Ethical Discourse of Psychiatrists About Gender Identity and Sexual Orientation: A Qualitative Study. / Cinsiyet Kimligi ve Cinsel Yönelim Hakkinda Psikiyatristlerin Etik Söylemleri: Nitel Bir Arastirma.

OBJECTIVE: In Turkey, the studies that aim to elaborate on the experiences of people with gender identities and sexual orientations incongruent with social norms are limited both in bioethics and in psychiatry. The general aim of this study is to provide a deeper understanding about the value based problems related to the gender identity and sexual orientation of the patients who seek medical advice in psychiatry practice. In this study, psychiatrists' discourse on gender identity and sexual orientation is discussed from an ethical perspective based on their experiences in providing healthcare to LGBT individuals. METHOD: In-depth interviews with 35 Psychiatry residents and specialists were conducted in the context of a qualitative field study. The data received from in-depth interviews were evaluated using the thematic content analysis method. RESULTS: The raw data received from the in-depth interviews with psychiatrists were analyzed and the themes and the contexts were derived. Discrimination, LGBTs access to healthcare services, counselling practice, beneficence, non-maleficence, being empathic, self-improvement, communicating with the family and interaction with LGBTs are the main themes that emerged. These main themes were handled within the contexts of providing healthcare services, professional responsibility of the psychiatrists, physician-patient/client and family relations. The relationship between the themes and the contexts were interpreted from an ethical perspective. CONCLUSION: The results of the study show that in the absence of comprehensive and adequate education on gender identity and sexual orientation, psychiatrists may tend to adopt scientifically debatable METHODS in diagnosis, observation and treatment of LGBT patient/ counselee.

Burnout in caregivers of patients with schizophrenia.

BACKGROUND/AIM: To evaluate the burnout of schizophrenia patients' caregivers and to determine the possible relationships between sociodemographic characteristics, symptomatology, perceived social support, and the burnout profile of the caregivers. MATERIALS AND METHODS: Subjects included in the study are 76 schizophrenia patients, diagnosed according to DSM-IV-TR criteria, and their caregivers. A sociodemographic form, the Scale for the Assessment of Positive Symptoms, and the Scale for the Assessment of Negative Symptoms were applied to evaluate the severity of the symptoms. The Maslach Burnout Inventory for Caregivers and the Multidimensional Scale of Perceived Social Support were applied to the caregivers of the patients. The collected data were analyzed via Student's t-test, one-way analysis of variance, and Pearson's correlation analysis. RESULTS: The burnout profile of the caregivers was highly correlated with the perceived social support of the caregivers and was also correlated with negative symptoms of the patients. Lower perceived social support was related to all subscales of the Maslach Burnout Inventory. CONCLUSION: Perceived social support is a major factor for caregiver burnout and it was highly correlated with all subscales in our study. We think that having social support provides caregivers with better feelings and so they provide better help to the patients. Appropriate approaches should be taken to intervene in the social and clinical factors that may exacerbate the burnout process.

Attachment style and perceived social support as predictors of biopsychosocial adjustment to cancer.

BACKGROUND/AIM: Social support is associated with a decrease in psychological symptoms and a better quality of life in cancer patients. The aim of this study was to investigate the role of attachment dimensions on social and psychological adjustment to cancer and to explore the social and psychological adjustments, and medical adherence, among patients. MATERIALS AND METHODS: The study was conducted with 68 cancer patients, between 18 and 74 years of age. The measures taken were the Demographic Information Form, Multidimensional Scale of Perceived Social Support (MSPSS), Experiences in Close Relationships-Revised (ECR-R), and Psychosocial Adjustment to Illness Scale (PAIS-SR). RESULTS: The results showed that an avoidant attachment style was related to difficulties in social relationships and an increase in psychological distress following cancer diagnosis. People who perceive more social support orient to health care more easily than people who perceive less social availability. It was shown that a higher level of perceived social support has a positive impact in adjustment to family relationships and leads to experiencing less psychological distress than in people who perceived less social support. CONCLUSION: Considering the complicated nature of cancer, a multi-perspective approach should be applied during the treatment process, and it is important to determine the psychosocial factors, and the causal pathways by which they lead to a better adjustment, in developing effective interventions.