Psychological Impact of Covid-19 Pandemic on Mental Health Practitioners in Selangor, Malaysia

@#Introduction: The Coronavirus disease pandemic of 2019 (COVID-19) has had psychological implications and altered the public’s well-being. In response to the pandemic, mental health practitioners play an essential role in mitigating the adverse psychological effects among the public. However, as the demand for mental health services increases, the responsibilities of mental health professionals are far stretched from what they can handle. Therefore, this research is aimed to explore the psychological impact of the pandemic on the mental health practitioners in Selangor and their coping strategies. Method: A total of 10 mental health practitioners who are clinical psychologists and counselors participated in the one-to-one interview. The collected data were analysed using thematic analysis. Result: The higher client loads, the transition to virtual therapy, burnout, and anxiety were found to have an impact on the mental health practitioners’ well-being. Despite the challenging psychological impact, the mental health practitioners expressed a high level of satisfaction with their jobs, which they attributed to the supportive organisational culture and their intrinsic drive for selecting this profession. The mental health practitioners have reported that perceived organisational support, social support, and self-care approaches are effective coping mechanisms. Mindfulness skills such as breathing techniques and meditation are often practiced by the participants to calm the mind and body from a long day of work. Conclusion: The implication of the study contributes to breaking the stigmatisation of help seeking behaviour among the helping professions, as well as urging the policy makers, governments, and foundations to play a part in providing accessible and quality mental healthcare to the society.

Más allá de la "falla hormonal": concepciones de profesionales de atención primaria sobre el climaterio en Santiago, Chile / Beyond the "ovarian failure": primary healthcare practitioners' views on climacteric in Santiago, Chile

OBJETIVO: El presente artículo busca conocer cómo los profesionales conciben la sexualidad de mujeres en etapa de climaterio, enfatizando aspectos relativos a la salud sexual, al deseo sexual y a los problemas de la sexualidad. MÉTODOS: Enfoque cualitativo basado en la Teoría Fundamentada (Grounded Theory). Se realizaron diez entrevistas en profundidad a profesionales de dos Centros de Salud Familiar (CESFAM) del sector sur de Santiago. RESULTADOS: Los resultados muestran que, si bien existe cierta tendencia a concebir el climaterio desde un punto de vista biologicista centrada principalmente en la "falla hormonal", los/as profesionales muestran diversos grados de reflexividad respecto a cómo aspectos socioculturales, económicos y de género moldean la sexualidad de mujeres en la etapa de climaterio. CONCLUSIONES: Los/as profesionales asumen posturas críticas respecto al rol de las instituciones y programas en salud, a las limitaciones laborales en los centros de salud (por ej. materiales, tiempo, etc.) y a la formación profesional. Este artículo promueve la formulación de políticas de salud en la materia, así como la revisión de los planes de estudio de las carreras de la salud.

OBJECTIVE: This article aims to examine how professional practitioners view womens sexuality in the climacteric stage, emphasizing aspects related to sexual health, sexual desire, and sexual disorders. METHODS: Qualitative approach based on the Grounded Theory. Ten in-depth interviews were conducted with professionals from two Family Health Centers (CESFAM) in southern Santiago. RESULTS: The results show that, although there is a certain tendency to approach the climacteric from a biological viewpoint focused mainly on the “ovarian failure”, practitioners show different degrees of reflexivity regarding how sociocultural, economic and gender aspects shape womens sexuality in the climacteric stage. CONCLUSIONS: Practitioners adopt critical positions regarding the role of health institutions and programs, work limitations in health centers, and the practitioners training. This article promotes the development of health policies in the matter, as well as the revision of study plans of health careers.

Tratamiento de la desregulación emocional en hospitales del área metropolitana de Buenos Aires: una encuesta a profesionales / Treatment of emotional dysregulation in hospitals of the metropolitan area of Buenos Aires: a survey to practitioners

Resumen El proceso de regulación emocional está siendo foco de gran cantidad de investigaciones en la actualidad. Se estima que se encuentra asociada al desarrollo y mantenimiento del 75 % de los trastornos mentales del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM, por sus siglas en inglés). En esta línea se han estado estudiando en los últimos años, a nivel global, protocolos transdiagnósticos que tienen, como foco de tratamiento, dicho proceso. El objetivo de este estudio consistió en explorar la familiaridad de los profesionales de la salud mental, de hospitales públicos del área metropolitana de Buenos Aires, con el constructo de la desregulación emocional y los protocolos diseñados para el tratamiento de pacientes con dichas características. A su vez, se buscó conocer el grado de acercamiento de los profesionales clínicos a las investigaciones sobre psicoterapias. A estos fines, se diseñó un cuestionario con 40 preguntas de respuestas abiertas y opción múltiple que fue completado por 75 profesionales (psicólogos y psiquiatras) de hospitales públicos del área metropolitana de Buenos Aires. La mayoría reportó conocer el constructo de desregulación emocional, pero al pedirles que conceptualicen un caso diseñado para este estudio muy pocos utilizaron el constructo. En cuanto a los protocolos transdiagnósticos diseñados para intervenir en la desregulación emocional, son muy poco implementados. Por su parte, menos de la mitad reportó haber leído investigaciones empíricas. Los cursos elegidos para continuar la formación son en su mayoría psicoanalíticos y la participación en congresos internacionales es escasa. Se propone la necesidad de fomentar el uso de intervenciones basadas en evidencia en hospitales públicos y la divulgación de protocolos transdiagnósticos con evidencia para la desregulación emocional.

Abstract A substantial amount of evidence regarding comorbidity among mental disorders has been accumulated during the last years. Moreover, it has been identified that there is a great variability within nosological categories. These limitations of categorical systems lead to the development of the transdiagnostic paradigm which contemplates the existence of underlying processes common to different diagnoses. The process of emotional regulation is currently the focus of many investigations. It is estimated that it is associated with the development and maintenance of 75 % of DSM mental disorders. Emotional dysregulation is being studied particularly as a common factor in depression and anxiety, the two most prevalent disorders in Argentina. Related to this, transdiagnostic protocols aiming this process have been studied in the last years at a global level. The Unified Protocol has been developed by Barlow from a transdiagnostic perspective aiming to offer an evidence-based intervention that could be faithfully used in heterogeneous groups. It was created for emotional disorders with a specific focus on emotional dysregulation, contemplating comorbidity and heterogeneity. This makes the Unified Protocol a proper and valid intervention for the most prevalent disorders in Argentina. The objective of this study was to explore the familiarity of mental health practitioners, of public hospitals in the metropolitan area of ​​Buenos Aires, with the emotional dysregulation construct and protocols designed for the treatment of patients with these characteristics. Moreover, the degree in which clinicians approach psychotherapy research was evaluated. For this purpose, a cross-sectional descriptive study was carried on. A questionnaire was designed with 40 questions (25 with closed answer and 15 with short open answer) that investigated five thematic areas: demographic characteristics, therapeutic approach, knowledge about the emotional dysregulation construct and treatment protocols, knowledge about the transdiagnostic paradigm and approach to empirical research. The questionnaire was completed by 75 practitioners (psychologists and psychiatrists) from public hospitals of the metropolitan area of Buenos Aires. After analyzing the results, it can be said that the most prominent theoretical framework from which practitioners work in public hospitals is psychoanalysis. The most prevalent diagnoses are anxiety and depression and comorbidity is frequent (M = 2.23, SD = .707). When studying the familiarity to the construct of emotional dysregulation, it was observed that even though most of them reported knowing the emotional dysregulation construct (89.3 %), when asked to conceptualize a person with intense and long-lasting emotional distress and difficulty in controlling their behavior and recognizing their emotions, very few mentioned difficulties in the regulation of emotions (13.51 %). Individual format treatment was the most chosen by psychologists for patients with these characteristics (69 %). Psychiatrists reported pharmacotherapy as the most chosen treatment (87.5 %). Group format is not frequently used. In regards to transdiagnostic protocols designed to intervene in emotional dysregulation, they are very poorly implemented. Dialectical Behavioral Therapy was reported to be known by 80 % of the sample, but used by 33.9 %, while the Unified Protocol was referred to be known by 34.7 % and used by 7.69 % of them. On the other hand, the gap between clinical practice and research seems to be wide. Less than half of the practitioners reported reading empirical research (44 %). And the transdiagnostic paradigm is known by 46.7 % of practitioners. When asked to mention the most influential authors in their practice, Freud and Lacan (classical psychoanalytic authors) were mentioned by the majority. The courses chosen to continue their training are mostly psychoanalytic and participation in international congresses is low (10.45 %). These results show the need to look for ways to encourage the use of evidence-based interventions in public hospitals and specifically the dissemination of transdiagnostic protocols with evidence for emotional dysregulation, being emotional disorders the most prevalent.

Trastorno de alimentación: identificación y primeras intervenciones para los profesionales de salud / Eating disorders early identification and management: guidelines for health practitioners

Introducción: los trastornos de la alimentación e ingesta (TAI) son un complejo conjunto interdimensional de enfermedades mentales que afectan el rendimiento corporal, mental y social. El núcleo de la enfermedad es el miedo a ganar peso. Las estrategias de control de ingesta varían entre: restricción, selección y purga alimentaria. Afectan diferentes sexos, razas, etnias y edades. Con mayor frecuencia en adolescentes y mujeres jóvenes (9: 1). Presentan alta mortalidad, comorbilidad mental y conflictos familiares asociados. Método: integrar información disponible y útil según criterio de experto, orientada al manejo clínico de los TAI. Resultado: debido a que los profesionales de salud de diferentes áreas podrían ser el único contacto que el/la paciente busca para aliviar alguna dolencia aparentemente no relacionada con TAI, es necesario lograr identificar y diagnosticar los estadios patológicos e indicar las primeras conductas, así como hacer una referencia exitosa. El retraso en el diagnóstico causa alteraciones severas y crónicas en la fisiología, el comportamiento, la cognición y el funcionamiento psicosocial. Los objetivos de este estudio son: a. Presentar, en forma integrada, la información disponible de modo de facilitar a los profesionales de la salud la detección precoz de los TAI; b. Ofrecer un conjunto de acciones útiles que faciliten el diagnóstico TAI; c. Organizar la comprensión del riesgo TAI en un diagrama que facilite la construcción de la derivación utilizando las dimensiones: cuerpo, mente, relaciones; d. Mostrar las alternativas psicoterapéuticas en uso e. Proveer información para realizar las primeras intervenciones. Conclusión: reconocer tempranamente el cuadro TAI puede detener el curso patológico y los potenciales daños.(AU)

Introduction: eating disorders (ED) are a complex interdimensional set of mental disorders that affect social, bodily and mental performance. The core issue of the illness is the fear of weight gain. Food intake control strategies are displayed among eating restriction,selection and purging foods. ED affect people despite their sex, ethnicity or age often in adolescents and young women (9:1). EDhave been associated with high mortality, mental disorders comorbidity, and family conflicts. Method: to integrate expert selectedrelevant information to improve ED clinical management by health practitioners. Results: because health practitioners from differentareas may be the only contact the patient is looking for to alleviate an ailment apparently not related to ED, it is necessary to identifyand diagnose the pathological stages and indicate the first behaviors, as well as make a successful reference. Diagnosis delay causes severe and chronic alterations in physiology, behavior, cognition and psychosocial functioning. The objectives of this study are: a.To present integrated information about ED I order to facilitate early detection and diagnosis to health practitioners; b. To offer a setof useful actions that facilitate early ED detection; c. To organize the understanding of ED risk in a diagram that facilitates derivationusing the dimensions: body, mind, relationships; d. To show the current psychotherapies e. To provide information to perform the first interventions. Conclusion: early ED recognition can stop the pathological course and potential damage of the disease.(AU)

Reliability and Validity of Job Satisfaction Scale for Public Health Practitioners / 中国医科大学学报

Objective The study aimed to explore the reliability and validity of public health practitioners 'job satisfaction scale. Methods A questionnaire survey was conducted with professional and technical personnel in the province engaged in the work of public health of investigation;they were enrolled through the multi?stage cluster random sampling method for establishing the scale 's internal consistency reliability and structur?al validity. Results The Cronbach's alpha coefficient of the total satisfaction scale was 0.900. The Cronbach's alpha coefficients were 0.896, 0.781,and 0.799 for career development and achievement,relationship and career retention,and income and promotion latitudes,respectively. Four principal components were extracted and the results showed that the cumulative contribution rate was 69.72%and the factor analysis results were basically consistent with the theoretical structure. Conclusion The scale is thus considered to be a reliable and effective measurement tool assessing public health practitioners'job satisfaction,as it had good reliability and validity.

Assessment of the Knowledge and Perception of Probiotics amon Medical Science Students and Practitioners in Lagos State.

Aim: The study was conducted to assess the knowledge and perception of probiotics among medical science students and practitioners in Lagos state. Study Design: This is a questionnaire based survey. Place and Duration of Study: The study was conducted in Lagos state which is located in the south-western part of Nigeria. The questionnaires were distributed from March to August, 2013. Methodology: Predesigned pilot tested questionnaires were randomly administered to 270 medical science students and professionals from various health institutes in Lagos state. The knowledge level was scored 0-3 as poor, 4-6 as fair and 7-9 as good and analyzed using Epi info version 3.5.3. Results: Of the 270 questionnaires distributed, 265(98.1%) were returned by 164 medical science students and 101 practitioners. The knowledge score of medical science students and practitioners was low (Mean±SD of 3.62±2.7). Ninety-four (57.3%) students disclosed that they have never heard of probiotics before and 139(84.8%) indicated interest in knowing more. Seventy (69.3%) practitioners were familiar with the term probiotics but 42(41.6%) had poor knowledge. Seventy three percent were not aware of any proven probiotic product in Nigeria and none has prescribed probiotic products for any medical condition. All indicated interest in knowing more about probiotics. The comparison of knowledge result across the various groups was statistically significant (P<0.05). Conclusion: There is limited knowledge and poor perception on benefits of probiotic use among medical science students and professionals in Lagos state. The result of this study indicates a need for education on the availability, sources and benefits of probiotics.

Influencing public health without authority.

This paper analyzes the present processes, products and needs of post-graduate public health education for the health programming, implementation and oversight responsibilities at field level and suggests some solutions for the institutes to adopt or adapt for improving the quality of their scholars. Large number of institutions has cropped up in India in the recent years to meet the growing demand of public health specialists/practitioners in various national health projects, international development partners, national and international NGOs. Throwing open MPH courses to multi-disciplinary graduate's is a new phenomenon in India and may be a two edged sword. On one hand it is advantageous to produce multi-faceted Public health postgraduates to meet the multi tasking required, on the other hand getting all of them to a common basic understanding, demystifying technical teaching and churning out products that are acceptable to the traditional health system. These Institutions can and must influence public health in the country through producing professionals of MPH/ MD degree with right attitude and skill-mix. Engaging learners in experimentation, experience sharing projects, stepping into health professionals' roles and similar activities lead to development of relatively clear and permanent neural traces in the brain. The MPH institutes may not have all efficient faculties, for which they should try to achieve this by inviting veterans in public health and professionals from corporate health industry for interface with students on a regular basis. The corporate and public health stalwarts have the capacities to transmit the winning skills and knowledge and also inspire them to adopt or adapt in order to achieve the desired goals.