PubMed HealthSearch

Biomedical subjects

J Toews

Publications and source records attributed to J Toews.

18 recordsLinked to original sources

A call for primary prevention: reality or utopia.

The efficacy of primary prevention of mental disorders has been debated over the years. The debate is complicated by ideology, semantic confusion, methodological difficulties and a paucity of good evaluative studies. This paper reviews newer concepts of primary prevention and mental health promotion, methodological issues, model programs, and inherent ethical concerns. Further evaluative studies and an increased contribution of psychiatrists to the primary prevention debate are recommended as necessary steps in further evolution of the field.

Canada

Change with time in patients' reactions to committal.

The influence of time on patients' reactions to involuntary committal is a variable seldom considered in reports. The reactions to committal of thirty-four subjects interviewed one week/one month/three months/six months post committal are reported. Generally committal was viewed neutrally. The major changes in attitudes related to knowledge of the fact of committal and of rights of appeal. The importance of these findings for the management of committed patients is stressed.

Adult

Mental health professionals' knowledge in the field of caring for chronic mental disorders.

A national sample of 246 Canadian mental health professionals was given a knowledge test concerning principles of care for chronic mental patients. Results showed that: (1) mental health professionals were moderately knowledgeable on this topic (mean score 66%), (2) errors made were more commonly in the direction of over-enthusiastic support for the community approach and (3) there were no differences in knowledge scores by a demographic or professional status variables included in this study.

Adult

Patient care review: results of the Canadian Psychiatric Association Hospital Survey.

This paper is a report of the Education and Professional Liaison Council of the Canadian Psychiatric Association on the results of its questionnaire to 104 psychiatric hospital facilities in Canada on the extent, type and usefulness of patient care review procedures. The results indicate that the majority of hospitals appear to have initiated one or more patient care review activities within the last decade and have been carrying these out on a regular basis. These procedures have been considered useful for patient care and for continuing medical education. Both the frequency of patient care review activity and the type of procedure used, however, are directly related to the number of psychiatrists present in the center, with those hospitals having the least resources indicating little or no activity.

Canada

Patients' attitudes at the time of their commitment.

The discussion concerning who should be committed and by whom, has dominated the psychiatric literature for many years (1). More recently, the issue of whether committal allows merely for incarceration in the least restrictive alternative or whether it also entitles patients to be treated against their will, if necessary, has also received attention (2-5). As yet, few studies have attempted to define the characteristics of the committed population (6-11). Even fewer studies have attempted to define what patients themselves thought of their committal to hospital (12-15) and for the most part, have not obtained their opinions regarding the broader issues of committal that are being debated in the professional literature. This study seeks to elicit the opinions of patients in these matters.

Attitude to Health

On evaluating patient satisfaction: methodological issues.

The survey of patient satisfaction with the mental health services provided is recommended but involves a methodological dilemma. Concerns include a definition problem, the delineation of a representative sample, the selection of a survey technique and the type of questions to be used. A literature review and the authors' own experience with the process are presented. The investigation of patient satisfaction while, as yet, limited in the critical information it can provide for the evaluation of services, will help pinpoint areas where the most patient dissatisfaction exists. The process can also be useful therapeutically, but patient satisfaction, although an important outcome measure, is not systematically related to other measures of treatment success. Methodological suggestions to improve the validity of the data gathered conclude the paper.

Commitment of Persons with Psychiatric Disorders

Patients' reactions to their commitment.

The authors surveyed the reactions toward commitment of 61 respondents out of a sample of 100 patients who had been committed to hospital during a one year period. The patients reported little change in their life situation as a result of committal and most viewed committal quite neutrally. They generally felt uninformed of their rights and indicated little intent to appeal the commitments, but wished to be assured that their rights were being considered and protected. Most saw psychiatrists as the professional group best equipped to bring about a committal. The importance of consumer surveys in controversial areas such as this is underscored.

Adolescent

Continuing education for psychiatrists: report on Canadian Psychiatric Association questionnaire.

This report on the CPA Questionnaire on Continuing Education represents the answers of a sample of 485 of the 1,360 certified psychiatrists belonging to the Association. A total of 72.6% of the sample lived in urban centres with populations greater than 200,000; 28.9% worked in solo practice, but only 7.4% worked in settings where no other psychiatrists were present. The amount of time spent in continuing education activities was found to vary inversely with the distance that had to be travelled to major educational centres. Nevertheless, there were no psychiatrists that did not partake in some continuing education activities. Ninety-three percent read journals, 99% went to meetings, and 96% used consultation with other psychiatrists; 99% stated that these activities were useful. The favourite methods were reading and consultation. Eighty percent of the sample spent more than 41 hours per month in continuing education activities. Sixty-five percent stated that they would like a voluntary credit award system instituted. It is concluded that Canadian psychiatrists do spend a great deal of time in continuing education activities and believe that this is of value to their professional work.

Adult

Commitment of the mentally ill.

The medical legal debate concerning committal is outlined and the recent scientific contributions to the committal debate are evaluated. It is noted that scientific surveys have made few significant contributions to the debate. Suggestions are made for further research in the hope that an increased contribution of scientific fact may help diffuse the heated exchange between the supporters and detractors of the committal process for the better care of a significant portion of our mentally ill.

Canada