ABSTRACT
OBJECTIVE: To describe the experience of physicians and patients in the Telepsychiatry programme at the University of Antioquia's Faculty of Medicine in the first 12 months after its implementation in eight towns across Antioquia. METHODOLOGY: A descriptive study involving the evaluation of 111 patients during the programme's first year. An instrument was designed to evaluate patients' satisfaction and the Technology Acceptance Model (TAM) was used to evaluate the health professionals' satisfaction. RESULTS: 111 patients were seen on 340 occasions. 70 out of the 111 patients (63.1%) were seen by Telepsychiatry at least twice in the first year of implementation. A sample of 38 patients (34%) was used to evaluate their experience, of which 94.7% said their problem had been solved and 100% were highly satisfied. Nine health professionals took part in the programme, who agreed that the technology was useful and easy to use. They also stated that they wanted to continue using it. CONCLUSION: Health systems across the globe have failed to provide an adequate response to the mental health burden. Therefore, strategies such as telepsychiatry are considered an ideal treatment modality to give patients living in remote locations the specialised attention that they need.
Subject(s)
Attitude of Health Personnel , Mental Disorders/therapy , Patient Satisfaction/statistics & numerical data , Psychiatry/methods , Telemedicine , Adolescent , Adult , Aged , Aged, 80 and over , Child , Colombia , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Program Evaluation , Telemedicine/methods , Telemedicine/organization & administration , Treatment Outcome , Young AdultABSTRACT
Objetivo: Describir la experiencia que han tenido los médicos y pacientes del programa de Telepsiquiatría de la Facultad de Medicina de la Universidad de Antioquia en los primeros 12 meses de su implementación en 8 municipios del departamento. Métodos: Estudio descriptivo, que incluyó a 111 pacientes atendidos durante el primer año. Se diseñó un instrumento para evaluar la satisfacción de los pacientes y se empleó el instrumento de aceptación de tecnología para evaluar la de los profesionales de la salud. Resultados: Se realizaron 340 atenciones durante ese periodo a 111 pacientes; 70 (63,1%) de ellos recibieron al menos 2 atenciones por telepsiquiatría en el primer año. Se evaluó la experiencia en una muestra de 38 pacientes (34%), quienes manifestaron la resolución del problema (94,7%) y una satisfacción alta (100%). En el programa participaron 9 profesionales de la salud, que estuvieron de acuerdo en que la tecnología es útil y fácil de usar y tienen la intención de seguir usándola. Conclusiones: Los sistemas de salud de todo el mundo no han dado una respuesta adecuada a la carga de trastornos mentales; por esto, estrategias como la telepsiquiatría se consideran una modalidad de atención ideal para personas que viven en lugares remotos y tienen dificultad de acceso a los servicios de salud especializados, con adecuada aceptación.
Objective: To describe the experience of physicians and patients in the Telepsychiatry pro gramme at the University of Antioquia's Faculty of Medicine in the first 12 months after its implementation in eight towns across Antioquia. Methodology: A descriptive study involving the evaluation of 111 patients during the programme's first year. An instrument was designed to evaluate patients' satisfaction and the Technology Acceptance Model (TAM) was used to evaluate the health professionals' satisfaction. Results: 111 patients were seen on 340 occasions. 70 out of the 111 patients (63.1%) were seen by Telepsychiatry at least twice in the first year of implementation. A sample of 38 patients (34%) was used to evaluate their experience, of which 94.7% said their problem had been solved and 100% were highly satisfied. Nine health professionals took part in the programme, who agreed that the technology was useful and easy to use. They also stated that they wanted to continue using it. Conclusion: Health systems across the globe have failed to provide an adequate response to the mental health burden. Therefore, strategies such as telepsychiatry are considered an ideal treatment modality to give patients living in remote locations the specialised attention that they need.
ABSTRACT
RESUMEN Introducción: Las personas con esquizofrenia y trastorno afectivo bipolar (TAB) tienen alto riesgo de embarazos no deseados y abortos, debido a su condición de vulnerabilidad o comportamientos hipersexuales (frecuentes en este último trastorno); a esto se asocia dificultad en la planeación de sus actos y escasez de educación sexual y consejos del personal médico, lo cual lleva a resultados obstétricos negativos e incapacidad para cuidar adecuadamente a sus hijos. Objetivo: Describir las características de una muestra de pacientes con trastorno bipolar y esquizofrenia en Medellín, Colombia, sobre salud sexual y reproductiva, el uso de anticoncepción y el asesoramiento al respecto en las consultas de psiquiatría. Métodos: Se realizó un estudio observacional de corte transversal. Se incluyó a los 160 participantes del ensayo clínico «Los Efectos de un Programa de Intervención Multimodal en Pacientes con Trastorno Afectivo Bipolar y Esquizofrenia¼, captados de la consulta del grupo de trastornos del ánimo y psicosis del Hospital Universitario San Vicente Fundación de Medellín. Un residente de tercer año de Psiquiatría contactó con ellos vía telefónica y les aplicó una encuesta acerca de las características de su vida sexual y reproductiva y la anticoncepción. Resultados: Casi todos los pacientes con esquizofrenia estaban solteros, no tenían estudios de pregrado y se encontraban desempleados. No se encontraron diferencias significativas en cuanto a la edad de inicio de las relaciones sexuales al comparar por diagnóstico y por sexo. Casi todos los pacientes con esquizofrenia y casi la mitad de los pacientes con TAB reportaron no tener vida sexual activa. Casi todos los que reconocieron tenerla afirmaron que usaban siempre algún método anticonceptivo; del grupo de TAB, solo el 48,8% de las mujeres solteras reconocieron estar planificando y poco más de la mitad de los varones afirmaron que se servían del condón en sus relaciones sexuales. Una cuarta parte de los embarazos fueron no planeados. El 57,4% de los pacientes con TAB y el 78,8% de los que tenían esquizofrenia se consideraban bien informados sobre planificación familiar, a pesar de que la mayoría afirmaba que nunca habían recibido información sobre este tema durante las consultas con su psiquiatra. Conclusiones: Los pacientes con enfermedad mental tienen alteraciones cognitivas y conductuales que afectan a su vida sexual y reproductiva, por lo cual los psiquiatras deben abordar este tema para garantizar la educación en cuanto a anticoncepción, planeación de la natalidad y riesgo de enfermedades de transmisión sexual, entre otras, y así velar por la seguridad y la calidad de vida de sus pacientes.
ABSTRACT Introduction: People with schizophrenia and bipolar disorder (BD) have a high risk of unwanted pregnancies and abortions, due to their condition of vulnerability or hypersexuality (common in BD). This is associated with difficulty in planning their actions and lack of sex education and counselling by medical personnel, and can lead to adverse obstetric outcomes and inability to care adequately for their children. Objective: To describe the characteristics in terms of sexual and reproductive health, and the use of contraception and counselling in psychiatric consultations, in a sample of patients with BD and schizophrenia in Medellin, Colombia. Methods: Observational cross-sectional study. We included the 160 participants from the clinical trial, "The effects of a multimodal intervention programme in patients with bipolar disorder and schizophrenia", who were recruited from the mood and psychosis disorders group clinic at Hospital Universitario de San Vicente Fundación in Medellin. They were contacted by phone by a third-year psychiatry resident, who applied a survey about the characteristics of their sex life, contraception and reproduction. Results: Almost all of the patients with schizophrenia were single, had no undergraduate studies and were unemployed. No significant differences were found regarding the age of starting sexual relations when comparing by diagnosis and gender. Almost all patients with schizophrenia and almost half of the patients with BD reported not having an active sexual life. Almost all of those who admitted to having an active sexual life claimed to always use contraception; in the BD group, only 48.8% of single women admitted to using contraception and a little over half of men stated that they used a condom when having sex. A quarter of the pregnancies were unplanned. Although the majority of the patients stated that they had never received information about family planning in the consultations with their psychiatrist, 57.4% of the patients with BD and 78.8% of those who had schizophrenia, considered themselves to be well informed on the subject. Conclusions: Patients with mental illness have cognitive and behavioural alterations that affect their sexual and reproductive lives. Psychiatrists should therefore address this issue, to ensure education in areas such as contraception, family planning and sexually transmitted diseases and help safeguard the safety and quality of life of their patients.
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Middle Aged , Schizophrenia , Bipolar Disorder , Pregnancy, Unwanted , Psychiatry , Psychotic Disorders , Quality of Life , Referral and Consultation , Sex Education , Sexually Transmitted Diseases , Diagnosis , Pioglitazone , Gender IdentityABSTRACT
INTRODUCTION: People with schizophrenia and bipolar disorder (BD) have a high risk of unwanted pregnancies and abortions, due to their condition of vulnerability or hypersexuality (common in BD). This is associated with difficulty in planning their actions and lack of sex education and counselling by medical personnel, and can lead to adverse obstetric outcomes and inability to care adequately for their children. OBJECTIVE: To describe the characteristics in terms of sexual and reproductive health, and the use of contraception and counselling in psychiatric consultations, in a sample of patients with BD and schizophrenia in Medellin, Colombia. METHODS: Observational cross-sectional study. We included the 160 participants from the clinical trial, "The effects of a multimodal intervention programme in patients with bipolar disorder and schizophrenia", who were recruited from the mood and psychosis disorders group clinic at Hospital Universitario de San Vicente Fundación in Medellin. They were contacted by phone by a third-year psychiatry resident, who applied a survey about the characteristics of their sex life, contraception and reproduction. RESULTS: Almost all of the patients with schizophrenia were single, had no undergraduate studies and were unemployed. No significant differences were found regarding the age of starting sexual relations when comparing by diagnosis and gender. Almost all patients with schizophrenia and almost half of the patients with BD reported not having an active sexual life. Almost all of those who admitted to having an active sexual life claimed to always use contraception; in the BD group, only 48.8% of single women admitted to using contraception and a little over half of men stated that they used a condom when having sex. A quarter of the pregnancies were unplanned. Although the majority of the patients stated that they had never received information about family planning in the consultations with their psychiatrist, 57.4% of the patients with BD and 78.8% of those who had schizophrenia, considered themselves to be well informed on the subject. CONCLUSIONS: Patients with mental illness have cognitive and behavioural alterations that affect their sexual and reproductive lives. Psychiatrists should therefore address this issue, to ensure education in areas such as contraception, family planning and sexually transmitted diseases and help safeguard the safety and quality of life of their patients.
Subject(s)
Bipolar Disorder/psychology , Reproductive Health , Schizophrenia , Sexual Health , Adult , Colombia , Contraception/statistics & numerical data , Counseling/statistics & numerical data , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Quality of Life , Sexual Behavior/statistics & numerical dataABSTRACT
Introducción: Estudios recientes han demostrado que la descripción de la polaridad predominante tiene efectos en la detección temprana y el inicio oportuno del tratamiento en los pacientes con trastorno afectivo bipolar (TAB). Metodología: Estudio descriptivo de corte transversal en 101 pacientes con TAB procedentes de una muestra poblacional genéticamente aislada de la región colombiana de Antioquia. Resultados: El estudio abarcó una población de 101 pacientes con diagnóstico de TAB tipo I, de los cuales 57,4% cumplieron criterios de polaridad maniaca (PM), 10,1% presentaron polaridad depresiva (PD) y 25,7% fueron clasificados con polaridad indefinida (PI). En comparación con los otros, los pacientes con PM tienen menor nivel educativo y menor edad de inicio y hay más solteros que en los otros grupos. La mayor prevalencia de suicidio se dio dentro del grupo de PM. El grupo de PM presentó un mayor consumo de cannabinoides y cocaína. Dentro del grupo de PD se registró una fuerte tendencia al consumo de cigarrillo y alcohol. Respecto a los fármacos consumidos a lo largo de la vida por los pacientes que conforman el estudio, los antipsicóti-cos fueron el grupo más usado, seguido por el litio y los anticonvulsivantes. Hay un elevado porcentaje de pacientes con PM que usaron antidepresivos a lo largo de su vida. Conclusiones: La polaridad del primer episodio de la enfermedad parece ser un parámetro de pronóstico válido en cuanto a la polaridad de los episodios subsiguientes; por lo tanto funciona de forma indirecta como predictor del curso de la enfermedad...
Introduction: Recent studies have shown that the predominant description of polarity has effects upon early detection and the timely beginning of treatment in patients with bipolar affective disorder (BAD). Methodology:Cross sectional cut and descriptive study in 101 BAD patients coming from a genetically isolated population from the Colombian Region of Antioquia. Results: The study covered a population of 101 patients with type-I BAD diagnosis, out of which 57,4% met the criteria for maniac polarity (MP), 10,1% exhibited depressive polarity (DP) and 25,7% were classified with Indefinite Polarity (IP). In comparison, MP patients have a lower education level and less starting age, including a greater number of single people. The MP group showed the greatest prevalence of suicide and greater use of cannabinoids and cocaine. Within the DP group there was a strong tendency to cigarette and alcohol consumption. With respect to pharmaceutical drugs consumed by the study patients during their lives, antipsychotics were the most widely used group, followed by lithium and anticonvulsivants. There is high percentage of MP patients who have used antidepressants during their lives. Conclusion: The polarity of the first episode of the disease seems to be a valid predictive parameter concerning the polarity of subsequent episodes; therefore, it works indirectly as a valid predictor of the diseases course...
Subject(s)
Affective Disorders, Psychotic , Affective Symptoms , Mental DisordersABSTRACT
INTRODUCTION: Recent studies have shown that the predominant description of polarity has effects upon early detection and the timely beginning of treatment in patients with bipolar affective disorder (BAD). METHODOLOGY: Cross sectional cut and descriptive study in 101 BAD patients coming from a genetically isolated population from the Colombian Region of Antioquia. RESULTS: The study covered a population of 101 patients with type-I BAD diagnosis, out of which 57,4% met the criteria for maniac polarity (MP), 10,1% exhibited depressive polarity (DP) and 25,7% were classified with Indefinite Polarity (IP). In comparison, MP patients have a lower education level and less starting age, including a greater number of single people. The MP group showed the greatest prevalence of suicide and greater use of cannabinoids and cocaine. Within the DP group there was a strong tendency to cigarette and alcohol consumption. With respect to pharmaceutical drugs consumed by the study patients during their lives, antipsychotics were the most widely used group, followed by lithium and anti-convulsivants. There is high percentage of MP patients who have used antidepressants during their lives. CONCLUSION: The polarity of the first episode of the disease seems to be a valid predictive parameter concerning the polarity of subsequent episodes; therefore, it works indirectly as a valid predictor of the disease's course.
ABSTRACT
This paper has been written by two dentists from Colombia who are currently waiting to take the International Qualifying Examination. They have been working as dental nurses in London and have gained insights into both NHS and non-NHS practice in London. They have a particular interest in preventive dentistry and have analysed recent developments in England with regard to the prevention of disease and oral disease in primary care. They propose a preventive approach which brings together recent policy developments in the United Kingdom and worldwide. They conclude that there are now potentially better opportunities than ever before to develop programmes to promote health and prevent oral disease, and to adopt a team approach to achieve these goals.
