Pub Date : 2022-05-21DOI: 10.1177/00912174221081633
D. Lipsitt
When psychiatrist Herbert Freudenberger popularized the concept of “burnout” in the 1970s, in no way could he have anticipated the overwhelming impact of the COVID-19 pandemic on the medical profession and the population at large. In his work with addicts, he described burnout as “becoming exhausted by making excessive demands on energy, strength, or resources” in the workplace. Frontline workers today acknowledge that the definition applies as well to coping with the ravages of the pandemic...only more so! In Freudenberger’s day, remedies for personal burnout included “fixing the healthcare system,” “clarifying costs of procedures,” “simplifying coding,” “promoting legislation,” “facilitating decision-making without outside intrusion,” and perhaps...while awaiting these time-delayed changes... “taking a vacation.” The idea of sharing one’s grief and complaints with others in Balint-like groups was not offered. The idea of Balint Groups began with Michael and Enid Balint in England in the 1950s in a kind of quasi-crisis. After the war, exhausted physicians were seeking ways to become re-acclimated to general medical practice, and the newly founded British National Health Service was looking for ways to care for a weary population. Groups of general practitioners organized by the Balints seemed a reasonable, if small, way to address these challenges. Opportunity was presented to a number of these overburdened post-war practitioners to come together in experimental groups to enhance sharing of clinical case experiences and to bolster mutual resilience. The experiment proved effective; Balint groups began to spring up around the world for tired, stressed, even exhausted
当精神病学家赫伯特·弗罗伊登伯格(Herbert Freudenberger)在20世纪70年代推广“职业倦怠”概念时，他绝对没有预料到COVID-19大流行对医学界和整个人群的压倒性影响。在他对成瘾者的研究中，他将倦怠描述为“在工作场所对能量、力量或资源的过度要求而变得筋疲力尽”。今天，一线工作人员承认，这一定义也适用于应对大流行的破坏。更是如此!在科罗伊登伯格的时代，个人倦怠的补救措施包括“修复医疗体系”、“澄清程序成本”、“简化编码”、“促进立法”、“在没有外界干扰的情况下促进决策”，也许还有……在等待这些延迟的变化时……“去度假。”在巴林特式的团体中与他人分享悲伤和抱怨的想法并没有被提出。巴林特集团的想法始于20世纪50年代英国的迈克尔和伊尼德·巴林特(Michael and Enid Balint)，当时正值一场准危机。战后，疲惫不堪的医生们在寻找重新适应普通医疗实践的方法，新成立的英国国民健康服务体系(British National Health Service)也在寻找照顾疲惫不堪的民众的方法。巴林茨夫妇组织的全科医生小组似乎是解决这些挑战的合理途径，尽管规模不大。一些战后负担过重的从业人员有机会在实验组中聚集在一起，以加强临床病例经验的分享，并加强相互的适应能力。实验证明是有效的;在世界各地，因疲劳、压力大、甚至筋疲力尽而成立的巴林人团体开始如雨后春笋般出现
{"title":"Editorial: Balint and burnout: A remedy for our time?","authors":"D. Lipsitt","doi":"10.1177/00912174221081633","DOIUrl":"https://doi.org/10.1177/00912174221081633","url":null,"abstract":"When psychiatrist Herbert Freudenberger popularized the concept of “burnout” in the 1970s, in no way could he have anticipated the overwhelming impact of the COVID-19 pandemic on the medical profession and the population at large. In his work with addicts, he described burnout as “becoming exhausted by making excessive demands on energy, strength, or resources” in the workplace. Frontline workers today acknowledge that the definition applies as well to coping with the ravages of the pandemic...only more so! In Freudenberger’s day, remedies for personal burnout included “fixing the healthcare system,” “clarifying costs of procedures,” “simplifying coding,” “promoting legislation,” “facilitating decision-making without outside intrusion,” and perhaps...while awaiting these time-delayed changes... “taking a vacation.” The idea of sharing one’s grief and complaints with others in Balint-like groups was not offered. The idea of Balint Groups began with Michael and Enid Balint in England in the 1950s in a kind of quasi-crisis. After the war, exhausted physicians were seeking ways to become re-acclimated to general medical practice, and the newly founded British National Health Service was looking for ways to care for a weary population. Groups of general practitioners organized by the Balints seemed a reasonable, if small, way to address these challenges. Opportunity was presented to a number of these overburdened post-war practitioners to come together in experimental groups to enhance sharing of clinical case experiences and to bolster mutual resilience. The experiment proved effective; Balint groups began to spring up around the world for tired, stressed, even exhausted","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"11 1","pages":"266 - 268"},"PeriodicalIF":0.0,"publicationDate":"2022-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85601114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-05DOI: 10.1177/00912174221095626
J. Freedy
Life is full of challenges—ups and downs—triumph and tragedy across typically a multi-decade journey. Some problems are small and easy to solve (e.g., “What should I eat for breakfast today?”). Other problems are more complex and vexing—challenges that are not so easily met (e.g., “How am I to cope with this tragic situation in such a way that growth, development, and well-being are likely to result, rather than anxiety, sadness, or the loss of hope?”). Based on the above quotes, Descartes, Einstein, and Rogers seem to suggest that curiosity, reason, and learning are essential to successful coping with complex, vexing, or sometimes overwhelming problems. The content of issue 57(4) of the International Journal of Psychiatry in Medicine (IJPM) presents a grouping of articles that represents how diverse groups may choose to address challenging problems in a constructive, growth-oriented manner. The content of this issue of IJPM contains two broad groupings of ten total articles for the reader’s consideration. The first six readings are based on the ideas of Michael
{"title":"Curiosity and scholarly endeavors are essential to catalyze human growth, development, and well-being","authors":"J. Freedy","doi":"10.1177/00912174221095626","DOIUrl":"https://doi.org/10.1177/00912174221095626","url":null,"abstract":"Life is full of challenges—ups and downs—triumph and tragedy across typically a multi-decade journey. Some problems are small and easy to solve (e.g., “What should I eat for breakfast today?”). Other problems are more complex and vexing—challenges that are not so easily met (e.g., “How am I to cope with this tragic situation in such a way that growth, development, and well-being are likely to result, rather than anxiety, sadness, or the loss of hope?”). Based on the above quotes, Descartes, Einstein, and Rogers seem to suggest that curiosity, reason, and learning are essential to successful coping with complex, vexing, or sometimes overwhelming problems. The content of issue 57(4) of the International Journal of Psychiatry in Medicine (IJPM) presents a grouping of articles that represents how diverse groups may choose to address challenging problems in a constructive, growth-oriented manner. The content of this issue of IJPM contains two broad groupings of ten total articles for the reader’s consideration. The first six readings are based on the ideas of Michael","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"6 1","pages":"251 - 255"},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79310707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-05DOI: 10.1177/00912174221093164
S. Bragg, J. Freedy
Researching a clinical question provides a unique opportunity to further one ’ s knowledge base while having a tangible impact on patient outcomes. Searching for an answer identi fi es articles related to your clinical query but can lead to unintended or serendipitous learning. Articles included in IJPM 57(3) are diverse in topic and scope. Diverse topics and types of research offer unique learning opportunities, which mirror the process of researching a clinical question for a patient. Our current edition impacts younger and older patients, conditions with an extensive body of literature and those with newly discovered associations, and psychiatric conditions associated with medication use and those with no drug treatment. This edition offers a unique opportunity to learn things you ’ ve never heard about and increase your capacity to grow from a diverse body of literature. 2 process of searching for a speci fi c answer a question or reading through a medical journal provides many of these conditions as one signals their to learn information and presented ’
{"title":"Serendipitous discovery: Learning through the review of research","authors":"S. Bragg, J. Freedy","doi":"10.1177/00912174221093164","DOIUrl":"https://doi.org/10.1177/00912174221093164","url":null,"abstract":"Researching a clinical question provides a unique opportunity to further one ’ s knowledge base while having a tangible impact on patient outcomes. Searching for an answer identi fi es articles related to your clinical query but can lead to unintended or serendipitous learning. Articles included in IJPM 57(3) are diverse in topic and scope. Diverse topics and types of research offer unique learning opportunities, which mirror the process of researching a clinical question for a patient. Our current edition impacts younger and older patients, conditions with an extensive body of literature and those with newly discovered associations, and psychiatric conditions associated with medication use and those with no drug treatment. This edition offers a unique opportunity to learn things you ’ ve never heard about and increase your capacity to grow from a diverse body of literature. 2 process of searching for a speci fi c answer a question or reading through a medical journal provides many of these conditions as one signals their to learn information and presented ’","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"376 1","pages":"183 - 186"},"PeriodicalIF":0.0,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74920879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1177/00912174211024491
S. Haley, Russell S Blackwelder, J. Freedy
This special issue of the International Journal of Psychiatry in Medicine (IJPM) speaks to the reality of the liminal space healthcare providers and society at large find ourselves in. Over a year since the World Health Organization declared SARS-CoV-2 (COVID-19) a pandemic, we have lived through the unexpected shock, sacrifice, and loss brought about by an emerging virus that has effected the whole world. Not only have healthcare workers continually adjusted and dealt with the care of the medical consequences of COVID-19, we have also been placed in the front row for the political and societal strains that only made our work more challenging. Just as real as the devastating effects of COVID-19 on individual bodies and minds, we have also confronted the reality of how fragile the social fabric and the belief in science and truth actually are. However, with vaccine distribution continuing and the stealthy pace of scientific discovery, we can also peer around the world and see glimpses of post-pandemic life emerging, one that will benefit greatly from the hard forged lessons and knowledge gained since March, 2020. Between these two realities, this issue of IJPM sheds light on some of those lessons and forces us to confront the immense impact of COVID-19 on the mental health and well-being of patients and those going into the medical work.
{"title":"SARS-CoV-2/COVID-19 Pandemic Lessons for Mental Health and Well-Being","authors":"S. Haley, Russell S Blackwelder, J. Freedy","doi":"10.1177/00912174211024491","DOIUrl":"https://doi.org/10.1177/00912174211024491","url":null,"abstract":"This special issue of the International Journal of Psychiatry in Medicine (IJPM) speaks to the reality of the liminal space healthcare providers and society at large find ourselves in. Over a year since the World Health Organization declared SARS-CoV-2 (COVID-19) a pandemic, we have lived through the unexpected shock, sacrifice, and loss brought about by an emerging virus that has effected the whole world. Not only have healthcare workers continually adjusted and dealt with the care of the medical consequences of COVID-19, we have also been placed in the front row for the political and societal strains that only made our work more challenging. Just as real as the devastating effects of COVID-19 on individual bodies and minds, we have also confronted the reality of how fragile the social fabric and the belief in science and truth actually are. However, with vaccine distribution continuing and the stealthy pace of scientific discovery, we can also peer around the world and see glimpses of post-pandemic life emerging, one that will benefit greatly from the hard forged lessons and knowledge gained since March, 2020. Between these two realities, this issue of IJPM sheds light on some of those lessons and forces us to confront the immense impact of COVID-19 on the mental health and well-being of patients and those going into the medical work.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"21 1","pages":"207 - 209"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76648133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1177/0091217419885751
J. Cordes, M. Woite, C. Engelke, G. Regenbrecht, K. Kahl, C. Schmidt-Kraepelin, U. Henning, D. Kamp, A. Klimke
Objective It is well established that long-term hypothyroidism is associated with cognitive deficits. Based on recent literature, we hypothesized that pharmacologically induced euthyroidism would lead to improved cognitive performance compared to a hypothyroid state. Methods We analyzed data from 14 nondepressed thyroidectomized female patients after differentiated thyroid carcinoma during hypothyroidism (due to a four-week withdrawal of thyroid hormone, T1) and euthyroidism brought about by substitution with L-thyroxine (T2). At both measurement points, patients completed a cognitive test battery as our dependent measure and Beck’s Depression Inventory to control depressive states. Results A Wilcoxon signed-rank tests revealed a significant improvement in the Rey–Osterrieth complex figure test (cognitive reproduction), Z = −3.183, p = 0.001, and the D2 concentration score, Z = −1.992, p = 0.046 in euthyroidism compared to hypothyroidism. Conclusions Our results confirm that hormone replacement therapy with L-thyroxine promotes cognitive reproduction and concentration in thyroidectomized female patients after differentiated thyroid carcinoma.
{"title":"Hormone replacement therapy with L-thyroxine promotes working memory and concentration in thyroidectomized female patients after differentiated thyroid carcinoma","authors":"J. Cordes, M. Woite, C. Engelke, G. Regenbrecht, K. Kahl, C. Schmidt-Kraepelin, U. Henning, D. Kamp, A. Klimke","doi":"10.1177/0091217419885751","DOIUrl":"https://doi.org/10.1177/0091217419885751","url":null,"abstract":"Objective It is well established that long-term hypothyroidism is associated with cognitive deficits. Based on recent literature, we hypothesized that pharmacologically induced euthyroidism would lead to improved cognitive performance compared to a hypothyroid state. Methods We analyzed data from 14 nondepressed thyroidectomized female patients after differentiated thyroid carcinoma during hypothyroidism (due to a four-week withdrawal of thyroid hormone, T1) and euthyroidism brought about by substitution with L-thyroxine (T2). At both measurement points, patients completed a cognitive test battery as our dependent measure and Beck’s Depression Inventory to control depressive states. Results A Wilcoxon signed-rank tests revealed a significant improvement in the Rey–Osterrieth complex figure test (cognitive reproduction), Z = −3.183, p = 0.001, and the D2 concentration score, Z = −1.992, p = 0.046 in euthyroidism compared to hypothyroidism. Conclusions Our results confirm that hormone replacement therapy with L-thyroxine promotes cognitive reproduction and concentration in thyroidectomized female patients after differentiated thyroid carcinoma.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"81 1","pages":"114 - 122"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73330298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1177/0091217419870669
P. Zarkowski
Objective To assess the relative prevalence and factors affecting the prescription of medication combinations with a theoretical efficacy limiting pharmacodynamic interaction, defined as two medications with opposing indications and side effects or antagonistic action at the primary receptor of mechanism of action. Method One hundred sixteen combinations were identified for 10 types of pharmacodynamic interactions. PubMed was searched for each combination to assess the quality of evidence either supporting clinical use or verifying reduced efficacy. Micromedex was searched to determine the presence of warnings to prescribers of reduced efficacy. The prevalence in clinical practice was determined by computer review of the Genoa Healthcare database for all prescribers at 10 participating community mental health centers. The expected prevalence was calculated as the product of the probability of each medication prescribed alone and was compared with the actual prevalence of the combination using the test of proportions. Results The frequency of prescription of eight combinations met the Bonferroni corrected level of significance of p < 0.001. Four were combinations of amphetamine and D2 antagonists and each were prescribed less often than chance, p = 0.0001 consistent with epidemiological studies and multiple animal studies verifying an efficacy limiting interaction. Despite epidemiological studies indicating increased risk of accidents, alprazolam and amphetamine were prescribed more often than chance, p = 0.0001. Micromedex generated warnings for efficacy limiting interactions for five other combinations, but with no subsequent change in prescription frequency. Conclusions Neither presence of medical evidence nor warnings from Micromedex consistently affect the prescription of combinations with pharmacodynamic efficacy limiting interactions.
{"title":"Relative prevalence of 10 types of pharmacodynamic interactions in psychiatric treatment","authors":"P. Zarkowski","doi":"10.1177/0091217419870669","DOIUrl":"https://doi.org/10.1177/0091217419870669","url":null,"abstract":"Objective To assess the relative prevalence and factors affecting the prescription of medication combinations with a theoretical efficacy limiting pharmacodynamic interaction, defined as two medications with opposing indications and side effects or antagonistic action at the primary receptor of mechanism of action. Method One hundred sixteen combinations were identified for 10 types of pharmacodynamic interactions. PubMed was searched for each combination to assess the quality of evidence either supporting clinical use or verifying reduced efficacy. Micromedex was searched to determine the presence of warnings to prescribers of reduced efficacy. The prevalence in clinical practice was determined by computer review of the Genoa Healthcare database for all prescribers at 10 participating community mental health centers. The expected prevalence was calculated as the product of the probability of each medication prescribed alone and was compared with the actual prevalence of the combination using the test of proportions. Results The frequency of prescription of eight combinations met the Bonferroni corrected level of significance of p < 0.001. Four were combinations of amphetamine and D2 antagonists and each were prescribed less often than chance, p = 0.0001 consistent with epidemiological studies and multiple animal studies verifying an efficacy limiting interaction. Despite epidemiological studies indicating increased risk of accidents, alprazolam and amphetamine were prescribed more often than chance, p = 0.0001. Micromedex generated warnings for efficacy limiting interactions for five other combinations, but with no subsequent change in prescription frequency. Conclusions Neither presence of medical evidence nor warnings from Micromedex consistently affect the prescription of combinations with pharmacodynamic efficacy limiting interactions.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"13 1","pages":"104 - 82"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81601589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1177/0091217419874277
Hyun-Ah Kim, J. W. Lee, S. Kim, H. Oh, W. Im, Ji-Woong Kim
Objective Among the risk factors for cerebrovascular/cardiovascular disease or thromboembolic events caused by the administration of second-generation antipsychotics, clinicians have mainly focused on metabolic side effects, with little interest in the effects on platelet activity. Because excessive platelet activity can increase the risk for cerebrovascular/cardiovascular disease, the aim of this study was to investigate the effect of second-generation antipsychotics on platelet activity in patients with schizophrenia. Methods The medical records of patients with schizophrenia who were treated with second-generation antipsychotics were retrospectively reviewed. The degree of platelet activation was assessed by measuring the mean platelet component. Results Wilcoxon signed-rank test revealed that mean platelet component levels were significantly decreased by the administration of second-generation antipsychotics (V = 20; p < 0.05), suggesting that the administration of second-generation antipsychotics may increase platelet activation. Conclusion Because platelet activation is an additional risk factor for the occurrence of cerebrovascular/cardiovascular disease, results of this study suggest that clinicians should carefully monitor the degree of platelet activation after the administration of second-generation antipsychotics.
{"title":"Second-generation antipsychotics activate platelets in antipsychotic-naive and antipsychotic-free patients with schizophrenia: A retrospective study","authors":"Hyun-Ah Kim, J. W. Lee, S. Kim, H. Oh, W. Im, Ji-Woong Kim","doi":"10.1177/0091217419874277","DOIUrl":"https://doi.org/10.1177/0091217419874277","url":null,"abstract":"Objective Among the risk factors for cerebrovascular/cardiovascular disease or thromboembolic events caused by the administration of second-generation antipsychotics, clinicians have mainly focused on metabolic side effects, with little interest in the effects on platelet activity. Because excessive platelet activity can increase the risk for cerebrovascular/cardiovascular disease, the aim of this study was to investigate the effect of second-generation antipsychotics on platelet activity in patients with schizophrenia. Methods The medical records of patients with schizophrenia who were treated with second-generation antipsychotics were retrospectively reviewed. The degree of platelet activation was assessed by measuring the mean platelet component. Results Wilcoxon signed-rank test revealed that mean platelet component levels were significantly decreased by the administration of second-generation antipsychotics (V = 20; p < 0.05), suggesting that the administration of second-generation antipsychotics may increase platelet activation. Conclusion Because platelet activation is an additional risk factor for the occurrence of cerebrovascular/cardiovascular disease, results of this study suggest that clinicians should carefully monitor the degree of platelet activation after the administration of second-generation antipsychotics.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"45 1","pages":"105 - 113"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79905406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-04DOI: 10.1177/0091217420904910
{"title":"Reviewer List","authors":"","doi":"10.1177/0091217420904910","DOIUrl":"https://doi.org/10.1177/0091217420904910","url":null,"abstract":"","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"46 1","pages":"142 - 143"},"PeriodicalIF":0.0,"publicationDate":"2020-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87409236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-17DOI: 10.1177/0091217419885468
J. Clabby
Forgiveness as a procedure has been gaining prominence. The objective of this article is to provide the basics of forgiveness as an intervention so primary care clinicians can facilitate its use. These clinicians include but are not limited to physicians, nurses, medical assistants, pharmacy professionals, physical therapists, social workers, psychologists, case managers, and clergy. This narrative explains the rationale for understanding forgiveness as a procedure and ways to explain it. To assist clinicians and patients in making informed decisions, samples of forgiveness research are included that describe its positive relationship to specific physical health situations. The article also describes an evidence-based forgiveness therapy, circumstances in which it is harmful to forgive oneself or others, describes the limitations of this article, and suggests future directions.
{"title":"Forgiveness: Moving on can be healthy","authors":"J. Clabby","doi":"10.1177/0091217419885468","DOIUrl":"https://doi.org/10.1177/0091217419885468","url":null,"abstract":"Forgiveness as a procedure has been gaining prominence. The objective of this article is to provide the basics of forgiveness as an intervention so primary care clinicians can facilitate its use. These clinicians include but are not limited to physicians, nurses, medical assistants, pharmacy professionals, physical therapists, social workers, psychologists, case managers, and clergy. This narrative explains the rationale for understanding forgiveness as a procedure and ways to explain it. To assist clinicians and patients in making informed decisions, samples of forgiveness research are included that describe its positive relationship to specific physical health situations. The article also describes an evidence-based forgiveness therapy, circumstances in which it is harmful to forgive oneself or others, describes the limitations of this article, and suggests future directions.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"57 1","pages":"123 - 130"},"PeriodicalIF":0.0,"publicationDate":"2019-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84929111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-09DOI: 10.1177/0091217419887639
R. R. Szuster, Jane M M Onoye, M. Eckert, D. Kurahara, Reid K Ikeda, Courtenay R Matsu
Background Residents’ well-being tends to decline in the course of training, yet research on preventive and restorative interventions for residents is limited. Mindfulness-based interventions have been successfully employed to support well-being in practicing physicians, but their impacts on residents are not well established. Objective This paper describes the structure, content, and evaluation of a pilot mindfulness-based intervention program designated PRACTICE (presence, resilience and compassion training in clinical education) that was designed specifically to support resident well-being. Methods A combined sample of 14 postgraduate year one residents from two residency training programs participated in a four-session (8 h) mindfulness-based intervention in the Fall/Winter of 2018. Participants were surveyed before, after, and at 3 months postintervention, on measures of wellness (Professional Fulfillment Index) and mental health (Patient Health Questionnaire-4), along with measures of program engagement. Results Participants demonstrated a significant reduction in burnout at the conclusion of the program. Depression and anxiety screening scores also trended toward improvement. However, participants were not able to sustain these gains. Three months after the conclusion of the program wellness measures had returned to preintervention levels. Conclusions The results of this study support the use of mindfulness-based interventions in resident wellness programs. The lack of an enduring effect indicates the need for a maintenance phase intervention.
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