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1.
Adm Policy Ment Health ; 50(6): 849-860, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37428398

RESUMO

This multicenter cross-sectional study explored the responsiveness of Mental Health Services (MHS) to two years of COVID-19 emergency in Italy. Specifically, the study explored the ability of staff to: acknowledge users' capabilities and value teamwork; reinvent the service and maintain/introduce good practices; and, acknowledge the positive aspects of the pandemic experience. These aspects were investigated in relation to socio-demographic and professional variables. Professionals from 17 MHS of 15 Italian Regions completed an online questionnaire on the MHS transformation during COVID-19. Data were collected at the end of the national health emergency (March 1-April 30, 2022). Most of the 1077 participants said they: paid more attention to users' physical health; revised treatment plans; mediated between user needs and safe work procedures; revalued the importance of gestures and habits; discovered unexpected personal resources in users; and, found positive aspects in the COVID-19 experience. The multivariate analyses showed significant differences in staff opinions related to gender, workplace, professional role, and geographic area of the MHS, covarying with staff work experience. Compared to male staff, female staff perceived MHS as more flexible and capable to maintain best practices, and female staff acknowledged more capabilities to the users. Compared to central and northern Italy staff, southern Italy staff gave more values to teamwork, perceived MHS as more capable to maintain best practices and acknowledged higher positive transformations. These findings may be useful for planning community-oriented MHS in the post-pandemic period, taking into account both the experience gained by staff and the MHS process of adaptation.


Assuntos
COVID-19 , Serviços de Saúde Mental , Humanos , Masculino , Feminino , Estudos Transversais , Pandemias , Itália/epidemiologia
2.
Community Ment Health J ; 58(8): 1437-1447, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35218472

RESUMO

This study investigated whether priests' attitudes regarding individuals with schizophrenia and depression participating in religious practices varied in relation to priests' adherence to prejudices about these mental disorders (MD). A sample of 559 Italian priests completed a questionnaire on their views of either schizophrenia or depression. Data were analyzed using a multiple-group structural equation in which the diagnostic group was a moderator and the size of the municipalities in which the churches were located was a covariate. The study revealed that: priests' attitudes towards churchgoers with MDs are related to views of these individuals as dangerous, easy to recognize and poorly aware of their MDs; community size has a direct effect on priests' attitudes and an indirect effect through perceived dangerousness; the above-mentioned relationships do not differ by type of disorder. Sensitizing priests on stigma may be helpful to facilitate the participation of believers with MDs to religious practices.


Assuntos
Clero , Esquizofrenia , Humanos , Catolicismo , Depressão , Preconceito
3.
J Relig Health ; 60(2): 1318-1338, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33263840

RESUMO

This study explored views of Catholic priests about schizophrenia and depression in Italy. Participants completed a questionnaire on their views about either schizophrenia (N = 282) or depression (N = 277). The depression group was surer than the schizophrenia group that: the disorder was due to psychosocial causes; curable; non-requiring long-term pharmacotherapy; the persons with depression could participate in religious activities. The older priests were more convinced than the younger priests that: the prayer and long-term pharmacotherapy are useful; the persons with mental disorders had affective difficulties, are recognizable and kept at distance. Priests should receive education on stigma in mental disorders, particularly schizophrenia.


Assuntos
Esquizofrenia , Catolicismo , Clero , Depressão/terapia , Humanos , Itália , Esquizofrenia/complicações , Esquizofrenia/terapia
4.
Community Ment Health J ; 56(6): 1077-1084, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32020387

RESUMO

This study explored the views of non-psychiatric medical specialists about people with schizophrenia and depression and examined whether specialists' approach to these clients, and their perception of dangerousness and social distance, differed by disorder. Non-psychiatric medical specialists working in community centers in Italy read either a schizophrenia or depression description and then completed a questionnaire on their views about people with that disorder. The schizophrenia-group (N = 114) was more sure than the depression-group (N = 97) that the patients should be approached differently in outpatient specialized clinics like those where the respondents worked; are incapable of caring for their own health; and are kept at distance by others. Perceived dangerousness did not significantly differ between the two groups. These findings highlight the potential effects of attitudes on medical practice and outline the need to educate non-psychiatric medical specialists on stigma as a strategy to reduce health discrepancies, particularly toward people diagnosed with schizophrenia.


Assuntos
Esquizofrenia , Depressão/terapia , Humanos , Itália , Esquizofrenia/terapia , Estigma Social , Especialização , Inquéritos e Questionários
5.
Community Ment Health J ; 52(3): 361-9, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26081981

RESUMO

This study explored views of 566 Italian psychology students about schizophrenia. The most frequently cited causes were psychological traumas (68 %) and heredity (54 %). Thirty-three percent of students firmly believed that people with the condition could recover. Reporting heredity among the causes, and identifying schizophrenia were both associated with prognostic pessimism, greater confidence in pharmacological treatments and lower confidence in psychological treatments. Schizophrenia labeling was also associated with higher perception of unpredictability and dangerousness. Compared to first year students, fourth/fifth year students more frequently reported heredity among the causes, and were more pessimistic about schizophrenia recovery. Stigma topics should be included in future psychologists' education.


Assuntos
Atitude Frente a Saúde , Psicologia/educação , Esquizofrenia , Psicologia do Esquizofrênico , Estigma Social , Estereotipagem , Estudantes/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Itália , Masculino , Esquizofrenia/diagnóstico , Esquizofrenia/etiologia , Esquizofrenia/terapia , Adulto Jovem
6.
Muscle Nerve ; 52(1): 13-21, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25363165

RESUMO

INTRODUCTION: This study explores burden and social and professional support in families of young patients with muscular dystrophies (MDs) in Italy. METHODS: The study was carried out on 502 key relatives of 4- to 25-year-old patients suffering from Duchenne, Becker, or Limb-Girdle MD who were living with at least 1 adult relative. RESULTS: A total of 77.1% of relatives reported feelings of loss, 74.0% had feelings of sadness, and 59.1% had constraints in leisure activities. Burden was higher among relatives of patients with higher disability and who spent more daily hours in caregiving. Practical difficulties were higher among relatives who perceived lower help in patient emergencies and less practical support by their social network. Psychological burden was higher in those relatives who were unemployed, those with poorer support in emergencies, and those with lower social contacts. CONCLUSIONS: Caring for patients with MDs may be demanding for relatives even in the early stages of these disorders, especially when social support is poor and the patient's disability increases.


Assuntos
Família/psicologia , Distrofias Musculares/economia , Distrofias Musculares/epidemiologia , Relações Profissional-Paciente , Apoio Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Distrofias Musculares/terapia , Análise de Regressão , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
7.
Acta Myol ; 33(3): 136-43, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25873782

RESUMO

This study explored the burden in parents and healthy siblings of 4-17 year-old patients with Duchenne (DMD) and Becker (BMD) muscular dystrophies, and whether the burden varied according to clinical aspects and social resources. Data on socio-demographic characteristics, patient's clinical history, parent and healthy children burden, and on parent's social resources were collected using self-reported questionnaires administered to 336 parents of patients with DMD (246) and BMD (90). Parents of patients with DMD reported higher burden than those of patients with BMD, especially concerning feeling of loss (84.3% DMD vs. 57.4% BMD), stigma (44.2% DMD vs. 5.5% BMD) and neglect of hobbies (69.0% DMD vs. 32.5% BMD). Despite the burden, 66% DMD and 62.4% BMD parents stated the caregiving experience had a positive impact on their lives. A minority of parents believed MD has a negative influence on the psychological well-being (31.0% DMD vs. 12.8% BMD), and social life of unaffected children (25.7% vs. 18.4%). In the DMD group, burden correlated with duration of illness and parent age, and burden was higher among parents with lower social contacts and support in emergencies. In DMD, difficulties among healthy children were reported as higher by parents who were older, had higher burden and lower social contacts. In both groups, burden increased in relation to patient disability. These findings underline that the psychological support to be provided to parents of patients with MD, should take into account clinical features of the disease.


Assuntos
Cuidadores , Saúde da Família , Distrofia Muscular de Duchenne , Pais/psicologia , Irmãos/psicologia , Adolescente , Adulto , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Família , Humanos , Itália , Pessoa de Meia-Idade , Distrofia Muscular de Duchenne/fisiopatologia , Distrofia Muscular de Duchenne/psicologia , Apoio Social , Fatores Socioeconômicos
8.
J Psychosom Res ; 184: 111856, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38972099

RESUMO

OBJECTIVE: To investigate fear of hypoglycemia (FoH) in parents of children with type 1 diabetes (T1D) before and after undergoing training to learn intranasal (IN) glucagon administration. METHOD: In this pre-test/post-test uncontrolled study 364 caregivers of patients with T1D (6-18 years) completed questionnaires measuring sociodemographic characteristics, diabetes-related factors (e.g., type of insulin therapy, glycemic control), and parents' trait anxiety. Parents' FoH was assessed at baseline (T0, training) and after nine months (T1). Two repeated-measure mixed analyses of covariance (ANCOVA) compared the FoH at T0 and at T1 and analyzed the moderating roles of anxiety proneness and type of insulin therapy, as well as of anxiety proneness and use of sensor. Age, T1D duration, HbA1c values, and SES were included as covariates. RESULTS: Parental FoH at T1 (M = 1.72; SE = 0.06/M = 1.57; SE = 0.09) was significantly lower than parental FoH at T0 (M = 1.89; SE = 0.06/M = 1.77; SE = 0.09). The group with high trait-anxiety had a higher level of FoH (M = 2.05; SE = 0.08/M = 1.89; SE = 0.12) than the group with low trait-anxiety (M = 1.57; SE = 0.08/M = 1.46; SE = 0.09) at both time points. SES was negatively associated with FoH at T0 (t = -2.87; p = .004/t = -2.87; p = .005). No other significant effects were found. CONCLUSIONS: Training and educating parents on IN glucagon use can help them effectively manage hypoglycemic episodes and alleviate the fear that generally accompany such events.

9.
Soc Psychiatry Psychiatr Epidemiol ; 48(10): 1647-55, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23117816

RESUMO

PURPOSE: This study explored medical students' causal explanations and views of schizophrenia, and whether they changed during medical education. METHOD: The survey was carried out on medical students of the Second University of Naples, Italy, who attended their first-year and their fifth- or sixth-year of lessons. The 381 who accepted were asked to read a case-vignette describing a person who met the ICD-10 criteria for schizophrenia and then fill in the Opinions on mental illness Questionnaire. RESULTS: The most frequently cited causes were psychological traumas (60%) and stress (56%), followed by misuse of street drugs (47%), and heredity (42%). 28% of students stated that persons with the disorder could be well again, and 28% that they were unpredictable. Labeling the case as "schizophrenia" and naming heredity among the causes were associated with pessimism about recovery and higher perception of social distance. First-year students more frequently reported psychological traumas among the causes (76 vs. 45%), and less frequently heredity (35 vs. 81%) and stress (42 vs. 69%), and they perceived less social distance from the "schizophrenics" than fifth/sixth-year students. In particular, 18% percent of first-year versus 38% of fifth/sixth-year students believed that these persons were kept at a distance by the other, and 45 versus 57% felt frightened by persons with the condition. CONCLUSIONS: These results indicate a need to include education on stigma and recovery in schizophrenia in the training of medical students.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Psiquiatria/educação , Esquizofrenia/etiologia , Estudantes de Medicina/psicologia , Adulto , Educação de Graduação em Medicina/métodos , Feminino , Humanos , Itália , Masculino , Esquizofrenia/diagnóstico , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários
10.
J Psychosoc Rehabil Ment Health ; : 1-13, 2022 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-36217317

RESUMO

Psychology students are a target population to increase the likelihood that Persons With Schizophrenia (PWS) will receive evidence-based psycho-social interventions in the future. The willingness of future psychologists to care for PWS can be supported through anti-stigma educational interventions. During the pandemic, university education was delivered largely at-distance, which was later combined with in-presence education. This study explored whether an At-Distance Educational Intervention (ADEI), addressing stigma in schizophrenia via scientific evidence and testimony: would improve psychology students' views of PWS, at the one-month post intervention re-assessments; would be more effective of the same In-Presence Educational Intervention (IPEI). ADEI was delivered online to students of two Master's degrees in Psychology at the University of Campania "Luigi Vanvitelli", Caserta, Italy. IPEI was administered to a similar group of 76 students in the pre-pandemic era. Participants completed an anonymous questionnaire about their views on schizophrenia before the intervention (two three-hour sessions one week apart) and one month after its completion. Compared to their pre-intervention assessments, at post-intervention reassessments the 65 ADEI students were: more confident in the recovery and the usefulness of psychological therapies; surer of the PWS awareness and capability to report health problems to professionals; more skeptical about PWS dangerousness, social distance, and affective difficulties; more uncertain on the opportunity to discriminate PWS in hospital and psychology practices. ADEI was more effective than IPEI in five of the ten dimensions analyzed and similarly effective in the remaining others. ADEI may represent a valuable alternative to IPEI for improving future psychologists' view of PWS. Supplementary Information: The online version contains supplementary material available at 10.1007/s40737-022-00308-1.

11.
Acta Myol ; 41(2): 89-94, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35832506

RESUMO

This study explored views of users with muscular dystrophies and their caregivers on staff-user relationships and the treatments provided by a Rehabilitation Centre during the pandemic. Patients and relatives were asked to anonymously complete an open-ended questionnaire exploring their views on these aspects. Fifty-four patients and 40 caregivers gave their informed consent and participated in the survey. Fifty-three patients were adults, 28% suffering from Duchenne/Becker muscular dystrophy. Patients reported 269 comments on health care services provided during the pandemic, 132 (49%) concerning positive aspects and 137 (51%) negative aspects. The prompt restart of the rehabilitation therapies and the staff closeness over the pandemic were the practical aspects most frequently appreciated (46.9%), while closer family contacts and the perception of being able to rely on the Centre's constant support were the most cited psychological aspects (53.1%). Architectural barriers, difficulties in accessing public health services, economic difficulties, and lack of support from welfare and other agencies were the practical critical points most frequently reported (89%). In addition, social isolation, and loneliness due to fear of contagion were the most negative psychological aspects (10.1%). As regard the caregivers' views, participants reported 151 comments. Of these, 86 (56.9%) were positive and 65 (43.1%) were negative. Among the positive aspects, the psychological ones - such as closer family contacts, not feeling abandoned and counting on the constant Centre's professional support prevailed (53.5%). As for the negative aspects, most caregivers (92.6%) believe that the pandemic exacerbated their financial and bureaucratic difficulties, particularly in poorer families.


Assuntos
COVID-19 , Distrofia Muscular de Duchenne , Adulto , COVID-19/epidemiologia , Cuidadores/psicologia , Atenção à Saúde , Humanos , Distrofia Muscular de Duchenne/psicologia , Distrofia Muscular de Duchenne/reabilitação , Pandemias , Apoio Social
12.
J Psychosoc Rehabil Ment Health ; 9(3): 239-249, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35075406

RESUMO

This study explored views of mental health services (MHS) professionals regarding positive changes in service practices and organizations, and staff-user relationships after one year of COVID-19 in Italy. Professionals from a community-oriented MHS completed online the Questionnaire on MHS Transformations during the COVID-19 pandemic, a 30-item tool developed by a participatory approach and validated. Of the 184 participants, 91.8% felt it was "true/definitely true" that during the pandemic they had informed users on procedures to reduce contagion risks, and 82.1% stated that they had increased telephone contact with users. Sixty-nine percent of professionals reported that staff revised treatment plans according to new needs of care and 78.6% stated that they had been able to mediate between user needs and safe working procedures. Moreover, 79.4% of respondents stated that they had rediscovered the importance of gestures and habits, and 65% that they had gained strength among colleagues to face fear. Fifty-four percent of participants admitted that they had discovered unexpected personal resources in users. Overall, 59.6% of participants stated that they found some positives in the COVID-19 experience. Perceived positive changes was greater among professionals from community facilities vs. those from hospital and residential facilities. In community-oriented MHS, the pandemic offered an opportunity to change practices and rethink the meaning of relationships between people. This data may be useful in generating a more balanced understanding of COVID-19's impact on MHS and for MHS planning in the pandemic era.

13.
Soc Psychiatry Psychiatr Epidemiol ; 46(10): 1019-25, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20640568

RESUMO

PURPOSE: This study examines how the term "schizophrenia" is used in Italian newspapers. METHODS: The survey was carried out on the 22 Italian newspapers which allow word scanning on their online website. In each newspaper, the terms "schizophrenia" and "schizophrenic" were scanned in all articles, from January 1, 2008 to December 31, 2008. Each article containing these terms was analyzed in relation to metaphorical usage to describe or denigrate people or groups not diagnosed "schizophrenic" and in relation to non-metaphoric, direct descriptions of people using mental health services, or the illness itself. RESULTS: "Schizophrenia/schizophrenic" was reported in 1,087 articles. It was used far more frequently as a metaphor (73.7%) than in reference to people actually given the diagnosis (19.2%) or to the disorder itself (7.1%). The 801 metaphoric uses were classified into the following categories: incoherence/contradiction/split (682, 85.1%), dangerousness/aggressiveness (34, 4.4%), and eccentricity/oddness (84, 10.5%). 117 out of 209 (55.9%) articles on people diagnosed with the disorder were in news section of which 57 (48.7%) referred to homicides, 17 (14.5%) to other assaults by the person, and 33 (28.2%) to assaults directed at the person. CONCLUSIONS: These data confirm previous studies showing that the media disproportionately report negative stories about people diagnosed with "schizophrenia", and in particular, equate the diagnosis with violence. The study also demonstrates that the metaphorical use of the term to denigrate groups or individuals may be an equal or greater contributor to the stigma and prejudice experienced by people with this mental disorder.


Assuntos
Metáfora , Jornais como Assunto , Esquizofrenia , Coleta de Dados , Itália
14.
Am J Orthopsychiatry ; 91(1): 66-75, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33411552

RESUMO

For many persons with mental disorders (MDs), having a job is a main life goal and a recovery sign. The possibility for these persons to enter the job market is limited by stigma. This study explored whether the participation of people with MDs in a job-training course would positively influence employees' opinions about workmates with these disorders. The job-training course was run by company trainers in a megastore 3 times over a 2-year period for a total of 18 participants with MDs. In the training store, employees' views regarding persons with MDs were assessed at pre- and postintervention with the use of matched questionnaires. At postintervention, views among the training store's employees were also compared with those of employees from other stores (controls). Compared with paired preintervention assessment, at postintervention, the training store's employees were more optimistic about recovery; more skeptical about unpredictability, dangerousness, and social distance from persons with MDs; more skeptical about difficulties of these persons in that workplace; more willing to have workmates with MDs; and more confident in the acceptance of workers with MDs by colleagues. Compared with controls, at postintervention, the training store's employees had higher levels of acceptance and lower perception of dangerousness and unpredictability, were more confident in the capacities of persons with MDs to acquire organizational skills and in their acceptance by colleagues, and were surer that having coworkers with MDs would improve the company public image. Providing job-training courses to persons with MDs could be helpful to reduce stigma against such persons in ordinary work contexts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Transtornos Mentais , Local de Trabalho , Atitude , Humanos , Estigma Social , Inquéritos e Questionários
15.
Acta Myol ; 40(3): 132-134, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34632295

RESUMO

The outbreak of COVID-19 has forced the health care system to undergo profound rearrangements in services and facilities, especially during the periods of lockdown. In this context, inpatient and outpatient services had to rethink and reorganize their activities to meet the needs of severely disabled patients, as those affected by Muscular Dystrophies (MDs). We present the preliminary results of a survey aiming to explore the staff views on the changes in the care provided by the Gaetano Torre Rehabilitation Centre, and, the impact of these changes on professionals, patients and their families. The survey was carried out using an open-ended questionnaire including six-items, on the practical and psychological aspects emerged during the pandemic in relation to the healthcare services provided by the Centre and to the patients/caregivers conditions. The participants, most of them physiotherapists, highlighted 169 aspects emerging in the pandemic, 48.5% referring to the resources used to cope with critical issues and 51.5% concerning the difficulties encountered. Emotional aspects prevailed on practical aspects both in resources (52.4 vs 47.6%) and in difficulties (57.5 vs 42.5%) categories. In particular, with regard to patients' resources, psychological benefits, despite the burden, were greater than practical ones (87 vs 13%), in the form of improved intra-family relationships, feeling more cared for, and satisfaction for the received care. As for the patients' relatives, the staff indicated more resources than difficulties (72.8 vs 17.2%). Among the former, 75% concerned the emotional sphere, such as the perception of having a point of reference even in such a difficult time.


Assuntos
Atitude do Pessoal de Saúde , COVID-19/epidemiologia , Doenças Musculares/reabilitação , Centros de Reabilitação/organização & administração , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Controle de Infecções , Itália , Masculino , Pandemias , SARS-CoV-2 , Inquéritos e Questionários
16.
Orphanet J Rare Dis ; 16(1): 163, 2021 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-33827635

RESUMO

BACKGROUND: Hereditary transthyretin amyloidosis (hATTR), alias ATTR variant (ATTRv) is a severe and disabling disease causing sensory and motor neuropathy, autonomic dysfunction, and cardiomyopathy. The progressive decline of patient's functional autonomy negatively affects the patient's quality of life and requires increasing involvement of relatives in the patient's daily life. Family caregiving may become particularly demanding when the patient is no longer able to move independently. This study is focused on the psychosocial aspects of ATTRv from the patient and relative perspectives. In particular, it explored: the practical and psychological burdens experienced by symptomatic patients with ATTRv and their key relatives and the professional and social network support they may rely on; whether burden varied in relation to patients' and relatives' socio-demographic variables, patients' clinical variables, and perceived professional and social network support; and, any difference in burden and support between patients and their matched relatives. METHODS: The study was carried out on symptomatic patients included in the ATTRv Italian national registry and living with at least one adult relative not suffering from severe illness and being free from ATTRv symptoms. Patients and relatives' assessments were performed using validated self-reported tools. RESULTS: Overall, 141 patients and 69 relatives were evaluated. Constraints of leisure activities, feelings of loss and worries for the future were the consequences of ATTRv most frequently reported by patients and relatives. Both in patients and their relatives, the burden increased with the duration of symptoms and the level of help in daily activities needed by the patient. In the 69 matched patient-relative pairs, the practical burden was significantly higher among the patients than among their relatives, while the psychological burden was similar in the two groups. Moreover, compared to their relatives, patients with ATTRv reported higher levels of professional and social network support. CONCLUSIONS: These results show that ATTRv is a disease affecting quality of life of both patients and their families. Supporting interventions should be guaranteed to patients, to facilitate their adaptation to the disease, and to their families, to cope as best as possible with the difficulties that this pathology may involve.


Assuntos
Qualidade de Vida , Apoio Social , Adulto , Neuropatias Amiloides Familiares , Humanos , Itália , Inquéritos e Questionários
17.
Psychol Psychother ; 93(4): 674-689, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-31502403

RESUMO

OBJECTIVES: To examine the causal beliefs about schizophrenia of non-psychiatric doctors and whether differential belief in biogenetic vs. psychosocial causes influences doctors' views about treatments and prognosis. DESIGN AND METHODS: Three hundred and five non-psychiatric doctors working in outpatient community centres completed the 'Opinions on mental disorders Questionnaire' after reading a clinical description of people with schizophrenia. RESULTS: The factors most frequently reported as causes of schizophrenia were heredity (65.2%) and use of street drugs (54.1%). Seventy-five per cent of participants endorsed both one or more biological causal factors and one or more psychosocial causal factors. Of the 264 participants who expressed their opinion about the most important cause of schizophrenia, 53.8% indicated a biogenetic cause. Fifty-two per cent of respondents thought it 'completely true' that drugs are useful in schizophrenia, and 33.9% thought it 'completely true' that people with schizophrenia must take drugs all their life. Participants stating that the most important cause was biogenetic more frequently recommended a psychiatrist and less frequently a psychologist. Compared to doctors who indicated a psychosocial cause as the most important one, those who indicated a biogenetic cause were more sceptical about recovery, more confident in the usefulness of drugs, and more convinced of the need of lifelong pharmacological treatments in schizophrenia. CONCLUSIONS: These findings suggest the need to provide some doctors with training on the multiple, interacting causes of schizophrenia and the efficacy of the broad range of available treatments. The education of health professionals regarding stigma and its effects on clinical practice is also needed. PRACTITIONER POINTS: Viewing schizophrenia as mainly due to a biological cause is associated with greater confidence in the usefulness of drugs, higher belief in the need for lifelong pharmacological treatments, and greater prognostic pessimism. Belief in a biologically oriented model of schizophrenia may lead doctors to underestimate the value of psychologists. Prognostic pessimism among doctors may negatively influence clinical decisions, the information doctors provide to their clients, and clients' own beliefs about their chances of recovery. Belief in the need for lifelong pharmacological treatments in schizophrenia may lead doctors to resist drug withdrawal in case of severe side effects.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Esquizofrenia/diagnóstico , Esquizofrenia/tratamento farmacológico , Psicologia do Esquizofrênico , Antipsicóticos/farmacologia , Atitude do Pessoal de Saúde , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Modelos Psicológicos , Estereotipagem
18.
Psychiatr Serv ; 59(7): 795-9, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18586998

RESUMO

OBJECTIVE: This study explored the views of 241 patients with schizophrenia about their own disorder. METHODS: Patients' knowledge of their diagnosis, confidence that they will be well again, and perception of limitations in their own life as a result of the disorder were explored in relation to patients' opinions about the social consequences of schizophrenia. Study results were presented to participants, and suggestions were collected regarding how these study results should be used. RESULTS: Seventy-two respondents (30%) reported that a psychiatrist told them that they have schizophrenia. Respondents who were confident that they would be well again had a lower duration of contact with psychiatric services and a less pronounced perception of affective and social difficulties related to schizophrenia. Respondents who did not feel limited in their life by the disorder reported less social distance and more optimism about the usefulness of treatments. CONCLUSIONS: Participatory studies may provide ideas for a more constructive interaction between patients and professionals.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Esquizofrenia/terapia , Psicologia do Esquizofrênico , Autoimagem , Participação da Comunidade/estatística & dados numéricos , Estudos Transversais , Humanos , Itália , Modelos Logísticos , Serviços de Saúde Mental , Relações Médico-Paciente , Escalas de Graduação Psiquiátrica , Esquizofrenia/diagnóstico , Inquéritos e Questionários
19.
Int J Soc Psychiatry ; 63(3): 224-234, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28466742

RESUMO

BACKGROUND: General practitioners (GPs) play a key role in the care of somatic and psychiatric problems in people diagnosed with schizophrenia (PWS). It is probable that, like other health professionals, GPs are not all free of prejudices toward PWS. In clinical practice, GPs sometimes interact with clients diagnosed with schizophrenia by specialists, passively accepting this diagnosis. Other times, GPs interact with clients having symptoms of schizophrenia but who have not been diagnosed. In this case, GPs are expected to actively make a diagnosis. Giving the key role of GPs in the process of care, it is worthwhile examining whether passive acceptance and active usage of the diagnosis schizophrenia have differential effects on GPs' attitudes toward people with this disorder. AIMS: To investigate GPs' views of schizophrenia and whether they were influenced by a 'schizophrenia' label, passively accepted or actively used. METHODS: A total of 430 randomly selected GPs were invited to complete a questionnaire about their views of schizophrenia, either after reading a description of this disorder and making a diagnosis, or without being provided with a description but passively accepting the label 'schizophrenia' given in the questionnaire. RESULTS: The GPs who passively accepted the label schizophrenia ( n = 195) and those who actively identified schizophrenia from the description ( n = 127) had similar views. Compared to the GPs who did not identify schizophrenia in the description ( n = 65), those who used the diagnosis, actively or passively: more frequently reported heredity and less frequently psychosocial factors as causes of the disorder; were more skeptical about recovery; were more convinced of the need for long-term pharmacotherapies; believed more strongly that PWS should be discriminated against when in medical hospital; and perceived PWS as more dangerous and as kept at greater social distance. CONCLUSION: The diagnosis 'schizophrenia', however used, is associated with pessimistic views. Stigma education should be provided to GPs.


Assuntos
Atitude do Pessoal de Saúde , Clínicos Gerais/psicologia , Papel do Médico , Esquizofrenia/diagnóstico , Estigma Social , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Preconceito , Distância Psicológica , Inquéritos e Questionários
20.
Am J Orthopsychiatry ; 87(5): 559-566, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27977285

RESUMO

This study explored the relationships between General Practitioners' (GPs) beliefs about People With Schizophrenia (PWS) and GPs' recommendations regarding restrictions for such people when in medical (nonpsychiatric) hospital, and whether these relationships were mediated by dangerousness perception. There were 322 randomly selected Italian GPs who completed a questionnaire measuring beliefs about PWS. Structural Equation Model (SEM) was used to explore the effects of these beliefs on the GPs' views about the need for restrictive rules in hospital. Thirty-1 percent of GPs firmly believed that, in medical wards, PWS should be supervised and 18% that they should be separated from other patients. SEM revealed that belief in such differential treatment was positively related to a belief that PWS need medication for the rest of their lives, and to perceptions of others' need for social distance, and of dangerousness. Dangerousness was, in turn, positively related to the belief that PWS need medication for their lives, and to a perception of the need for social distance, but negatively related to perceived capacity to report health problems. Analyses of indirect effects showed that the relationships of belief in discriminatory treatment with belief in medication for life and with perceived social distance were mediated by perceived dangerousness. GPs' attitudes about PWS appear closely with their beliefs on discriminatory behaviors in hospital, and the mediating role of dangerousness perceptions. Providing GPs with education about schizophrenia treatments and prognosis, and countering stereotypes about dangerousness, could be helpful to reduce GPs' beliefs in the need for discriminatory treatment of PWS. (PsycINFO Database Record


Assuntos
Atitude do Pessoal de Saúde , Comportamento Perigoso , Clínicos Gerais , Conhecimentos, Atitudes e Prática em Saúde , Hospitalização , Esquizofrenia , Feminino , Clínicos Gerais/estatística & dados numéricos , Humanos , Itália , Masculino , Pessoa de Meia-Idade
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