Medical Services Professionals Research Articles

Bypassing Emergency Service: Decoding the Drivers of Self-Referral During Acute Myocardial Infarction on Rural Areas in Sachsen-Anhalt, Germany

Background/Objectives: the timely and effective management of acute myocardial infarction (AMI) is crucial to improve patient outcomes. ‘Self-Referral’ is defined as instances either where patients arrive at the hospital by their own means or are transported by someone else, rather than through professional emergency medical services. This approach can lead to treatment delays and potentially worsen outcomes. This study aims to identify the factors associated with the choice of self-referral among patients with AMI in Saxony-Anhalt, Germany. Methods: We used the data from the Regional Myocardial Infarction Registry of Saxony-Anhalt (RHESA), which included 4044 patients with confirmed acute myocardial infarction (AMI), including 48.7% from urban areas (city of Halle) and 51.3% from rural areas (Altmark). The gender distribution was 65% male and 35% female, covering an age range from 25 to over 80 years. Multivariable logistic regression identified factors associated with self-referral and its impact on reaching a hospital with percutaneous coronary intervention (PCI) capability. Results: Rural residents were more likely to self-refer compared to those in urban settings (adjusted odds ratio 2.43 [95% CI: 2.00–2.94]). Odds of self-referral decreased with age, while metabolic factors, including hypertension, high body mass index (BMI), and diabetes, as well as sex were not associated with self-referral. Self-referral did not increase the odds of arriving in a hospital without PCI capability. (Adjusted odds ratio 1.12 [95% CI: 0.85–1.47]). Furthermore, in cases of self-referral, women did not have a disadvantage in reaching a hospital with PCI (0.91; 0.59–1.41) compared to men. However, in medically attended transports, women were at a disadvantage (odds ratio: 1.33; 95% CI: 1.06–1.67). Conclusions: These findings highlight the need for public education on self-referral and for medical personnel training to prevent gender bias in AMI transport to PCI-capable hospitals.

34 Improving language concordant care in the paediatric emergency department

Abstract Background Paediatric patients and families with limited English proficiency (LEP) experience worse health outcomes. Use of professional medical interpreter services (IS) helps ensure that all patients receive high quality care, regardless of their preferred language of communication. Objectives The aim of this quality improvement (QI) study was to improve language concordant care within a paediatric emergency department (ED) in downtown Toronto by increasing the rate of over-the-phone interpreter use by 50% by July 2024 and to understand common reasons for interpreter non-use. Design/Methods Using the model for improvement, we assembled an interdisciplinary team that included physicians, ED registration clerks, triage nurses, and language services staff to understand current workflow and develop targeted interventions aimed at addressing key drivers through multiple plan-do-study-act (PDSA) cycles. Interventions included introduction of a standardized script to capture language preference at ED registration, EMR-integrated preferred language notification and smart text template in provider notes for standardized IS use or non-use documentation, and departmental education. Our primary outcome measure was rate of over-the-phone IS use for all ED visits. Process measures were rate of EMR documentation of patients and caregivers with non-English language preference (NELP) and rate of provider documentation of IS use or non-use. Balancing measures included time to provider initial assessment (PIA) and ED length of stay. Results The baseline period (November 2022-April 2023) revealed an over-the-phone IS rate of 5.2% for all ED visits. The initial results from the first 6 months of the intervention period demonstrated an increase in physician documentation of IS use or non-use in patients with NELP, from 10% to 76%. Additionally, 18.6% of patients or caregivers with NELP had IS use per provider notes. Over the next 9 months of the intervention period, special cause variation is anticipated in the rate of IS use and rate of EMR documentation of NELP. The most common reasons for IS non-use were: ‘deemed unnecessary by provider’, ‘declined by family’ and ‘use of family member/friend as interpreter’. There was no change in PIA or ED length of stay for patients with NELP. Conclusion This QI initiative increased consistent provider documentation of IS use in ED patient records in one of the most linguistically diverse cities in the world. Future efforts will focus on exploring additional ways to capture language preference beyond registration, facilitating IS use in the ED, and addressing top reasons for non-use of IS in patients and caregivers with NELP.

The Role of Hospital By Laws in Providing Legal Protection Against Alleged Medical Malpractice at the Padang Panjang City Regional General Hospital

Hospital By Laws (HBL) is an internal hospital rule designed to provide legal protection to both patients and medical personnel. In the context of Padang Panjang Hospital, HBL should function as a reference in resolving medical disputes and maintaining the quality of health services. Based on the analysis of the situation, HBL has not functioned optimally, especially in dealing with cases of alleged medical malpractice. The purpose of this study was to analyze the role of HBL in providing legal protection against alleged medical malpractice at Padang Panjang Hospital, as well as to find obstacles faced in its implementation. The method used is a sociological juridical approach with primary data obtained through interviews with related parties in the hospital, and secondary data from related legal literature. The results of the study show that many cases of alleged malpractice are resolved informally through mediation, without using strict legal procedures based on HBL. Several cases such as misalignment of surgery, incorrect installation of infusions in infants, and negligence in the installation of Nasogastric Tube (NGT) are examples of the weak implementation of HBL at Padang Panjang Hospital. The main obstacle found in the implementation of HBL is the lack of understanding and awareness from hospitals of the importance of HBL as a legal instrument. Dispute resolution is more often carried out through a family approach without involving the formal rules regulated in the HBL. This shows that there is a gap between existing regulations and practices carried out in the field. The supervision mechanism for the implementation of HBL in hospitals has also not run well, so this rule is not functioning as it should. This study suggests the need to strengthen the implementation of HBL at Padang Panjang Hospital through more intensive socialization to all medical personnel and hospital management as well as training on professional ethics and medical service standards. Supervision is needed to ensure that these rules are properly implemented in resolving medical disputes. Padang Panjang Hospital is expected to improve the quality of its services while providing better legal protection for patients.

Optimization of service quality management in clinical processes

This study aims to explore the specific application and optimization strategies of service management in clinical practice, with the core goal of improving the quality of medical services, enhancing patient satisfaction, and optimizing the allocation of medical resources. Through continuous improvement and optimization of service management strategies, we hope to promote the development of the medical service system towards a healthier and more efficient direction, and provide patients with higher quality and professional medical services. Meanwhile, this effort will also contribute to enhancing the comprehensive competitiveness and social image of medical institutions, laying a solid foundation for building a more harmonious and trustworthy doctor-patient relationship. We believe that through continuous research and practice, we can create a better medical environment for patients and inject new vitality into the development of the medical service industry.

Research on the Management Strategy of College Medical Professional Practice Based on the Perspective of Talent Training

Medical practice is an important link of medical education in universities. Its purpose is to help students get familiar with the tasks and responsibilities of medical work, let students understand the specific application of professional theoretical knowledge and skills, and improve students' professional quality and medical service level. A good job of intern management can effectively achieve this goal. At present, there are many problems, such as medical practice in colleges and universities, such as imperfect management system, weak responsibility of some teachers, and poor adaptability of students, which need to be paid attention to by relevant educators. Based on the perspective of talent training, this paper briefly analyzes the importance of medical practice in colleges and universities, expounds the prominent problems of medical practice management in colleges and universities and the corresponding solutions, aiming to improve the quality of intern education management and promote the better development of students.

Innovations in medical tourism

Medical tourism in the modern world is becoming a new, actively developing market segment. This market segment is expanding due to the active introduction of highly professional medical services. Instruments such as innovation certificates (vouchers) for small and medium-sized high-tech companies to pay for medical R&D services. This is an investment by the government to support innovation in medicine and population wellness. The results of the global ranking for 2022 made it possible to highlight the key advantages and disadvantages of the innovation system of the Russian Federation. It is noted that the main purpose of innovation implementation in medical tourism is to improve its efficiency, the question of measuring the impact of innovation on the quality of medical services provided to tourists inevitably arises. In this regard, we have reviewed some of the innovations that can be used in medicine such as: artificial intelligence, DNA sequencing for deciphering the genetic code, CRISPR-Cas9 system for genetic "scissors", virtual and augmented reality technology for treating neurological and psychosomatic disorders, VR technology, patient-specific devices (PSD) for customized implants, Cast21 for prosthetic limbs, bioprinting, smart insulin port, Kardiaelectrocardiograph. They can be used in the development of proposals for medical tours. With the application of innovations in medicine and the introduction of an international certification system in the medical sector, the attractiveness of medical tourism will increase significantly and attract new clients.

A simulation-based randomized trial of ABCDE style cognitive aid for emergency medical services CHecklist In Prehospital Settings: the CHIPS-study

BackgroundChecklists are a powerful tool for reduction of mortality and morbidity. Checklists structure complex processes in a reproducible manner, optimize team interaction, and prevent errors related to human factors. Despite wide dissemination of the checklist, effects of checklist use in the prehospital emergency medicine are currently unclear. The aim of the study was to demonstrate that participants achieve higher adherence to guideline-recommended actions, manage the scenario more time-efficient, and thirdly demonstrate better adherence to the ABCDE-compliant workflow in a simulated ROSC situation.MethodsCHIPS was a prospective randomized case–control study. Professional emergency medical service teams were asked to perform cardiopulmonary resuscitation on an adult high-fidelity patient simulator achieving ROSC. The intervention group used a checklist which transferred the ERC guideline statements of ROSC into the structure of the ‘ABCDE’ mnemonic. Guideline adherence (performance score, PS), utilization of process time (items/minute) and workflow were measured by analyzing continuous A/V recordings of the simulation. Pre- and post-questionnaires addressing demographics and relevance of the checklist were recorded. Effect sizes were determined by calculating Cohen’s d. The level of significance was defined at p < 0.05.ResultsTwenty scenarios in the intervention group (INT) and twenty-one in the control group (CON) were evaluated. The average time of use of the checklist (CU) in the INT was 6.32 min (2.39–9.18 min; SD = 2.08 min). Mean PS of INT was significantly higher than CON, with a strong effect size (p = 0.001, d = 0.935). In the INT, significantly more items were completed per minute of scenario duration (INT, 1.48 items/min; CON, 1.15 items/min, difference: 0.33/min (25%), p = 0.001), showing a large effect size (d = 1.11). The workflow did not significantly differ between the groups (p = 0.079), although a medium effect size was shown (d = 0.563) with the tendency of the CON group deviating stronger from the ABCDE than the INT.ConclusionChecklists can have positive effects on outcome in the prehospital setting by significantly facilitates adherence to guidelines. Checklist use may be time-effective in the prehospital setting. Checklists based on the ‘ABCDE’ mnemonic can be used according to the ‘do verify’ approach. Team Time Outs are recommended to start and finish checklists.

IMPACT OF FALSE FIRST AID INFORMATION AND MYTHS ON PARAMEDIC EDUCATION

Aim: The purpose of this study was to evaluate the effect of false information and myths related to first aid on paramedic education that have been formed in society.&#x0D; Method: A two-level qualitative approach was employed. Focus group interviews with paramedic students were conducted at the beginning of their paramedic training and subsequently, at the end of the second semester, when they had completed their basic paramedic training. An independent qualitative researcher conducted thematic analysis in two stages. Furthermore, to complete the analysis and triangulation of data, paramedic educators involved in the research team reviewed and interpreted the presented themes independently.&#x0D; Findings: Ten themes emerged from the first focus group interviews, including misinformation about first aid and practices that may be considered myths. The participants also revealed that the media and family elders disseminated false information and myths related to first aid. Furthermore, while false information could be corrected in subjects such as foreign body aspiration and hemorrhages that are taught mainly in practice in the curriculum, there was resistance when attempting to rectify false information in more theoretical subjects such as poisoning and epilepsy.&#x0D; Conclusion: Paramedic students are affected by false information related to first aid. Despite the academic education they received to become professional emergency medical service (EMS) employees, they appeared to resist replacing some incorrect first aid information with that which is correct. It is deemed that the media is the most important means to replace false information with true information and spread scientific information.

Home Health Care Problem Related to Routing and Scheduling

Home Health Care (HHC) is a form of nursing that provides medical and non-medical health services to patients in their places of residence. It aims to help individuals who require treatment, monitoring, or recovery to receive professional medical services in the comfort of their homes. The purpose of this paper is to propose a literature survey on HHC dealing with routing and scheduling and some discussions on current trends with a focus on the medical resource aspects.

Tick tock on the stomach clock: Factors affecting time to diagnosis of gastric adenocarcinoma at an urban cancer center with a large East Asian patient population.

e18508 Background: Gastric cancer is the fifth most common cancer in the world and disproportionately affects the East Asian population. Various factors contribute to this disparity such as genetics and environmental exposure. Given that language barriers can contribute to reduced quality of healthcare delivery, screening rates, and patient safety, it is important to assess the impact of language on the diagnosis of gastric cancer. Tufts Medical Center’s proximity to Boston’s Chinatown make our patient population unique for analysis of these factors. Here we present a single-institution experience of the factors affecting gastric adenocarcinoma time to diagnosis. Methods: We used ICD-10 codes to retrospectively identify patients at Tufts Medical Center with a diagnosis of gastric cancer between January 2011 and December 2021. We excluded patients that did not have a diagnosis of gastric adenocarcinoma or lacked adequate clinical documentation. We recorded demographic, clinical, and treatment characteristics including race (White, Asian, or other), primary language (English, Asian or other), presenting symptoms, enrollment in hospice, and interpreter status (certified, non-certified, none, or not applicable). Certified interpreters included professional medical services for in-person, video, or phone interpreters. Non-certified interpreters included family members, physicians fluent in the language, or others. We assessed the impact of these on the time between initial presentation to the healthcare system and eventual diagnosis of gastric cancer. Results: 80 patients were included in the analysis. Mean days to diagnosis by race were as follows: White (40), Asian (43), other (25), p = 0.20. Mean days to diagnosis based on language were as follows: English (40), Asian (43), other (6), p = 0.07. Mean days to diagnosis based on interpreter status were as follows: certified (19), non-certified (13), none (73), NA (40) (p = 0.05). When pairwise comparison was done, there was no difference between certified and non-certified interpreter (p = 0.40). There was no difference between certified interpreter and no interpreter (p = 0.06). There was a statistically significant difference between non-certified interpreter and no interpreter (p = 0.04). Presenting symptoms and eventual enrollment in hospice did not significantly impact time to diagnosis. Conclusions: We saw a shorter time from initial presentation to diagnosis of gastric adenocarcinoma in non-English speaking patients who used an interpreter at the initial visit compared to those who did not. One should always consider interpreter availability as an important part of reducing health disparities.

Hospital dual-channel adoption decisions with telemedicine referral and misdiagnosis

With the rapid development of telemedicine and the impact of the COVID-19 pandemic, more and more patients are now resorting to using telemedicine channels for healthcare services. However, for hospitals, there exists a lack of managerial guidance in place to help them adopt telemedicine in a practical and standardized way. This study considers a hospital operating with both telemedicine (virtual) and face-to-face (physical) medical channels, and which allocates its capacity by also taking into account the possibility of both referrals and misdiagnosis. Methodologically, we construct a game model based on a queuing framework. We first analyze equilibrium strategies for patient arrivals. Then we propose the necessary conditions for a hospital to develop a telemedicine channel and to operate both channels simultaneously. Finally, we find the optimal decisions for the service level of telemedicine, which can also be regarded as the optimal proportion of diseases treated by telemedicine, and the optimal hospital capacity allocation ratio between the two channels. We also find that hospitals in a full coverage market (e.g., for certain small-scale hospitals and community hospitals or cancer hospitals) are more difficult to adopt telemedicine than hospitals in a partial coverage market (e.g., for comprehensive large-scale hospitals with many potential patients). Small-scale hospitals are more suited to operating telemedicine as a gatekeeper to help triage patients, while large hospitals are more prone to regard telemedicine as a medical channel for providing professional medical services to patients. We also analyze the effects of the telemedicine cure rate and the cost ratio of telemedicine to the physical hospital on the overall healthcare system performance, including the physical hospital arrival rate, patients’ waiting time, total profit, and social welfare. Then we compare the performance, ex ante versus ex post, the implementation of telemedicine. It is shown that when the market is partially covered, the total social welfare is always higher than it was before the implementation. However, as far as the profit goes, if the telemedicine cure rate is low and the cost ratio is high, the total hospital profit may be lower than it was prior to using telemedicine. However, the profit and social welfare of hospitals in the full coverage market are always lower than it was before the implementation. In addition, the waiting time in the hospital is always higher than that before the implementation, which means that the implementation of telemedicine will make patients who must receive treatment in the physical hospital face even worse congestion than before. More insights and results are gleaned from a series of numerical studies.

Examining the Dilemma Between Artificial Intelligence Techniques and Professional Medical Service: A Hybrid Balancing Perspective

Artificial intelligence (AI), which is reshaping the resource landscape by detecting patterns and structuring new rules within the medical industry, has been recognized as the latest disruptive innovation wave in the health-care industry. However, that has also caused a contradiction, which is between quantificationism logic and medical professionalism logic. To combine co-existing logics within a health-care organization, this research delivers a practical-oriented hybrid balancing model with multidimensional mechanisms to tackle dual institutional logics, including valuable data standard establishment, securable information interface design, and dynamic intelligent service development. This study extends our understanding of intelligent hospital development by examining the balance between AI techniques and professional medical service.

A WEIGHTED NEURAL MATRIX FACTORIZATION HEALTH MANAGEMENT RECOMMENDATION ALGORITHM INTEGSCORING DEEP LEARNING TECHNOLOGY

With the rapid development of Internet medical information technology, a large amount of medical data appeared on the Internet, however, how to extract effective information from the massive and complex medical data to provide professional medical services and suggestions to users has become a hot spot for this research. The recommendation system can effectively solve the problem of accurate matching of complex medical data resources; however, the cold start, data sparsity and user interest migration of the system in the complex data environment have a large impact on the recommendation effect; therefore, this paper proposes a weighted neural matrix decomposition improved health management recommendation scheme incorporating deep learning techniques. The scheme first uses an implicit feedback method to improve the prediction scores and improve the linear model performance of the matrix decomposition algorithm to form a weighted neural matrix decomposition health management recommendation algorithm. Second, the improved method and deep neural network are fused to improve the performance of the nonlinear model part of the algorithm by using the structural properties of the neural network. Finally, this paper’s method is compared with the mainstream six recommendation algorithms on four publicly available real datasets. The experimental results show that the root mean square error (RMSE) of the WENMF algorithm is smaller than that of the comparison algorithm on all four datasets, and the convergence speed is faster. The hit rate (HR) and normalized discounted cumulative gain (NDCG) of the WENMF algorithm are higher than those of the comparison algorithm on all four datasets, and the maximum difference is 0.04. Therefore, the recommendation accuracy and ranking quality of the WENMF algorithm in the recommendation system are verified, and the cold start and data sparsity problems of the recommendation system are effectively alleviated.

The dilemma and outlet of judicial determination of medical liability in China.

Medical damage liability is directly related to the diagnosis and treatment behavior of medical institutions. It is the most basic form of liability because patients enter the doctor-patient relationship with the expectation that they will receive highly professional medical services from the medical institution. This paper outlines the features of the development of China's medical damage liability system, points out the problems of the system in practice, and proposes improvements. It explores how to solve the legal dilemma of identifying medical liability in China from three perspectives: perfecting the formation and adoption procedures of expert opinions, standardizing the identification of fault by medical institutions, and standardizing the application of the rules of reducing liability for the cause.

Analysing the global and local spatial associations of medical resources across Wuhan city using POI data

BackgroundThere is a sharp contradiction between the supply and demand of medical resources in the provincial capitals of China. Understanding the spatial patterns of medical resources and identifying their spatial association and heterogeneity is a prerequisite to ensuring that limited resources are allocated fairly and optimally, which, along with improvements to urban residents’ quality of life, is a key aim of healthy city planning. However, the existing studies on medical resources pattern mainly focus on their spatial distribution and evolution characteristics, and lack the analyses of the spatial co-location between medical resources from the global and local perspectives. It is worth noting that the research on the spatial relationship between medical resources is an important way to realize the spatial equity and operation efficiency of urban medical resources.MethodsLocalized colocation quotient (LCLQ) analysis has been used successfully to measure directional spatial associations and heterogeneity between categorical point data. Using point of interest (POI) data and the LCLQ method, this paper presents the first analysis of spatial patterns and directional spatial associations between six medical resources across Wuhan city.Results(1) Pharmacies, clinics and community hospitals show “multicentre + multicircle”, “centre + axis + dot” and “banded” distribution characteristics, respectively, but specialized hospitals and general hospitals present “single core” and “double core” modes. (2) Overall, medical resources show agglomeration characteristics. The degrees of spatial agglomeration of the five medical resources, are ranked from high to low as follows: pharmacy, clinic, community hospital, special hospital, general hospital and 3A hospital. (3) Although pharmacies, clinics, and community hospitals of basic medical resources are interdependent, specialized hospitals, general hospitals and 3A hospitals of professional medical resources are also interdependent; furthermore, basic medical resources and professional medical resources are mutually exclusive.ConclusionsGovernment and urban planners should pay great attention to the spatial distribution characteristics and association intensity of medical resources when formulating relevant policies. The findings of this study contribute to health equity and health policy discussions around basic medical services and professional medical services.

Innovative Development Path of the Pension Model Under the Background of the Aging Society: Taking Chongqing as an Example

The aging society has dawned on China, and the pension industry is now considered to be a sunrise industry. In 2020, the number of people over the age of 65 in Chongqing had reached more than 5.47 million. At present, the mainstream home-based care, children support, and institutional care cannot fully meet the needs of the elderly for food, housing, medical care, nursing, and entertainment. The value curve model from “Blue Ocean Strategy” is used to look for innovative, differentiated competitive strategies. Through community-sharing pension institutions, it is believed that a new model that provides lower prices and more professional medical care services for the elderly, enriches the spiritual world of the elderly with rich entertainment activities, and connects social services through an elderly studio to meet the needs of the elderly for self-realization can be introduced.

Telemedicine in Remote Areas: Possibility of Establishing a Telemedicine System

The COVID-19 epidemic is a severe test for the whole medical industry. Under such a circumstance, healthcare is seeking creative business models. Contemporarily, many countries have developed telemedicine, which is an innovative way of consultation brought by digitalization to healthcare. It has developed more rapidly under the spread of COVID-19. Popularizing telemedicine is a perfect method to deal with the epidemic, which can be specified with telediagnosis, teletherapy, and telemonitoring. Since patients in remote districts also long for professional medical services, this paper intends to explore the possibility of building a medical institution to provide telemedicine for patients living in remote areas. Besides, this paper discusses the application of each function and its limitations. Though telemedicine brings more chances for the patients who have a distance to the medical institution, high quality equipment and funds are needed to support the run of telemedicine. However, the implementation of 5G can improve the performance of telemedicine, especially in the latency of telesurgery. Overall, though building a medical station that supports telemedicine is challenging, there are particular populations have demand on it. These results shed light on guiding further exploration of digital updating for medical industry.

Choroba od kuchni. Dieta a zdrowie w społeczeństwie polskim końca XVII w. na podstawie analizy wybranych porad i receptur kulinarnych dzieła Jakuba Kazimierza Haura

Due to the lack of possibility to precisely analyse the influence of food products on the human body at the end of the seventeenth century, people started searching for causes of their malaise in a number of theories at the intersection of astrology, metaphysics and medicine. The frequent inaccessibility of professional medical services made sometimes home remedies the only help in dealing with many diseases. Healing recipes played a key role in home treatment. That is why the subject of this analysis is the seventeenth-century views on diet, beliefs regarding properties of certain food products and the extent and importance of recipes in the process of treatment of different diseases. An analysis and comparison of theories, advice, correlations and practices from the field of dietetics show the general condition of dietetics at the time and make one of many elements of the complex mentality system of the end of the seventeenth-century Polish society easier to understand.

Sağlık Turistlerinin Talepleri Doğrultusunda Türkiye’nin Medikal Turizm Pazarındaki Durumunun Saptanması

Medical tourism is the process that people, who need surgical intervention, travel from their region to another region at the request of receiving more professional and cheaper medical services. The main purpose of this study is to provide a better understanding of consumer demand in the medical tourism market and to find out what can be done to gain a competitive advantage in the medical tourism market of Turkey in accordance with these conclusions. Medical tourism practices in the world and Turkey have been analyzed and comparisons have been made in line with this purpose. In the study, SWOT analysis has been used to reveal the current situation of Turkey by compiling the secondary data. It is found that Turkey has not yet got the share which it wants in the medical tourism market. In addition to keeping up with the technological developments in health tourism, Turkey has been also making new investments in health tourism. At the same time, there are studies that aim to develop health tourism by including it in development plans. These studies will enable health tourism to institutionalize and to be planned in a coordinated way. Considering the wealth of alternative tourism in Turkey, the increase in investments and the research of the demands of health tourists will also bring a competitive advantage. This study is important in terms of proper guidance on investments of medical tourism in Turkey, in the future.

Do clergy recognize and respond appropriately to the many themes in obsessive-compulsive disorder?: Data from a Pacific Island community

ABSTRACT Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition with high rates of misdiagnoses and extended treatment gaps. These may derive in part from poor mental health literacy (MHL) among clergy, who are frequently consulted by those with mental health problems. Therefore, the current study examined the MHL of OCD among clergy on Guam. Clergy (N = 110) provided diagnostic impressions, treatment recommendations, and referral recommendations in response to one of six randomized vignettes describing a common manifestation of OCD: contamination, symmetry, religion, homosexuality, pedophilia, or aggression. Clergy typically misidentified OCD (64.5%), especially in vignettes describing taboo thoughts. They more often recommended that the cases described in the vignettes receive pastoral/biblical counseling and a referral to a clergyperson for professional help rather than professional medical or mental health services. Overall, results reveal needs among clergy for increased MHL, especially concerning OCD's heterogeneous symptomology and evidence-based treatments.