Pub Date : 1900-01-01DOI: 10.4172/1522-4821.1000231
M. Mauri, A. Petracca, M. Miniati, S. Fratta, E. Fui, I. Giunti, G. Macchia, M. Mariani, E. Calderani, C. Gesi, C. Carmassi, L. Dell’Osso
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced noteworthy revisions to Post-Traumatic Stress Disorder (PTSD) criteria, including a four-factor model and some new symptomatic criteria. To date, only a limited number of studies investigated the impact of such changes on the prevalence rates of the disorder. On 29 June 2009, in the railway station of Viareggio (Italy), a freight train carrying liquefied petroleum gas derailed with a subsequent fire leading to a large area of the town being damaged: 32 people died and 26 were severely injured. A total sample of 111 subjects who survived to the railway accident were assessed for PTSD according to either DSM-5 or DSM-IV-TR criteria by means of a spectrum assessment instrument: the Trauma and Loss Spectrum-Self Report (TALS-SR). A DSM-5 PTSD diagnosis emerged in 50.4% with respect to 54.7% according to DSM-IV-TR criteria. Most of the subjects fulfilling DSM-IV-TR but not DSM-5 criteria did not endorse new Criterion C (active avoidance). For what concern new DSM-5 PTSD symptoms: 1 (2.6%) survivor endorsed symptom D3; 29 (76.32%) D4; 6 (15.79%) both D3 and D4; 8 (27.59%) E2. This is the first study to report PTSD prevalence rates among survivors to the Viareggio 2009 railway accident. Our results corroborate the substantial equivalence between the DSM-5 and DSM-IV-TR algorithms for PTSD diagnosis and further suggest that avoidance and/or negative alterations in cognition and mood should alert the clinician for possible PTSD development.
{"title":"Estimates of Prevalence and Criteria Comparison in DSM-5 versus DSM-IV-TR Post-Traumatic Stress Disorder in 111 Survivors to the 2009 Railway Accident in Viareggio-Italy","authors":"M. Mauri, A. Petracca, M. Miniati, S. Fratta, E. Fui, I. Giunti, G. Macchia, M. Mariani, E. Calderani, C. Gesi, C. Carmassi, L. Dell’Osso","doi":"10.4172/1522-4821.1000231","DOIUrl":"https://doi.org/10.4172/1522-4821.1000231","url":null,"abstract":"The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced noteworthy revisions to Post-Traumatic Stress Disorder (PTSD) criteria, including a four-factor model and some new symptomatic criteria. To date, only a limited number of studies investigated the impact of such changes on the prevalence rates of the disorder. On 29 June 2009, in the railway station of Viareggio (Italy), a freight train carrying liquefied petroleum gas derailed with a subsequent fire leading to a large area of the town being damaged: 32 people died and 26 were severely injured. A total sample of 111 subjects who survived to the railway accident were assessed for PTSD according to either DSM-5 or DSM-IV-TR criteria by means of a spectrum assessment instrument: the Trauma and Loss Spectrum-Self Report (TALS-SR). A DSM-5 PTSD diagnosis emerged in 50.4% with respect to 54.7% according to DSM-IV-TR criteria. Most of the subjects fulfilling DSM-IV-TR but not DSM-5 criteria did not endorse new Criterion C (active avoidance). For what concern new DSM-5 PTSD symptoms: 1 (2.6%) survivor endorsed symptom D3; 29 (76.32%) D4; 6 (15.79%) both D3 and D4; 8 (27.59%) E2. This is the first study to report PTSD prevalence rates among survivors to the Viareggio 2009 railway accident. Our results corroborate the substantial equivalence between the DSM-5 and DSM-IV-TR algorithms for PTSD diagnosis and further suggest that avoidance and/or negative alterations in cognition and mood should alert the clinician for possible PTSD development.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132569851","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 : 1900-01-01DOI: 10.4172/1522-4821.1000161
Virgininia Dube-Mawerewere
The study sought to explore the experiences and involvement of the judicial team in the processes for the rehabilitation of forensic psychiatric patients in Zimbabwe. An exploratory qualitative design was used utilizing the Charmaz grounded theory approach. Findings reflected that the engagement of the judiciary is at variance with what will enable patient recovery; instead, its engagement is prohibitive and discrepant. The disengagement of the judiciary is reflected in processes that are prohibitive to recovery; negative attitudes impacting on the overall rehabilitation processes; judicial linguistic habitus and its selective reinterpretation that digress the discourse of patient rehabilitation, and the role of family in the recovery process. Development of a systematic and jurisprudent framework is projected to realign the judicial system to be in sync with the medical system with regard of forensic psychiatric patients in Zimbabwe
{"title":"The Dinosaur of Judicial Disjuncture with Forensic PsychiatricRehabilitation Processes in Zimbabwe","authors":"Virgininia Dube-Mawerewere","doi":"10.4172/1522-4821.1000161","DOIUrl":"https://doi.org/10.4172/1522-4821.1000161","url":null,"abstract":"The study sought to explore the experiences and involvement of the judicial team in the processes for the rehabilitation of forensic psychiatric patients in Zimbabwe. An exploratory qualitative design was used utilizing the Charmaz grounded theory approach. Findings reflected that the engagement of the judiciary is at variance with what will enable patient recovery; instead, its engagement is prohibitive and discrepant. The disengagement of the judiciary is reflected in processes that are prohibitive to recovery; negative attitudes impacting on the overall rehabilitation processes; judicial linguistic habitus and its selective reinterpretation that digress the discourse of patient rehabilitation, and the role of family in the recovery process. Development of a systematic and jurisprudent framework is projected to realign the judicial system to be in sync with the medical system with regard of forensic psychiatric patients in Zimbabwe","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132584868","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 : 1900-01-01DOI: 10.4172/1522-4821.1000195
A. Pendergrass, C. Becker, M. Hautzinger, K. Pfeiffer
A variety of psychosocial interventions have been developed to support dementia caregivers. Compar- ing positive effects on caregivers across these intervention studies are difficult because of the diverse endpoints. The objectives of this review were: (1) to show what types of interventions were conducted in international randomized controlled trails with dementia caregivers; (2) to provide an overview of what main caregiver outcome dimensions can be categorized; and (3) what validated instruments are most frequently used to assess these outcomes. A sys- tematic, computerized literature search was conducted using the electronic databases PubMed, Medline, EBSCO, and PsycINFO. Records of interest were randomized controlled trials for informal caregivers of home dwelling care recipients with any type of dementia. In the 69 identified studies 82 different validated assessments were used, which were categorized in 15 dimensions. About two out of three studies examined psychoeducational interventions. The five most prevalent outcomes were: depressive symptoms (N = 34); burden (N = 33); self-efficacy/coping/mastery (N = 19); emotional distress (N = 19); and quality of life (N = 17). These outcomes were mostly assessed with: the Center for Epidemiologic Studies Depression Scale (N = 23); the Zarit Burden Interview (N = 24); the Revised Scale for Caregiving Self-Efficacy (N = 4); the Cohen Perceived Stress Scale (N = 7); and the WHO Quality of Life (N = 5). This literature review serves as the first step to identify outcomes and assessments which have actually been used. An important next step to improve comparability between studies could be the development of taxonomy to classify and describe the key influential components of interventions in this research field.
{"title":"Dementia Caregiver Interventions: A Systematic Review of CaregiverOutcomes and Instruments in Randomized Controlled Trials","authors":"A. Pendergrass, C. Becker, M. Hautzinger, K. Pfeiffer","doi":"10.4172/1522-4821.1000195","DOIUrl":"https://doi.org/10.4172/1522-4821.1000195","url":null,"abstract":"A variety of psychosocial interventions have been developed to support dementia caregivers. Compar- ing positive effects on caregivers across these intervention studies are difficult because of the diverse endpoints. The objectives of this review were: (1) to show what types of interventions were conducted in international randomized controlled trails with dementia caregivers; (2) to provide an overview of what main caregiver outcome dimensions can be categorized; and (3) what validated instruments are most frequently used to assess these outcomes. A sys- tematic, computerized literature search was conducted using the electronic databases PubMed, Medline, EBSCO, and PsycINFO. Records of interest were randomized controlled trials for informal caregivers of home dwelling care recipients with any type of dementia. In the 69 identified studies 82 different validated assessments were used, which were categorized in 15 dimensions. About two out of three studies examined psychoeducational interventions. The five most prevalent outcomes were: depressive symptoms (N = 34); burden (N = 33); self-efficacy/coping/mastery (N = 19); emotional distress (N = 19); and quality of life (N = 17). These outcomes were mostly assessed with: the Center for Epidemiologic Studies Depression Scale (N = 23); the Zarit Burden Interview (N = 24); the Revised Scale for Caregiving Self-Efficacy (N = 4); the Cohen Perceived Stress Scale (N = 7); and the WHO Quality of Life (N = 5). This literature review serves as the first step to identify outcomes and assessments which have actually been used. An important next step to improve comparability between studies could be the development of taxonomy to classify and describe the key influential components of interventions in this research field.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117178446","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 : 1900-01-01DOI: 10.4172/1522-4821.1000279
C. Rubinstein.
Personality disorders are prevalent pathology in outpatient psychiatric services. The patient with borderline disorder presents many difficulties for treatment as often lacks awareness of disease, consultation and also nonspecific symptoms, while still keeping a judgment of reality preserved under certain circumstances it may deviate.
{"title":"Children with Borderline Disorder: Sons of Postmodernism?","authors":"C. Rubinstein.","doi":"10.4172/1522-4821.1000279","DOIUrl":"https://doi.org/10.4172/1522-4821.1000279","url":null,"abstract":"Personality disorders are prevalent pathology in outpatient psychiatric services. The patient with borderline disorder presents many difficulties for treatment as often lacks awareness of disease, consultation and also nonspecific symptoms, while still keeping a judgment of reality preserved under certain circumstances it may deviate.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121117153","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 : 1900-01-01DOI: 10.4172/1522-4821.1000242
M. Pompili, P. Venturini, D. Lamis, Rachel N. Waford, D. Erbuto, G. Serafini, M. Amore, P. Girardi
Background: Several studies have shown that substance use disorder (SUD) among adolescents is related to multiple behavioural problems and needs specific treatment compared to adults. Objectives: The aim of the present paper was to investigate the gold standard of rehabilitation efficacy for SUD in adolescence. Methods: A careful systematic review of the literature was conducted on the treatment and rehabilitation of adolescents with SUD. A total of 11 articles from peer-reviewed journals were selected for this review. Results: Family therapy is the treatment with the strongest evidence of effectiveness for reducing SUDs in adolescents, although other types of treatments appear to be beneficial such as cognitive-behavioural therapy and other psychological approaches. Despite the effectiveness of the treatments, the rate of relapse remains high among adolescents with SUD. Conclusion: Currently, psychological treatments, particularly family therapy, are most frequently applied to adolescents with SUD. Pharmacotherapy is reserved for adolescents with a SUD in co-morbidity with other mental disorders and a therapeutic community is suggested for these at-risk adolescents.
{"title":"Rehabilitation of the Adolescent with a Substance Use Disorder: Overview of Treatment Efficacy","authors":"M. Pompili, P. Venturini, D. Lamis, Rachel N. Waford, D. Erbuto, G. Serafini, M. Amore, P. Girardi","doi":"10.4172/1522-4821.1000242","DOIUrl":"https://doi.org/10.4172/1522-4821.1000242","url":null,"abstract":"Background: Several studies have shown that substance use disorder (SUD) among adolescents is related to multiple behavioural problems and needs specific treatment compared to adults. \u0000Objectives: The aim of the present paper was to investigate the gold standard of rehabilitation efficacy for SUD in adolescence. \u0000Methods: A careful systematic review of the literature was conducted on the treatment and rehabilitation of adolescents with SUD. A total of 11 articles from peer-reviewed journals were selected for this review. \u0000Results: Family therapy is the treatment with the strongest evidence of effectiveness for reducing SUDs in adolescents, although other types of treatments appear to be beneficial such as cognitive-behavioural therapy and other psychological approaches. Despite the effectiveness of the treatments, the rate of relapse remains high among adolescents with SUD. \u0000Conclusion: Currently, psychological treatments, particularly family therapy, are most frequently applied to adolescents with SUD. Pharmacotherapy is reserved for adolescents with a SUD in co-morbidity with other mental disorders and a therapeutic community is suggested for these at-risk adolescents.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114945216","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 : 1900-01-01DOI: 10.4172/1522-4821.1000272
E. Gutiérrez, Carlos Libisch, O. Carrera
A dispassionate view of psychotherapy, leaving aside allegiances to particular schools, reveals it is extremely uncommon to find clear differences in efficacy between diverse treatment approaches (Luborsky et al., 2002). Even worse, when active treatments are compared to structurally equivalent placebos, only negligible effects are obtained in comparison to former treatments (Baskin, Tierney, Minami & Wampold, 2003). A plausible explanation for the apparent similarity in efficacy of different treatments is the existence of underlying common factors shared by all treatments which is ultimately responsible for the purported equivalence attained by different therapeutic approaches (Frank & Frank, 1993). This shared equivalence has been recently reinforced by the literature on placebo, and particularly research using neuroimaging techniques showing how patients’ expectancies interact with the clinical setting stimulating the rewarding brain circuitry.
{"title":"A Blueprint for the Future Development of Psychotherapy","authors":"E. Gutiérrez, Carlos Libisch, O. Carrera","doi":"10.4172/1522-4821.1000272","DOIUrl":"https://doi.org/10.4172/1522-4821.1000272","url":null,"abstract":"A dispassionate view of psychotherapy, leaving aside allegiances to particular schools, reveals it is extremely uncommon to find clear differences in efficacy between diverse treatment approaches (Luborsky et al., 2002). Even worse, when active treatments are compared to structurally equivalent placebos, only negligible effects are obtained in comparison to former treatments (Baskin, Tierney, Minami & Wampold, 2003). A plausible explanation for the apparent similarity in efficacy of different treatments is the existence of underlying common factors shared by all treatments which is ultimately responsible for the purported equivalence attained by different therapeutic approaches (Frank & Frank, 1993). This shared equivalence has been recently reinforced by the literature on placebo, and particularly research using neuroimaging techniques showing how patients’ expectancies interact with the clinical setting stimulating the rewarding brain circuitry.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115575469","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 : 1900-01-01DOI: 10.4172/1522-4821.1000319
G. Flett, D. Molnar, P. Hewitt
There is now a voluminous literature on the role of perfectionism in psychopathology, but one topic has been almost entirely neglected – how perfectionists respond following exposure to traumatic stressors. The relatively few research studies conducted thus far are summarized below. First, however, we note some of the reasons why there should be a positive association between perfectionism and post-traumatic symptoms. Traumatic experiences may be responded to quite negatively by people with elevated perfectionism because perfectionists often have a strong need for control and they are highly stressed by events beyond their control (for a discussion see Hewitt & Flett, 2002). Moreover, perfectionists tend to feel overly responsible and have a propensity to experience self-blame and self-criticism following negative outcomes and events. The vulnerable perfectionist who actually makes a serious mistake that escalates into a traumatic experience is someone who most likely will find it quite difficult to stop ruminating and he or she will find it difficult to live with the mistake and their sense of inefficacy.
{"title":"The Traumatized Perfectionist: Understanding the Role of Perfectionism in Post-Traumatic Reactions to Stress","authors":"G. Flett, D. Molnar, P. Hewitt","doi":"10.4172/1522-4821.1000319","DOIUrl":"https://doi.org/10.4172/1522-4821.1000319","url":null,"abstract":"There is now a voluminous literature on the role of perfectionism in psychopathology, but one topic has been almost entirely neglected – how perfectionists respond following exposure to traumatic stressors. The relatively few research studies conducted thus far are summarized below. First, however, we note some of the reasons why there should be a positive association between perfectionism and post-traumatic symptoms. Traumatic experiences may be responded to quite negatively by people with elevated perfectionism because perfectionists often have a strong need for control and they are highly stressed by events beyond their control (for a discussion see Hewitt & Flett, 2002). Moreover, perfectionists tend to feel overly responsible and have a propensity to experience self-blame and self-criticism following negative outcomes and events. The vulnerable perfectionist who actually makes a serious mistake that escalates into a traumatic experience is someone who most likely will find it quite difficult to stop ruminating and he or she will find it difficult to live with the mistake and their sense of inefficacy.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123514898","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 : 1900-01-01DOI: 10.4172/1522-4821.1000315
Ken Inoue, H. Kaiya, N. Hara, Y. Okazaki
In the Diagnostic and Statistical Manual of Mental Disorders (DSM), panic disorder is one type of anxiety disorder. There have been few detailed reports on the relationship between suicide and panic disorder. We examined the comorbidities and personality inventory tendencies in panic disorder with an increased suicide risk. Our participants were patients with panic disorder. We found that an increased risk of suicide must be kept in mind when treating patients with panic disorder that is accompanied by mood disorders or anxiety disorders. This study also found that such patients are thought to be “very sensitive and emotional and easily distracted”, “introverted, humble and serious”, and “hedonistic”. The risk of suicide must be ascertained during the treatment of panic disorder.
{"title":"Clear Trends in Panic Disorder with a Possibility of Suicide Risk","authors":"Ken Inoue, H. Kaiya, N. Hara, Y. Okazaki","doi":"10.4172/1522-4821.1000315","DOIUrl":"https://doi.org/10.4172/1522-4821.1000315","url":null,"abstract":"In the Diagnostic and Statistical Manual of Mental Disorders (DSM), panic disorder is one type of anxiety disorder. There have been few detailed reports on the relationship between suicide and panic disorder. We examined the comorbidities and personality inventory tendencies in panic disorder with an increased suicide risk. Our participants were patients with panic disorder. We found that an increased risk of suicide must be kept in mind when treating patients with panic disorder that is accompanied by mood disorders or anxiety disorders. This study also found that such patients are thought to be “very sensitive and emotional and easily distracted”, “introverted, humble and serious”, and “hedonistic”. The risk of suicide must be ascertained during the treatment of panic disorder.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123938270","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 : 1900-01-01DOI: 10.4172/1522-4821.1000247
G. d'Ettorre, Mariarita Greco
Background: The wellbeing of mental health workers (MHWs) is a priority for Departments of Mental Health in order to ensure a better protection of MHWs and a better health service. However, to date, several factors affecting the healthcare sector in Italy such as organizational changes involving working time and intensity, type of employment contract, psychosocial factors at work, health and safety policies within the organization, appear to interfere with the workers' wellness. Methods: The authors carried out an integrated analysis of stress sentinel indicators and of objective stress factors of occupational context and content, among two General Hospital Psychiatric Units (GHPUs) and four Community Mental Health Centres (CMHCs), following the European Framework Agreement on Work-Related Stress of 8 October 2004, incorporated in Italy into Legislative Decree 81/08. Results: All the GHPUs and the CMHCs investigated through the objective approach to w.r.s. assessment reported a medium level of w.r.s., among both psychiatrists than nurses. Following the evaluation were identified the priority organizational interventions focused on work context issues; these interventions showed effectives to minimize the sources of w.r.s. among the GHPUs and the CMHCs. Conclusion: The results of this study suggest that organizational interventions focused on improvement of work context issues may contribute to an effective reduction of WRS among nurses and psychiatrists employed in GHPUs and CMHCs. A special effort is required by the head psychiatrists and the head nurses of GHPUs and CMHCs to implement effective policies about the management of WRS.
{"title":"Organizational Interventions as a Strategy to Prevent Work Related Stress among Mental Health Workers","authors":"G. d'Ettorre, Mariarita Greco","doi":"10.4172/1522-4821.1000247","DOIUrl":"https://doi.org/10.4172/1522-4821.1000247","url":null,"abstract":"Background: The wellbeing of mental health workers (MHWs) is a priority for Departments of Mental Health in order to ensure a better protection of MHWs and a better health service. However, to date, several factors affecting the healthcare sector in Italy such as organizational changes involving working time and intensity, type of employment contract, psychosocial factors at work, health and safety policies within the organization, appear to interfere with the workers' wellness. \u0000Methods: The authors carried out an integrated analysis of stress sentinel indicators and of objective stress factors of occupational context and content, among two General Hospital Psychiatric Units (GHPUs) and four Community Mental Health Centres (CMHCs), following the European Framework Agreement on Work-Related Stress of 8 October 2004, incorporated in Italy into Legislative Decree 81/08. \u0000Results: All the GHPUs and the CMHCs investigated through the objective approach to w.r.s. assessment reported a medium level of w.r.s., among both psychiatrists than nurses. Following the evaluation were identified the priority organizational interventions focused on work context issues; these interventions showed effectives to minimize the sources of w.r.s. among the GHPUs and the CMHCs. \u0000Conclusion: The results of this study suggest that organizational interventions focused on improvement of work context issues may contribute to an effective reduction of WRS among nurses and psychiatrists employed in GHPUs and CMHCs. A special effort is required by the head psychiatrists and the head nurses of GHPUs and CMHCs to implement effective policies about the management of WRS.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130754829","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 : 1900-01-01DOI: 10.4172/1522-4821.1000154
James Metcalf
Critical literary analysis of Michael Ondaatje’s The English Patient identifies death as a major part of both its theme and its setting. The English patient himself represents the interface between life and death. His fingers are burned and fused. His face is scarred and expressionless, and the remainder of his frame is wrapped in gauze like a mummy: he is death. Death also surrounds Hana, his nurse. Her baby and its father are dead, as is her own father and of course many of her patients. In a larger sense the villa itself is death, the remains of a time and culture now dead from war. Hana is a nurse among the dead and near dead. Euthanasia is routine…merciful enough, but premeditated murder nonetheless. Ondaatje presents such euthanasia as an ethical part of nursing practice. In Ondaatje’s novel, the past, the present, and the future intersect and entwine as they move toward death and beyond. Life and death are segments upon the same continuum. Necrophilia occurs upon that continuum as a post-mortem episode of a continuing passion.
{"title":"Necrophilia and Medical Euthanasia in Michael Ondaatjes TheEnglish Patient: An Illustrated Literary Analysis","authors":"James Metcalf","doi":"10.4172/1522-4821.1000154","DOIUrl":"https://doi.org/10.4172/1522-4821.1000154","url":null,"abstract":"Critical literary analysis of Michael Ondaatje’s The English Patient identifies death as a major part of both its theme and its setting. The English patient himself represents the interface between life and death. His fingers are burned and fused. His face is scarred and expressionless, and the remainder of his frame is wrapped in gauze like a mummy: he is death. Death also surrounds Hana, his nurse. Her baby and its father are dead, as is her own father and of course many of her patients. In a larger sense the villa itself is death, the remains of a time and culture now dead from war. Hana is a nurse among the dead and near dead. Euthanasia is routine…merciful enough, but premeditated murder nonetheless. Ondaatje presents such euthanasia as an ethical part of nursing practice. In Ondaatje’s novel, the past, the present, and the future intersect and entwine as they move toward death and beyond. Life and death are segments upon the same continuum. Necrophilia occurs upon that continuum as a post-mortem episode of a continuing passion.","PeriodicalId":358022,"journal":{"name":"International Journal of Emergency Mental Health and Human Resilience","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124895691","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}
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