ABSTRACT
Introducción: La simulación se ha empleado como herramienta de aprendizaje en diferentes disciplinas y profesiones, como la medicina y sus especialidades. Su utilidad está directamente relacionada con la integración a los objetivos, contenidos, metodologías y recursos específicos en cada área del conocimiento. Objetivo: Describir el desarrollo de una experiencia pedagógica implementada en la Pontificia Universidad Javeriana Cali con los estudiantes de Conducta Humana II del programa de Medicina entre 2012 y 2013. Dicha experiencia se apoyó en la participación de pacientes simulados por actores del grupo representativo Altergesto, que fueron entrevistados por los estudiantes con la supervisión de los psiquiatras docentes de la materia, utilizando el Hospital Simulado de la Universidad. Métodos: Recuento histórico del desarrollo de la secuencia didáctica desde el primer semestre de 2012 hasta el segundo semestre de 2013, planteamiento de los objetivos pedagógicos y descripción de la estrategia de enseñanza-aprendizaje. Resultados: Se realizaron 158 entrevistas en un periodo de 2 años, en el transcurso de los cuales fue necesario plantear soluciones metodológicas para adaptar la secuencia pedagógica a los contenidos y los objetivos de la materia. Conclusiones: La simulación de alta fidelidad, integrando a actores que representan a los pacientes psiquiátricos y la tecnología del Hospital Simulado, resultó útil para lograr el cumplimiento de los objetivos propuestos en el curso de Conducta Humana II del programa de Medicina de la Pontificia Universidad Javeriana Cali. Paralelamente, la construcción de la experiencia como un proyecto interdisciplinario y el enfoque práctico de esta estrategia pueden impactar en las dimensiones cognitivas, emocionales y conductuales de los significativo. Es necesario construir una base de datos de fácil acceso con el material recopilado y estudiar los efectos de esta estrategia en la formación de los estudiantes a largo plazo.
Introduction: Simulation has been used as a learning tool in different disciplines and pro-Simulation scenario fessions, including medicine and its specialties. Its usefulness is directly related to the Psychiatric interview integration of objectives, contents, methodologies and specific resources in each area of Simulated patient actor knowledge. Objective: To describe the development of an educational experience implemented in the Pontificia Universidad Javeriana Cali (Cali, Colombia) with medical students of Human Behavior II program, between 2012 and 2013. This experience was performed with simulated patients played by actors of the Altergesto theater group, that were interviewed by students under the supervision of psychiatrists and teachers of the subject, using the Simulated Hospital of the University. Methods: A historical development recall of the teaching sequence was made from the first half of 2012 to the second half of 2013, a statement of pedagogical objectives, and a description of the teaching-learning strategies. Results: 158 interviews were conducted over a period of two years during which it was necessary to raise methodological solutions to adapt this teaching sequence to the content and objectives of the subject. Conclusions: The high-fidelity simulation, integrating actors who represent psychiatric patients mixed with the technology of a Simulated Hospital was useful to achieve compliance with the objectives proposed in the course of Human Behavior II, as a part of the program of Medicine at the Pontificia Universidad Javeriana Cali. In parallel, the construction of experience as an interdisciplinary project and the practical approach of this strategy may impact on cognitive, emotional, behavioral dimensions of the participants, encouraging meaningful learning. An easy access database for the collected material and the study of the effects of this strategy in the formation of long-term students is needed.
Subject(s)
Humans , Male , Female , Adult , Students, Medical , Simulation Exercise , Learning , Occupational Groups , Organization and Administration , Patients , Psychiatry , Teaching , Technology , Health Strategies , Knowledge , MethodsABSTRACT
El incesto es un tema lleno de mitos y es importante conocer la transcendencia en el ámbito emocional de los menores, niños y niñas, que son víctimas de abuso sexual por parte de un pariente cercano y los motivos que llevan al resto de la familia a callar estos sucesos. Conocer características de las posibles víctimas y de los posibles agresores nos permitirán evaluar las circunstancias en que se da el abuso sexual y sus secuelas a corto y largo plazo...
Subject(s)
Humans , Male , Female , Child Abuse, Sexual , Child Psychiatry , Community Psychiatry , Domestic Violence , Family , Forensic Medicine , Forensic Psychiatry , Incest , Interview, Psychological , PsychiatryABSTRACT
OBJECTIVES: The diagnosis and assessment of personality disorders are crucial for research, as well as for clinical practice. The Structured Interview for the DSM-IV Personality (SIDP-IV) is a structured diagnostic interview for DSM-IV personality disorders (PD). This study aimed to develop the Korean version of the SIDP-IV and to test its inter-rater reliability. METHODS: A panel consisting of 7 psychiatrists translated the SIDP-IV into Korean. Six psychiatrists and 1 psychiatric nurse, all trained to apply the SIPD-IV, interviewed 70 inpatients (male, 30;female, 40) using this translation, two joint-examiners per patient interview. We used kappa coefficients to test diagnosis agreement, the Pearson correlation coefficient to test K-SIDP-IV total score agreement, and percent agreement to test the agreement on the number of DSM-IV criteria met. RESULTS: The kappa coefficients for most of the PDs, such as paranoid, borderline, histrionic, narcissistic, avoidant, dependent, and obsessive-compulsive, were excellent (> or =0.80). Moreover, the kappa coefficients for schizoid and antisocial PD were acceptable (k=0.66). The Pearson correlation coefficient for the K-SIDP-IV total scores were high for all personality disorders (r=0.91-0.97). Percent agreement regarding the number of DSM-IV criteria met varied from 92.9% to 100%. CONCLUSION: The Korean version of the SIDP-IV is a reliable instrument for the assessment and diagnosis of personality disorders.
Subject(s)
Humans , Diagnostic and Statistical Manual of Mental Disorders , Inpatients , Personality Disorders , PsychiatryABSTRACT
The objective of the present study was to establish the frequency of psychiatric comorbidity in a sample of diabetic patients with symmetric distal polyneuropathy (SDPN). Sixty-five patients with type 2 diabetes mellitus were selected consecutively to participate in the study at Instituto Estadual de Diabetes e Endocrinologia. All patients were submitted to a complete clinical and psychiatric evaluation, including the Portuguese version of the structured clinical interview for DSM-IV, the Beck Depression Inventory, the Neuropathy Symptom Score, and Neuropathy Disability Score. SDPN was identified in 22 subjects (33.8 percent). Patients with and without SDPN did not differ significantly regarding sociodemographic characteristics. However, a trend toward a worse glycemic control was found in patients with SDPN in comparison to patients without SDPN (HbA1c = 8.43 ± 1.97 vs 7.48 ± 1.95; P = 0.08). Patients with SDPN exhibited axis I psychiatric disorders significantly more often than those without SDPN (especially anxiety disorders, in general (81.8 vs 60.0 percent; P = 0.01), and major depression - current episode, in particular (18.2 vs 7.7 percent; P = 0.04)). The severity of the depressive symptoms correlated positively with the severity of SDPN symptoms (r = 0.38; P = 0.006), but not with the severity of SDPN signs (r = 0.07; P = 0.56). In conclusion, the presence of SDPN seems to be associated with a trend toward glycemic control. The diagnosis of SDPN in diabetic subjects seems also to be associated with relevant psychiatric comorbidity, including anxiety and current mood disorders.
Subject(s)
Humans , Male , Female , Middle Aged , /psychology , Diabetic Neuropathies/psychology , Mental Disorders/epidemiology , Polyneuropathies/psychology , Ambulatory Care/statistics & numerical data , Comorbidity , Diagnostic and Statistical Manual of Mental Disorders , Mental Disorders/diagnosis , Mental Disorders/etiology , Psychiatric Status Rating Scales/statistics & numerical data , Severity of Illness Index , Socioeconomic FactorsABSTRACT
OBJECTIVE: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-IV(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. METHOD: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. RESULT: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent (>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable (>0.40) in the evaluation of current disorders. In the evaluation of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-IV allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. CONCLUSION: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.
Subject(s)
Humans , Agoraphobia , Alcoholism , Anxiety Disorders , Appointments and Schedules , Axis, Cervical Vertebra , Bipolar Disorder , Depressive Disorder, Major , Diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Feeding and Eating Disorders , Hospitals, Psychiatric , Hypochondriasis , Inpatients , Korea , Outpatients , Schizophrenia , Schizophrenia, Paranoid , Somatoform DisordersABSTRACT
Con la finalidad de estimar la prevalencia de transtornos mentales en estudios epidemiológicos en la comunidad, hemos desarrollado la Entrevista Psiquiátrica Modificada (EPM), un instrumento semiestructura derivado de la Standardized Psichiatric Interview de Goldberg y colaboradores, para ser aplicada por entrevistadores con experiencia clínica en el área de la salud mental. Este artículo tiene como finalidad evaluar el grado de acuerdo entre entrevistadores clínicos (utilizando un diseño entrevistador-observador), empleando la EPM en pacientes que asistieron a la consulta externa de un hospital general de la Secretaría de Salud, como parte de una investigación sobre prevalencia de transtornos mentales en un segundo nivel de atención médica. Se analizó el grado de acuerdo entre los entrevistadores en las diferentes secciones que comprenden el instrumento en base a tres estadísticos: correlación producto-momento de Pearson, estadístico de Kappa y el Coeficiente "Y" de Yule. Los resultados obtenidos indicaron un alto nivel de confiabilidad en cada una se las secciones de la EPM