively influences mental health of men who are alienated from their children. Fathers who have lost some or all contact with their children for months or years following separation or divorce may be depressed and suicidal.

Improving VTE prophylaxis adherence among hospitalized adolescents using Human-Centered Design

2021 ◽  
Vol 26 (4) ◽  
pp. 172-178 ◽  
Author(s):  
Soobin Kim ◽  
Jessie Klugman ◽  
Sarah Norell ◽  
Alexandra Kenefake ◽  
Laurel Komos ◽  
...  
Keyword(s):  
The United States ◽  
Intermittent Pneumatic Compression ◽  
Practice Variation ◽  
Educational Materials ◽  
Problem Statement ◽  
Human Centered Design ◽  
Educational Tools ◽  
Vte Prophylaxis ◽  
Improve Compliance ◽  
Pneumatic Compression Device

Background/problem statement Venous thromboembolism (VTE) is the leading cause of preventable hospital mortality in the United States; however, compliance with VTE prophylaxis is poor. Most materials for education about VTE prophylaxis are oriented toward adults rather than adolescents, for whom VTE risks are lower and prophylaxis indications differ. We hypothesized that educational materials for adolescents could improve compliance with VTE prophylaxis, reduce nurse burden for initiating and maintaining VTE prevention practices, and reduce practice variation by standardizing the conversation between clinicians and patients. Methods A multidisciplinary team including physicians, nurses, quality experts, communication designers, service designers, and medical students applied a human-centered design (HCD) process to define, iteratively prototype, and test education tools for nurses assigned to adolescents. We piloted a suite of six educational tools for adolescent VTE prophylaxis to fit into the existing hospital workflow. Results An in-room poster was selected after 85% of nurses responded favorably to this intervention. Adolescent adherence with Intermittent Pneumatic Compression Device increased from 69% to 79%, attaining the benchmark goal of 78%. Staff reported greater confidence in educating adolescent patients after the intervention: 62% of nurses and 72% of residents. Conclusion An HCD process helped nurses improve VTE prophylaxis for adolescents with an in-room poster and messaging strategy. Engaging staff in the design increased receptivity and adoption. The piloted materials also helped to create an environment of shared priority among the clinicians.

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