Knowledge Of Electroconvulsive Therapy Research Articles

Nigerian Medical Students Attitudes to Unmodified Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is an effective and affordable form of treatment for a range of psychiatric disorders. Historical antecedents, the media, and movies have generated myths about its continued use and relevance. We explored medical students' knowledge of and attitude to ECT on completion of an 8-week clinical rotation (clerkship) in psychiatry. A cross-sectional survey was carried out among final-year medical students at the end of a clerkship in psychiatry using a self-administered questionnaire adapted from previously published work, to assess their attitudes to and knowledge of unmodified ECT. Knowledge of medicine, psychiatry, and ECT were self-rated as average by most students. Most had an interest in pursuing psychiatry as a profession and would receive ECT if judged clinically appropriate. Most students had positive attitudes toward ECT; the vast majority thought it was a relevant form of treatment and did not think that ECT was used to control violent or used by government to torture opponents. Although an overwhelming majority did not think ECT was outmoded or causes permanent brain damage, answers about pain associated with ECT and about the dangers associated with the procedure seem to be more evenly split. A minority thought that ECT was used only in the poor and should not be given to the elderly or children. A substantial majority thought that ECT was the treatment of last resort. Respondents who were likely to choose psychiatry as a profession agreed that ECT causes pain, but disagreed that it was used by governments to torture political opponents or that it causes permanent brain damage. Students with minimal knowledge of ECT showed more negative attitudes toward the myth that ECT is misused and should be a treatment of last resort. The similarity of the attitudes of students exposed to unmodified ECT with attitudes of students exposed to modified ECT suggests that modification has made little impact on the attitudes of health professionals. The importance of lectures, patient follow-up while on clinical rotations has significant contributions in shaping attitudes and should be harnessed during training.

Knowledge of and Attitude Toward Electroconvulsive Therapy

To assess the knowledge of and attitudes toward electroconvulsive therapy (ECT) in Hungarian anesthesiology residents. A self-administered questionnaire comprising 39 questions compiled by the authors. Of the 82 sophomore residents who completed the questionnaire, 29 have administered ECT. These residents were significantly more likely to consider ECT to be efficacious and less likely to be dangerous or lethal than the other residents (P = 0.017 and 0.004). Fifty-three residents (65%) rated their knowledge of ECT as "minimal," 26 (32%) as "moderate," and 1 (1.3%) as "considerable." In the case of severe depression, 49% of the "minimal" knowledge group would consent to be treated with ECT. The corresponding figure in the "moderate" knowledge group was 16% (P = 0.009). Having previously administered ECT had a positive effect on the anesthesiology residents' attitudes toward ECT. Having a level of knowledge about ECT treatment that was perceived as "minimal" did not prejudice residents against it.

Knowledge of Attitude Toward Experience and Satisfaction With Electroconvulsive Therapy in a Sample of Iranian Patients

Despite the wide consensus over the safety and efficacy of electroconvulsive therapy (ECT), it still faces negative publicity and unfavorable attitudes of patients and families. Little is known about how the experience with ECT affects the patients' and their families' attitude toward it. The aim of this study was to examine a sample of Iranian patients and their families regarding their experience with ECT and to compare their knowledge and attitude toward ECT before and after this experience and their satisfaction with it. We surveyed 22 patients with major depressive disorder about to undergo ECT and 1 family member of each patient for their knowledge and attitude toward ECT and then surveyed them again after the trial of ECT to compare those variables while assessing their experience and satisfaction with ECT. Patients were rated using the Hamilton Depression Rating Scale and Mini-Mental Status Examination before and after the treatment. We found that, before ECT, family members had a more favorable attitude toward ECT than patients, but after ECT, the patients' attitude changed more positively compared with their families. Both patients and their families had a poor knowledge of ECT before the ECT trial, but their total knowledge increased afterward, although not in the areas of indications and therapeutic effects. The majority of patients and their families found ECT to be beneficial and were satisfied with it. Satisfaction with ECT was independent of treatment outcome. There was a high rate of perceived coercion to consent to ECT. Attention should be paid toward educating patients and their families about the ECT process, indications, risks, safety, and effects as well as informing them about their freedom of choice and right to refuse.

P02-84 Knowledge of attitude toward experience and satisfaction with electroconvulsive therapy in a sample of Iranian patients

Despite the wide consensus over the safety and efficacy of electroconvulsive therapy (ECT), it still faces unfavorable attitudes of patients and families. Little is known about how the experience with ECT affects the patients’ and their families’ attitude toward it. This study examined a sample of Iranian patients and their families regarding their experience with ECT and compared their knowledge and attitude toward ECT before and after this experience and their satisfaction with it. We surveyed 22 patients with major depressive disorder about to undergo ECT and 1 family member of each patient for their knowledge and attitude toward ECT and then surveyed them again after the trial of ECT to compare those variables while assessing their experience and satisfaction with ECT. Patients were rated using the Hamilton Depression Rating Scale and Mini-Mental Status Examination before and after the treatment. Before ECT, family members had a more favorable attitude toward ECT than patients, but after ECT, the patients’ attitude changed more positively. Both patients and their families had a poor knowledge of ECT before the ECT trial, but their total knowledge increased afterward, although not in the areas of indications and therapeutic effects. The majority of patients and their families found ECT to be beneficial and were satisfied with it. There was a high rate of perceived coercion to consent to ECT. Attention should be paid toward educating patients and their families about the ECT as well as informing them about their freedom of choice and right to refuse.

Knowledge and Attitudes Regarding Electroconvulsive Therapy Among Medical Students and the General Public

To explore the state of knowledge and attitudes toward electroconvulsive therapy (ECT) among a sample of the adult British general public (n = 70) in comparison with a sample of medical students (n = 70) and MRCPsych students (n = 20). Despite documented efficacy, an uncritical anti-ECT stance is often adopted by the media. It has been suggested that medical students are relatively unfamiliar with ECT. If they do hold the same misconceptions as the general public, there are implications for the future use of ECT. Participants were opportunistically recruited for a Likert scale questionnaire developed for this study and designed to investigate the source of ideas about ECT, extent of knowledge, and lasting impressions of ECT as portrayed in films. The lay sample was significantly less knowledgeable and had less positive attitudes and greater fear of ECT than the medical students. The aspects of ECT that medical students were least knowledgeable about were the potential risks and side effects involved. Popular films portraying ECT still seem to have a negative impact on their audiences. The targets for education both in the public forum and in medical schools should be the procedure of administering ECT and explanation of the associated risks. Outdated and inaccurate depictions of ECT in films are still a frequently reported source of knowledge of ECT for both the general public and medical students.

Are patients' attitudes towards and knowledge of electroconvulsive therapy transcultural? A multi‐national pilot study

Electroconvulsive therapy (ECT) is an effective, yet controversial treatment. Most patients receiving ECT have depression and it is likely that the majority having this treatment are older adults. However, attitudes towards ECT and knowledge of ECT in this population have never been studied in relation to the patients' cultural background. To compare the attitudes and knowledge of ECT among older adults depressed patients across three culturally different populations and to explore the relationship between culture, knowledge and attitudes. The study was conducted in one centre in each country. A semi-structured survey was used which included three sections: demographics characteristics, attitudes towards and knowledge of ECT. A total of 75 patients were recruited in this study: 30 patients from England; 30 patients from Argentina; and 15 patients from Canada. There was a significant difference in knowledge about ECT across the three countries. No significant difference was found in terms of attitudes. Knowledge was poor in all three countries. The most influential factor shaping subjects' attitudes and knowledge of ECT differed for the three countries. A weak correlation was found between knowledge of and attitudes towards ECT across all patients from the three different countries. Attitudes towards ECT are a very complex phenomenon. We could not find evidence that a particular cultural background affects attitudes towards ECT. Generalising the results of our study is restricted by the fact that this was a pilot study that suffered from limitations including small sample size and number of settings.

Knowledge of and Attitudes Toward Electroconvulsive Therapy of Medical Students in the United Kingdom, Egypt, and Iraq

To investigate the knowledge of and attitudes toward electroconvulsive therapy (ECT) in 3 samples of medical students from Iraq, Egypt, and the United Kingdom, respectively. Medical students from Baghdad, Iraq, Cairo, Egypt, and Sheffield, United Kingdom medical schools completed a self-administered questionnaire including item of factual knowledge and of attitudes toward ECT. The Iraqi and Egyptian students were in their final year. The United Kingdom students have just finished their psychiatric placements. A total of 339 students responded (181 from Iraq, 85 from Egypt, and 73 from the United Kingdom). The theoretical knowledge base of the Iraqi sample was found to be better than that of the other 2 samples. Overall, the knowledge of ECT was not good especially in the Egyptian sample, where nearly two thirds were unable to mention any indication or side effect, and only 3.5% of them had the chance to observe ECT. The United Kingdom sample showed very positive attitudes (no one said that psychiatrists abuse ECT, and only 4% thought that ECT is a cruel treatment), followed by the Iraqi and the Egyptian samples. Different teaching styles and possibly some cultural factors affect the knowledge base of and the attitudes toward ECT. Finishing a psychiatric placement might have led to the very positive attitudes in the United Kingdom sample. Ensuring that medical students from the other 2 samples should observe ECT might improve their attitudes. A specific lecture about ECT would improve the knowledge of the 3 samples.

Effects of an Education Training Program on Attitudes to Electroconvulsive Therapy

Widespread negative attitudes toward electroconvulsive therapy (ECT) are present in the general public and among heath care professionals. However, there is evidence to suggest that clinical experience and knowledge of ECT positively improve attitudes toward this treatment. The purpose of this study was to evaluate the effects of an ECT education training program on attitudes toward ECT. Participants were 73 student nurses (91.8% women) and 21 care aid students (81.0% women) undertaking a 6-week rotation in psychiatry at a large provincial psychiatric hospital in British Columbia, Canada. The ECT education training program consisted of a brief lecture, viewing of an educational videotape, familiarization with the ECT equipment, and observation of an ECT treatment. Participants completed a short questionnaire pretraining and posttraining program. Attitudes toward ECT did not substantially differ between the 2 groups. For the entire sample, only 8.5% reported that they were well informed about ECT before the training session. More favorable attitudes were reported upon completion of the ECT education program compared with attitudes reported before training. These findings suggest that attitudes toward ECT increase favorably when individuals are provided with training and experience.

A Western Australian Survey On Public Attitudes Toward and Knowledge of Electroconvulsive Therapy

Healthcare professionals have debated the use and effects of electroconvulsive therapy (ECT) for more than 65 years. Yet, knowledge about, and attitudes towards, ECT have not been thoroughly researched within the Australian community. This study focused on a Western Australian perspective on these issues. The objectives were achieved with specifically developed questionnaires. Six hundred surveys were distributed across the metropolitan area of Perth, Australia. A total of 379 completed questionnaires indicated that more than 60% of respondents had some knowledge about the main aspects of ECT. Participants were generally opposed to the use of ECT on individuals with psychosocial issues, on children and on involuntary patients. Public perceptions of ECT were also found to be mainly negative. The findings suggest that clinicians should ensure that individuals recommended for ECT are knowledgeable about basic ECT processes and implications in order to ensure their full informed consent.

Knowledge and Attitudes Toward Electroconvulsive Therapy Among Health Care Professionals and Students

Widespread variations in electroconvulsive therapy (ECT) prescription between and within countries have led many researchers to study professionals' attitudes to the procedure. A questionnaire looking at knowledge and attitudes was administered to 593 medical and nursing students, psychiatrists and anesthetists, and theater and psychiatric nurses. Respondents were based in 2 Irish cities, Dublin and Cork. Poorer knowledge of ECT was found in the nursing group, and this included psychiatric nurses: a third overestimate ECT mortality, most did not know if it caused permanent brain damage, and only 1 psychiatric nurse (2.9%) expressed positive attitudes to its use. Nursing students had significantly lower knowledge and more negative attitudes than medical students, and exposure to the procedure of ECT failed to improve their attitudes. The strongest predictor of better knowledge and more positive ECT attitudes was membership of the medical group. There were direct associations between better knowledge and more positive attitudes in the medical group but not among the nursing group. Low ECT knowledge among psychiatric nurses has implications in obtaining patients' valid consent. Our failure to link exposure to ECT to better nursing attitudes is discussed along with other educational lessons.

Teaching Electroconvulsive Therapy to Medical Students: Effects of Instructional Method on Knowledge and Attitudes

To compare the effects of learning about electroconvulsive therapy (ECT) via live observation to learning via an instructional videotape. During their psychiatry clerkship, 122 medical students were randomized using these two educational methods, and their ECT knowledge and attitudes were assessed during the first and last weeks of the 6-week clerkship. For both the knowledge and attitudes measures, the clerkship (time) effect was statistically significant (i.e., posttest scores were higher than pretest scores). The interaction effect was significant for knowledge only (pretest scores for students in the live group were slightly lower at pretest than those for students in the videotape group and slightly higher at posttest). The effect size was very small, however, suggesting little meaningful educational difference between the two instructional methods. Both live demonstration and viewing a videotape appear to be effective methods for teaching medical students about ECT.

Attitudes Towards Electroconvulsive Therapy Among Hungarian Psychiatrists

Participants of a postgraduate biologic psychiatric course were surveyed about their attitudes toward electroconvulsive therapy (ECT) with a self-administered questionnaire. Among the respondents, 65 persons were specialists in psychiatry, 32% of whom would not consider using ECT even if they were in a psychotic depressive state. According to the bias factor, which has been calculated based on the answers to the 11 questions regarding attitudes, those psychiatrists who worked in inpatient care showed a less negative attitude. Among the items concerning knowledge of ECT, incorrect answers were most frequent to questions about myocardial infarction as a contraindication, and about the identity of the person who had pioneered this treatment. The negative attitude of Hungarian psychiatrists, especially of those who work in outpatient care, may have an important role in the decrease of the application of ECT in the past decade in Hungary.

Knowledge of ECT among staff of a mental health service.

Electroconvulsive therapy (ECT) is frequently projected as a controversial treatment to the general public. In England and Wales, user groups have reported an insufficient provision of information on which to base a decision regarding consent to ECT. In view of these findings, a study was carried out to assess the knowledge of ECT among mental health staff in a general hospital setting, as they are frequently the source of information for patients and caregivers. All staff in the mental health unit were invited to complete a semistructured questionnaire that consisted of questions about ECT including their knowledge of the laws about informed consent. Seventy-five staff members, representing about two thirds of the staff population, returned the questionnaires. Seventy of them responded that they knew the indications for ECT, of which the most frequently quoted were depression, mania, and schizophrenia. Only 24 (36.9%) staff members knew of the guidance with respect to informed consent and ECT. The finding in this study led to a revision of the local ECT training program for patients, caregivers, and staff. A review of the impact of the changes made will take place in the future. The Royal College of Psychiatrists itself has decided to implement changes by setting up a commission to assess and accredit various ECT units in England and Wales.

Patients' and their relatives' knowledge of, experience with, attitude toward, and satisfaction with electroconvulsive therapy in Hong Kong, China.

Although electroconvulsive therapy (ECT) is a safe and efficacious treatment, there is a widespread negative view of ECT in public and professional circles. There are no data on Chinese patients' knowledge of, experience with, attitude toward, and level of satisfaction with ECT in Hong Kong. The aims of this study were to examine patients' experience of ECT, and patients' and their relatives' knowledge of, attitude toward, and level of satisfaction with ECT. To this effect, a prospective cross-sectional survey was conducted, involving 96 patients and their 87 relatives. The study showed that the majority of patients believed they had not received adequate information about ECT. The most commonly reported side effect was memory impairment. Patients and relatives had only limited knowledge of ECT, yet the majority of them were satisfied with the treatment and, having found it beneficial, maintained a positive attitude toward its use. The researchers concluded that Hong Kong Chinese patients and their relatives accepted ECT as a treatment. The way information is provided to patients and relatives when obtaining consent for ECT needs improvement.

Mental health professionals' attitudes towards and knowledge of electroconvulsive therapy

The efficacy and safety of electroconvulsive therapy (ECT) have been established, yet widespread negative public attitudes towards the procedure remain. Little research has been carried out into the attitudes towards and knowledge of ECT among mental health staff of different disciplines. Method: Two hundred and sixty-eight staff from four mental health disciplines (psychiatrists, psychologists, nurses and social workers) were sent the Questionnaire on Attitudes and Knowledge of ECT (QuAKE) and asked about demographic details. Attitudes and knowledge were compared by discipline and the results analysed using the Kruskal-Wallis test. Results: The response rate was 74% ( n =198). The questionnaire revealed significant differences in attitudes to and knowledge of the therapy between the four disciplines, with psychiatrists being most favourably disposed and most knowledgeable, followed by nurses, social workers and psychologists. The attitudes scale was shown to have good internal consistency and split-half reliability. Conclusion: Discipline is an accurate predictor of attitudes towards ECT. There is a need for awareness of differences of opinion towards the treatment in multidisciplinary teams, as well as for better education about ECT for all members of the clinical team.

The knowledge and attitudes of mental health nurses to electroconvulsive therapy.

This study attempted to illicit the knowledge and attitudes of mental health nurses to electroconvulsive therapy (ECT). A total of 167 questionnaires containing attitude/knowledge scales were returned from the 345 sent out. The author discovered limitations in the reliability of the instrument and thus reliable measures of the respondents' knowledge of ECT were not obtained. The author's findings indicated correlations with higher levels of knowledge and (a) length of experience and (b) area of clinical practice. He also noted significant variations in knowledge of cognitive side-effects. The author concludes that nurses' knowledge of ECT requires improvement in many cases and that this has implications for nurse education.

The effect of structured consent on recall of information pre- and post-electroconvulsive therapy: a pilot study

Aims and methodA randomised, blind comparison of a structured consent procedure against routine consent was conducted to determine whether it had any utility in improving treatment knowledge In patients receiving electroconvulsive therapy (ECT). Additionally we aimed to determine whether degree of cognitive impairment intelligence and severity of depression influenced recall of information.ResultsThirty-two subjects were investigated. Structured consent significantly improved the number of knowledge items recalled pre-ECT (P<0.05). Knowledge scores declined significantly after completion of the treatment course in both structured consent (P<0.05) and control groups (P<0.06). There was a significant correlation between Mini-Mental State Examination (MMSE) scores and the number of knowledge items recalled both pre- (r=0.43, P<0.05) and post-ECT (r=0.53, P<0.01).Clinical implicationsStructured consent procedures may be a useful way of improving patient knowledge of ECT and merit further study. Low scores on MMSE should caution clinicians to take particular care when consenting patients to ECT.

Patients' perceptions and knowledge of electroconvulsive therapy

Most research on electroconvulsive therapy (ECT) has focused on technical aspects, such as indications for treatment, efficacy, side effects of treatment, and theories of mechanism of action. Little investigation has been made of the attitudes and experience of patients receiving ECT and less regarding patients' understanding and knowledge of this treatment. Earlier studies have looked at specific aspects of patients' perceptions of ECT, such as subjective side effects, (Gomez, 1975), or the effect of the media on attitudes towards ECT (Bird, 1979). Other studies have investigated these and related issues more comprehensively (Freeman & Kendell, 1980; Hughes et al, 1980). These studies were carried out some time after the ECT course had been completed; in some cases, over a year. It may be that patients' perception and knowledge of ECT are different before and after treatment. Attitudes and knowledge may also change or fade over time.