scholarly journals Self-Perceived Incompetence in Psychiatric Practice of Practitioners from Southern Thailand: One Year Following Graduation

Author(s):  
Chonnakarn JATCHAVALA ◽  
Jarurin PITANUPONG

General psychiatric training is one of the essential requirements for all Thai medical doctors, as declared by the Medical Council of Thailand in 2012. Hence, psychiatric training for medical students must be fulfilled to achieve these requirements. This study was designed to examine the change of subjects and the self-perceived incompetence in psychiatric practice of a cohort of medical doctors who graduated in the academic year of 2017, in concerns to their practices one year after graduation. Most participants were female doctors, with an average age of 25.7 years, and were working in Southern Thailand. Compared with 1 year prior, they showed a statistically significant frequency of physical disorders and increasing stress from their work. The largest topic of psychiatric practice, for which they were statistically more concerned with, concerned child and adolescent psychiatry. Self-perceived incompetence in both diagnosis and treatment significantly increased from graduation, with the exceptions of diagnoses of mental retardation, attention deficit hyperactivity, and tics/Tourette’s disorder. Substance-related disorders in adults, along with basic psychological support, were found to be general practice self-perceived incompetence, at both outpatient clinics and inpatient units. However, practice in adult outpatients at psychiatric clinics mostly demonstrated significantly more self-perceived competence. Moreover, emergency care, especially concerning patient suicide and multi-disciplinary practice, was shown to have increasing self-perceived competence among general practitioners having worked for a year following graduation. This information should be used as feedback for stakeholders in both medical education and mental health care. HIGHLIGHTS Medical doctors who graduated in southern Thailand the previous year mostly worked in the same part of Thailand and significantly increased stress and physical illness Basic psychological support in both outpatient and inpatient unit’s practices, were statistically significantly increased, compared with when the doctors graduated one year earlier The general practitioners stated that they had been most concerned with children and adolescent psychiatric practice since they graduated Emergency care and multi-disciplinary practice in psychiatric practice were shown to have increasing self-perceived competence among those who graduated M.D. a year before

1989 ◽  
Vol 4 (4) ◽  
pp. 241-244
Author(s):  
P. Lemoine

SummaryIt is difficult to undertake field studies with non marketed psychotropic drugs because of two apparently contradictory conditions : on the one hand, the methodology has to be rigorously controlled, and on the other hand, such studies have to be carried out in their future environment by general practitioners (GPs). Bearing in mind the lack of training and experience regarding this kind of approach, the author adopted a discussion group method according to the techniques developed by M. Balint. The study group comprised five GPs, a clinical pharmacology expert and a doctor from the pharmaceutical laboratory which had developed the test drug. These persons met on a monthly basis over a one year period. In the present paper, the author indicates the benefits of such a methodology, based on six years’ experience and several trials, with special emphasis placed on the pedagogical aspects.


Author(s):  
Athamaica Ruiz Oropeza ◽  
Annmarie Lassen ◽  
Susanne Halken ◽  
Carsten Bindslev-Jensen ◽  
Charlotte G Mortz

1991 ◽  
Vol 29 (26) ◽  
pp. 104.1-104

Articles in the Bulletin have been unsigned since it began. This is because they aim to present a consensus view which incorporates contributions from many people, including specialists, general practitioners and members of the pharmaceutical industry, as well as the Bulletin’s Advisory Council. We are very grateful to them all, but although we have often been asked who they are, we cannot name the many hundreds who have helped us in any one year. However, we can at least name those not listed in our tailpiece who have taken a major share in the production of articles published in the last year, and do so now.


2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Christilia G. Wagiu ◽  
Erwin G. Kristanto ◽  
Theo Lumunon

Abstract: According to the Minister of Health regulation No. 290 Year 2008 article 1 which is relevant to medical intervention issues, informed consent has to be signed by the patient prior to any medical intervention after the patient has been informed completely about the purpose and the risk of certain intervention. In general, medical doctors already admits that informed consent is an important part of the ethical code of their profession. Albeit, in certain circumstances such as in emergency cases with life or physical handicap threatening, the medical doctors are demanded to do medical intervention ‘ignoring’ the informed consent. This study was aimed to obtain the implementation of informed consent in Emergency Care Unit at Prof. Dr. R. D. Kandou Hospital Manado, the central referral hospital in East Indonesia. In this study, we used qualitative method through interview, direct field observation, and document observation as secondary data. The results showed that informed consent was implemented at the Emergencey Care Unit, however, in emergency cases, informed consent was given orally, followed by signing it as soon as the intervention had been completely performed. Conclusion: Informed consent was implemented in every medical intervention at Prof. Dr. R. D. Kandou Hospital including the Emergency Care Unit.Keywords: informed consent, emergency care unitAbstrak: Menurut ketentuan Permenkes No. 290 tahun 2008 pasal 1 yang mengatur tentang tindakan medik disebutkan bahwa ijin melakukan tindakan medik diberi oleh pasien setelah terlebih dahulu pasien mendapat penjelasan tentang tujuan dan manfaat maupun risiko dari tindakan medik tersebut. Umumnya dokter telah mengetahui dan mengakui bahwa persetujuan tindakan medik atau informed consent ialah bagian kode etik profesi sebelum diatur dalam ketentuan undang-undang tentang rumah sakit, praktik kedokteran, maupun peraturan menteri kesehatan. Dalam keadaan tertentu dokter juga dituntut untuk dapat segera melaksanakan tindakan medis dan mengesampingkan informed consent antara lain dalam keadaan gawat darurat dimana terdapat ancaman kematian atau kecacatan. Penelitian ini bertujuan untuk mengetahui penyelenggaran persetujuan tindakan medik di Instalasi Gawat Darurat RSUP Prof. Dr. R. D. Kandou yang merupakan rumah sakit pusat rujukan di Indonesia Timur. Pada penelitian ini digunakan metode kualitatif melalui wawancara, pengamatan langsung di lapangan, dan observasi dokumen sebagai data sekunder. Hasil penelitian mendapatkan bahwa informed consent di Instalasi Gawat Darurat masih tetap dipakai, walaupun pada keadaan gawat darurat persetujuan diberikan secara lisan baru setelah selesai tindakan baru dimintakan tanda tangan pada lembar informed consent. Simpulan: Informed consent tetap diperlukan untuk setiap tindakan kedokteran yang dilakukan di RSUP Prof. Dr. R. D. Kandou termasuk pada Instalasi Gawat Darurat.Kata kunci: informed consent, emergency unit care


2013 ◽  
Vol 29 (6) ◽  
pp. 390-396
Author(s):  
J-P Benigni ◽  
X Ansolabehere ◽  
X Saudez ◽  
M Toussi ◽  
S Branchoux ◽  
...  

Objectives Recent French data describing real-life compression stocking use are lacking. This study aimed to describe the actual situation for patients who were prescribed compression stockings by their general practitioner and to assess annual treatment costs from a societal perspective. Methods A retrospective analysis using Disease Analyzer database data from 6349 adults with at least one compression stocking prescription between July 2009 and June 2010. Results Mean patient age was 58 years, and 72.3% of patients were women. Seven out of 10 patients received only a single compression stocking prescription over one year. The estimated mean annual per patient cost was 152.2 ± 100.7 Euros. Conclusion Most patients received only a single compression stocking prescription during one year. General practitioners prescribing compression stockings more often may have a better understanding of venous disease and may manage their patients differently. Although more expensive, this approach may be one which should be accepted more widely.


1980 ◽  
Vol 136 (3) ◽  
pp. 205-215 ◽  
Author(s):  
Peter Kennedy ◽  
Fiona Hird

SummaryDuration of stay for unselected admissions to an acute psychiatric ward was reduced to an average of 11 days. The clinical methods by which this was achieved are described. Comparing patients randomly allocated to this experimental ward and other admission wards: (i) the readmission rate to the experimental ward was higher but readmissions were briefer so that total in-patient experience per patient over the course of one year remained substantially lower; (ii) symptom levels and burden on the family had improved equally at three weeks and at four months after discharge; (iii) experimental ward patients made fewer demands on their general practitioners and reported fewer parasuicides. Beds can be released for other purposes in this way.


2006 ◽  
Vol 13 (8) ◽  
pp. 427-431 ◽  
Author(s):  
M Labrecque ◽  
M Lavallée ◽  
MF Beauchesne ◽  
A Cartier ◽  
LP Boulet

BACKGROUND AND OBJECTIVES: Asthma remains uncontrolled in a large number of asthmatic patients. Recent surveys have shown that a minority of asthmatic patients are referred to asthma educators. The objective of the present study was to assess the influence of increased access to spirometry in asthma education centres (AECs) on the rate of patient referrals to these centres by general practitioners.METHODS: A one-year, prospective, randomized, multicentric, parallel group study was conducted over two consecutive periods of six months each, with added spirometry being offered in the second six-month period to the experimental group. Ten AECs were enrolled in the project. An advertisement describing the AECs’ services was sent by mail to a total of 303 general practitioners at the start of each period, inviting them to refer their patients. Measures of the frequency of medical referrals to the AECs were assessed for each period.RESULTS: The group of AECs randomly selected for spirometry in the second six-month period received 48 medical referrals during the first period and 32 during the second one, following proposed spirometry. AECs that had not offered spirometry received five referrals during the first period and seven during the second period. One AEC withdrew a few weeks after the study began and others encountered administrative problems, reducing their ability to provide interventions.CONCLUSIONS: Referral to AECs is not yet integrated into the primary care of asthma and offering more rapid access to spirometry in the AECs does not seem to be a significant incentive for such referrals.


1986 ◽  
Vol 19 (04) ◽  
pp. 214-215
Author(s):  
H. Gutzmann ◽  
W. Gaebel ◽  
M. Linden

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