A cross-sectional study on the relationship between stress and the level of job satisfaction among the burn unit staff of UP-PGH

OBJECTIVES: This study looked into the relationship between stress and the level of job satisfaction among the Burnt Unit staff of UP-PGH. Emphasis was placed in identifying the common stressors that the Burn Unit Staff of UP-PGH experience as a result of their day to day work in a critical care setting.The level of job satisfaction among staff was also determined.METHODOLOGY: Questionnaires assessing stress and job satisfaction were handed out to all the 31 participants of the study. The study population included 10 doctors and 21 nurses who had worked at the Burn Unit during the period of March to September 2007. Odds ratios were computed to determine if the presence of stress affects the level of job satisfaction among the Burn Unit Staff of UP-PGH. The resulting odds ratios were further tested for statistical significance using Fisher exact test and confidence limits.RESULTS: Of the 31 survey forms initially handed out to the Burn Unit staff, only 28 forms were completed and returned to the investigator at the end of the study period. Two items in the Stressful Situations Questionnaire were rated to be "stressful" by majority (>50%) of the respondents. Twenty-five percent of the respondents obtained positive scores in the Job Dissatisfaction Scale and were classified as being "dissatisfied" with their jobs. Twenty-two situations in the Stressful Situations Questionnaire were found to be significantly associated with job dissatisfaction among the Burn Unit staff of UP-PGH. These situations concerned the following areas: relationship with patients, family rejection, identification with the patient, deterioration and complications, job criticism, workspace, daily work, and therapeutic decisions.CONCLUSIONS: From the results of the study, recommendations were made to promote a system of stress-reduction for the Burn Unit staff. Regular group psychosocial processing sessions can be provided to allow the staff to ventilate their thoughts and feelings regarding personal and professional concerns. Team building activities for the staff can likewise be scheduled regularly to help solidify the group and resolve interpersonal conflicts among them. Future researchers could explore if a difference exists between the nurses and surgery residents in terms of their perceived stressors and their level of job satisfaction with their work in the Burn Unit.

The utilization pattern of psychiatric consultation services at the University of the Philippines-Philippine General Hospital (UP-PGH) from 1999-2008

OBJECTIVE: This study describes the utilization pattern of psychiatric consultation services at the UP-PGH from 1999 - 2008 by reviewing the demographic data of patients referred, describing the Axis I (Clinical Disorders and Other Disorders That May Be a Focus of Clinical Attention) and Axis III (General Medical Conditions) diagnoses of referred patients, and by identifying the sources of, and reasons for the different referrals.METHODS: Relevant data from the annual census of the Consultation - Liaison (CL) Psychiatry Section from 1999 - 2008 was reviewed according to age, sex, civil status, reasons for referral, DSM-IV TR Multi-axial diagnoses and sources of referrals.RESULTS: The percentage of referrals to consultation psychiatry has increased from 1.03% in 1999 to 1.77% in 2008. There is equal distribution between males and females. Majority of the consultation referrals were married and belonged to the 21-40 age group. The top five referring services were general medicine, surgery and trauma, obstetrics-gynecology, otorhinolaryngology and orthopaedic departments. The top three reasons for referring patients were mood problems, agitation and restlessness, and suicide attempts/behaviour. Majority of the axis I diagnoses were adjustment disorder, depressive disorders, and psychological reactions to illness. According to Axis III diagnoses, majority of the referrals were associated with poisoning and injury, neoplasms, and endocrine, nutritional, metabolic and immunity disorders.CONCLUSION: The referral rate to the CL-Psychiatry Section at the UP-PGH has increased throughout the period studied. This may be attributed to programs and activities that improve efficiency in the delivery of psychiatric knowledge and skills, and better personnel supervision. The referral rate of 1.03% to 1.82% was consistent with those in other countries.

Prevalence of depression and phantom limb pain among amputated patients of the Philippine Orthopedic Center from April-May 2001

OBJECTIVES: The aim of this study is to determine the prevalence of depression and phantom limb pain among amputated patients at the Philippine Orthopedic Center (POC) from April to May 2001, as well as describe the characteristics of such patients. This study also seeks to determine if there is an association between phantom limb pain and depression among the amputated patients at POC. METHODS: This is a cross sectional study where 48 in and out patients from 18-61 years old were interviewed using the McGill Pain Questionnaire (MPQ) to evaluate the presence of phantom limb pain and Beck Depression Inventory (BDI) to evaluate the presence of depression, for the time period between April and May 2001. RESULTS: Eighteen (37.5 percent) patients were noted to be depressed, while only eight (16.7 percent) reported experiencing phantom limb pain. Among the 18 depressed patients, majority (68.8 percent) did not experience any pain but about one third (33.3 percent) admitted to phantom limb pain. Among the 8 who experienced phantom limb pain, 6 (75 percent) were depressed as compared to only 30 percent of those without phantom limb were depressed. Depression was more severe among those who were amputated due to a medical illness (24 percent) and interviewed within a year after their amputation (27.3 percent). CONCLUSION: Depression was more prevalent than phantom limb pain among amputees of the POC. Using the Fisher test for independent variables and Mann-Whitney 2 sample test, an association between phantom limb pain and depression was observed among the amputated patients in this study. Depression may also be more evident within the first year after amputation and more prevalent among those with medical illness.

Developing a trophoblastic disease psychiatric liaison program

Psychiatric Liaison Programs are designed to provide service, training and research technology using the biopsychosocial approach for problems encountered in a general hospital ward or specialty clinic. When psychosocial problems arise in individuals or groups comprehensive liaison programs are designed based on an analysis of needs that consider the psychosocial dynamics of patients, their family, nursing staff, and medical staff of that particular ward or clinic. These programs are created and implemented by a multidisciplinary team of psychiatrists, social worker, nurse, OT/PT, and consultee physician. Liaison Programs have been set up at the Trophoblastic Disease Ward and the Cancer Institute of the Philippine General Hospital. Among the interventions set up are regular group therapy sessions for patients and their relatives, expressive therapy including visual art therapy, and music, relaxation techniques, meditation, and guided imagery activities, and activity therapy. For the nursing and medical staff seminars and workshops were held to aid in the detection and early intervention-of behavioral problems. Group therapy sessions were also done when interpersonal problems and burn-out were detected; Individual psychotherapy was done when the need arose. At the Trophoblastic Disease Ward, the physiological, psychological and social domains of the WHO-DOH Quality of Life questionnaire were administered to in-patient before instituting the Liaison Program, and six months after. A comparison of the pre-test and post-test scores showed a significant improvement in all the domains a p-0.05 level of significance. A Purpose-in-life test was also administered to the bantays of these patients which showed significant improvement in their scores after six months at p-0.05 level of significance. Subjective evaluations done on the ward staff showed an improvement in interpersonal relationships with other staff, patients and their bantays. We endorse Psychiatric Liaison Programs as effective interventions in dealing with the psychosocial problems of cancer patients, their bantays, and the ward staff.