Psychological Distress and Cognitive Impairment in Neurological In-Patients: Its Prevalence and its Recognition by Residents

Objective: This pilot study investigated the prevalence of psychological distress and cognitive impairment in neurological in-patients by means of three widely accepted questionnaires. We examined residents' recognition of corresponding disturbances. Method: We interviewed fifty-five consecutively admitted in-patients of a neurological unit with the MMSE, GHQ-28 and BDI. We asked the neurological residents whether they found cognitive impairment or psychological disturbances in their patients and to indicate the extent of those abnormalities. Results: Fifteen percent of patients showed cognitive impairment, but as many as one-third showed psychological problems warranting further work-up. Recognition of such by residents as well as specification of psychiatric diagnoses and important psychosocial factors in the final reports was poor. Conclusion: Psychological problems are common in neurologic in-patients. They are insufficiently recognized by residents and usually not taken into consideration in patient-care. We suggest the improvement of neurologic training to include appropriate interview techniques, providing the integration of biological, psychological and social factors in diagnosis and therapy.

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A pilot study of attachment relationships, psychological problems and negative automatic thoughts among college students in Pakistan

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2019-0264 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Siddrah Irfan ◽

Nor Sheereen Zulkefly

Keyword(s):

Pilot Study ◽

Cross Sectional Study ◽

Psychological Problems ◽

Peer Attachment ◽

Automatic Thoughts ◽

Cross Sectional ◽

Attachment Relationships ◽

Automatic Thought ◽

Symptoms Of Depression ◽

Negative Automatic Thoughts

AbstractObjectivesThe present pilot study examined the associations between attachment relationships, psychological problems, and negative automatic thoughts among late adolescents in Rawalpindi, Pakistan.SubjectsA total of 98 participants (male = 49, female = 49) were recruited from government colleges in Rawalpindi, Pakistan.MethodsThe measures used to assess the research variables of this cross sectional study were the Inventory of Parent-Peer Attachment (IPPA-Urdu), Depression, Anxiety, and Stress Scale (DASS-Urdu), and the Automatic Thought Questionnaire (ATQ-Urdu).ResultsAll of these measures had good reliabilities. Findings of the correlation analyses demonstrated that maternal, paternal and peer attachment relationships were negatively related to symptoms of depression and anxiety as well as to negative automatic thoughts. On the other hand, depressive and anxiety symptoms were positively associated with negative automatic thoughts. Additionally, findings suggested that future studies must investigate adolescents from two-parent households and exclude those with only one living parent.ConclusionThe results underscored the need for further investigations of the linkages between attachment relationships, negative automatic thoughts and psychological problems on larger samples.

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A mixed methods study to evaluate the impact of a student-run clinic on undergraduate medical education

BMC Medical Education ◽

10.1186/s12909-021-02621-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nathan G. Rockey ◽

Taylor M. Weiskittel ◽

Katharine E. Linder ◽

Jennifer L. Ridgeway ◽

Mark L. Wieland

Keyword(s):

Mixed Methods ◽

Patient Care ◽

Social Factors ◽

Healthcare Access ◽

Community Services ◽

Student Understanding ◽

Learning Objectives ◽

Barriers To Healthcare ◽

The Impact ◽

Barriers To Healthcare Access

Abstract Background The purpose of this study was to evaluate the extent to which a longitudinal student-run clinic (SRC) is meeting its stated learning objectives, including providing critical community services and developing physicians who more fully appreciate the social factors affecting their patients’ health. Methods This was a mixed methods program evaluation of an SRC at Mayo Clinic Alix School of Medicine (MCASOM). A survey was conducted of medical students who had participated in the clinic and seven interviews and three focus groups were conducted with SRC patients, students, faculty, staff, and board members. Transcripts were coded for systematic themes and sub-themes. Major themes were reported. Survey and interview data were integrated by comparing findings and discussing areas of convergence or divergence in order to more fully understand program success and potential areas for improvement. Results Greater than 85% of student survey respondents (N = 90) agreed or strongly agreed that the SRC met each of its objectives: to provide a vital community service, to explore social determinants of health (SDH), to understand barriers to healthcare access and to practice patience-centered examination. Qualitative data revealed that the SRC contextualized authentic patient care experiences early in students’ medical school careers, but the depth of learning was variable between students. Furthermore, exposure to SDH through the program did not necessarily translate to student understanding of the impact of these social factors on patient’s health nor did it clearly influence students’ future practice goals. Conclusions The MCASOM SRC experience met core learning objectives, but opportunities to improve long-term impact on students were identified. Participation in the SRC enabled students to engage in patient care early in training that is representative of future practices. SRCs are an avenue by which students can gain exposure to real-world applications of SDH and barriers to healthcare access, but additional focus on faculty development and intentional reflection may be needed to translate this exposure to actionable student understanding of social factors that impact patient care.

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