Prevalence of autism in early 1970s may have been underestimated.
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Autistic Disorder↗
Biomedical subjects
P Standen
Publications and source records attributed to P Standen.
Student nurses' experiences of caring for patients in pain.
Poor pain assessment contributes to inadequate pain relief. Studies in the United States have shown that while student nurses become more sensitive to psychological distress during training, they become less sensitive to pain. However, a recent study by the authors in the United Kingdom found that while inferences of psychological distress increased there was no change in inferences of pain over the common foundation programme. This study set out to explore their experiences of caring for patients in pain during the first 18 months of their training in order to understand how these experiences might affect their sensitivity to patient's pain. Interviews with 15 students following their common foundation programme showed that they experienced a wide range of strong emotions when caring for patients in pain. Their relatively junior status in the wards seemed to place them in difficult positions and provided them with little support. Theories of desensitisation, cognitive dissonance and acculturation have been proposed to explain decreasing sensitivity to pain. The lack of a significant change in students' inferences of pain and the analysis of their interviews suggest that their experiences are more varied than these theories suggest. The students experiences echo those found in previous studies relating to the socialisation of student nurses and emotional labour (Melia, 1987. Learning and Working. The Occupational Socialization Nurses. Tavistock Publishers, London; Smith, 1992. The Emotional Labour of Nursing. Macmillan, London). These findings have important implications for both nurse education and the mechanisms to support student nurses in clinical practice.
Acculturation↗
Bullying and people with severe intellectual disability.
Although bullying has been shown to reduce quality of life in many spheres, anti-bullying strategies have yet to be incorporated into services for adults with severe intellectual disability (ID). The present study employed a survey of staff and parent concerns about 54 previously surveyed students who had left a school for pupils with severe ID. A content analysis of follow-up interviews was performed in 10 cases. Staff identified 19% of the survey sample as bullying others and 11% as being picked on. Neither gender nor communication ability had an impact. There was no significant change in bully or victim status over time, although some people did change. Parents or staff raised bully/victim problems in more than half of the interviews. There is sufficient evidence of bullying behaviour to warrant the adoption of anti-bullying strategies.
Adult↗
The attitudes of 'tomorrow's doctors' towards mental illness and psychiatry: changes during the final undergraduate year.
AIMS: To compare the efficacy of two teaching styles, didactic teaching and problem based learning, in producing enduring change in final-year medical students' attitudes towards psychiatry and mental illness. METHOD: A 1-year follow-up questionnaire survey of two groups of medical students taught psychiatry in their fourth-year training by two different methods. One-year follow-up scores were compared with pre-attachment and post-attachment scores in the fourth year. RESULTS: 70 (68%) students completed both questionnaires at follow-up. The follow-up scores were significantly lower compared with both the fourth-year pre-attachment and post-attachment scores, suggesting that the positive change in attitudes following psychiatric training in the fourth year significantly decayed during the final year. The two teaching methods did not differ in the magnitude of this reduction. CONCLUSIONS: The positive change that occurs in medical students' attitude towards psychiatry, psychiatrists and mental illness after their fourth-year psychiatric training is transient and decays over the final year.
Attitude↗
Nurses' and doctors' attitudes towards suicidal behaviour in young people.
This paper presents an exploratory study performed to identify the attitudes towards suicidal behaviour in young people, amongst nurses (and nursing lecturers), and doctors working in in-patient medical and mental health care settings. The Suicide Opinion Questionnaire (SOQ) was administered to 59 participants. Responses were scored using eight clinical scales, and tested by using a Kruskal-Wallis one way analysis of variance. An Independent Sample t-test was used to analyse gender differences. Qualitative interviews were conducted in a sample of respondents. SOQ findings revealed no overall significant differences in the relevant groups of nurses and doctors, with the exception of gender and the clinical scale relating to a 'Cry for Help'. The focused interviews generated five categories relating to suicidal behaviour and young people. Nurses and doctors working in these areas possess a range of influential perceptions of suicidal behaviour and need to be considered in the contexts of care and treatment of young people.
Adolescent↗
The home as a workplace: work-family interaction and psychological well-being in telework.
Home-based telework is a growing phenomenon with great potential to affect employees' psychological well-being. Although prior studies show both positive and negative effects on work-family interaction, conclusions are limited by the way telework, well-being, and work-family interaction have been modeled. The authors present a conceptual framework that describes telework as a multidimensional phenomenon and separates the effects of the home environment from those of distance from the organization. Propositions concerning work-family interaction are developed from P. Warr's (1987) model of the environmental antecedents of well-being, prior telework studies, and the work-family literature. Spillover between work and nonwork domains of well-being is discussed, and suggestions for future research on this complex issue are presented.
Family Relations↗
Changing the attitudes of 'tomorrow's doctors' towards mental illness and psychiatry: a comparison of two teaching methods.
The General Medical Council's document 'Tomorrow's Doctors' (1993, GMC, London) recommended major changes in the undergraduate curricula of UK medical schools. In Nottingham, the fourth-year psychiatric attachment became shorter in duration, and interactive, problem-oriented, workshop-based learning replaced lectures. We compared the efficacy of this new teaching style in changing medical students' attitudes towards psychiatry and mental illness with that of old-style, didactic, lecture-based teaching. On the first and last days of their psychiatric attachment, 110 fourth-year-medical students (45 old curriculum; 65 new curriculum) completed two self-administered attitudinal measures: the Attitude to Psychiatry Questionnaire (ATP-30) and the Attitude to Mental Illness Questionnaire (AMI). We found that students had favorable attitudes towards psychiatry and mental illness before the attachment. These attitudes became more positive after the attachment in students from both curricula, with no significant difference between the groups and no gender difference. Students found patient contact rewarding, become more accepting of community care, and had greater appreciation of the therapeutic potential of psychiatric interventions. The interactive, student-centred, problem-oriented teaching of the shortened new curriculum appeared as effective in changing medical student' attitudes as a longer attachment with traditional teaching.
Attitude of Health Personnel↗
Common and modality-specific processes in the mental lexicon.
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Adult↗
Accidents to patients in hospital: a comparative study.
A comparative study of 50 reported accident patients (cases) and 50 non-accident patients (controls) was carried out in 10 wards in a large, acute hospital, using primary and secondary data from patients, nurses and records. Folstein's Mini-Mental State test was used to measure the mental status of patients. The mental status of the controls was significantly better than that of the cases. Nurses' responses indicated that significantly more accident patients were incontinent of urine than non-accident patients. There were also indications from patients of three additional unreported accidents. Further study was needed to estimate, more closely, the frequency of unreported patient accidents. This is the second paper in a series of three. The first appeared in Nursing Times on August 17, and the final one will be published on September 28, along with implications for practice and recommendations.
Accidents↗
Unreported accidents to patients in hospital.
A study to discover the incidence of unreported patient accidents was carried out in 10 wards in a large acute hospital. There were three separate survey days, 10 weeks apart, and sources of data included patients, records and accident report books. The 574 patients who participated in the study had sustained, during their stay in hospital, 75 accidents. Of these 49 (65%) were reported (documented on an accident report form) and 26 (35%) were unreported. Multiple unreported accidents to three patients accounted for 14 of the unreported accidents. Patient responses suggested that staff knew about the unreported accidents in the majority of cases. Conclusions and recommendations from this, and the two preceding studies include improved maintenance, increased awareness of patients' views and radical change to the present reporting procedure, as ways of improving patient accident data, patient safety and care.
Accidents↗
Incidence and documentation of patient accidents in hospital.
A one-year in-depth, prospective study of 728 reported patient accidents in 10 wards at a large acute hospital was carried out, using both primary and secondary data from patients, staff and records. Over 200 patients were interviewed. The fact that this represented just 29% of study patients was not surprising, owing to the high incidence of poor mental status among accident patients. However, a large amount of valuable information was collected. Some results confirmed earlier studies, in particular, that falls to older patients were the most common type of accident. The new findings revealed large differences between patients' and staff's accounts of the accidents, that the reporting of the most serious accident outcomes were often the most poorly recorded and that lunar cycles may influence patient accident frequency. This is the first in a series of three articles on patient accidents in hospital. Each one is the account of a distinct study but they were carried out consecutively at the same hospital, using the same ward population. The studies, each with different strengths and limitations, are intended to stand together to provide a more comprehensive understanding of patient accidents.
Accidents↗