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PubMed1990

[Medical-psychological problems in dental practice].

Medical-psychological problems are of great importance in dental practice. The paper presents an overview on the ways of establishing the dentist-patient-relationship, on the perception of pain and anxiety, the influence of the dentist in this respect, the information process and psychological preparation for surgery. A thorough intervention-oriented consideration of the psychological factors involved will lead to a further improvement of quality and effectiveness in dentistry.

Anxiety↗
PubMed1992

Human immunodeficiency virus transmission in health care settings. Risks to health care workers.

Taken together, studies of seroconversion, exposure incidents, and compliance with Universal Precautions Policy help researchers understand the risks to health care workers of occupationally acquired HIV infection. The seroconversion studies show that the risk of infection is low (1 in 250) even when the incident is a percutaneous exposure to blood from a known HIV-positive patient. When the exposure is to blood from a patient whose HIV-status is unknown, or if the exposure is not through the skin, or if the exposure is to a body substance other than blood, the risk is considerably lower. The studies of exposure incidents show that for most health care workers, percutaneous exposures to blood are infrequent. Studies of compliance with Universal Precautions Policy show that exposure incidents that do occur can be prevented nearly half the time. The risk of patient-to-provider transmission of HIV is small but not completely negligible. This small risk can be made even smaller by adhering to recommended infection control guidelines, but it cannot be eliminated completely. Although most health care workers enter the medical field accepting that their work may expose them to infectious agents, there is still a desire for risk-free practice. Achieving an entirely risk-free practice is probably impossible; it is certainly not within reach today. For the foreseeable future, the only reasonable course is to fully understand the risks, to enter into practice psychologically prepared to accept these risks, and to practice in a way that minimizes exposures without compromising patient care.

Acquired Immunodeficiency Syndrome↗
PubMed2003

The provision of clinical psychology services within a general hospital: an analysis and interpretation of referral rates.

A semi-structured interview was administered to fifteen hospital based medical and surgical consultants. This aimed to assess the level of knowledge and understanding regarding the activities of clinical psychologists and to evaluate the perception of need for the clinical psychology service within a general hospital in Central Scotland. Differences between high/regular and occasional/non-referring departments were examined. Results indicated that high/regular referring departments displayed a greater level of knowledge and understanding of clinical psychology practice than occasional/non-referring departments. The occasional/non-referring departments demonstrated more cautious attitudes regarding psychological input to the care of patients than high/regular referring departments. This study suggests that lower referral rates were more likely to be a result of generally low levels of awareness and understanding of psychological issues rather than mistrust of psychological methods. This highlights the need for education about the role of clinical psychology in general hospitals and improved communication between the psychology service and other departments in the hospital.

Health Knowledge, Attitudes, Practice↗
PubMed2006

Ethical clinical practice and sport psychology: when two worlds collide.

From their own practices, the authors offer insight into potential ethical dilemmas that may frequently develop in an applied psychology setting in which sport psychology is also being practiced. Specific ethical situations offered for the reader's consideration include confidentiality with coaches, administration, parents, and athlete-clients; accountability in ethical billing practices and accurate diagnosing; identification of ethical boundaries in nontraditional practice settings (locker room, field, rink, etc.); and establishment of professional competence as it relates to professional practice and marketing.

Clinical Competence↗
PubMed2005

The role of psychological well-being in retaining rural general practitioners.

OBJECTIVE: Retention of rural GPs is an increasing area of concern and is receiving considerable attention from the government, medical authorities and the media. This study aimed to examine the potential for psychological interventions to assist in the retention of rural GPs through targeting their psychological well-being. DESIGN: GPs completed a questionnaire, including questions about their level of support in rural practice, psychological health (work-related morale and distress, distress related specifically to working in rural general practice, quality of work life) and intentions to leave rural practice. SETTING: Rural general practices in South Australia. PARTICIPANTS: One hundred and eighty-seven rural GPs. RESULTS: Results indicated that rural GPs who were seriously considering leaving rural practice had higher work-related distress, higher distress related specifically to working in a rural general practice and lower quality of work life. GPs who considered leaving rural practice also reported having fewer colleagues with whom to discuss professional issues. CONCLUSION: Results indicated that psychological interventions (such as cognitive behavioural training), assistance with stress reduction and coping mechanisms (such as more interaction with colleagues) may be of benefit to GPs who are considering leaving rural practice. Such training may increase the number of GPs who ultimately stay in rural practice.

Adult↗
PubMed2005

Perceptions of the impact of depression and anxiety and the medication for these conditions on safety in the workplace.

BACKGROUND: The number of people taking prescribed medication for anxiety and depression has increased greatly, but little is known of how this medication impacts on safety at work. AIMS: To examine the relation between anxiety and depression, prescribed medication, performance, and safety in the workplace. METHODS: The research involved nine focus groups with sufferers of anxiety and depression to investigate experiences of mental health problems and the impact of psychotropic drugs. A further three focus groups were conducted with staff in human resources, personnel, occupational health, and health and safety departments, to explore organisational perspectives. The sample comprised 74 individuals drawn from a wide range of occupational sectors. Finally, the results were presented to a panel of experts from occupational medicine, general practice, psychology, health and safety, and psychiatry, to consider the implications for practice. RESULTS: Workers reported that both the symptoms and the medication impaired work performance. Participants described accidents which they attributed to their condition or to the medication. Workers with responsibilities for others, such as teachers, healthcare workers, and managers appeared to present a particular safety risk. Healthcare workers believed that they placed themselves and their patients at risk when carrying out medical procedures. CONCLUSIONS: Respondents in this study felt that their symptoms of anxiety and depression and the medication they took to treat these conditions placed them at risk with respect to safety in the workplace. Drawing on the results, the authors outline areas for improvement in the management of mental health problems at work.

Accidents, Occupational↗
PubMed1997

Measuring general practitioner psychology: the personal construct perspective.

BACKGROUND: According to personal construct theory (PCT), psychological processes are determined by the way in which individuals perceive differences and similarities between aspects of their environment and by the way this information is used to assist in the prediction of events. The important discriminations made by individuals are called "constructs'. OBJECTIVE: This article seeks to introduce PCT as a psychological measurement procedure to complement traditional standardized scales in research in general practice. METHOD: The repertory grid technique is a method of eliciting the content of the individual's constructs and determining their structure and inter-relationships. PCT and traditional measurement procedures are compared and contrasted, and the relevance of PCT to general practice psychology is discussed.

Attitude of Health Personnel↗
PubMed1991

Clinical psychology and general practice.

General practitioners who secure the collaboration of a clinical psychologist in treating patients, especially in a community setting, are likely to benefit the patients and themselves. Transfer of skills may be an important way for the two professions to collaborate. Health promotion could be a fruitful field for collaboration but has so far been little explored.

Family Practice↗
PubMed2006

Essential tension: specialization with broad and general training in psychology.

The practice fields of psychology develop through specialization in training and education. The recognized specialties play a major role in developing new opportunities for professional psychology and providing quality services for the public. The essential tension comes from the balance of innovation and tradition and, in professional psychology, from the balance of fragmentation and unification. As an example, specialization in clinical child psychology is integrated within the broad and general traditions. The greater degree of focused science and practice in a specialty is the logical consequence of advances of the discipline and profession of psychology. ((c) 2006 APA, all rights reserved).

Education↗
PubMed2004

Care arrangements for people with dementia in developing countries.

BACKGROUND: Rapid demographic ageing will soon lead to large increases in the numbers of persons with dementia in developing countries. This study is the first comprehensive assessment of care arrangements for people with dementia in those regions. METHODS: A descriptive and comparative study of dementia care; caregiver characteristics, the nature of care provided, and the practical, psychological (Zarit Burden Interview, General Health Questionnaire) and economic impact upon the caregiver in 24 centres in India, China and South East Asia, Latin America and the Caribbean and Africa. RESULTS: We interviewed 706 persons with dementia, and their caregivers. Most caregivers were women, living with the person with dementia in extended family households. One-quarter to one-half of households included a child. Larger households were associated with lower caregiver strain, where the caregiver was co-resident. However, despite the traditional apparatus of family care, levels of caregiver strain were at least as high as in the developed world. Many had cutback on work to care and faced the additional expense of paid carers and health services. Families from the poorest countries were particularly likely to have used expensive private medical services, and to be spending more than 10% of the per capita GNP on health care. CONCLUSIONS: Older people in developing countries are indivisible from their younger family members. The high levels of family strain identified in this study feed into the cycle of disadvantage and should thus be a concern for policymakers in the developing world.

Aged↗
PubMed1995

Psychotherapeutic implications of self-discoveries made in exploring psychologically-caused physical symptoms.

A personal case study conducted over a 49-year period of the relationship between physical symptoms and psychological "hang-ups" and flaws is described. Some of the psychological work done to outgrow these problems, which led both to the dissipation of the symptoms and to personal and psychological growth, is presented in a condensed form. Clarified from this study is the irony that with practice, psychological therapy led to less preoccupation and obsession with the body and more frequent intimate-separating involvements with life outside the body. Implications of this case study for psychotherapy are described.

Adult↗
PubMed2003

[Guidelines on psychological intervention in cardiac rehabilitation- methodological process].

The development and the role of cardiac rehabilitation in healthcare programs related to cardiovascular diseases has led to the growth of knowledge, experience and specific technical, scientific, organizational and cultural skills on the part of the different health professionals engaged with the cardiologist in the management of rehabilitation programs. The need to define the characteristics of the psychological intervention in cardiac rehabilitation programs on the basis of scientific evidence encouraged the Board of the Italian Group of Cardiac Rehabilitation and Prevention [Gruppo Italiano di Cardiologia Riabilitativa e Preventiva (GICR)] to set up a working group (WG), composed of psychologists chosen on the basis of their proven specific experience in clinical research, with the task of defining the state-of-the-art of the psychological intervention in cardiac rehabilitation on the basis of documented efficacy, as a first step to formulating Guidelines on Psychological Intervention in Cardiac Rehabilitation. The methodology adopted by the WG was in line with the recommendations of the National Guidelines Program of the Italian Ministry of Health; the WG chose, in addition, to exploit a detailed critical review of clinical psychology practice in order to provide systematic evidence for recommendations and clinical approaches at present supported only by expert opinion. The document, which represents the basis upon which the Guidelines on the psychological activity in cardiac rehabilitation will be drawn up, is subdivided into three parts: an introduction, the main body of the text, and some appendices. In the introduction, the theme and context of the Guidelines are defined, preceded by a series of notes and user instructions; also defined in this section are the intended audience. The main body of the document is structured on the basis of the steps that characterize the interactions between the patient suffering from heart disease and the psychologist, through a qualitative analysis of the intervention offered by the psychologist. The phases of this process have been schematized as follows: selection, entry, evaluation, intervention, follow-up. For each of these phases, the evidence is given in support of the evaluative and therapeutic tools at the psychologist's disposition in the context of cardiac rehabilitation. The appendices to the document contain syntheses of the scientific information, some tables, a glossary and a section providing more in-depth information on specific topics. The recommendations contained in the document elaborated by the WG were formulated on the basis of a systematic review of the evidence available in the Italian and international literature, codified according to the National Guidelines Program. Also included is a series of recommendations or working instructions based on the shared clinical experience of the members of the WG. The state of progress of the work of formulating the Guidelines, the objectives, the methodological premises and the deadlines set for the phases of development, diffusion and implementation were presented at the VI National Congress of the GICR which was held in Cosenza, 3-5 October 2002. The base-draft of the document was submitted to the Scientific Committee of Reviewers. In October 2002 the Executive Committee of the GICR announced to the National Guidelines Program of the Ministry of Health, in the persons of the Presidents of the Advanced Institute of Health and of the Regional Health Services Agency, the planning and the timetable for the formulation of the Guidelines. In the course of the first 4 months of 2003 the document produced will be discussed and reviewed jointly by the WG, the Cardiologic Scientific Board instituted by the GICR enlarged to include a delegate of the patient and volunteer no-profit worker associations. The following phases will include the publication by mid 2003 of a position-paper. The final draft of the Guidelines on Psychological Intervention in Cardiac Rehabilitation will be submitted to the Commission of the National Guidelines Program.

Cardiac Rehabilitation↗
PubMed2003

Development and evaluation of a breast cancer prevention decision aid for higher-risk women.

OBJECTIVE: To develop and evaluate the effectiveness of a breast cancer prevention decision aid for women aged 50 and older at higher risk of breast cancer. DESIGN: Pre-test-post-test study using decision aid alone and in combination with counselling. SETTING: Breast Cancer Risk Assessment Clinic. PARTICIPANTS: Twenty-seven women aged 50-69 with 1.66% or higher 5-year risk of breast cancer. INTERVENTION: Self-administered breast cancer prevention decision aid. MAIN OUTCOME MEASURES: Acceptability; decisional conflict; knowledge; realistic expectations; choice predisposition; intention to improve life-style practices; psychological distress; and satisfaction with preparation for consultation. RESULTS: The decision aid alone, or in combination with counselling, decreased some dimensions of decisional conflict, increased knowledge (P < 0.01), and created more realistic expectations (P < 0.01). The aid in combination with counselling, significantly reduced decisional conflict (P < 0.01) and psychological distress (P < 0.02), helped the uncertain become certain (P < 0.02), and increased intentions to adopt healthier life-style practices (P < 0.03). Women rated the aid as acceptable, and both women and practitioners were satisfied with the effect it had on the counselling session. CONCLUSION: The decision aid shows promise as a useful decision support tool. Further research should compare the effect of the decision aid in combination with counselling to counselling alone.

Aged↗
PubMed2005

Training in family psychology: a competencies-based approach.

After providing an overview of the family psychology landscape and the competencies-based movement in professional psychology, attention is paid to eight family-specific competencies in the following areas: the application of scientific knowledge to practice, psychological assessment, psychological intervention, consultation and interprofessional collaboration, supervision, professional development, ethics and legal issues, and individual and cultural diversity. Effective strategies for providing family-focused education and training to psychology trainees at the doctoral, internship, and postdoctoral levels and to psychologists through continuing professional education in these core competency domains are provided.

Clinical Competence↗
PubMed2005

Scientific personae in American psychology: three case studies.

This paper studies the constellations of attitudes--sentimental, moral, epistemological, and social--that three leading psychologists active in turn-of-the-twentieth-century America took to be essential to the production of scientific knowledge. William James, G. Stanley Hall, and Edward Titchener located the virtues and traits proper to the scientific frame of mind, and combined them into normative images of the man of science, or, 'scientific personae' as I use the term here. I argue that their competing formulations of the scientific ethos informed their psychological practice and epistemological commitments. James, Hall, and Titchener mobilized their representations of the man of science in order to reconfigure the field of psychology and redefine its boundaries, as well as to promote forms of sociability and define the proper role of scientists both within the academy and in the wider polity.

History, 19th Century↗