Assuntos
Competência Clínica/normas , Pessoal de Saúde/educação , Pessoal de Saúde/organização & administração , Modelos Educacionais , Avaliação de Resultados em Cuidados de Saúde/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Aprendizagem Baseada em Problemas/organização & administração , Humanos , Avaliação de Programas e Projetos de Saúde , WashingtonRESUMO
A variety of occupational health hazards can cause employees to experience feelings of victimization and to develop work-related post-traumatic stress responses. The author presents assessment guidelines developed in work with people suffering from toxic exposures to help identify factors that can place employees at high risk for such stress responses. These guidelines can be adapted to evaluate employee reactions to any type of occupational injury. Clinicians also need to move beyond individual treatment approaches to address workplace and policy interventions.
Assuntos
Doenças Profissionais/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adaptação Psicológica , Exposição Ambiental , Humanos , Satisfação no Emprego , Fatores de Risco , Serviço Social em Psiquiatria , Transtornos Relacionados ao Uso de Substâncias/psicologiaRESUMO
An unusual case is presented of a psychotic young man who experienced command auditory hallucinations which directed him to amputate his right hand and distal penis to atone for a "terrible sexual transgression." The existing literature on genital self-mutilation is reviewed as well as some recent work on factors that might be used to predict an episode of self-mutilation. In patients who are felt to be at extremely high risk, careful monitoring and rapid medication schedules might be effective in preventing such an incident.