Biomedical subjects

Christopher Tennant

Publications and source records attributed to Christopher Tennant.

6 recordsLinked to original sources

PubMed2006

The response of doctors to a formal complaint.

OBJECTIVES: This pilot study investigates the psychological impact on doctors of a complaint to the New South Wales Health Care Complaints Commission and the doctor's perception of legal risk. METHOD: Doctors who received a complaint were sent a set of questionnaires embracing psychological variables and their perceptions of legal risk. RESULTS: The response rate was 60%. Thirty-eight per cent of respondents met screening criteria for psychiatric disorder. There was, however, minimal functional impairment of work, social or family life. Respondents scored highly on altruism, but at the same time were 'tough minded'. The questionnaire to assess the doctor's perception of legal risk appeared to have acceptable construct validity but showed that doctors still misunderstand medico-legal risk. CONCLUSIONS: Psychiatric morbidity rates of our sample were comparable with other Australian medical samples. This small sample appeared to cope with the stress of a complaint better than those reported in other studies.

Attitude of Health Personnel↗

PubMed2005

Psychological factors associated with persistent postnatal depression: past and current relationships, defence styles and the mediating role of insecure attachment style.

BACKGROUND: This study prospectively investigated the factors underlying the maintenance and persistence of postnatal depression beyond the first year after birth. METHOD: One hundred primiparous women who were admitted to a parentcraft hospital for a week were assessed after discharge at 4 and 12 months postpartum. Various measures of mood, interpersonal relationships and defence styles were administered at 4 months and the relation between these measures and clinically elevated symptoms of depression at 12 months was examined. RESULTS: At 12 months, 30% of all mothers and 60% of those diagnosed depressed at 4 months continued to report clinically significant levels of depressive symptomatology. The strongest predictor of depression at 12 months was severity of symptoms at 4 months, and women from a non-English speaking background were significantly more likely to remain depressed. Reports of low maternal care in childhood, marital dissatisfaction at 4 months, an attachment style characterised by anxiety over relationships and immature defence styles were significant predictors of clinically elevated depression scale scores at 12 months. Furthermore, an insecure attachment style was shown to mediate the effect of low maternal care in childhood, while other cognitive and interpersonal factors appeared to contribute additively in maintaining depressive symptoms. LIMITATIONS: Self-report measures were used to measure insecure attachment styles and depression at 12 months. CONCLUSIONS: Findings demonstrate that both childhood and concurrent relationship difficulties contribute to the maintenance of postpartum depression. Interventions for persistent depression need to address relationship difficulties as well as depressive symptomatology.

Adult↗

PubMed2004

The psychological impact of complaints and negligence suits on doctors.

OBJECTIVE: To describe the psychological impact of complaints and negligence litigation on doctors. METHODS: A review of the literature from 1966 to 2003 was conducted. Additional sources were obtained from targeted experts and organizations. RESULTS: Doctors who have been sued or who have had formal complaints made against them describe the process as an extremely stressful experience. Depression and adjustment disorder were relatively common, while drug and alcohol abuse, physical illness and suicidal ideation were reported less frequently. The majority of doctors who have been the subject of a complaint or law suit practice more 'defensively'. CONCLUSIONS: A complaint or law suit is uncommon in the daily practice of doctors, yet in today's medicolegal environment they pose a constant potential threat. The threat of, or actual, legal process can cause psychological, physical and behavioural practice changes. The obsessional personality of many doctors may make them particularly vulnerable to seeing the process as a challenge to their professional and personal identity.

Attitude of Health Personnel↗

PubMed2003

Parents of 5-year-old in vitro fertilization children: psychological adjustment, parenting stress, and the influence of subsequent in vitro fertilization treatment.

Sixty-six parents who had conceived by in vitro fertilization (IVF) were compared with 46 matched naturally conceiving control parents regarding psychosocial adjustment and parenting stress 5 years after the birth of their first child. IVF mothers reported a more external locus of control than did control mothers but did not differ on other measures. Within the IVF group, higher levels of treatment predicted lower parenting stress and more defensive responding on the Parenting Stress Index (R. Abidin, 1990). The more positive reporting of high-treatment IVF parents may be attributable to either defensive responding or the fact that they are particularly highly motivated and competent parents. The study findings confirm a growing body of research regarding overall positive adjustment in IVF parents but also highlight the importance of considering individual differences among IVF mothers with respect to treatment experience.

Adaptation, Psychological↗

PubMed2002

Deinstitutionalization for long-term mental illness: a 6-year evaluation.

OBJECTIVE: Forty-seven patients with long-term mental illness were transferred to the community following the closure of a psychiatric hospital in Sydney. This 6-year evaluation is an extension of a detailed clinical, ethnographic and economic study of the initial 2-years of community transition. METHOD: Quantitative evaluation was conducted using the Brief Psychiatric Rating Scale, Life Skills Profile, Social Behaviour Scale, Montgomery Asberg Depression Rating Scale and Quality Of Life measures. Assessments were completed prior to discharge and at two- and 6-year intervals following community transfer. Repeated measures analysis was utilized to determine changes in outcome variables over time. The residents' perception of 6-years of community living was explored in qualitative semistructured interviews. Details of accommodation, level of care, readmissions, incidents and medication were also documented. RESULTS: During the 6 years following community relocation a total of seven residents returned to hospital for long-term care, three residents died from medical causes and one resident required detention in a corrective services facility. The 36 residents who remained in the community at the 6-year follow-up no longer required intensive 24-h supervision. Living semi-independently, 23 residents resided in two to three person accommodation with either daily or weekly case manager visits. Clinically, community residents remained stable over the 6 years without significant changes in psychiatric symptoms, depression, living skills or social behaviour problems. Clinical stability was achieved with significant reduction in medication levels over the 6 years. Community-based residents continued to experience improved quality of life and reported their marked preference for living in the community. CONCLUSION: The residents maintained community tenure with significant improvement in quality of life and a reduction in medication, supported by a mental health system with adequate community resources. Issues regarding continuing rehabilitation and social integration need to be addressed. Further deinstitutionalization will require 24-h supervision for most initially and for some on a continuing basis. An ageing population will require specific age related medical and psychiatric services.

Activities of Daily Living↗

PubMed2002

Life events, stress and depression: a review of recent findings.

OBJECTIVE: To review recent empirical prospective studies on the relation between life event stressors and depression. METHOD: A systematic literature search focusing on predictive studies was carried out from 1980 to early 2001 using Medline, Embase and PsychInfo. RESULTS: The empirical findings for the most part support clinical impressions of the relation of stressors to depression but at the same time provide some clearer understanding in relation to differences of stressor impact on depression type and on index episode, relapse or recurrence. Twin studies now provide the strongest evidence of the relative magnitude of effect of environmental stressors and genetic factors: the former explains at least as much of the variance in depression as our genes. CONCLUSIONS: Continuing research into life events and depression have been fruitful especially those studies assessing the effect of stressors in combination with other aetiological variables such as genetic factors.

Adolescent↗