Abstract
ABSTRACT Objectives The primary objective was to measure the effect of psychiatry rotation in students self-confidence (SC) for managing mental health (MH) issues. Methods An eighteen questions version of “Preparation for Hospital Practice Questionnaire” (PHPQ) adapted for MH was applied before, after and six months later the psychiatry rotation. Sociodemographic and experience with mental illness was measured as confounding factors. Results Hundred and ten students were recruited and four factors were identified: “Diagnosis elaboration and basic care” (F1), “Crisis management and prevention” (F2), “External sickness determinants” (F3) and “Personal distress with clinics” (F4). Cronbach Alpha ranged from 0.71 to 0.90. Previous MH training were not frequent (9.09%), and associated with better SC in F2 (after p < 0.05, 6m p = 0.03). Previous mental disorder was frequent (42.16%), and associated with more SC on F2 (p < 0.01) and F3 (p = 0.03) before course, but only on F3 after (p < 0.01) and not 6 months later. Male gender had more SC in F4 (p < 0.01) before course, but after course and 6m later female gender became more SC in F1 (after p = 0.02, 6m p = 0.01) and equivalent in F4. All factors had higher scores after and 6 months later (p < 0.001). The class considered that an interview script is very important for their SC, and improves assistance (mean > 9.0/10.0). Conclusion Obligatory rotation in MH improved SC in students. Previous training and gender were related with long lasting effects in SC.
Highlights
Community health systems are proposed by WHO as the most affordable and effective way to provide mental health (MH) care for large populations[1]
The MH practical activities are carried on a Psychosocial Center (CAPS – ZN) in Santos – SP aimed to care for severely mentally ill patient (MIP), offer rehabilitation and crisis management
Regarding student’s demographic composition, this sample is equivalent to other studies with medical students in Brazil[10,11], and with official estimates related to gender and age[12]
Summary
Community health systems are proposed by WHO as the most affordable and effective way to provide mental health (MH) care for large populations[1]. Specialists doctors and health workers are expensive, difficult to train and require harder technologies to work. They should be reserved for complex cases and to offer support for the generalists that are the spearhead of care. After diagnostic and therapeutic strategy elaboration, even a complex patient should return to their family doctor, the one responsible for their care management[1]. Only recently it’s been implemented[2] that in SUS, generalists should manage common health’s demand, including MH. Clinicians should use their knowledge and receive support from Núcleos Ampliados de Saúde da Família e Atenção Básica – NASF-AB (Family Health and Basic Attention Amplified Nucleus), composed by specialist and other professionals[3]. New directives for the medical curriculum propose that all doctors should be prepared to work as generalists[4], but only in 2014, an MH internship became obligatory in medical courses[5]
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