Emotion work and resilience of nurses and physicians towards Palestinian Authority patients.

AIM: The purpose of this study was to explore the emotion work and resilience of Israeli healthcare personnel who treat paediatric patients from the Palestinian Authority in Israel. BACKGROUND: Healthcare personnel deal with internalized emotional conflict deriving from the ethos of health care and the ethos of conflict. Emotion work may be used to overcome emotional conflict, while resilience serves as a protective process against emotional conflict. METHODS: A mixed methods study among 101 healthcare workers: 84 nurses and 17 physicians. Quantitative data were analysed using IBM SPSS 24.0, and qualitative data were analysed using the constant comparative analysis method. FINDINGS: Empathy was the highest ranking emotion and contempt was the lowest, for experienced and expected emotions. Positive correlations were found between identification with the ethos of health care and resilience, emotional gap and emotion work, and between the level of Arabic language and emotion work. A negative correlation was found between emotional gap and resilience. The qualitative data yielded three themes: Knowledge of the Arabic language, familiarity with the Arab culture and equitable treatment. DISCUSSION: The language proficiency of patients belonging to a minority group increases nurses' and physicians' emotion work. Identification with the ethos of health care increases resilience, as both are linked to a sense of vocation and an intrinsic willingness to care for paediatric patients. CONCLUSION: The study supports the theory of emotion work and refines the role of the ethos of health care in building resilience. Language and cultural capability have a significant role in providing healthcare personnel with methods to treat minorities equitably. IMPLICATIONS FOR HEALTH POLICY: Hospital managements may supply tailor-made interventions to enhance healthcare personnel's transcultural communication skills, build resilience and cultivate emotion work capabilities. Nursing practice could encourage the use of nursing care plans specific to the individual paediatric patient that can be used by nursing staff to keep care current and applicable.

Treatment of cannabis dependence using escitalopram in combination with cognitive-behavior therapy: a double-blind placebo-controlled study.

BACKGROUND: Cannabis is the most frequently used illegal substance in the United States and Europe. There is a dramatic increase in the demand for treatment for cannabis dependence. Cannabis users frequently have co-morbid mood symptoms, especially depression and anxiety, and regular cannabis users may self-medicate for such symptoms. OBJECTIVES: We report a double-blind, placebo-controlled treatment study, for the prevention of cannabis use in cannabis-dependent individuals. METHOD: Regular cannabis-dependent users (n = 52) were treated for 9 weeks with weekly cognitive-behavior and motivation-enhancement therapy sessions together with escitalopram 10 mg/day. Urine samples were collected to monitor delta-9 tetrahydrocannabinol (THC) during treatment and questionnaires were administered to assess anxiety and depression. RESULTS: We observed a high rate of dropout (50%) during the 9-week treatment program. Fifty-two patients were included in the intention-to-treat analysis. Of these, ten (19%) remained abstinent after 9 weeks of treatment as indicated by negative urine samples for THC. Escitalopram provided no advantage over placebo in either abstinence rates from cannabis or anxiety and depression scores during the withdrawal and abstinent periods. CONCLUSIONS: Escitalopram treatment does not provide an additional benefit either for achieving abstinence, or for the treatment of the cannabis withdrawal syndrome. Due to limitations of our study, namely, a high dropout rate and effects of low abstinence rates on measures of anxiety, depression and withdrawal, it is premature to conclude that selective serotonin reuptake inhibitors are not effective for treatment of the cannabis withdrawal syndrome.