Personal Experience Of Illness Research Articles

Attitude of interns toward mental illness and psychiatry: A study from tertiary care hospital

ABSTRACT Background: The rising prevalence of psychiatric disorders in India, as high as 14.9 per 1000, is juxtaposed with a significant shortage of psychiatrists, with only 0.75 psychiatrists per 1 lakh population against the recommended 3 per 1 lakh, this mental health gap is further exacerbated by negative attitudes and stigma toward psychiatry among medical professionals. Limited exposure to psychiatry in undergraduate medical education, coupled with misconceptions, contributes to this gap. This study assesses the attitudes of medical interns toward psychiatry and mental illness before and after their postings in a tertiary care hospital. Aim: To assess the attitudes of medical interns toward psychiatry and determine if exposure to psychiatry postings improves these attitudes. Study Setting and Design: This cross-sectional and comparative study was conducted at a tertiary care hospital in Hyderabad for a period of 4 months. Materials and Methods: Institutional Ethics Committee approval was obtained before conducting this study. The study included 100 medical interns attending a 2-week psychiatry posting as the part of their compulsory rotatory internship. Participants completed an intake pro forma, attitude toward psychiatry (ATP) 30 scale, and Modified Kuppuswamy Scale on the 1st day of posting. ATP 30 scale was administered on the first and last days of posting. Results: The mean ATP score increased from 109.47 ± 10.5145 before the posting to 115.12 ± 12.5081 after the posting, indicating a significant improvement in attitudes (P < 0.05). Improvements were observed across all the domains. Interns with personal or familial experiences of psychiatric illness had higher ATP scores, although not statistically significant. Conclusions: A structured 2-week psychiatry posting significantly improves medical interns’ attitudes toward psychiatry. The study underscores the importance of psychiatric education in reducing stigma and fostering a positive outlook toward psychiatry among future medical professionals.

Teacher Self-Efficacy in Asthma Management in Elementary and Middle Schools

Background/Objectives: This study assessed teacher self-efficacy in school-based asthma management in two southern states in the United States. Current literature focuses primarily on supporting school-based asthma management, but few studies have focused on teacher self-efficacy in the asthma management process. Methods: With data collected from a two-state survey of a randomly selected group of teachers in grades kindergarten to grade eight (n = 379), teachers’ demographic variables, general opinions about asthma management practices, and their self-perceptions on the Teacher Asthma Management and Information Seeking Scale, which assesses self-efficacy, were examined. Results: Teachers’ self-efficacy in managing asthma and seeking information was significantly higher among teachers who had completed in-service professional learning sessions and those who had access to community resources or links to community agencies. Additionally, teachers with personal experience of chronic illness, asthma, or allergies and those who had students with chronic illnesses in their classrooms reported higher self-efficacy scores. Conclusions: Findings suggest that providing professional learning about asthma for teachers, offering access to asthma action plans and community resources, and increasing awareness of chronic conditions and training for handling medical emergencies can enhance teachers’ self-efficacy and improve outcomes for students with chronic illnesses.

PCR30 Perfect Health Reporting on EQ-5D-5L: The Role of Personal, Family and Social Network Illness Experiences

PCR30 Perfect Health Reporting on EQ-5D-5L: The Role of Personal, Family and Social Network Illness Experiences

Health leaders’ perspectives and attitudes on medical assistance in dying and its legalization: a qualitative study

BackgroundMedical Assistance in Dying (MAiD) has transformed health policy and practice on death and dying. However, there has been limited research on what shaped its emergence in Canada and the beliefs and views of health leaders who hold positions of influence in the healthcare system and can guide policy and practice. The objective of this study was to examine health leaders’ perspectives on the factors that led to the emergence of MAiD and explore their attitudes about the legalization of MAiD.MethodsIn this qualitative study, we conducted online semi-structured interviews with health leaders from April 2021 to January 2022. Purposive and snowball sampling techniques were used to recruit health leaders who have expertise and engagement with the delivery of MAiD or palliative and end-of-life care, and who hold positions of leadership relevant to MAiD in their respective organisations. Inductive thematic analysis was used to analyze the transcribed interviews.ResultsThirty-six health leaders were interviewed. Participants identified six factors that they believed to have led to the introduction of MAiD in Canada: public advocacy and influence; judicial system and notable MAiD legal cases; political ideology and landscape; policy diffusion; healthcare system emphasis on a patient-centred care approach; and changes in societal and cultural values. Participants expressed wide-ranging attitudes on the legalization of MAiD. Some described overall agreement with the introduction of MAiD, while still raising concerns regarding vulnerability. Others held neutral attitudes and indicated that their attitudes changed on a case-by-case basis. Participants described four factors that they considered to have had influence on their attitudes: personal illness experiences; professional experiences and identity; moral and religious beliefs; and, the valence of patient autonomy and quality of life.ConclusionsThis study highlights the wide-ranging and complex attitudes health leaders may hold towards MAiD and identifies the convergence of multiple factors that may have contributed to the legalization of MAiD in Canada. Understanding health leaders’ attitudes and perspectives on the legalization of MAiD may inform stakeholders in other countries who are considering the legalization of assisted dying.

Health-Related Experiences as a Motivation for Pursuing Health Professional Education

Health professional students may experience overlaps between their own lives and their course of study. Such experiences may include: personal experiences of illness or disability; family illness, caregiving or bereavement; and collective experiences of health inequities. However, little is known about the role of such experiences in students’ decisions to study health. We describe findings from interviews with 22 students and graduates in Aotearoa New Zealand, who self-identified as having experienced significant overlaps between their study and own lives. Participants described studying health in response to health-related experiences in four ways: meeting family needs; improving life for others in similar situations; exposure to healthcare as consolidating interests; and making meaning after bereavement. We also explore contexts in which participants made decisions about study, including family support, secondary school, and early tertiary study. We argue that health-related experiences and commitment to whānau| family should be recognised more widely in exploring why and how students select health professional qualifications. We also identify the importance of academic and career mentoring programmes throughout secondary and early tertiary education which nurtured students’ aspirations for success in sciences and health education.

Výsledky projektu DIPEX zaměřeného na Crohnovu nemoc a uclerózní kolitidu

Summary: Introduction: The paper reports on the project DIPEx, which has created the website www.hovoryozdravi.cz. The concept is based on the stories of patients themselves in different health conditions. The paper reports specifically on the part of the project devoted to IBD patients, the module “Crohn‘s disease and ulcerative colitis, as well as on the scientific results published in the framework of applied qualitative research in health psychology. Patients and methods: 36 patients, 19 with Crohn‘s disease and 17 with ulcerative colitis, were asked to tell their story with IBD and were also asked questions about health care, living with IBD, coping with the disease, etc. The Database of Personal Experiences of Health and Illness (DIPEx) methodology, developed in Oxford and standardized in the Czech Republic as an innovative qualitative research tool, was used. Results: Further elaboration of the participants‘ narratives also led to more in-depth analyses already published, namely: patients‘ expectations in the doctor–patient relationship and issues of intimacy and family planning. Conclusion: The website www.hovoryozdravi.cz is useful for patients, their loved ones, and also for teaching healthcare professionals. Qualitative research on the experiences of IBD patients is unique in its scope in the field of health psychology. Key words: Crohn‘s disease – ulcerative colitis – quality of life – health psychology – qualitative research – patients‘ experience

Exploring intimacy and family planning in Inflammatory Bowel Diseases: a qualitative study

Background Inflammatory bowel diseases (IBD), comprising ulcerative colitis and Crohn’s disease, have a profound impact on people’s lives. This study aims to investigate the perceived impact of IBD on sexual life and family planning to enhance understanding of the interplay between IBD, sexuality, intimacy and family planning to foster a better quality of life for those living with the condition. Materials and methods The study used the qualitative DIPEx method (Database of Personal Experiences of Health and Illness) developed by the Health Experiences Research Group at the University of Oxford, standardized for the Czech Republic. Semi-structured interviews with 36 participants (19 with Crohn’s disease, 17 with ulcerative colitis) were conducted, employing open coding and thematic analysis. The maximum variation sampling was utilized, considering various factors, such as disease stage, medications, treatments, age, age at diagnosis and sociodemographic characteristics. Results Five main topics emerged: sexual activity, body image and discomfort, partner relationships, family planning, and the role of gastroenterologists in family planning decisions. Participants’ perceptions of sexuality varied, with some experiencing reduced sexual activity during acute phases of the disease. IBD had contrasting effects on partner relationships, and family planning was an important concern, with women valuing support and collaboration with their gastroenterologists in making pregnancy decisions. Information dissemination and open communication from professionals are highly needed. Conclusions This is the first study concerning the sexuality and family planning of people with IBD in the Czech Republic. It highlights the need for information and open communication from professionals.

Attitudes and Knowledge of Electroconvulsive Therapy: An Exploration of Medical Students' Perspectives.

To explore knowledge and attitudes of medical students before and after exposure to a technology-enhanced learning and teaching (TELT) session about electroconvulsive therapy (ECT). Adequate knowledge of and attitudes toward ECT is essential for medical students. However, the impact of teaching on knowledge and attitudes is infrequently studied. Fourth- and fifth year medical students at the University of Glasgow were provided with an online questionnaire before and after engaging in a remote TELT session, led by a consultant psychiatrist with expertise in ECT. The online teaching session used resources developed by a multidisciplinary team who specialize in ECT. The teaching session lasted around 1 hour. The questionnaire contained 3 sections: baseline demographics, knowledge of ECT, and attitudes toward ECT. Changes in scores were analyzed. Sixty-seven students completed the teaching session. Response rate to the precourse questionnaire was 68.7% (n = 46), and the postcourse questionnaire was 44.8% (n = 30). Prior to engaging with the learning materials, 9 students reported no knowledge of ECT and a third believed that ECT did not cause a seizure. In general, students who had personal experience of mental illness (friend, relative, or self) had more positive attitudes toward ECT and higher knowledge scores. In general, an increase in knowledge and attitude scores was found in the postcourse questionnaire. Exposing medical students to a TELT session focused on ECT during their psychiatric placement appeared to improve knowledge and attitudes surrounding ECT.

Samostigma med strokovnjaki na področju duševnega zdravja v Sloveniji

Stigma, javna ali samostigma, zaviralno vpliva na iskanje pomoči v primeru duševne stiske. Lahko je prisotna med aktivno epizodo duševne bolezni ali pa jo posameznik predvideva, če bi se duševna bolezen razvila (predvidena stigma). Pomembna in ranljiva skupina za razvoj duševnih bolezni, ki je žal velikokrat spregledana, so strokovnjaki na področju duševnega zdravja. Na vzorcu strokovnjakov iz Slovenije (N = 93), ki se pri svojem delu srečujejo z vsebinami duševnega zdravja, smo raziskovali, kako se osebne izkušnje s težavami v duševnem zdravju in samomorilnim vedenjem povezujejo z različnimi vrstami predvidene samostigme (samostigme duševnih bolezni in iskanja pomoči). V preteklosti je 49 % udeležencev imelo težave na področju duševnega zdravja ali se je z njimi soočalo v času raziskave (56 % je poiskalo pomoč); 16 % udeležencev je v preteklosti imelo samomorilne misli ali se je z njimi soočalo v času raziskave (20 % jih je poiskalo pomoč). Spol ni bil opazno povezan z nobeno vrsto predvidene stigme. Starost je nizko negativno korelirala z izkušnjo težav v duševnem zdravju in predvideno samostigmo duševnih težav. Udeleženci z osebnimi izkušnjami duševnih težav so izkazovali več predvidene samostigme duševnih težav kot udeleženci, ki teh izkušenj nimajo. S samostigmo duševnih težav je bila nizko povezana tudi samostigma iskanja pomoči. Na osnovi rezultatov zaključujemo, da so pri strokovnjakih za duševno zdravje lastne izkušnje težav v duševnem zdravju povezane z višjo samostigmo duševnega zdravja, ta pa z višjo samostigmo iskanja pomoči. Zato bi bile tudi pri njih potrebne specifične intervencije, usmerjene v destigmatizacijo duševnih težav in iskanja pomoči, predvsem pa nadaljnje raziskave na tem področju.

Nurses' career choice and satisfaction with mental health transition-to-practice programs: A cross sectional study.

INTRODUCTION: Globally, there are consistent issues recruiting staff into the mental health nursing workforce. In Australia, recent efforts to expand the workforce include recruitment of a wider range of nurses in addition to new graduates into mental health transition-to-practice programs. Understanding the career motivations of nurses entering the field is an important element of recruitment and retention. To describe nurses' satisfaction with their mental health transition program and identify factors influencing their choice of mental health as a career. An online cross-sectional survey with questions on program satisfaction and career choice was responded to by n = 55 enrolled and registered nurses in a mental health transition program. Nurses reported overall high satisfaction with their program and identified increased time release for professional development and being supernumerary as necessary to support role development. Almost 25% of nurses reported personal experience of mental illness as an influence in choosing a mental health career. Mental health transition programs are important in recruitment and retention and need to be tailored to the needs of a wide range of nurses and include support for staff wellbeing. Tailored transition programs can help strengthen role clarity, and support staff retention.

Stigma and its effect on clergy collaboration with mental health professionals in the delivery of mental health services in Imo state Nigeria.

ABSTRACT Background: In resource-limited countries such as Nigeria, the clergy forms a significant part of the pathway to mental health care of patients. Stigma and negative attitudes toward mental illness may lead to the unwillingness of the clergy to collaborate with mental healthcare professionals Aim and Objectives: The paper aimed to assess stigma and its effect on clergy collaboration with mental health professionals in the delivery of mental health services in a developing country. Methods: A cross-sectional descriptive study was carried out among 237 Christian clergies working in Aboh Mbaise LGA of Imo state. A self-administered structured questionnaire was used to collect socio-demographic data and information on personal experience of mental illness. The forty-item Community Attitudes Towards Mental Illness (CAMI) scale was used to assess stigma and clergy attitudes toward mental illness Results: One hundred and seventy-six (74.3%) of the clergy were willing to collaborate with mental health care professionals. Among the 176 respondents who were willing to work with health workers, just above half (56.8%) reported offering health education to church members as the most preferred method of collaboration. There was a significant association between willingness to collaborate with mental health workers and a lower mean authoritarianism score (t=0.69, p=0.01), higher mean benevolence score (t=13.80, p=0.001), and higher mean social restrictiveness score (t=1.03, p=0.01) Conclusion: There is a high level of negative attitude among the clergy towards persons suffering mental illness but despite this, the clergy are willing to collaborate with mental health practitioners.

Trajectories of sentiment in 11,816 psychoactive narratives.

Can machine learning (ML) enable data-driven discovery of how changes in sentiment correlate with different psychoactive experiences? We investigate by training models directly on text testimonials from a diverse 52-drug pharmacopeia. Using large language models (i.e. BERT) and 11,816 publicly-available testimonials, we predicted 28-dimensions of sentiment across each narrative, and then validated these predictions with adjudication by a clinical psychiatrist. BERT was then fine-tuned to predict biochemical and demographic information from these narratives. Lastly, canonical correlation analysis linked the drugs' receptor affinities with word usage, revealing 11 statistically-significant latent receptor-experience factors, each mapped to a 3D cortical Atlas. These methods elucidate a neurobiologically-informed, sequence-sensitive portrait of drug-induced subjective experiences. The models' results converged, revealing a pervasive distinction between the universal psychedelic heights of feeling in contrast to the grim, mundane, and personal experiences of addiction and mental illness. Notably, MDMA was linked to "Love", DMT and 5-MeO-DMT to "Mystical Experiences" and "Entities and Beings", and other tryptamines to "Surprise", "Curiosity" and "Realization". ML methods can create unified and robust quantifications of subjective experiences with many different psychoactive substances and timescales. The representations learned are evocative and mutually confirmatory, indicating great potential for ML in characterizing psychoactivity.

Learner Experiences of Preceptor Self-Disclosure of Personal Illness in Medical Education.

The notion of physician invulnerability to illness contributes to the ongoing marginalization of physicians with personal experiences of illness and complicates professional identity development in medical learners. As such, physician self-disclosure of lived experiences as patients has seen an increasing role in medical education. Existing literature, centered on mental health, has characterized the positive effect of physician discussion of experience with mental illness on medical students and residents. However, the ways learners process and understand physician illness stories beyond this context and their use in education remain unclear. This study aimed to explore undergraduate medical students' perspectives on physician illness discussions of both physical and mental illness, including their perceptions of its use as a pedagogical tool. This qualitative study followed an interpretive descriptive design using activity theory as a sensitizing concept. Semistructured interviews with medical students were conducted between January and April 2022 at McMaster University in Hamilton, Ontario, Canada. The authors analyzed transcripts using reflexive thematic analysis. Twenty-one medical students participated in interviews. Although rare, self-disclosure conversations occurred across varied settings and addressed diverse aspects of illness experiences. Discussions involved teaching of pathophysiology, career advice, and wellness guidance. Five themes were developed: the opposition of physicianhood, patienthood, and situating the learner identity; invisibility and stigmatization of physician illness; impact of preceptor stories on learners' relationship with medicine; challenging the "rules" of physicianhood; and situating self-disclosure in medical education. Students strongly appreciated physician self-disclosure conversations. Self-disclosure can act as an effective pedagogical tool by fostering expansive learning among medical students. Further research is necessary to explore physician perspectives and supports for self-disclosure in education.

Structural and Psychosocial Challenges Among Underserved Patients Receiving Hemodialysis During and Beyond the COVID-19 Pandemic: A Qualitative Study

Structural and Psychosocial Challenges Among Underserved Patients Receiving Hemodialysis During and Beyond the COVID-19 Pandemic: A Qualitative Study

Research Directions for Leveraging and Supporting the Lived Experience of Mental Illness within Psychology.

This paper explores the lived experience of mental illness within the field of psychology across higher education and the mental health workforce. There is a high prevalence of mental health issues among psychology students and practitioners, and it is critical not only to provide support for these populations, but also to acknowledge the value of leveraging their lived experience within their education and practice. There has been increased interest in and advocacy for the involvement of those with lived experience of mental illness within mental healthcare service provision to improve patient experiences and outcomes. However, there have been limited acknowledgement and research regarding the role of psychologists with personal lived experiences of mental illness, and how to leverage this experience. Further, there are challenges faced by both psychology students and practising psychologists with lived experience that act as barriers to leveraging their unique skills and experiences. Psychology students with lived experience face stigma, inadequate support, and incongruence between the course material and their personal experiences. Similarly, practising psychologists with lived experience encounter stigma and isolation, indicating the need for a culture change that promotes transparency and understanding. The paper calls for research in five key directions to provide evidence that can be used to support and leverage lived experience in psychology.

A Market of Lived Experience—User Involvement and the Commodification of Personal Experiences of Mental Illness

Working actively to engage service users in participatory practices is both a policy expectation and a moral imperative for mental health social workers in contemporary Western mental health care. Recent research suggests that such practices of service user involvement are becoming increasingly individualised and driven by market logic. Based on an ethnographic study within a Swedish public psychiatric organisation, this article applies the concept of commodification to examine this trend. By showing how the practice of user involvement takes the form of a market where personal narratives and experiences of mental health problems are bought and sold as commodities, the analysis illuminates how market logic permeates the everyday practice of user involvement. One consequence of this commodification is that user organisations, as well as individual service users, are restricted in their role as independent actors pursuing their own agenda, and instead increasingly act on behalf of the public and as providers of personal experiences. While it is vital that service user perspectives are heard and recognised within mental health services, mental health social workers need to be aware of the risks of commodifying lived experience. When attention is directed to individual experiences and narratives, there is a risk that opportunities to advocate on behalf of the user collective as a whole and speak from a more principled and socio-political standpoint are lost. In addition, the commodification of personal experience tends to rationalise and privilege user narratives that conform to the dominant institutional logic of the mental health organisation, while excluding more uncomfortable and challenging voices, thereby undermining the ability of service users to raise critical issues that do not align with the interests of the mental health organisation.

A scoping review of studies examining mental health literacy among Arabs worldwide.

There is growing interest in Mental health literacy (MHL) worldwide, given its important role in overcoming barriers to service use and reducing mental health disparities. However, little is known about MHL among Arabs. We conducted a scoping review to examine MHL levels and correlates among Arabs in both Arab and non-Arab countries, based on Jorm's MHL framework. We conducted a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using six electronic databases: PubMed, PsycINFO, CINAHL, Soc Index, Web of Science, and Scopus. Data were summarized and synthesized. Nine studies examining MHL among Arabs met our inclusion criteria. Seven of them used a quantitative cross-sectional design. Four studies were conducted in Arab, and five were in non-Arab countries. Five studies were conducted among university students. The studies included indicate moderate to high levels of MHL. Higher MHL was associated with female gender, personal experience of mental health illness, and with help-seeking behaviours. Our review shows a significant lack of empirical studies on Arabs' MHL. These findings should be considered as a call for action for public health researchers, mental health workers, and policymakers to prioritize research in this field.

Patient identity narratives through the cultural formulation interview in a New York City outpatient clinic.

Anthropologists have critiqued cultural competence programs in medical settings while introducing mental health clinicians to social theories on culture for practice. We explore how patients articulated narratives about themselves and how clinicians responded to such narratives through an intervention known as the Cultural Formulation Interview that anthropologists have helped develop. We conducted over 500 hours of fieldwork from 2014 to 2019 at an outpatient clinic in New York, analyzing multiple data (participant observation, medical records, patient-clinician sessions, and individual debriefing interviews) in a trial joining clinical and ethnographic methods. Our study enrolled 45 patients and six clinicians, yielding 117 patient-clinician appointments and 98 debriefing interviews. Most patients differed in how they presented their identities through demographic forms and discussed them in sessions with their clinicians. Two-thirds of the patients drew connections between their personal identities and experiences of mental illness. These results reveal why cultural identities should not be taken for granted in clinical settings.

Personal experience of mental illness and stigma

Personal experience of mental illness and stigma

The relationship between personal and interpersonal mental health experiences and stigma-related outcomes in Hong Kong

BackgroundPrevious research indicates that personal mental health experiences (e.g. one's current mental health status) and interpersonal mental health experiences (e.g. one's familiarity with someone with mental illness) are associated with stigma-related outcomes. These outcomes include knowledge, attitudes and desire for social distance from people with mental illness.AimsTo explore the extent to which current personal mental health status and familiarity with mental illness predict stigma-related outcomes in Hong Kong.MethodData were drawn from a larger research project examining mental well-being in Hong Kong citizens. Citizens (N = 1010) aged ≥18 years were surveyed between August and September 2021.ResultsMultiple regression analyses revealed that immediate family and friends showed better attitudinal outcomes and lower desire for social distance compared with people who did not know anyone with mental illness (all β > 1.00, all P < 0.05), whereas people with personal experience of mental illness showed higher prejudicial attitudes compared with people who did not know anyone with mental illness (β = −0.744, P = 0.016). Better current personal mental health predicted lower prejudicial attitudes (β = 0.488, P < 0.001) and mixed outcomes on different realms of mental health knowledge.ConclusionsCultural concerns surrounding ‘saving face’ and emphasis on collectivistic values may explain the nonlinear relationship between personal and interpersonal mental health experiences and stigma-related outcomes. Future anti-stigma interventions should tailor their approaches to the needs of people with different levels of familiarity with mental illness and include efforts to support the mental health of the overall population.