ORIGINAL_ARTICLE
Overcoming the Barriers to Insulin Initiation in Type II Diabetic Patients: Clinical Evidence Available to Nurses
The prevalence of diabetes has been on a growing trend worldwide; accordingly, it has increased from 4.5% in 1980 to 8.5% in 2014 (1). The aim of controlling diabetes is to achieve a hemoglobin a1c (HbA1c) level of lower than 7%. However, this target cannot be fulfilled in almost 50% of the diabetic patients. Poor blood glucose control is a risk factor for the complications associated with diabetes mellitus (2, 3).Oral hypoglycemic drugs are typically used to control this disease. In case of failure in achieving the normal blood glucose level, another oral drug or insulin may be required (4(.According to the literature, only 20% of the diabetic patients are interested in insulin initiation. Furthermore, insulin initiation in these patients is challenging for the health care providers (5).The barriers to insulin initiation can be categorized in terms of their relationship with the health care providers and patient.According to the previous studies, the barriers related to the health care providers include the fear of hypoglycemia, lack of sufficient time to educate the patients, patient's low socioeconomic status, lack of sufficient knowledge and experience, absence of a common language with the patients, and poor patient-staff relationship.On the other hand, the barriers related to the patients entail inconvenience and limitation in lifestyle, loss of independence, social embarrassment, poor self-efficacy, needle phobia, depression, failure to receive convincing answers from the health care providers about the benefits and risks of insulin, incomplete conceptualization of diabetes, use of traditional herbal treatments, and fear of weight gain due to using insulin (3, 4, 6-9). Regarding this, delay in insulin initiation is a common practice.Research has shown that around 50% of the patients with poor diabetes control do not initiate insulin therapy timely, and that even insulin initiation is delayed for 3-5 years after receiving no response from oral hypoglycemic drugs. Therefore, this issue requires the direction of special attention because except for a few barriers, including low socioeconomic status, the rest of the aforementioned barriers can be altered and resolved by the health care providers (8).Nurses are among the most important members of the health care providers, who are in contact with patients.They are the ones who should provide the diabetic patients with knowledge and specialized skills to educate and motivate the patients regarding insulin consumption.In this respect, they can contribute to the fulfillment of treatment objectives, which include the reduction of complications and achievement of a suitable HbA1c level (10).In addition, there is a need for evidence-based scientific documents as a basis for delivering essential education to the patients.In order to achieve this evidence, an electronic search was conducted using the international databases, including the web of science (ISI), Pubmed, Scopus, and Google Scholar, with the keywords of “initiate or starting”, type II diabetes”, and “insulin”. The search results indicated that the number of interventional studies investigating the field of nursing and “insulin initiation” was very limited.Accordingly, among the Persian electronic databases, such as SID (Scientific Information Database) and Magiran, only one “descriptive, cross-sectional” study was found (11).Using various studies, the barriers to insulin initiation were listed and investigated. The review was indicative of the implementation of only a few nursing interventions to overcome these barriers. Considering the importance of insulin initiation and the significant role of nurses as the facilitators of this process, there was a gap in the interventional studies targeted toward guiding the nurses in the clinical practice in this regard.Consequently, the researchers are suggested to give more attention to this dimension of diabetes management and take more effective and practical steps to overcome the barriers to insulin initiation in type II diabetic patients.
https://psj.mums.ac.ir/article_10569_9b028901206382605c7d940591a4b757.pdf
2018-01-01
634
635
10.22038/psj.2018.10569
Barriers
Initiating insulin
Nursing, Overcome
Type 2 diabetes
Mahboobeh
Firooz
mahbobehfirooz@yahoo.com
1
Department of Nursing, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran.
AUTHOR
Es-hagh
Ildarabadi
ildarabadi@gmail.com
2
Department of Nursing, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran.
AUTHOR
Seyed Javad
Hosseini
3
Department of Nursing, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran.
LEAD_AUTHOR
1- Ates E, Set T, Saglam Z, Tekin N, Eray IK, Yavuz E, Sahin MK, Selcuk EB, Cadirci D, Cubukcu M.
1
Insulin initiation status of primary care physicians in Turkey, barriers to insulin initiation and knowledge
2
levels about insulin therapy: A multicenter crosssectional study. Primary care diabetes. 2017 Oct 1;11(5):430-6.
3
2- Barag SH. Insulin therapy for management of type 2 diabetes mellitus: strategies for initiation and long-term patient adherence. Journal of the American Osteopathic Association. 2011 Jul 1;111(7 Supplement 5):S13.
4
3- Batais MA, Schantter P. Prevalence of unwillingness to use insulin therapy and its associated attitudes amongst patients with Type 2 diabetes in Saudi Arabia. Primary care diabetes. 2016 Dec 1;10(6):415-24.
5
4- Eliaschewitz FG, de Paula MA, Pedrosa HC, Pires AC, Salles JE, Tambascia MA, Turatti LA. Barriers to insulin initiation in elderly patients with type 2 diabetes mellitus in Brazil. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2018 Jan 1;12(1):39-44.
6
5- Holmes-Truscott E, Blackberry I, O’Neal DN, Furler JS, Speight J. Willingness to initiate insulin among adults with type 2 diabetes in Australian primary care: results from the Stepping Up Study. Diabetes research and clinical practice. 2016 Apr 1;114:126-35.
7
6- Haque M, Navsa M, Emerson SH, Dennison CR, Levitt NS. Barriers to initiating insulin therapy in patients with type 2 diabetes mellitus in public-sector primary health care centres in Cape Town. Journal of Endocrinology, Metabolism and Diabetes of South Africa. 2005 Nov 1;10(3):94-9.
8
7- Woudenberg YJ, Lucas C, Latour C, Scholte op Reimer WJ. Acceptance of insulin therapy: a long shot? Psychological insulin resistance in primary care. Diabetic Medicine. 2012 Jun;29(6):796-802.
9
8- Hassan HA, Tohid H, Amin RM, Bidin MB, Muthupalaniappen L, Omar K. Factors influencing insulin acceptance among type 2 diabetes mellitus patients in a primary care clinic: a qualitative exploration. BMC family practice. 2013 Dec;14(1):164.
10
9- Ross SA, Tildesley HD, Ashkenas J. Barriers to effective insulin treatment: the persistence of poor glycemic control in type 2 diabetes. Current Medical Research and Opinion. 2011 Nov 1;27(sup3):13-20.
11
10- Levich BR. Diabetes management: optimizing roles for nurses in insulin initiation. Journal of multidisciplinary healthcare. 2011;4:15.
12
11- Rahimi M, Niromand E, Ajami E, Egbalian A, Barati M, Rajabi Gilan N. Belifs On Insulin Injection Non-Adherence Among Type 2 Diabetic Patients: Assessmentbased On Health Belief Model. Iranian Journal of Diabetes and Metabolism. 2016 Jan 15;15(2):110-9.
13
ORIGINAL_ARTICLE
Evidence on the Patient Safety Culture and Nursing Work Environment in Iran
Introduction: Patient safety is a universal concern with numerous gaps requiring research. Nurses are the largest workforce in healthcare system and play a pivotal role in the profitability and patient safety indices in hospitals. The present study aimed to evaluate the perception of nurses toward the patient safety culture and nursing work environment in Iran. Materials and Methods: This cross-sectional study was conducted on 100 nurses in Khoy, located in West Azerbaijan, Iran. Data were collected using the hospital survey on patient safety culture (HSPSC), which was completed by the participants during July 1st-30th 2017. Data analysis was performed in SPSS version 19.Results:Positive response rate was 7-82% for 42 items in the HSPSC. The highest positive response rate was in the item "When one area in the ward becomes very busy, others help out." (82%), whereas the lowest rate was in the item "We have enough staff to handle the workload." (7%). In addition, the lowest positive response rate belonged to the dimension of ‘staffing’ (21%), while the highest rate belonged to the dimension of ‘teamwork within units’ (76%).Conclusion: According to the results, nurses had a positive perception toward teamwork. However, they believed that the number of the staff to manage the workload was insufficient and occasionally caused poor interactions among the staff. As an external quality evaluation tool, accreditation could be applied to develop the patient safety culture. Therefore, further investigation is recommended regarding the influence of hospital accreditation on the patient safety culture in Iran.
https://psj.mums.ac.ir/article_10103_9b888e98e255ca28a783e467f3672078.pdf
2018-01-01
636
643
Accreditation
Nursing
Patient safety
Abdolah
Khorami Markani
khorami.abdolah@gmail.com
1
Department of Nursing, Urmia University of Medical Sciences, Khoy University of Medical Sciences, Iran, Khoy.
LEAD_AUTHOR
Leila
Mokhtari
2
Department of Nursing, Urmia University of Medical Sciences, Khoy University of Medical Sciences, Iran, Khoy.
AUTHOR
Zahra
Khanalilo
3
Student Research Center, Urmia University of Medical Sciences, Khoy University of Medical Sciences, Iran, Khoy.
AUTHOR
1- World Health Organization. World alliance for patient safety: forward programme 2005.
1
2- Bates DW, Sheikh A. The role and importance of cognitive studies in patient safety.
2
3- Van Doormaal JE, Van den Bemt PM, Mol PG, Zaal RJ, Egberts AC, Haaijer-Ruskamp FM, Kosterink JG. Medication errors: the impact of prescribing and transcribing errors on preventable harm in hospitalised patients. BMJ Quality & Safety. 2009 Feb 1;18(1):22-7.
3
4- Ahmed M, Arora S, Baker P, Hayden J, Vincent C, Sevdalis N. Building capacity and capability for patient safety education: a train-the-trainers programme for senior doctors. BMJ Qual Saf. 2013 Aug 1;22(8):618- 25.
4
5- Thomas AN, Taylor RJ. An analysis of patient safety incidents associated with medications reported from critical care units in the North West of England between 2009 and 2012. Anaesthesia. 2014 Jul;69(7):735-45.
5
6- Griffiths P, Jones S, Maben J, Murrells T. State of the art metrics for nursing: a rapid appraisal. Kings Colege Lonondon; 2008 Jan 1.
6
7- Maben J, Morrow E, Ball J, Robert G, Griffiths P. High quality care metrics for nursing; 2012.
7
8- Duffield C, Roche M, O’Brien-Pallas L, Diers D, Aisbett C, King M, Aisbett K, Hall J. Glueing it together: Nurses, their work environment and patient safety. Sydney: University of Technology. 2007 Jul.
8
9- Stone PW, Mooney-Kane C, Larson EL, Horan T, Glance LG, Zwanziger J, Dick AW. Nurse working conditions and patient safety outcomes. Medical care. 2007 Jun 1:571-8.
9
10- Mitchell PH. Defining patient safety and quality care; 2008.
10
11- Greenfield D, Braithwaite J. Health sector accreditation research: a systematic review. International journal for quality in health care. 2008 Mar 28;20(3):172-83.
11
12- Jha AK, Prasopa-Plaizier N, Larizgoitia I, Bates DW. Patient safety research: an overview of the global evidence. BMJ Quality & Safety. 2010 Feb 1;19(1):42- 7.
12
13- Cho E, Sloane DM, Kim EY, Kim S, Choi M, Yoo IY, Lee HS, Aiken LH. Effects of nurse staffing, work environments, and education on patient mortality: an observational study. International journal of nursing studies. 2015 Feb 1;52(2):535-42.
13
14- Van Bogaert P, Dilles T, Wouters K, Van Rompaey B. Practice environment, work characteristics and levels of burnout as predictors of nurse reported job outcomes, quality of care and patient adverse events: a study across residential aged care services. Open journal of nursing. 2014;4(5):343-55.
14
15- Kirwan M, Matthews A, Scott PA. The impact of the work environment of nurses on patient safety outcomes: a multi-level modelling approach. International journal of nursing studies. 2013 Feb 1;50(2):253-63.
15
16- Rochefort CM, Clarke SP. Nurses’ work environments, care rationing, job outcomes, and quality of care on neonatal units. Journal of advanced nursing. 2010 Oct;66(10):2213-24.
16
17- US Department of Health and Human Services. Agency for Healthcare Research and Quality. Hospital Nurse Staffing and Quality of Care; 2008.
17
18- Momeni B, Golpira R, Mayelafshar M. The study of the domains of patient safety culture in Rajaie Cardiovascular, Medical and Research Center in 2012. Iranian Journal of Cardiovascular Nursing. 2014 Jun 15;3(1):34-41.
18
19- Sorra J, Nieva V, Famolaro T, Dyer N. Hospital survey on patient safety culture: 2007 comparative database report. AHRQ Publication No. 07-0025. Rockville, MD: Agency for Healthcare Research and Quality; 2007. Khorami Markani et al Patient Safety and Nursing Environment 643 Patient Saf Qual Improv, Vol. 6, No. 1, Win 2018
19
20- Marcelino CF, Alves DF, Gasparino RC, Guirardello ED. Validation of the Nursing Work IndexRevised among nursing aides and technicians. Acta Paulista de Enfermagem. 2014 Aug;27(4):305-10.
20
21- Gozlu K, Kaya S. Patient Safety Culture as Perceived by Nurses in a Joint Commission International Accredited Hospital in Turkey and its Comparison with Agency for Healthcare Research and Quality Data. Journal of Patient Safety & Quality Improvement. 2016;4(4):441-9.
21
22- Kiaei MZ, Ziaee A, Mohebbifar R, Khoshtarkib H, Ghanati E, Ahmadzadeh A, Teymoori S, Khosravizadeh O, Zieaeeha M. Patient safety culture in teaching hospitals in Iran: assessment by the hospital survey on patient safety culture (HSOPSC). Journal of Health Management and Informatics. 2016 Mar 14;3(2):51-6.
22
23- Onã PM. Are there differences in patient safety between different countries using the HSOPSC. Master of Public Health. Copenhagen University, Copenhagen (Denmark). 2012.
23
ORIGINAL_ARTICLE
Perspectives of Multidisciplinary Staff toward the Improvement of Communication and Patient Safety by Safety Huddles
Introduction: Evidence in the literature shows that healthcare utilizing deliberate discussion linking events (HUDDLEs) for patient safety could enhance inter-professional relationships through improved communication, thereby increasing the situational awareness of healthcare professionals. The present study aimed to assess the perspectives of frontline staff toward the impact of safety huddles on patient safety and explore further strategies to improve their delivery in order to enhance the situational awareness of patient safety.Materials and Methods: Safety huddles were implemented in two inpatient wards at Great Ormond Street Hospital (GOSH), a tertiary children’s hospital in London, UK. A staff survey was conducted at two intervals (18 and 30 months) before the initiation of the huddles using a questionnaire to evaluate the perceptions of the staff toward the huddles. The questionnaire was devised and scored based on Likert scales and free-text responses.Results:The healthcare staff believed that safety huddles played a critical role in highlighting the problems of patients and identifying clinical deterioration. Moreover, they could improve the communication within the healthcare team, reduce anxiety, and enhance team cohesiveness.Conclusion: According to the results, safety huddles had an extremely positive influence on frontline staff. Therefore, they could be implemented in healthcare settings to increase situational awareness and improve teamwork and communication, thereby enhancing patient safety. Considering their positive impact, safety huddles were introduced to the other wards and specialties across GOSH as well. In addition, safety huddles were incorporated into the RCPCH S.A.F.E program as a key intervention to improve situational awareness.
https://psj.mums.ac.ir/article_10728_8d5c106a284b7611f404b77945a52995.pdf
2018-01-01
644
649
10.22038/psj.2018.10728
Patient safety
Safety huddle
Situational awareness
Staff perception
Team work
Aishwarya
Venkataraman
draraman9@gmail.com
1
International and Private Patients Service, Great Ormond Street Hospital, London, UK.
LEAD_AUTHOR
Rory
Conn
rconn@doctors.org.uk
2
Darzi fellow in Quality Improvement and Patient Safety, Great Ormond Street Hospital, London, UK.
AUTHOR
Rachel
L Cotton
3
Imperial College London, UK.
AUTHOR
Sally
Abraham
sally.abraham@nhs.net
4
International and Private Patients Service, Great Ormond Street Hospital, London, UK.
AUTHOR
Maria
Banaghan
maria.banaghan@gosh.nhs.uk
5
Quality Improvement Team, Great Ormond Street Hospital, London, UK.
AUTHOR
Bridget
Callaghan
bridget.callaghan@gosh.nhs.uk
6
Clinical Lead for SAFE project, Great Ormond Street Hospital, London, UK.
AUTHOR
1- Lancaster G, Kolakowsky‐ Hayner S, Kovacich J, Greer Williams N. Interdisciplinary communication and collaboration among physicians, nurses, and unlicensed assistive personnel. Journal of Nursing Scholarship. 2015 May 1;47(3):275-84.
1
2- Gardner D. Ten lessons in collaboration. Online journal of issues in nursing. 2005 Jan 1;10(1).
2
3- Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care. 2004;13(Suppl 1):i85-i90. 4- Singh H, Petersen LA, Thomas EJ. Understanding diagnostic errors in medicine: a lesson from aviation. Qual Saf Health Care. 2006;15(3):159-164.
3
5- Endsley MR. Toward a Theory of Situation Awareness in Dynamic Systems. Hum Factors J Hum Factors Ergon Soc. 1995;37(1):32-64.
4
6- Endsley MR, Garland DJ. Theoretical underpinnings of situation awareness: A critical review. Situat Aware Anal Meas. 2000:3-32.
5
7- Riehle A, Braun B I. Improving Patient and Worker Safety. 2013;28(2):99-102.
6
8- Brady PW, Goldenhar LM. A qualitative study examining the influences on situation awareness and the identification, mitigation and escalation of recognised patient risk. BMJ Qual Saf. 2014;23(2):153- 161.
7
9- Manser T. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiol Scand. 2009;53(2):143-151.
8
10- Goldenhar LM, Brady PW, Sutcliffe KM, Muething SE. Huddling for high reliability and situation awareness. BMJ Qual Saf. 2013;22(11):899-906.
9
11- Kellish AA, Smith-Miller C, Ashton K, Rodgers C. Team Huddle Implementation in a General Pediatric Clinic. J Nurses Prof Dev. 2015;31(6):324-327.
10
12- Edelson DP, Litzinger B, Arora V, et al. Improving in-hospital cardiac arrest process and outcomes with performance debriefing. Arch Intern Med. 2008;168(10):1063-1069.
11
13- Glymph DC, Olenick M, Barbera S, Brown EL, Prestianni L, Miller C. Healthcare utilizing deliberate discussion linking events (HUDDLE): A systematic review. AANA J. 2015;83(3):183.
12
14- Provost SM, Lanham HJ, Leykum LK, McDaniel Jr RR, Pugh J. Health care huddles: Managing complexity to achieve high reliability. Health Care Manage Rev. 2015;40(1):2-12.
13
15- Ali M, Osborne A, Bethune R, Pullyblank A. Preoperative surgical briefings do not delay operating room start times and are popular with surgical team members. J Patient Saf. 2011;7(3):139-143.
14
16- Bethune R, Sasirekha G, Sahu A, Cawthorn S, Pullyblank A. Use of briefings and debriefings as a tool in improving team work, efficiency, and communication in the operating theatre. Postgrad Med J. 2011:pgmj-2009.
15
17- Muething SE, Goudie A, Schoettker PJ, et al. Quality improvement initiative to reduce serious safety events and improve patient safety culture. Pediatrics. 2012;130(2):e423-e431.
16
18- Brady PW, Muething S, Kotagal U, et al. Improving situation awareness to reduce unrecognized clinical deterioration and serious safety events. Pediatrics. 2013;131(1):e298-e308. Venkataraman et al Safety Huddles 649 Patient Saf Qual Improv, Vol. 6, No. 1, Win 2018
17
19-Nervecentre. http://nervecentresoftware.com/solutions/electronicobservations/.
18
20- Cooper RL, Meara ME. The organizational huddle process—optimum results through collaboration. Health Care Manag (Frederick). 2002;21(2):12-16.
19
21- Wheelan SA, Burchill CN, Tilin F. The link between teamwork and patients’ outcomes in intensive care units. Am J Crit Care. 2003;12(6):527-534.
20
22- Hanson CC, Randolph GD, Erickson JA, et al. A reduction in cardiac arrests and duration of clinical instability after implementation of a paediatric rapid response system. Postgrad Med J. 2010;86(1015):314- 318.
21
23- Wilbur K, Scarborough K. Medication safety huddles: teaming up to improve patient safety. Can J Hosp Pharm. 2005;58(3).
22
24- Fogarty CT, Schultz S. Team huddles: the role of the primary care educator. Clin Teach. 2010;7(3):157- 160.
23
25- Mardon RE, Khanna K, Sorra J, Dyer N, Famolaro T. Exploring relationships between hospital patient safety culture and adverse events. J Patient Saf. 2010;6(4):226-232.
24
26- Singer S, Lin S, Falwell A, Gaba D, Baker L. Relationship of safety climate and safety performance in hospitals. Health Serv Res. 2009;44(2p1):399-421.
25
27- Westat R, Sorra J, Famolaro T, Dyer MPSN, Khanna K, Nelson D. Hospital Survey on Patient Safety Culture: 2010 User Comparative Database Report. 2010.
26
ORIGINAL_ARTICLE
Awareness and Attitude of the Managers in Teaching Hospitals of Tabriz University of Medical Sciences towards Health Promoting Hospitals
Introduction: The mission of health promoting hospitals is to change the treatment-based attitude to health-based and health promoting attitude to patients, personnel, clients and all groups of the society. The present study was conducted to investigate the awareness and attitude of the managers of teaching hospitals in Tabriz City towards health promoting hospitals.Materials and Methods: The present study was descriptive-analytic research. The study population included all the bosses and managers at different levels of teaching hospitals in Tabriz City. A researcher-made questionnaire was used to data collection. Data were analyzed using SPSS19 Software, descriptive statistics, t-test, analysis of variance (ANOVA) and Spearman’s correlation coefficient test.Results:In the studied teaching hospitals, awareness and attitude of managers were significantly higher than mean. In addition, there was significant relationship between managers’ awareness and their attitudes (P<0.013). The results of ANOVA test showed that there was significant difference between the awareness of managers having 6-10 years of work experience and managers who had 11-15 years of work experience (P<0.01).Conclusion: The results of present study showed that the awareness and attitude of managers towards health promoting hospitals were at desirable level. This could be a basis for informing other personnel and establishing health promoting policy in hospitals. Regarding the readiness of hospitals, it seems necessary to determine a given and specific framework and policy in the Ministry of Health in order to establish health promoting hospitals.
https://psj.mums.ac.ir/article_10570_7bce8dd2299ca553415b299fb5d2fbeb.pdf
2018-01-01
650
655
10.22038/psj.2018.10570
Attitude
Awareness
Health promoting hospitals
Hospital
Managers
Masumeh
Gholizadeh
1
Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
AUTHOR
Ali
Janati
janati1382@gmail.com
2
Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
AUTHOR
Yalda
Mousazadeh
3
Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
LEAD_AUTHOR
Mahlaga
Solahay Kahnamuee
4
School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
AUTHOR
Mohamad Reza
Narimani
5
School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
AUTHOR
1- Naderi Sh, Amiri M, Khosravi A, Riahi.L. Effect of Health Promoting Hospitals' Standards on Hospital Performance A Case Study in Fatemieh Hospital in Shahrod. Hospital 2014; 2: 101-109 (In Persian).
1
2- Shojaee H. Medical and Social Sciences general textbook. 2nd ed. Tehran: Samat publication; 2011: 26- 30 (In Persian).
2
3- Rafiee far SH, Ahmadzadeh asl M, Sarifi M. The comprehensive health education system for patients in the Islamic Republic of Iran. 1nd ed. Tehran: Pazhohesh bedun marz institute; 2006: 9 (In Persian).
3
4- Röthlin F, Schmied H, Dietscher C. Organizational capacities for health promotion implementation: results from an international hospital study. Health Promot Int 2015; 30(2):369-79.
4
5- Polluste K, Alop J, Groene O, Harm T, Merisalu E, Suurong L. Health Promoting Hospitals in Estonia: What are they doing differently?. Health Promot Int 2007; 4: 327-336.
5
6- Tonnesen H, Echristensen M, Groene O, Oriordan N, Simonelli F, Suurorg L et al. An evaluation of model for the systematic documentation of hospital based health promotion activities: result from a multicenter study. BMC Public Health 2007; 145: 1-9.
6
7- Keshavarz Mohammadi N, Zarei F, Rezaei M, Keshavarz A, Kalhor R. Exploring perspectives of medical staff on hospital’s effects on their health: a health promoting hospital’s approach. RJMS 2013; 113:36-47(In Persian).
7
8- Maleki M, Delgoshayee B, Nasiri pour A, Yaghoubi M. A Comparative Study of hospital committed to promoting health in European hospitals. Health information management 2013; 2: 245-254 (In Persian).
8
9- Parsay S, Abachizadeh K, Heydarniya MA, Rasuli M, Jafari H, Mohseni M. Designing a Model for the Prevention of Clinical Prevention in Taleghani Hospital in Tehran. Hospital 2011; 1: 9-18 (In Persian).
9
10- Potvin L, Jones CM. Twenty-five Years after the Ottawa Charter: The Critical Role of Health Promotion for Public Health. Can J Public Health 2011; 4: 244- 248. Gholizadeh et al Managers’ Perspective Towards Health Promoting Hospitals 655 Patient Saf Qual Improv, Vol. 6, No. 1, Win 2018
10
11- Estebsari F, Mostafaie D M, Taghdisi M H, Ghavami M. Health Promoting Hospitals: Concepts, Indexes and Standards. Journal of Health Education Health Promotion 2016; 3:281-286 (In Persian). 12- Karvarzi F,Pishgoee A, Taheriyan A. Healthpromoting behaviors in employed nurses in selected military hospitals. JHPM 2015; 2:7-15 (In Persian).
11
13- Haynes C. Health promotion services for life style development within UK hospital- patient’s experiences and views. BMC Public Health 2008 8:284.
12
14- Oppedal K, Nesvag S, Pedersen B, Skjotskift S, Ullaland S, Pederson K. Health and need for health promotion in hospital patient. Eur J Pub Health 2010; 14:744-749.
13
15- Rooney E. Health Promoting Hospitals network in Northern Ireland. Health Promoting Hospitals (HPH) network in Northern Ireland. Public Health Agency: Ireland, 2006–2007update report: 1-29. 16- Whitehead D. The European Health Promoting Hospitals (HPH) project: how far on? Health Promot Int 2004; 2: 259-267.
14
17- Law of the Fourth Plan of Economic, Social and Cultural Development of the Islamic Republic of Iran. Approved by the Islamic Consultative Assembly. Section 3, Chapter 7, Adopted in 2004 (In Persian).
15
18- Johnson A, Baum F. Health promoting hospitals: a typology of different organizational approaches to health promotion. Health Promot Int 2001; 16: 281– 287.
16
19- Heydarniya MA, Abachizadeh K, Damari B, Azargashb A, Vosugh moghadam A. Assessing the viewpoints of experts about providing health promotion services to patients in Shahid Beheshti University hospitals and presenting a proposed model. Journal of Shahid Beheshti University of Medical Sciences (Pazhohandeh) 2009; 4: 183-190 (In Persian).
17
20- Mohseny M, Parsay S, Rassouli M, Heidarnia MA, Azargashb E, Abachizadeh K. Components of Clinical Preventive Services System in a Specialized Educational Hospital: a Qualitative Approach . Hakim Health System Research journal 2011; 3:151-158 (In Persian).
18
21- X. H. Guo, X. Y. Tian, Y. S. Pan, X. H. Yang,S. Y. Wu. Managerial attitudes on the development of health promoting hospitals in Beijing. Health Promot Int 2007; 22(3): 182-190.
19
22- Tountasi,Y. Pavi, E. Tsamandouraki, K. Arkadopoulos, N and Triantafyllou, D. Evaluation of the participation of Aretaieion Hospital, Greece in the WHO Pilot Project of Health Promoting Hospitals. Health Promot Int. 2004;19(4):453-462.
20
ORIGINAL_ARTICLE
Reasons for Discharge against Medical Advice among Patients Admitted to Ghaem Research-Training and Medical Center of Mashhad, Iran, in 2015
Introduction: Discharge against medical advice (DAMA) indicates the existence of serious problems in the quality of hospital services, which can exacerbate the disease and increase the risk of hospital readmission. This study was targeted toward examining the reasons for DAMA among the patients admitted to Ghaem Hospital of Mashhad, Iran, in 2015.Materials and Methods: This cross-sectional, descriptive study was conducted on 6,645 patients discharged from the Ghaem Hospital of Mashhad with their own personal desire in the first 9 months of 2015. Data collection was performed using the information recorded in the health information system of the hospital; in addition, the required information which was not available in this system were obtained via making a telephone call with the respondents. The data were analyzed using descriptive statistics in SPSS, version 22.Results:Out of the 53,558 patients admitted to Ghaem Hospital of Mashhad in the first nine months of 2015, 6,645 (12.4%) cases were discharged with their own desire. Regarding the reasons of DAMA, 13.1% and 86.7% of the patients had called for DAMA due to the reasons related to hospital and personal issues, respectively. Accordingly, the main reasons for DAMA were categorized into patient- and hospital-related reasons, including patient's personal and family reasons (41.8%) and overcrowding of wards (6.6%), respectively.Conclusion: Improved communication between physician and patient, patient’s increased awareness regarding the probable complications of early discharge, improved quality of hospital services, use of clinical aids, and designing green space and a pleasant environment are the recommended strategies to reduce the rate of DAMA.
https://psj.mums.ac.ir/article_10104_e1309303e41c003b386132ed7a705c99.pdf
2018-01-01
656
661
Discharge against medical advice
Hospital services
Quality Improvement
Marjan
Vejdani
1
Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar. Iran
AUTHOR
Yasamin
Molavi Taleghani
yasamin_molavi1987@yahoo.co
2
Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
LEAD_AUTHOR
1- Taqueti VR. Leaving against medical advice. The New England journal of medicine. 2007 Jul 19;357(3):213-5.
1
2- Carrese JA. Refusal of care: patients' well-being and physicians' ethical obligations: "but doctor, I want to go home". JAMA : the journal of the American Medical Association. 2006 Aug 9; 296(6):691-5.
2
3- Gerbasi JB, Simon RI. Patients' rights and psychiatrists' duties: discharging patients against medical advice. Harvard review of psychiatry. 2003 Nov-Dec; 11(6):333-43.
3
4- Brook M, Hilty DM, Liu W, Hu R, Frye MA. Discharge against medical advice from inpatient psychiatric treatment: a literature review. Psychiatric services (Washington, DC). 2006 Aug;57(8):1192-8.
4
5- Henry B, Dunbar T, Barclay L, Thompson R. Selfdischarge against medical advice from Northern Territory Hospitals. Australia2007
5
6- Ibrahim SA, Kwoh CK ,Krishnan E. Factors Associated With Patients Who Leave Acute-Care Hospitals Against Medical Advice. American Journal of Public Health. 2007;97(12):2204-8.
6
7- Saitz R, Ghali WA, Moskowitz MA. The Impact of Leaving Against Medical Advice on Hospital Resource Utilization. Journal of general internal medicine. 2000;15(2):103-7.
7
8- Hwang SW, Li J, Martin RE. What happens to patients who leave hospital against medical advice? Canadian Medical Association Journal. 2003;168(4):417-20.
8
9- Anis AH, Sun H, O'Shaughnessy MV. Leaving hospital against medical advice among HIV-positive patients. Canadian Medical Association Journal. 2002;167(6):633-70.
9
10- Weingart SN, Davis RB, Phillips RS. Patients discharged against medical advice from a general medicine service. Journal of general internal medicine. 1998 Aug;13(8):568-71.
10
11- Saitz R, Ghali WA, Moskowitz MA. The impact of leaving against medical advice on hospital resource utilization. Journal of general internal medicine. 2000 Feb;15(2):103-7.
11
12- Tavallaei S. A, Asari Sh, Habibi M, Khodami H. R, Siavoshi Y, Nouhi S, Radfr Sh. Discharge Against Medical Active from Psychiatric Ward. Journal of Military Medicine. 2006;8(1):24-30.
12
13- Manouchehri J, Goodarzynejad H, Khoshgoftar Z, Fathollahi MS, Abyaneh MA. Discharge against Medical Advice among Inpatients with Heart Disease in Iran. The Journal of Tehran University Heart Center. 2012;7(2):72-7.
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14- Green P, Watts D, Poole S, Dhopesh V. Why patients sign out against medical advice (AMA): factors motivating patients to sign out AMA. The American journal of drug and alcohol abuse. 2004 May;30(2):489-93.
14
15- Alfandre DJ. "I'm going home": discharges against medical advice .Mayo Clinic proceedings Mayo Clinic. 2009 Mar;84(3):255-60.
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16- Shirani F, Jalili M, Asl ESH. Discharge against medical advice from emergency department: results from a tertiary care hospital in Tehran, Iran. European journal of emergency medicine : official journal of the European Society for Emergency Medicine. 2010 Dec;17(6):318-21.
16
17- Jeddi FR, jeddi MR, Rezaeiimofrad M. Patients’ Reasons for Discharge against Medical Advice in University Hospitals of Kashan University of Medical Sciences in 2008. Hakim Research Journal. 2010;13(1):33-9
17
18- Vahdat S, Hesam S, Mehrabian F. Effective factors on patient discharge with own agreement in selected Therapeutic Training Centers of Ghazvin Shahid Rajaei .Journal of Colleges of Nursing and Midwifery, Gilan. 2010;20(64).
18
19- Tolaee SA, Asari S, Habibi M, Khodami H. Discharge with own agreement of Psychiatry. Journal of Military Medicine. 2006;8(1):24-30.
19
20- Kabirzade A, Rezazade E, Saravi BM. Frequency and causes of discharge with own agreement in children in BUALI hospital-Sari. Journal of North Khorasan University of Medical Sciences. 2011;2(4):57-62. Vejdani et al (DAMA) of Patients in Ghaem Hospital 661 Patient Saf Qual Improv, Vol. 6, No. 1, Win 2018
20
21- Anis AH, Sun H, Guh DP, Palepu A, Schechter MT, O'Shaughnessy MV. Leaving hospital against medical advice among HIV-positive patients. CMAJ. 2002;167(6):633-7.
21
22- Berger JT. Discharge against medical advice: ethical considerations and professional obligations. Journal of hospital medicine : an official publication of the Society of Hospital Medicine 2112 .Sep;3(5):403-8.
22
23- Ebrahimipour H, Meraji M, Hooshmand E, Nezamdoust F, Molavi-Taleghani Y, Hoseinzadeh N, Vafaee-Najar A. Factors Associated with Discharge of Children from Hospital Against Medical Advice (AMA) at Doctor Sheikh Pediatric Hospital (DSPH) in Mashhad: 2011-2013. World Journal of Medical Sciences2014. 11 (2): 196-201.
23
ORIGINAL_ARTICLE
Associations of the Quality of Work Life and Depression, Anxiety, and Stress in the Employees of Healthcare Systems
Introduction: Human resources are an important asset to any organization, and it is essential to preserve their health in order to achieve organizational goals. The present study aimed to investigate the associations between the quality of work life (QWL) and depression, anxiety, and stress in the employees in the healthcare system of Islamabad-e-Gharb Health Care Network, Iran.Materials and Methods: This cross-sectional, descriptive-analytical study was conducted on 158 healthcare network employees using the census method. Data were collected using Walton’s quality of work life evaluation and depression, anxiety, and stress scale (DASS). Data analysis was performed using descriptive statistics, Spearman’s correlation-coefficient, Mann-Whitney U test, and Kruskal-Wallis test.Results:Mean and standard deviation of QWL, depression, stress, and anxiety were 80.45±17.70, 4.9±4.1, 6.34±4.2, and 3.7±3, respectively. Significant negative correlations were observed between QWL and depression (r=-0.255; P=0.001), anxiety (r=-0.260; P=0.001), and stress (r=-0.242; P=0.002). Each of depression, stress, and anxiety had individually no significant correlation with age, work experience, number of child, gender, work pattern, second job and level of education (P> 0.05). However, the relationship between depression and marital status was significant such that depression is found higher among single persons (P= 0.026). As was the correlation between residential status and stress (P=0.03) in which the stress was higher in tenants compared with residence owners. It also appeared that having a refractory patient at home has significantly associated with stress (P=0.027) and anxiety (P=0.045).Conclusion: According to the results, improving the QWL is essential to mitigating the rates of depression, anxiety, and stress in healthcare providers.
https://psj.mums.ac.ir/article_11176_86e1aaf320da9d53623598413b18d00a.pdf
2018-01-01
662
667
10.22038/psj.2018.11176
Anxiety
Depression
Employees of healthcare system
Quality of work life
stress
Ehsan
Bakhshi
ehsanbakhshi63@gmail.com
1
Healthcare Center, Islamabad-e-Gharb Health Care Network, Kermanshah University of Medical Sciences, Kermanshah, Iran.
LEAD_AUTHOR
Ali
Moradi
alimoradi54@gmail.com
2
Faculty of Humanities, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran.
AUTHOR
Mohammadreza
Naderi
3
Healthcare Center, Islamabad-e-Gharb Health Care Network, Kermanshah University of Medical Sciences, Kermanshah, Iran.
AUTHOR
Reza
Kalantari
4
Department of Ergonomics, School of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran.
AUTHOR
1-.Kanten S, Sadullah O. An empirical research on relationship quality of work life and work engagement. Procedia-Social and Behavioral Sciences. 2012;62:360- 6.
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2- Nazir U, Qureshi TM, Shafaat T, Ilyas A. Office harassment: A negative influence on quality of work life. African Journal of Business Management. 2011;5(25):10276.
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3- Argentero P, Miglioretti M, Angilletta C. Quality of work life in a cohort of Italian health workers. G Ital Med Lav Ergon. 2007;29(1 Suppl A):A50-4.
3
4- Pérez-Zapata D, Zurita R .Calidad De Vida Laboral En Trabajadores De Salud Pública En Chile. Salud & Sociedad. 2014;5(2):172-80. (Abstract)
4
5- Almalki MJ, FitzGerald G, Clark M. The relationship between quality of work life and turnover intention of primary health care nurses in Saudi Arabia . BMC health services research. 2012;12(1):314.
5
6- Razak NA, Ma’amor H, Hassan N. Measuring Reliability and Validity Instruments of Work environment Towards Quality Work Life. Procedia Economics and Finance. 2016;37:520-8.
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7- Mental and Neurological Disorders. The world health report, 2001: Available from: www.who.int/entity; [cited 2017].
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8- Rada RE, Johnson-Leong C. Stress, burnout, anxiety and depression among dentists. The Journal of the American Dental Association. 2004;135(6):788-94.
8
9- What is anxiety?: availabe from: http://www.niazemarkazi.com/papers/10005500.html; [cited 2017]. 10- Zandi A, Sayari R, Ebadi A, Sanainasab H. Abundance of depression, anxiety and stress in militant Nurses. Journal Mil Med. 2011;13(2):103-8.
9
11- Nouroozi Kushali A ,Hajiamini Z, Ebadi A, Khamseh F, Rafieyan Z, Sadeghi A. Comparison of intensive care unit and general wards nurses’ emotional reactions and health status. Advances in Nursing & Midwifery. 2013;23(80):5383.
10
12- Walton RE. Quality of worklife: what is it. Sloan management review. 1973;15(1):11-21.
11
13- Karimi H, Rezvanfar A. The effect of quality of work life on organizational commitment among agricultural promotion professionals in Kerman. Iranian Journal of Agricultural Economics and Development. 2014;45(1):125-41.
12
14- Virme G. Human behavior; improving performance at work New York: Perntice-Hell. Inc; 2001. 15- Ghaleei A, Mohajeran B, Taajobi M, Imani B. Relationship between quality of work life and occupational stress in staff of Bu-ali Sina university of Hamadan, 2013. Pajouhan Scientific Journal. 2015;13(4):60-6.
13
16- Lovibond P, Lovibond. Manual for the depression anxiety stress scales. The Psychology Foundation of Australia Inc. 1995.
14
17- Asghari Moghadam MA, Saed F, Dibajnia P, Zangana J. Preliminary Study of Reliability and Validity of Depression, Stress and Anxiety Scales in Non-Clinical Samples. Daneshvar (Raftar) Shahed University. 2008;15(31):22-38. Bakhshi et al Relationship between Quality of Work Life & Depressio 667 Patient Saf Qual Improv, Vol. 6, No. 1, Win 2018
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18- Biglari I, Fahimdoin H, Nabavi Sh, Ahmadi M. Predicting employees’ mental health based on life-work quality. Journal of North Khorasan Universi ty of Medical Sciences. 2014;6(3):507-11.
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19- Olfati S, Olfati J, Haidari F, Shirzadi R. Relationship quality of work life with depression omong managers of sports organizations in west provinces of Iran International Management Conference, Challenges and Solutions: available from: https://www.civilica.com/Paper-ICMM01- ICMM01_0740.html 2013 [Cited 2017].
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20- Gonzalez-Baltazar R, Hidalgo-González BJ, de Sandi VIR-D, León-Cortés SG, Contreras-Estrada MI, Aldrete-Rodríguez MG, et al. Quality of Work Life, Depression and Anxiety in Administrative Staff of an Institution of Higher Education. Advances in Social & Occupational Ergonomics: Springer; 2017. p. 295-304.
18
21- Vafaei-Najar A, Houshmand E, yousefi M, Esmaily H, Ashrafnezhad F. Obvious and hidden anxiety and quality of worklife among nurses in educational hospitals. Journal of the Iranian Institute for Health Sciences Research. 2015;5(14):565-76.
19
22- Kawano Y. Association of job-related stress factors with psychological and somatic symptoms among Japanese hospital nurses: effect of departmental environment in acute care hospitals. Journal of occupational health. 2008;50(1):79-85.
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23- Rusli BN, Edimansyah BA, Naing L. Workconditions, self-perceived stress, anxiety, depression and quality of life: a structural equation modelling approach. BMC public health. 2008;8(1):48.
21
24- Thardsatien K. The Impacts of Corporate Social Responsibility and Quality of Work Life on JobRelated Outcomes in Thailand. NIDA Development Journal: 2016:56(4)
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25- Zarei E, Ahmadi F, Danshkohan A, Ramezankhani A. The correlation between organizational commitment and the quality of worklife among staff of Sarpolzahab health network. Journal of Health Promotion Management. 2016;5(2):61-9.
23
26- Saeid Bakhtiarpor RA. The Relationship between Job Satisfaction with Mental Health and its Dimensions (Physical Symptoms, Anxiety, Social Functional Disorder, Depression) in Emergency Ward Fire Departments Dezful and Andimeshk First National Conference on Psychology and Family: available from: https://www.civilica.com/Paper-PSFA01- PSFA01_026.html 2015 [Cited 2017].
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27- Parsa S, kasraie s, abdi R, radmanesh m, ghasemzade A. The Relationship between Quality of Work Life, Performance, Stress, Job Satisfaction. Social Welfare. 2014;14(54):61-83.
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28- Omidi HAH, Abbasi AA. Relationship between night shift and nueses depression amd anexitey. Quarterly journal of nursing management. 2015;4(2)29- 38.
26
29- Demir F, Ay P, Erbas M, Ozdii M, Yasar E .The prevalence of depression and its associated factors among resident doctors workin a training hospital in Istanbul. Turk Psikiyatri Dergisi. 2007;18(1):31. 30.Khaje Nasir F. Prevalence of depression and its risk factors in nurses of Imam Khomeini hospital. J Med. 2000;1:5-11.
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31- Taghva A, Yazdani A, Ebrahimi M, Alizadeh K, Sakhabakhsh M. Prevalence of depression in psychiatric nurses and comparison with other parts of the AJA hospitals. 2013.
28
32- Abdullah KL, Chong MC, Chua YP, Al Kawafha MM. Stress, Anxiety, Depression and Sleep Disturbance among Jordanian Mothers and Fathers of Infants Admitted to Neonatal Intensive Care Unit: A Preliminary Study. Journal of Pediatric Nursing. 2017;36:132-40.
29
33- Wang X, Sundquist K, Rastkhani H, Palmér K, Memon AA, Sundquist J. Association of mitochondrial DNA in peripheral blood with depression, anxiety and stress-and adjustment disorders in primary health care patients. European Neuropsychopharmacology. 2017;27(8):751-8.
30
ORIGINAL_ARTICLE
Patient Preferences for the Notification of Skin Biopsy Results: A Retrospective Review
Introduction: Skin cancer screening clinics constitute a major part of general dermatologists’ workload. Patient preferences for the communication of histological results following skin biopsy have not been properly explored in the literature. Primary care physicians locally report their increased workload with the patients who seek these results directly. The present study aimed to ascertain the preferences for the notification of skin biopsy results among the patients referring to our department and explore this process from their perspective.Materials and Methods: Interviews were conducted with departmental clinical staff to determine the important factors to investigate regarding the biopsy experiences of patients, and the subject matter was generally discussed with the patients. Afterwards, a retrospective study was designed using a questionnaire, which was posted to 100 consecutive patients. Data of the questionnaires were recorded and analyzed.Results:Our findings suggested the need for the greater involvement of the patients in selecting the most appropriate approach for the notification of biopsy results. Moreover, a proportion of the patients were found to benefit from anxiety evaluation at the outset of the treatment so as to identify the high-risk cases for postoperative anxiety.Conclusion: According to the results, changing the methods of result notification may facilitate a patient-centred approach to identify potentially anxiety-provoking and life-changing processes. It is recommended that further investigation be conducted to explore the postoperative psychological states of patients prior to receiving test results for comparison with our findings.
https://psj.mums.ac.ir/article_10106_b3be6a4c1cd2d32445b080f9618c8471.pdf
2018-01-01
668
670
10.22038/psj.2018.10106
Patient preferences
Result notification
Skin biopsy result
Fiona
Cunningham
fionajcunningham@gmail.com
1
Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, United Kingdom.
LEAD_AUTHOR
Grant
Wylie
grantwylie@nhs.net
2
Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
AUTHOR
1- Leiter U, Eigentler T, Garbe C. Epidemiology of skin cancer. InSunlight, vitamin D and skin cancer
1
2014 (pp. 120-140). Springer, New York, NY.
2
2- Al-Shakhli H, Harcourt D, Kenealy J. Psychological distress surrounding diagnosis of malignant and nonmalignant skin lesions at a pigmented lesion clinic. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2006 May 1;59(5):479-86.
3
3- Choudhry A, Hong J, Chong K, Jiang B, Hartman R, Chu E, Nelson K, Wei ML, Nguyen T. Patients' preferences for biopsy result notification in an era of electronic messaging methods. JAMA dermatology. 2015 May 1;151(5):513-21.
4
4- Meza JP, Webster DS. Patient preferences for laboratory test results notification. The American journal of managed care. 2000 Dec;6(12):1297-300.
5
5- Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta psychiatrica scandinavica. 1983
6
Jun 1;67(6):361-70.
7
ORIGINAL_ARTICLE
Stigma as a Barrier in the Emergency Section for a Patient with Neuroleptic Malignant Syndrome: A Case Report
Introduction: Stigma is defined as a set of negative attitudes and beliefs toward specific conditions, such as mental disorders. Mental disorders are among the most stigmatizing conditions throughout the world. In general, the principle of stigma involves the physical health of the patients with mental conditions.Case: In this article, we presented the case of a 28-year-old single, male patient with paranoid schizophrenia and neuroleptic malignant syndrome. Stigma was a significant barrier in the emergency sections of the psychiatric and general hospitals.Conclusion: According to the results, the curricula of health education must be revised in undergraduate and postgraduate levels.
https://psj.mums.ac.ir/article_10726_dc86cf92f87ae170f013b89880419e21.pdf
2018-01-01
671
673
10.22038/psj.2018.10726
Emergency
Neuroleptic malignant syndrome
Schizophrenia
Stigma
Forouzan
Elyasi
forouzan.el@gmail.com
1
Psychiatry and Behavioral Sciences Research Center, Addiction Institute, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
LEAD_AUTHOR
Mohsen
Fazlali
2
Department of Psychology, Sari Branch, Islamic Azad University, Sari, Iran.
AUTHOR
Seyed Mohammad
Hosseininejad
3
Department of Emergency Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
AUTHOR
1- Chan SW. Global perspective of burden of family caregivers for persons with schizophrenia. Archives of
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psychiatric nursing. 2011 Oct 1;25(5):339-49.
2
2- Pinto-Foltz MD, Logsdon C. Reducing Stigma Related to Mental Disorders: Initiatives, Interventions,
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and Recommendations for Nursing .Arch PsychiatrNurs. 2009; 23(1): 32- 40.
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3- Angermeyer MC, Dietrich S. Public beliefs about and attitudes towards people withmental illness: a
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review of population studies. ActaPsychiatr Scand. 2006; 113(3):163-79.
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4- Norman sartorius .Physical illness in people with mental disorders .Geneva, Switzerland World
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Psychiatry 6:1 - February 2007
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5- Link BG, Phelan JC, Bresnahan M, Stueve A, Pescosolido BA. Public conceptions of mental illness: labels, causes, dangerousness, and social distance. Am J Public Health .1999; 89(9):1328-33.
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6- Nojomi M, Malakouti SK, Ghanean H, Joghataei MT, Jacobsson L. Mental Illness Stigma in City of Tehran, 2009. Razi Journal of Medical Sciences. 2010- 2011;17 (78):45- 52. [In Persian].
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7- Ghanean H, Nojomi M, Jacobsson L. A Community Study on Attitudes to and Knowledge of Mental Illness
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in TehranOpen Journal of Psychiatry. 2015; 5:26-30.
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8- Bolhari, J., Nouri GhassemAbadi, R. and RamezaniFarani, A. In: Hussain Khan, Z., Ed., Quranic Verses on Mental Health for Mental Health Workers and School Counselors, Office for Islamic Studies of Mental Health, Tehran, 2002; 22.
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9- Ku¨ey L. The impact of stigma on somatic treatment and care for people with comorbid mental and somatic
14
disorders .Current Opinion in Psychiatry. 2008; 21:403–411.
15
10- Mitchell AJ, Malone D, Doebbeling CC. Quality of medical care for people with and without comorbid mental illness and substance misuse: systematic review of comparative studies. Br J Psychiatry .2009; 194:491–9.
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11- Strawn, J. R., Keck, P. E., Jr., & Caroff, S. N. Neuroleptic malignant syndrome. American Journal of Psychiatry .2007; 164(6):870– 876.
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12- Agar L, RN .Recognizing Neuroleptic Malignant Syndrome in the Emergency Department: A Case. Perspectives in Psychiatric Care .2010; 46(2): 143.
18
13- Shefer G, Cross S, Howard LM, Murray J, Thornicroft G, Henderson C. .Improving the diagnosis of physical illness in patients with mental illness who present in emergency Departments: Consensus study .Journal of Psychosomatic Research. 2015; 78(4): 346–351.
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14- Meyer JM, Nasrallah HA. Medical illness and schizophrenia. Washington: American Psychiatric Publishing, 2003.
20