bluuebunny/crossref_metadata_2025 huggingface dataset:
Modifiable Factors Influencing Emotional Intelligence Among Medical Interns
Authors: Hassan Nurulhuda Mat , Daud Norwati , Mahdi Nik Nor Ronaidi Nik , Ibrahim Mohd Salami , Yusop Yuzana Mohd , Pauzi Mohd Faeiz
Published: June 2022

Aims

Emotional intelligence is crucial for medical professionals. Medical interns are expected to have a high degree of emotional intelligence to face their professional career challenges. Emotional intelligence, often measured as an emotional quotient (EQ), is the capacity to recognize and regulate emotion in oneself. It enables one to monitor own feelings and emotions and others; and guide decisions and actions, and is crucial to ensure a successful work-related outcome or good performance. A higher EQ enhances physician and patient well-being, increases patient safety and augments healthcare teamwork. However, studies about EQ among medical interns are lacking. Therefore, this study intended to determine the level of EQ among medical interns in Malaysia and its associated factors.

Methods

This nationwide cross-sectional study recruited new medical interns reporting to 17 randomly selected Malaysian hospitals accredited for medical intern training from January to April 2020. They were invited to answer an online questionnaire incorporating USMEQ-i to measure EQ, Connor-Davidson Resilience Scale-10 items (CD-RISC-10) for resilience, Brief-Cope to assess coping styles, PHPQ to assess internship preparedness, DUREL for religiosity, and questions related to sociodemographic and undergraduate training.

Results

A total of 524 from 619 medical interns responded. Mean (SD) EQ score was 3.08(0.58). Significant factors positively associated with EQ include resilience score (adjusted b = 0.65, 95% CI 0.58, 0.72, p <0.001), preparedness for internship (adjusted b = 0.11, 95% CI 0.09, 0.13, p < 0.001), approach-style coping (adjusted b = 0.17, 95% CI 0.11, 0.24, p <0.001), and religiosity (adjusted b = 0.09, 95% CI 0.01, 0.17, p <0.001). In contrast, avoidant-style coping (adjusted b=−0.19, 95% CI –0.28, 0.11, p <0.001) is negatively associated with EQ. Adjusted R2 of 67.6% substantiated the goodness of fit of the regression model.

Conclusion

This study showed that there are a few modifiable factors that significantly influence EQ among medical interns; namely resilience, coping style, preparedness for internship, and religiosity. There is a positive association between EQ and approach coping style, and a negative relationship with avoidant coping. Approach coping encapsulates constructive responses to stress such as positive reframing, acceptance, seeking helpful information, and reaching for emotional support, while avoidant coping includes self-distraction, denial, venting, substance abuse, behavioural disengagement, and self-blame. These significant factors in this study such as coping and resilience can be learned and taught as a skill. These findings will aid medical schools to design programmes and improve the medical education to increase EQ among medical students who will become better medical interns and doctors in the future.
Enhancing Innovation and Creativity Amongst Trainees in Psychiatry: Linking the Clinical Practice, Academic, and Social Experiences
Authors: Okhiai Lopez , Loo Jiann Lin
Published: June 2022

Aims

In the face of constant and rapid changes in the landscape of medical practices especially psychiatry, innovation and creativity are essential competencies for all trainees to remain future-proof and competent in facing the future healthcare-related challenges. Recognising this, the General Medical Council (GMC) has highlighted the need for trainees to undertake any form of quality improvement initiatives to improve patients’ care, which trainees can struggle with. This article is aimed to share the authors reflective experience on how to improve their creativity during their training in psychiatry.

Methods

This is a self-study based on the authors’ personal reflections on experiences on promoting innovation and creativity in academic and non-academic work.

Results

One of the beginning points of learning how to be creative is to learn from others on how to formulate a question that can be answered using research. It can be achieved by reading journals, attending conferences, and watching up-to-date webinars. By modelling others, their ideas can be translated to local practice through adaptation which essentially involves the process of innovative work. Once a person has become more adept in asking questions, deliberate observation in clinical practice helps to consolidate creativity and ideas. With an appropriate level of curiosity, everyone's experience can potentially be transformed into research questions. Effort needs be invested to review available literatures. This will help to construct a clear picture of what is available and what is the gap that has yet to be filled in, i.e., the opportunity of improvement through innovation and creativity. Working in groups allows collaborative problem-solving approaches, which is a good platform to spark new ideas. It is common to encounter obstacles and pitfalls where perseverance is crucial as a trainee can explore alternative ways of problem-solving, which again is a source of innovation.

Conclusion

From the experience of the authors, a broad-based creative exploration is helpful at the initial stage and further narrowing of focus once a creative idea has taken off is important to ensure the vision of a project is achieved. Erich Fromm once said creativities requires the letting go of certainties. The core nature of psychiatry, i.e., the uncertainties is not a limitation but an opportunity to be capitalised. Rather than telling ourselves what is not possible, ask the question of “how can I do this differently”.
Redeveloping Leadership Training for Higher Trainees in the West Midlands
Authors: Patel Devika , Pantall Shay-Anne , Aziz Humaira , Nainar Feroz
Published: June 2022

Aims

Many of the competencies that trainees in psychiatry are required to achieve can be linked to leadership in the broadest sense, yet specific training is not often systematically provided. The West Midlands Psychiatry Leadership Development Programme aims to support the acquisition of important leadership skills already set out in the curriculum through provision of high-quality specialist leadership content within the existing programme. Here we present the findings of a scoping exercise exploring the views and attitudes towards leadership training held by higher trainees in psychiatry within the West Midlands.

Methods

All psychiatry higher trainees within West Midlands Deanery were invited to complete an anonymous online survey using Survey Monkey in November 2021. This survey incorporated questions about their preferred learning styles, confidence in their leadership skills and barriers to accessing leadership opportunities, generating both quantitative and qualitative data.

Results

Key results included:

•

37 responses were received. All subspeciality training programmes were represented. Almost half of respondents (46%) were ST6 or above and most were in training full time (84%).

•

Trainees expressed a preference for experiential learning about leadership (87%) as well as small group teaching (62%) and interactive workshop style content (62%).

•

Awareness of leadership opportunities was typically via their peer group (81%) or clinical supervisor (60%). Only 52% of trainees were aware of leadership opportunities within the Deanery.

•

Only 54% felt that existing leadership training met their curriculum requirements. Less than half of trainees (46%) felt confident to evidence their leadership experience within their training portfolio.

•

One-fifth of trainees (21%) reported experiencing barriers to leadership development. These included: inadequate awareness of opportunities, lack of senior support, time constraints and difficulty matching interests with available opportunities.

Conclusion

Trainees expressed interest in the redevelopment of a regional leadership training programme which would support them to achieve their curriculum competencies and prepare them for life as a consultant psychiatrist. The new multi-faceted regional leadership programme will offer resources in a variety of formats including webinars, podcasts, optional interactive workshops and action learning sets. It is hoped that this flexible programme, linked to the Medical Leadership Competency Framework, will better meet the needs of higher trainees as they pursue their own personal leadership journeys.
Setting Up a Cultural Psychiatry Group (CPG) at Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) – the Achievements, the Pitfalls and What We Have Learnt
Authors: Parsons Megan , Saeed Razan , Fathima Zulfiquar
Published: June 2022

Aims

Whilst psychiatry training is both demanding and enjoyable, we feel that the theory does not fully capture what we see in our everyday work. For many of our patients, it fails to contextualise their experience within their socio-politico-economic environment. Working with patients with different ways of seeing, knowing and being necessitates an awareness of one's own and the other's sociocultural world in order to build an empathetic and empowering doctor-patient partnership.

We started a CPG with the hope of exploring resources from those whose perspectives are often left out of our training experience, with a view towards integrating these voices together with our clinical experiences and training program. We aimed to create a space where we could regularly explore the experiences of ourselves, our patients, and the societies in which we work, reflecting on the conscious and unconscious roles we inhabit.

Our aims for the space were to: recognise that everyone will have something valuable to contribute. Cultivate a space where people feel able to share openly. Maintain the safety of the space through compassion and accountability. - Show willingness to be uncomfortable but continue engaging in order to learn together.

Methods

In Spring 2021, four Core Psychiatry Trainees from BSMHFT met together to plan a trust-wide CPG. There were three clear cycles of CPG meetings, the first consisting of member led sessions, the second outside speaker led sessions and the third an amalgamation of the two. Meetings were continually reviewed throughout each cycle with more formal evaluation and alteration at the end.

Results

The first part of the discussion focuses on what went well with the themes being:

–

Developing habits of lifelong learning

–

Developing relationships with peers and the community

–

Creating space for self and group reflection

–

Developing transferable skills (leadership, management, teamwork).

The second part of the discussion focusses on the problems that the group encountered and how they were overcome. The main themes being:

–

Technology

–

Communication

–

Engagement

–

Management.

Conclusion

At an individual level, this experience has been challenging but rewarding and we have received overwhelmingly positive feedback. Locally, the BSMHFT CPG has been invited to work with our trust on their “inequality strategy”, as well as universities and organisations represented by outside speakers. Nationally, the blueprint laid out in our conclusion aims to help those wanting to set up a similar group in their area benefit from our experience.
Improving Clinical Skills in Psychiatry Using Online Simulation
Authors: Rudra Sonya , Swerdlow Abigail
Published: June 2022

Aims

The COVID-19 pandemic impacted medical education with teaching moving online. The aim of this study was to evaluate whether online simulation is an effective tool for the delivery of student psychiatric clinical skills teaching. This has important implications for the future planning of psychiatric clinical skills teaching.

Methods

162 students were divided across nine online psychiatric simulation sessions held over a four month period. The sessions lasted 3.5 hours and consisted of three simulated scenarios with a professional actor and experienced facilitator. Students were asked to rate: confidence in taking a psychiatric history, conducting a mental state exam, formulating treatment plans, conducting risk assessment, assessing capacity and communicating with patients in psychiatry. Confidence ratings were completed pre and post session on Likert scale (1 = least confident, 10 = most confident). Students were also given the opportunity to provide qualitative feedback after the sessions. The study was conducted with permission from Associate Dean for Undergraduate Teaching and QMUL Centre Lead for Psychiatry.

Results

137 (92.7%) of students attending the workshop completed pre-session questionnaire and 122 (82.4%) completed post-session questionnaire. 95.1% students rated workshops as good/very good. Pre and post confidence comparisons showed significant increases in average confidence for all questions from pre (M = 5.1, SE = 0.2) to post (M = 7.1, SE = 0.2), t = 10.7 p < 0.001. Paired t-tests were used to compare average pre and post-session results for individual questions from the same session. All questions showed significant increases in scores. Qualitative feedback indicated that students valued the opportunity to practice, obtain feedback and requested more sessions.

Conclusion

Results show significant increases in confidence in psychiatric clinical skills using online psychiatric simulation. This supports our hypothesis that online simulation is an effective tool for delivery of student psychiatric clinical skills teaching. Students may benefit from online simulation increasing their confidence prior to attending psychiatric placements. This teaching method will also provide an additional method for practising clinical skills with increasing student numbers and demands on psychiatric placements. It therefore has important implications in the future of psychiatric education and could be adapted for use across clinical years and medical schools.
Face-to-Face Psychiatry Placements and Their Impact on Student Attitudes to Psychiatry
Authors: Swerdlow Abigail , Rudra Sonya
Published: June 2022

Aims

Last year the COVID-19 pandemic meant that there could not be any face-to-face psychiatry placements for medical students at QMUL (Queen Mary University of London). This year there has been a return to face-to-face placements within psychiatric settings. The aim of this project was to evaluate whether face-to-face placements have an impact on medical student attitudes to psychiatry. This will have implications for recruiting students into the specialty, once they qualify.

Methods

128 students were placed in face-to-face psychiatric settings at the beginning of their 4th year of medical school. The placements were 3 days a week for 5 weeks. The placements varied with some students being placed in inpatient services and others within the community, across a broad range of subspecialties including child and adolescent, general adult and forensic. Students were given the Attitudes To Psychiatry Questionnaire to fill out before and after their placement. Students were also given the opportunity to provide open text feedback on their placement in the form of a weekly feedback form. Results were analysed using simple descriptives of data and paired t-tests. The study was conducted with permission from Associate Dean for Undergraduate Teaching and QMUL Centre Lead for Psychiatry.

Results

115 students (89.8%) completed pre-placement attitudes to psychiatry questionnaire and 51 students (39.9%) completed the post-placement questionnaire.

Paired t-tests were used to compare average pre and post-placement results for individual questions. There were significant changes in student responses to questions about psychiatric undergraduate training being valuable, attitudes to psychiatrists and psychiatric treatment. Lots of students gave positive feedback on their placements citing interesting experiences, helpful seniors and varied learning opportunities.

Conclusion

Students having face-to-face psychiatry placements has objectively changed some attitudes to psychiatry and is very important for their experience and interest in the specialty. The students have valued the exposure and contact with patients and the varied experiences. This will hopefully lead to more students considering psychiatry as a career as well as keeping mental health as a priority for any patient that they see.
Implementation of Traffic Light System on Food Sold at Brockfield House Medium Secure Unit to Help Improve Healthy Food Options
Authors: Agunwamba Ngozi , Ho David , Deo Raman , Duffy Maniya , Madenlidou Stavroula , Larkin Fintan
Published: June 2022

Aims

Public Health England published a report in 2017 on Obesity in Secure Mental Health units. A key finding of the review was that not only is obesity and overweight more prevalent in the population detained within mental health secure units (with rates of up to 80% reported) than in the general population (around 60%), patients appear to be more at risk of weight gain when detained. The report found evidence that there is a high risk of weight gain following admission, stemming from the combined effects of incarceration, ease of access to high calorific food, and the potential lack of access to recommended levels of physical activity. This project aims to; 1. Implement a traffic light system on food and confectionaries sold at the shop at a Medium secure hospital. 2. Provide healthier food options at the shop by using the traffic light system as a visual aid 3. To achieve weight reduction and promote healthy lifestyle choices in patients admitted to our medium secure Forensic unit.

Methods

1.

Buying a new till system which is able to quantify what type of food is sold.

2.

Labelling food sold using a traffic light system.

3.

Calculate types of food sold following a three-month period after implementation.

Results

1.

Traffic light system provides a visual aid to patients in choosing healthier food.

2.

Patients in our medium secure unit achieve a reduction in their weight.

3.

Traffic light system can be replicated/ adopted by other secure hospitals.

Conclusion

The purpose of this research is to implement a traffic light system on food sold at a shop in our medium secure unit. It is hoped that by providing visual aids, patients have a means of easily identifying healthier food options. Choosing healthier food we hope will consequently result in weight reduction and overall improved lifestyle choices.
A Phenomenological Approach to Understanding the Association Between Psychosis and Violence
Authors: Anderson Coral , Nathan Rajan
Published: June 2022

Aims

Although there is an established but complex relationship between violence and psychosis, the nature of this relationship remains unclear. To date, there has been a predominant focus within group-level quantitative studies on specific types of psychopathology such as threat/control-override and command hallucinations. However, the literature has not produced a consensus on the profile of psychopathological predictors of violence. Furthermore, there is an emerging literature suggesting the predictive paradigm has limited clinical utility in the management of harm-related behaviour. In the way that phenomenological analysis has produced a fuller understanding of psychosis (that can inform improved aetiological and interventional frameworks), the authors assert that such an approach (with its focus on subjectivity) has the potential to advance our understanding of the relationship between psychosis and violence in a way that has clinical applicability. To test this assertion, it is necessary to develop a model of assessment and analysis. The aim of this paper is to develop an evidence-based model to explore the phenomenological underpinnings of violence in psychosis.

Methods

A two-stage method was followed. Firstly, drawing on existing phenomenological accounts of psychosis and approaches to understanding the subjectivity of violence perpetration, the authors developed a pilot evaluation model. This was tested and revised by applying the model to phenomenological case reports of psychosis and violence.

Results

The findings so far demonstrate that as well as the role of circumscribed psychopathology on the likelihood of violence, other experiences within the psychotic spectrum such as operative hyperreflexivity and disturbances of ipseity play an important role. Additionally, feelings of disconnectedness and loss of recognising others as real combined with impaired theory of mind can lead to loss of normal inhibitory processes and violent behaviour. In keeping with a recent shift in focus from strict diagnostic criteria to individual psychotic phenomena, existential analysis can be applied to explore changes in self-identity and sense of belonging in the world to develop our understanding of the association between psychosis and violence.

Conclusion

The phenomenological model developed produces a fuller picture of the association between psychosis and violence. As such it may generate insight into the association between psychosis and violence that has greater clinical utility than existing psychopathology-based theories do. This needs to be evaluated by field testing of the approach.
Gross Bimodal Diurnality in Dementia Behavioural Symptoms in an Inpatient Setting: High Noon and Sundown
Authors: Anderson David , Hamza Neveen , Reid Keith , Richardson Jonathan
Published: June 2022

Aims

Our purpose-built dementia unit investigates temperature and Behavioural and Psychological Symptoms of Dementia (BPSD). We sought to control for diurnality. Sundown Syndrome (SS) is emergence or worsening of BPSD in the late afternoon or early evening. The literature affords debate. Our methods of controlling for time as a confounder for temperature generated contributions which we offer here.

Methods

Data were collected from two Older People's Organic wards within the Cumbria, Northumberland Tyne and Wear NHS Foundation Trust. Collection used the Trust's “Talk First” data system. That is an established, verified record, including “aggression” (non-contact) or “violence” (contact). Data from 16 months, September 2019 to January 2021 were analysed.

Patients had moderate or severe dementia. Wards care for a maximum of 14 patients and serve either men or women. Data for the communal corridor and day room of each ward were analysed. This gave four site

We used two methods. The first was basic, the overall histogram of incidents through the day.

The second analysis counts “incident signals” from each time or temperature. Each actual occurring combination of temperature and time is assigned a “cell”. The background rate of all incidents per all cells is known. Any incident in any rare cell has low binomial probability. Low probabilities mean high “signal”. The square of sums of signals across each hour provides each hour's “incident signal”.

Results

Median ages were 79 (women) and 82 (men). There were 99 incidents.

The histogram has two peaks, around lunchtime and evening. Late afternoon is relatively safe. Thermal incident signals are summarised as moderately coherent. Diurnal incident signals controlling for temperature did not show any coherent trend.

Conclusion

We proffer approaches for controlling for temperature and time of day. The project has limits. We have a small sample. We have not compared sunset times; but that is not relevant to the mid-day peak. We present secondary data from an evaluation aimed at temperature. More favourably this is an a priori sample, shows the same thing is two ways, and adds to debate on an important and critiqued construct. Though SS uses “sun” as a shorthand, any effect will be mediated bio-psychosocially via light, social interaction, heat, circadian rhythms, etc. Our data support social interaction more than time of day. This may add to or challenge SS as a construct.
The Correlation Between Parenting Styles and Self-Esteem of Medical Students: A Cross-Sectional Study
Authors: Gul Fahad , Abbas Khawar , Saeed Sajeel , Arish Muhammad , Haider Tehseen , Tousif Kashif , Basit Jawad
Published: June 2022

Aims

Among various factors that determine an individual's self-esteem, parenting styles play a very significant role in this regard. Certain parenting styles that are practiced around the globe include authoritarian, authoritative and permissive parenting. The study aimed to investigate the co-relation between parenting styles and self-esteem among medical students.

Methods

A cross-sectional study was conducted among the MBBS students of Rawalpindi Medical University, Rawalpindi from December 2020 to March 2021. 255 students took part in this study. An online survey was prepared by using Parental Authority Questionnaire-Short Version and Rosenberg Self-Esteem Scale and students were asked to fill it. Simple Random sampling technique was applied. SPSS version 26.0 was used to enter and analyze data. Pearson Correlation, Logistic regression and Hierarchal regression analysis were applied.

Results

Out of 230, 60% of the sample population experienced authoritative, 29% experienced authoritarian whereas 11% experienced permissive style of parenting. Authoritative (r = 0.283, p < 0.001) and authoritarian (r = -0.227, p < 0.001) parenting styles were significantly correlated with self-esteem. Authoritarian parenting style (AOR = 2.20, 95% CI: 1.17, 4.14) was significantly associated with self-esteem of the participants compared to authoritative parenting style.

Conclusion

Results indicated that authoritative parenting was only parenting style that correlates positively with self-esteem which suggest authoritative parenting is the optimum parenting style in Pakistani culture.
Association of Social Anxiety Disorder and Physical Activity With Psychological Distress During COVID-19 Imposed Lockdown: A Medical Student Survey From a Developing Country
Authors: Arish Muhammad , Arham Muhammad , Rehan Fatima , Saeed Sajeel , Tousif Kashif , Farhan Muhammad
Published: June 2022

Aims

COVID-19 imposed lockdowns have impacted the mental health of medical students worldwide. However, the relationship of social anxiety disorder with psychological distress during the pandemic has not been studied. The objective of this study was to assess the association of social anxiety disorder and physical activity with psychological distress in medical students during COVID-19 imposed lockdown.

Methods

256 medical students (M/F: 144/112) took part in this online cross-sectional survey conducted in September 2020 during a government imposed lockdown. Kessler-10 (K10) questionnaire, social interaction anxiety scale (SIAS) and international physical activity questionnaire (IPAQ) - short form were used to assess psychological distress, social anxiety and physical activity, respectively. Data were analysed using SPSS v25, with application of multivariate logistic regression to assess association of various factors with psychological distress.

Results

Out of 256 medical students, 73 (28.5%) had severe psychological distress and 105 (41.0%) had mild to moderate distress. A logistic regression model to assess the effect of social anxiety disorder, level of physical activity and gender with the likelihood of having severe psychological distress was statistically significant (p < 0.001) with overall accuracy of 73.8%. The risk of developing severe psychological distress was higher among females [OR 2.13 (95% CI 1.17–3.87), p = 0.013] and those with social anxiety disorder [OR 4.56 (95% CI 2.27–9.16), p < 0.001]. Low physical activity was not a significant risk factor for psychological distress [OR 0.88 (95% CI 0.35–2.23), p = 0.794].

Conclusion

This study shows that COVID-19 imposed lockdown has adversely affected the mental health of medical students. Female students and those with social anxiety disorder are at more risk of developing severe psychological distress.
A Feasibility Evaluation of Discovery Group: Determining the Acceptability and Potential Outcomes of a Patient-led Research Group in a Secure Mental Health Inpatient setting
Authors: Arslan Mudassar , Aboaja Anne , Atewogboye Oluwatosin , Parry-Newton Lucia , Wilson Lindsey
Published: June 2022

Aims

Patient and public involvement and engagement (PPIE) is recognised as an essential part of health research. It provides an opportunity for patients to shape health research and acquire research skills, in the inpatient mental health setting, PPIE may have additional value in providing meaningful activity and enhancing recovery, as defined using connectedness, hope, identity, meaning and empowerment (CHIME) principles. An eight -session PPIE programme (“Discovery Group”) was designed to support patient-led research in a secure mental health hospital. This feasibility study aims to evaluate the acceptability of the programme from the perspective of patients and identify potential outcomes.

Methods

A retrospective single-arm post-programme evaluation of Discovery Group was undertaken. Participants attended an evaluation workshop where they were interviewed individually to complete an acceptability questionnaire designed using the domains of the Theoretical Framework of Acceptability. Participants also completed an outcomes questionnaire, which included CHIME-based recovery items. Quantitative data were analysed descriptively. Direct content analysis was applied to qualitative data.

Results

In our sample, eight participants attended at least one session of the discovery group with one patient attending all sessions. Most of the participants felt positive about taking part in the group and expressed interest in joining another group in future. All participants experienced some burden from the effort required during group sessions, but a low level of opportunity cost in terms of the extent to which they perceived they had to forfeit benefits to participate in the programme.Some described the group as effective in helping them learn about research. Of the five CHIME recovery domains, only connectedness was reported as a benefit of the group. The participants valued the opportunity to use their time.

Conclusion

Discovery Group is a novel intervention that offers high level, non-tokenistic PPIE suitable for use in secure mental health inpatient settings. It produces research of value to patients through a programme of high acceptability and provides them with potential benefits of recovery as well as research knowledge and skills, and an activity that alleviates boredom, enhances autonomy, breaks down some important power and paternalistic barriers that can be experienced by patients detained in secure mental health settings. Finally, a future evaluation study that involves patients during the design, implementation, evaluation and writing stages, aiming to measure the potential outcomes identified in the present study using pre- and post-testing with a control group would reliably demonstrate the effectiveness of the revised Discovery Group and ensure meaningful involvement with patients as co-researchers.
‘Sheldon' in the Medical Field: Emotional Intelligence and Its Associated Factors in Medical Students of Pakistan
Authors: Athar Unsa , Rehman Muhammad Bilal , Nawaz Ahsan , Siddique Aimen , Fatima Ambreen , Khan Alamgir Aslam , Nagi Muhammad Luqman
Published: June 2022

Aims

The dearth of emotional intelligence leads to medical students’ inability to handle the pressures of medical education, sub-sequently causing burnout and mental illnesses. Poor emotional intelligence in young doctors also begets increased mistrust from the public, lowering the quality of healthcare delivery. Emotional intelligence of Pakistani students, similar to global context, is impacted by a myriad of psycho-socio-economic factors. It is pertinent to find out the detrimental and/or protective factors, and design interventions to enhance emotional intelligence as a soft skill. With this aim in mind, we explored the relationship of emotional intelligence with adverse childhood experiences and prevalent mental illnesses (depression and anxiety) amongst the medical students of one of the most populous cities of Pakistan; Lahore.

Methods

A cross-sectional study was conducted including currently enrolled MBBS (Bachelor of Medicine and Surgery) students from first year to final year in 2 medical schools of Lahore. An online google form was constructed by combining Modified Adverse Childhood Experiences Score Scale (ACES), Brief Emotional Intelligence Scale (BEIS-10) and Hospital Depression and Anxiety Scale (HADS). Data were exported to SPSS version 25.0 for descriptive and analytical analysis. Pearson's chi-square analysis and logistic regression analysis were used to study the association between the outcome and dependent variables; Odd's ratio (OR) with 95% Confidence Intervals (CI) were calculated.

Results

Participants (N = 324) belonging to two different medical colleges in Lahore, namely King Edward Medical College (public) and Shalamar Medical and Dental College (private), took part in the study.

Pearson's chi-square showed significant association of emotional intelligence with early private schooling (p = 0.029), nuclear family system (0.044) and the presence of symptoms of depression (0.005). The adjusted logistic regression model showed that people who studied in a private sector school (OR: 2.12, CI: 1.01–4.45) and people who lived in a nuclear family (OR: 2.02, CI: 1.00–4.08) had significantly twice the likelihood of having high emotional intelligence. Also noteworthy is that respondents who were depressed according to HADS showed significantly lower emotional intelligence (OR: 0.37, CI: 0.16–0.86)

Conclusion

Emotional intelligence is now being recognized as an important life skill for healthcare providers. Emotional intelligence of medical undergraduates is influenced by a number of factors such as early schooling, family's living situation, current mental health and adverse childhood experiences. More prospective researches should be conducted to evaluate these relationships. Carefully crafted interventions for improving emotional intelligence for medical students must be implied at an early level to achieve better outcomes from medical education.
Comparative Study of Care Home Referrals During Three National COVID-19 Pandemic Lockdowns
Authors: Badrakalimuthu Vellingiri Raja
Published: June 2022

Aims

To compare characteristics, presentation and treatment of care home patients referred to care home pathway team during three lockdowns.

Methods

Data were collected from referrals to G&W care home pathway team during lock downs:

First: 23rd March 2020 to 30th June 2020

Second: 5th November 2020 to 2nd December 2020

Third: 5th January 2021 to 8th March 2021

Variables collected included number of referrals, age, gender, type of care home, reason for referral, type of behavioural and psychological symptoms of dementia (BPSD), diagnosis, new diagnosis of dementia, comorbidity, type and professional to make initial contact, blood tests at point of referral, appointments, duration on caseload, type of interventions for BPSD, admission, and use of antipsychotics. They were analysed for statistical significance at p value <0.05.

Results

There were 23, 21 and 34 referrals respectively in the three lockdowns, with significant reduction in the weekly average of referrals (1.6), and number of men (17.4%) referred in the first lockdown. Significantly greater proportion of referrals in first lockdown was for BPSD (65.2%), with aggression (40%) as most common BPSD. Alzheimer's dementia was commonest dementia (67%) across lockdowns with fewer new diagnosis (21.7%) made in first lockdown. There was lower rate of delirium (21.7%) in fist lockdown associated with fewer blood investigations (56.5%) at point of referral. Although there was no difference by type of professional, number of appointments, and discharges, duration on caseload (median 58.5 days) was significantly longer during first lockdown. There was access to medical, nursing, and psychological therapies input during all lockdowns. There was reduction in medication prescription including antipsychotics (33%), with no new antipsychotics commenced in all lockdowns.

Conclusion

Despite availability of mental health services, this study highlights reduction in access to mental health services as well as physical health investigations for elderly residents in care homes during the first lockdown.
Theory of Mind Deficits in Bipolar Disorder in Remission
Authors: Chauhan Shravani
Published: June 2022

Aims

Theory of mind (ToM) is the ability to represent one's own and other's mental state. Studies in bipolar affective disorder show mixed results possible due to confounding factors like intelligence, attention, phase of illness and current mood. Purpose of this study is to study ToM in remittent bipolar disorder patients and compare with normal controls to find if there are residual deficits during remission

Methods

40 bipolar patients in remission and 40 age and sex matched controls were recruited. Clinical remission for 3 months with YMRS <4 and HAM-D <7 was inclusion criteria. ToM was assessed by Faux Pas test. Data were analysed using SPSS-11.5 for Windows with parametric and non-parametric tests as indicated. Level of significance taken as p < 0.05 (two tailed).

Results

Mean age of onset of illness in patient group was 23.8 years with duration of illness 11.3 years. Mean number of episodes 6.7 and duration of remission 4.15 months. ToM test result revealed deficit in recognizing social cues in faux pas test by bipolar patients as compared to normal controls. There was no difference between both groups in test result on control stories.

Conclusion

Results suggest that ToM deficits are present in bipolar disorder patients even during apparent clinical remission, indicating it may be a trait marker of the illness. There is no deficit in understanding a regular social context without faux pas. It also revealed that there is no correlation with ToM and duration of illness
Origins of Callous-Unemotional Behaviours in Infants
Authors: Cheung Gloria , Whitehead Francesca , Geangu Elena
Published: June 2022

Aims

Callous-unemotional (CU) trait is a characteristic of conduct disorder. As CU-like behaviours emerge from early childhood, this could potentially be predicted early on in life. There is debate in whether general or specifically fear expression processing was impaired in those with CU traits. No studies investigated subliminal emotion processing in those with CU traits. Hence, this study addressed two questions. Firstly, we investigated whether attention to general facial expression or fearful expression is related to future CU behaviours. Secondly, we examined whether subliminal emotion processing can predict CU behaviours alongside supraliminal emotion processing by comparing EEG data to CU behaviours.

Methods

We performed EEG on 7 months old infants using fearful and happy faces as stimuli to investigate whether attention bias to general facial expression or fearful expression is related to future CU behaviours through the Nc component (300–600ms). We also used both subliminal and supraliminal eliciting techniques to determine whether there are any differences in terms of prediction of CU behaviours. The ERP data were then compared with behavioural data, including aggression and empathy scores, collected when the participants reach 14 to 18 months old through the infant-toddler version of the Multidimensional Assessment of Preschool Disruptive Behavior (MAP-DB) and the infant empathy and prosocial behaviour (IEPB) questionnaires.

Results

A total of 18 infant participants were included in our analyses. There is a significant interaction between emotion and empathy for the Nc component, but not aggression. Infants with low empathy paid less attention to fearful facial expressions compared to happy facial expressions while those with high empathy paid more attention to fearful facial expressions compared to happy facial expressions. Moreover, subliminal and supraliminal emotion processing had similar ERP eliciting ability.

Conclusion

Our study showed those with less empathy have a different pattern of attention bias to emotional expression and are less sensitive to fear emotion. Attention bias to emotional expression during infancy could be used to predict CU behaviours during toddlerhood. Being able to predict CU behaviours before their occurrence could help identify those in need of early intervention and help identify potential participants for longitudinal studies that could aid the development of interventions and understanding of CU behaviours. Furthermore, subliminal and supraliminal emotion processing has a similar predicting ability for CU behaviours. This is the first study that investigated subliminal emotion processing in infants with CU behaviours. Future studies would need to include a larger sample size to verify our findings.
The SHIELD Project: Designing an Intervention for Social Media With Young People
Authors: Cheung Gloria , Varvari Ioana , Fenton Clare
Published: June 2022

Aims

The primary aims of our study is to gather ideas from young people about developing an intervention for children who first started using social media. Our study also aims to investigate whether different types of social media use are associated with impact of social media on emotions and self-esteem.

Methods

An anonymous questionnaire was distributed to young people (16–25 years old), who were UK residents, through word of mouth, social media and university newsletters. We assessed participants’ baseline characteristics, including types of social media use (active, active-passive and passive), impact of social media. We also explored young people's idea on developing a social media intervention, including how it should be delivered, topics that needs to be covered. Quantitative data were analysed using descriptive statistics and ordinal regression analysis.

Results

90 young people completed the questionnaire. 37.8% of the participants started using social media before 13 years old. Analysis has shown that interacting with other users and creating social media content is associated with higher self-rated negative impact on self-esteem from social media, but there is no association between impact on self-esteem and reacting to other's social media content or browsing other's social media content. Types of social media use were not associated with a self-rated impact of social media on emotions. Regarding the co-development of an intervention for social media, young people believe the best ways to distribute information about social media is through an interactive session by professionals (36.7%) or teaching it in class (28.9%) while the least popular ways are poster/booklet (1.11%) and mobile phone app (1.11%). The majority of young people felt the following topics on social media to be useful to cover during interventions, including risks on social media (85.6%), emotional safety on social media (81.1%), social media hygiene (70.0%), coping strategies and finding help on social media (66.7%), communication on social media (58.9%).

Conclusion

Although types of social media use are not associated with impact on emotions from social media, those who create social media content are at higher risk of having more impact on self-esteem. Interventions should be developed to help protect or improve self-esteem while using social media. This could be done by focusing on different topics. Future interventions for young social media users should be interactive and led by experts. They should also start before children reaches the common legal age of social media use to make them more resilient to the digital world.
From Infancy to Modern Day: The History of Mother and Baby Units in the United Kingdom
Authors: Chin Rui-Ernn Natassia , Lim Mao Fong
Published: June 2022

Aims

Mother and baby units (MBUs) are inpatient units where women with severe acute postpartum psychiatric problems can be cared for alongside their babies. This is currently considered to be gold-standard care, recognising the importance of early childhood bonding and family-centered care. Great Britain has spearheaded the development of the MBU, however the history of MBUs in the United Kingdom (UK) has never been published.

Methods

Through a narrative review of published and grey literature, we explore the development of the MBU in the UK, from its infancy to modern day.

Results

We outline the history of the MBU model of care, from its early conception to current state. We also examine factors contributing towards the expansion of MBUs and more broadly, the expansion of perinatal mental health services throughout the UK. We also briefly describe the approach to MBUs worldwide, taking into consideration sociocultural differences and approaches to caring for the mother-baby dyad.

Conclusion

Since its conception, there has been considerable investment in and expansion of perinatal mental health services, both in community and inpatient settings. Sustained research and continued advocacy is required to expand provision of care.
Mind and Spirit. Chaplaincy and Spiritual Care in Inpatient Psychiatry – a Qualitative Study
Authors: Diamantis Elias , Miles-Marsh Rupert , Stowell Anita
Published: June 2022

Aims

Introduction. Despite society's secularisation, as of 2019 only 38.4% of the population of England and Wales identified as “No Religion”. The integration of chaplaincy and spiritual care teams into health services varies widely and we undertook this qualitative research to better understand the spiritual needs on psychiatric wards.

Methods

Between October 2021 and January 2022, we carried out semi-structured interviews with 10 patients and 10 staff-members, convenience sampled from acute General Adult Wards. The interviews were approximately 10–15 minutes long, documented in shorthand, compiled, and analysed thematically.

Results

Themes (P = patient, S = staff member)

1. Religion and belief, or lack of it, defies categorisation

P1 (36M) identified as Christian but didn't really believe, whilst S2 (Nurse Clinical Team Leader) professed no religion but prayed that her sister would be healed. P7 (59F) was brought up Christian but thought religion was a fantasy. P2(21M) identified as Wiccan but thought all religions hold truth.

2. An incarnational, embodied service

P9 (33F) wished chaplains wandered around the wards and S10 (F1 Junior Doctor) praised their presence in general hospitals. P1 wanted a “prayer circle” and S5 (Student Nurse) suggested weekly worship services.

3. Space to “be”

S10 liked an empty chapel to think in and P4 (29M) said he was Lacking space for reflection and meditation.

4. Unmet needs

P9 felt abandoned by God during the admission and her vicar had recently died. She wanted someone to sit, pray with her and point her to helpful scriptures but was not aware of the existence of chaplaincy. Of the patients, only P3 knew how to contact the service and S8 said it was rarely discussed by the MDT.

5. Caution, ignorance and suspicion

S1 and S8 said chaplaincy visits are sometimes distressing for patients preoccupied with devils and demons and P5 (26M) was worried they'd judge him.

6. Links with wider faith communities

P6 (46F) would like to attend church with her family, P4(29M) would like to know where he could go to worship and S2 was also curious of what's available outside hospital.

Conclusion

Discussion and clinical implications

Despite limitations of small size and recruitment bias, the themes emphasise the complexity of understanding someone's spirituality. It highlights a call for a more visible presence and thoughtful consideration of what a spiritual need is and how it can be met.

Ward visits should be prioritised, having recently been limited by COVID-19 restrictions. Patient information and staff education regarding chaplaincy and spiritual care is urgently needed on psychiatric inpatient wards.