ABSTRACT
BACKGROUND: Many doctors experience psychological ill health. Interns are known to be particularly vulnerable. AIM: To examine the level of depression, anxiety and stress in interns in Hong Kong, as well as the causes and how they cope. METHODS: A questionnaire was designed based on the themes identified in three focus groups of medical graduates of Year 2004 of the University of Hong Kong. The 21-item Depression, Anxiety and Stress Scale (DASS 21) was also administered. All 155 graduates of the same year were invited to participate with a response rate of 63%. RESULTS: Percentages of respondents with abnormal levels of depression, anxiety and stress were 35.8%, 35.4% and 29.2%, respectively. Frequent calls during night shift, long working hours and heavy workload constituted the most significant stressors. Factor analysis of the stressors showed that seven factors could explain 68% of the total variance: multidisciplinary team working issues, clinical difficulties, job seeking and employment, workload issues, ethical and interpersonal issues, adjustment to job rotation and performance appraisal. Holidays, peers and sleep offered the most significant relief. CONCLUSION: Interns experience considerable depression, anxiety and stress. The source of stress is multi-faceted, but workload is the most significant stressor. Peer support groups may relief stress.
Subject(s)
Adaptation, Psychological , Anxiety/epidemiology , Depression/epidemiology , Internship and Residency/statistics & numerical data , Stress, Psychological/complications , Adult , Anxiety/etiology , Data Collection , Depression/etiology , Female , Focus Groups , Hong Kong/epidemiology , Humans , Male , Psychometrics , Qualitative Research , Surveys and Questionnaires , Work Schedule Tolerance , Workload , Young AdultABSTRACT
BACKGROUND: Psychological morbidity is commonly found in medical students. AIMS: The Mental Health Support Group (MSG), a student-initiated and student-run web-based peer support service aims to provide mental health information, e mail counseling and an online forum for medical students. METHODS: The development process of MSG is described in the paper with presentation of preliminary evaluation results. RESULTS: Preliminary evaluation shows promising results. Student members of MSG acquired valuable skills in counseling, communication, webpage design and maintenance of an online forum. CONCLUSIONS: Future challenges include succession issues, strategies to keep up the momentum, enhancement of publicity and further diversification of service to meet the needs of our students.
Subject(s)
Consumer Health Information/methods , Health Promotion/methods , Mental Health , Students, Medical/psychology , Consumer Health Information/trends , Female , Hong Kong , Humans , Internet , Male , Mental Disorders/psychology , Peer Group , Program Evaluation , Sex Factors , Social Support , Stress, Psychological/psychology , Surveys and QuestionnairesABSTRACT
The practice of covertly administering medication is controversial. Although condemned by some as overly paternalistic, others have suggested that it may be acceptable if patients have permanent mental incapacity and refuse needed treatment. Ethical, legal, and clinical considerations become more complex when the mental incapacity is temporary and when the medication actually serves to restore autonomy. We discuss these issues in the context of a young man with schizophrenia. His mother had been giving him antipsychotic medication covertly in his soup. Should the doctor continue to provide a prescription, thus allowing this to continue? We discuss this case based on the "four principles" ethical framework, addressing the conflict between autonomy and beneficence/non-maleficence, the role of antipsychotics as an autonomy restoring agent, truth telling and the balance between individual versus family autonomy.
Subject(s)
Antipsychotic Agents/administration & dosage , Ethics, Medical , Food , Schizophrenia/drug therapy , Administration, Oral , Adult , Beneficence , Caregivers , Humans , Male , Mental Competency , Paternalism , Personal Autonomy , Physician-Patient RelationsABSTRACT
There has been much recent attention on psychological well-being and pastoral care for medical students. This study examines psychological morbidity (depression, anxiety and stress) in Hong Kong medical students, as well as their concerns, coping mechanisms and their help-seeking. Medical students in Hong Kong reported a higher level of psychological morbidity as compared with other tertiary education students. Their main concerns include examinations, stress, career, adjusting to the new medical curriculum and commitment to the course. The coping skills adopted were largely adaptive. Maladaptive coping skills like 'denial', 'self-blame' and 'behavioural disengagement' were highly correlated with depression, anxiety and stress scores. Most of the students concerned wanted support services that were specifically tailored to their needs and at least partly provided by people who had been through medical training themselves. The faculty at the University of Hong Kong is establishing a Programme for Effective Transition and Student Support (PETSS) to provide a multi-faceted support system for its medical students. The findings in this study help to ensure that the services provided will be relevant, accessible and acceptable to the students.
