scholarly journals Medical residency: factors relating to "difficulty in helping" in the resident physician-patient relationship

2011 ◽  
Vol 129 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Mario Alfredo De Marco ◽  
Vanessa Albuquerque Cítero ◽  
Maria Cezira Fantini Nogueira-Martins ◽  
Latife Yazigi ◽  
Lawrence Sagin Wissow ◽  
...  

CONTEXT AND OBJECTIVE: Previous studies have attempted to understand what leads physicians to label patients as 'difficult'. Understanding this process is particularly important for resident physicians, who are developing attitudes that may have long-term impact on their interactions with patients. The aim of this study was to distinguish between patients' self-rated emotional state (anxiety and depression) and residents' perceptions of that state as a predictor of patients being considered difficult. DESIGN AND SETTING: Cross-sectional survey conducted in the hospital of Universidade Federal de São Paulo (Unifesp). METHODS: The residents completed a sociodemographic questionnaire and rated their patients using the Hospital Anxiety and Depression Scale (HADS) and Difficulty in Helping the Patient Questionnaire (DTH). The patients completed HADS independently and were rated using the Karnofsky Performance Status scale. RESULTS: On average, the residents rated the patients as presenting little difficulty. The residents' ratings of difficulty presented an association with their ratings for patient depression (r = 0.35, P = 0.03) and anxiety (r = 0.46, P = 0.02), but not with patients' self-ratings for depression and anxiety. Residents from distant cities were more likely to rate patients as difficult to help than were residents from the city of the hospital (mean score of 1.93 versus 1.07; P = 0.04). CONCLUSIONS: Understanding what leads residents to label patients as having depression and anxiety problems may be a productive approach towards reducing perceived difficulty. Residents from distant cities may be more likely to find their patients difficult

2011 ◽  
Vol 9 (4) ◽  
pp. 393-400 ◽  
Author(s):  
Patricia Austin ◽  
Sharon Wiley ◽  
Peter M. McEvoy ◽  
Leigh Archer

AbstractObjective:This study compared the prevalence of anxiety and depression as measured on the Hospital Anxiety and Depression Scale (HADS) in palliative care patients being treated at home with those being treated as inpatients.Method:The participants were palliative care patients being treated at home (n = 46) and palliative care inpatients (n = 46). Subjects were assessed for functionality on the Karnofsky Performance Status Scale (KPS) and anxiety and depression were measured on the HADS.Results:The results showed that ~20% of all patients were depressed and anxious as measured on the HADS, regardless of the cutoff criteria. There was no significant difference in depression and anxiety between the two groups when socioeconomic status and functionality were controlled for. Functionality, as measured on the KPS, was uniquely a predictor of depression, and younger patients were shown to have greater anxiety.Significance of results:The results suggest that home-based palliative care patients and palliative care inpatients should receive equal psychological support, and that clinicians need to be aware of the psychological vulnerability of younger and less-functional patients. The prevalence of depression and anxiety indicates that all palliative care patients should be screened for psychological distress, to identify those who need further assessment and treatment.


2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaoling Li ◽  
Hegao Yu ◽  
Weiqiang Yang ◽  
Qihua Mo ◽  
Zhanggui Yang ◽  
...  

Background: We described the prevalence of anxiety and depression related to COVID-19 pandemic among different types of population and examined their potential risk factors.Methods: A cross-sectional survey was conducted to collect demographic characteristics, exposure histories, and many other concerns about COVID-19. The Zung's self-rating anxiety scale (SAS) and self-rating depression scale (SDS), followed by a four-step multiple logistic regression analysis was performed to identify factors associated with mental health outcomes.Results: Out of 3,303 participants, the quarantined people (40.9%), community workstation staffs-policemen-volunteers (CPV) (36.4%) and general public (30.7%) reported higher percentages of depression than the general medical staff (18.4%). Moreover, the quarantined people (19.1%) also showed higher prevalence of anxiety than the general public (9.1%) and the general medical staff (7.8%). The quarantined people had the highest risk of anxiety and depression, whereas the self-rated health was negatively associated with the risks of anxiety and depression. Younger age group (18 to 30 years) showed higher risks of anxiety (OR = 6.22, 95% CI = 2.89–13.38, p < 0.001) and depression (OR = 3.69, 95% CI = 2.40–5.69, p < 0.001). People who had exposure history or contact from Hubei province after December 1, 2019 (OR = 1.57, 95% CI = 1.07–2.30, p < 0.001), had family or friends engaged in front-line health care work (OR = 1.47, 95% CI = 1.02–2.14, p < 0.001), had confirmed case nearby (OR = 2.44, 95% CI = 1.43–4.18, p < 0.001) were all more likely to suffer from anxiety. Moreover, the negligence (OR = 1.85, 95% CI = 1.37–2.51, p < 0.001) or overindulgence (OR = 1.45, 95% CI = 1.03–2.04, p < 0.001) toward the epidemic information was associated with a higher risk of depression and anxiety.Conclusions: Our findings show that the CPV and quarantined people were most at-risk population. We have identified that the young people, people with exposure histories and negligence or overindulgence toward epidemic information are in grave need of attention.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Anish Khalil ◽  
Muhammad Faheem ◽  
Ammad Fahim ◽  
Haran Innocent ◽  
Zainab Mansoor ◽  
...  

Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care.Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting.Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI].Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS).Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7%) patients were suffering from anxiety and depression.Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associatedpvalue < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient’s awareness of his anxiety and depression. Out of 143 (47.7%) uneducated patients, 85 (59.4%) were depressed, hence making it the highest educational category suffering from depression and anxiety.Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing.Limitations. The frequency of female patients in our research was higher than those of male patients.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Durand-Hill ◽  
D I Ike ◽  
A N Nijhawan ◽  
A B Shah ◽  
A Dawson ◽  
...  

Abstract Introduction During the COVID pandemic, the 2019-2020 cohort of final year students were invited to participate in Foundation interim Year 1 placements (FiY1). FiY1 aimed to ease transition to Foundation Year 1 doctor (FY1). We assessed the psychological impact of FiY1 on final year medical students. Method A cross-sectional survey was distributed to final year medical students in the UK between June 4th and July 4th, 2020. The survey contained the following domains: participant demographics, rationale for FiY1 participation, a checklist of the key safety principles for FiY1s, the Hospital Anxiety and Depression Scale and the Perceived Stress scale-4. Results 107 final years responded to the survey. 72.0% (n = 77) of final year students surveyed were working as FiY1s. Final year students participating in FiY1 postings had reduced rates of anxiety (29.9% vs 43.4%, P = 0.186), depression (5.2% vs 20.0%, P = 0.018) and lower perceived stress levels (5.0 vs 7.2, P &lt; 0.001). 19.5% (15/77) FiY1s reported working beyond their competency, 27.3% (22/77) felt unsupervised, but 94.8% (73/77) of FiY1s felt the post prepared them for FY1. Conclusions Students participating in FiY1 postings felt less stressed and depressed than those not participating in the scheme and the majority felt it was preparing them for FY1.


2019 ◽  
Vol 7 (16) ◽  
pp. 2590-2594
Author(s):  
Dona Farila Agus ◽  
Elmeida Effendy ◽  
Vita Camellia

BACKGROUND: HIV, which causes AIDS, infects the immune system cells, by destroying or damaging the function of the CD4. PLWHA will have twice the risk of experiencing mental health disorders such as depression and anxiety compared with the general population, thereby suppressing immune function, decreasing their quality of life, decreasing the level of adherence to treatment, and contributing significantly to the occurrence of premature death. AIM: To determine the correlation Anxiety and Depression symptoms and CD4 levels in PLWHA who are undergoing Anti-Retroviral treatment at the HIV/AIDS METHODS: The study was a cross-sectional study, which assesses the correlation between Hospital Anxiety and Depression Scale scores (HADS) and CD4 levels in PLWHA who are receiving ARV in the HIV/AIDS Special Services Polyclinic Medan Haji general hospital. RESULTS: It was found that the average HADS-A score, PLWHA was 15.286 and the SD ± 2.244. This shows that PLWHA is in moderate to severe anxiety and moderate to severe depression. The mean CD4 level of people with HIV/AIDS/PLWHA was 288.171 and SD ± 88.955. According to WHO criteria, regarding the classification of HIV immunodeficiency in adults, are classified as moderate immunodeficiency. There was a significant correlation between the HADS-A score and CD4 level with a correlation value of r = -0.592 indicating a negative correlation with a moderate correlation strength, and the correlation between HADS-D score and CD4 level. The strength of the relationship between HADS-D score and CD4 level is r = -0.650, shows a negative correlation with strong correlation strength. CONCLUSION: from this study, it was found that there is a relationship between depression and anxiety symptom and CD4 level.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8597-8597
Author(s):  
P. H. Seo ◽  
R. Sloane ◽  
S. S. Ingram ◽  
D. Misra ◽  
E. C. Clipp ◽  
...  

8597 Background: Older cancer survivors may experience psychological distress due to their cancer experience and aging health. This study aimed to compare primary care and specialty providers’ inquiries of pain, depression and anxiety to older cancer survivors’ questionnaire responses. Methods: 153 patients seen in oncology clinics at the Veterans Affairs Medical Center (Durham, NC) from November 1999 until April 2000 completed the Hospital Anxiety and Depression Scale and a pain thermometer questionnaire. Blinded chart review examined health provider inquiries of pain, anxiety and depression. Cox proportional hazards survival analyses were performed on subjective pain, anxiety and depression with comorbidities and Karnofsky performance status (KPS) added in controlled models. Results: Patients were on average aged 68, had 5.4 comorbidities, 87.4% KPS, and were 3.1 years from a cancer diagnosis. Health providers missed 17 of 94 patients with significant levels of self-reported pain (sensitivity 0.82). Although 28 (20.6%) and 33 (25.8%) patients screened positively for depression and anxiety respectively, providers asked 7 patients about anxiety (sensitivity 0.15) and 16 patients about depression (sensitivity 0.25). The overall three year mortality was 37.9%. Pain was not associated with mortality. Patients screening for depression [HR 2.03 (95% CI: 1.03, 4.01)] and anxiety [HR 2.02 (95% CI: 1.01, 4.04)] had lower 3 year survival. KPS and comorbidities diminished these effects. Conclusions: In older cancer survivors, anxiety and depression may have an association with mortality. To improve detection, oncology and primary care providers should routinely inquire about mood and aim to intervene with pharmacologic or supportive treatments. No significant financial relationships to disclose.


2018 ◽  
Vol 10 (Especial 5) ◽  
pp. 89-94
Author(s):  
Silas de Oliveira Damasceno ◽  
José Henrique Piedade Cardoso ◽  
Raíssa Puzzi Ladvig ◽  
Luana Martins de Paula ◽  
Renilton José Pizzol ◽  
...  

Pain, anxiety, and depression are symptoms that need attention in physiotherapeutic practice, once they influence the functionality of patients, so understanding them becomes an important tool. The aim of the study was to verify the levels of pain, depression, and anxiety in patients attended at a physiotherapy center. A cross-sectional clinical study in which a sociodemographic questionnaire was applied, the Visual Analogue Scale (VAS), the Hospital Anxiety and Depression Scale (HADS) and the Roland Morris Disability Questionnaire (MRQ). Seven patients participated and presented a MRI score of 18.57 ± 2.63 points, HADS in the topic anxiety 12.71 ± 5.43 points, HADS depression 9.57 ± 5.22 points and the resting VAS presented an average of 4 , 42 ± 3.9 pain points and in motion showed 8.71 ± 0.95. It is concluded that the population with low back pain has high intensity of pain, probable anxiety and possible level of depression.


Author(s):  
Igor Burstyn ◽  
Karyn Holt

Abstract Background Anxiety and depression among physicians and nurses during the COVID-19 pandemic in the USA are not well described and their modifiable causes are poorly understood. Methods We conducted a cross-sectional survey of symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) among physicians and nurses in two US healthcare systems in June through September 2020; participation rate was 5–10%. We described features of work as well as their perceptions and associated concerns in relation to the risk of anxiety and depression, while controlling for health history via regression and path analyses. Results About a third of 684 nurses and 185 physicians surveyed showed symptoms of anxiety or depression, and the excess of symptoms of mood disorders was particularly prominent in nurses. The belief that one was infected was a dominant correlate of both anxiety and depression. This belief was more associated with history of symptoms of pneumonia than the contact with COVID-19 diagnosed patients. Factors found to be associated with reduced anxiety and depression in this working environment were having confidence in the competent use of and access to personal protective equipment, maintaining usual working hours, being surrounded by colleagues who were both sufficient in numbers and not stressed, and the support of immediate family and religious communities. Involvement in aerosol-generating procedures with infected patients was linked with lower depression in nurses but higher among physicians. Likewise, the setting of recent patient encounters affected risk of anxiety and depression differently for physicians and nurses. Conclusions Our findings may help develop mitigation measures and underscore the need to help nurses and physicians bear the psychological burden of the COVID-19 pandemic and similar events in the future.


2020 ◽  
Author(s):  
Arlene McGarty ◽  
Lisa McDaid ◽  
Paul Flowers ◽  
Julie Riddell ◽  
John Pachankis ◽  
...  

Abstract Background: Gay, bisexual and other men who have sex with men (GBMSM) are at a greater risk of mental health problems, such as anxiety and depression, than heterosexual adults. Numerous factors and stressors have been reported to impact men’s mental health, although it has been suggested that resilience could have a protective effect. The aim of this study is to explore mental health, minority stressors, and resilience among a large online cross-sectional survey of GBMSM in the Celtic nations. Methods: Data for this cross-sectional study were collected from the Social Media, GBMSM and Sexual and Holistic Health (SMMASH2) self-report online survey. Participants (n=3077) were recruited via gay sociosexual media in Scotland, Wales, Northern Ireland, and the Republic of Ireland. Binary logistic regression analyses were conducted to identify factors that increased the odds of moderate-to-severe anxiety and depression. Potentially relevant variables (p<0.05) were carried forward in hierarchal logistic regression analyses. Results: The prevalence of moderate-to-severe anxiety and depression was 19.9% and 14.4%, respectively. Having a disability (OR = 1.73) and having financial worries sometimes/all of the time (OR = 1.93) increased the odds of having moderate-to-severe depression and anxiety, respectively. No minority stressors were associated with depression, whereas experiencing any form of relationship abuse in the last 12 months significantly increased the odds of anxiety (OR = 1.50). Resilience, namely a sense of coherence, had a protective effect and significantly reduced the odds of moderate-to-severe depression (OR = 0.85) and anxiety (OR = 0.89). Discussion: Disability and financial worries were associated with increased depression and anxiety, respectively, while resilience had a protective effect for GBMSM in the SMMASH2 study. Future research is needed to better understand the role of resilience and the challenges and stresses of everyday life and intersecting health problems. Future research is also needed that incorporates the perspectives of those most affected by mental ill-health to co-develop effective solutions that respond to their contextual surroundings.


Author(s):  
Nazila Shahmansouri ◽  
Mehrdad Salehi ◽  
Ali Reza Bakhshandeh ◽  
Roya Sattarzadeh Badkoubeh ◽  
Masoumeh Lotfi-Tokaldani ◽  
...  

Background: Heart transplantation is a major procedure which imposes high emotional stress on patients. Illness perception (IP) is a psychological issue which affects psychological adjustment after transplantation. This study aimed to investigate the association between IP and emotional status in Iranian post-heart transplantation patients. Methods: The present cross-sectional study, conducted between 2018 and 2019 in Imam Khomeini Hospital, Tehran, Iran, recruited 121 post-heart transplantation patients. IP was measured using the Brief Illness Perception Questionnaire (B-IPQ), and emotional status was measured using the Hospital Anxiety and Depression Scale. The association between IP and depression/anxiety was assessed. Results: Men comprised 80.2% of the study population. The mean age of the participants was 43.9±12.95 years. Definite caseness for depression and anxiety was reported in 11.6% and 18.2% of the participants, respectively. The median score of IP was 55. The association between anxiety and IP in total IP and the 3 dimensions of IP was statically significant (P=0.015, P=0.018, P=0.002, and P=0.023 for the cognition, emotion, and understanding dimensions and the total IPQ, respectively). Additionally, the association between depression and IP was significant (P=0.001, P=0.029, and P=0.002 for the cognition and emotion dimensions and the total IPQ, correspondingly, except for the understanding dimension). Furthermore, lower levels of anxiety in the patients showed a greater impact on IP than did depression. Conclusion: There was a significant association between IP and depression and anxiety in our study population. Therefore, the diagnosis and management of anxiety and depression in heart transplantation patients may improve IP. The cross-sectional design of the present study precluded an investigation of the causality between IP and emotional status.


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