OBJECTIVE: This study aims to measure the point prevalence, degree of burnout among nurses assigned at Pavilion 10 in San Lazaro Hospital and determine if there is a correlation of the degree of burnout with selected socio-demographic characteristics.
METHODOLOGY: Purposive sampling of all 19 nurses assigned at Pavilion 10 was conducted. A questionnaire was developed to determine socio-demographic and work-related characteristics of the respondents. Burnout was measured using the Maslach Burnout Inventory Scale coupled with key informant interviews as to possible job stressors that would contribute to nurses burnout.
RESULTS: A mean age of 37.7 years was noted. The majority of the subjects were married, most of whom had spouses working in a non-health related profession. The predominant religion was Roman Catholic (89.5 percent). Most of them lived with their families. The majority of them had been working at the hospital for more than 10 years and at Pavilion 10 for more than 3 months. Most of them had respiratory problems. MBI scores revealed that 63.1 percent of the nurses had high levels of emotional exhaustion, 36.8 percent had low levels of personal achievement but only 26.3 percent had high levels of depersonalization. The mean score for Emotional Exhaustion was high but only average for the personal achievement and depersonalization subscales.
CONCLUSION: The results of the present survey suggest that our nurses were experiencing more burnout than "average". However the high scores on the EE compared to the DP and PA subscales suggest that they were still in the early stages of burnout. Programs designed to alleviate their burnout could prevent its progression. In the analysis of the data, no association was noted between the MBI scores and the selected socio-demographic and work characteristics.

Human ; Male ; Female ; Middle Aged ; Adult ; Burnout, Professional ; Nurses ; Achievement ; Burnout, Professional ; Catholicism ; Depersonalization ; Marriage ; Prevalence ; Spouses ; Surveys And Questionnaires

Psychiatric Liaison Programs are designed to provide service, training and research technology using the biopsychosocial approach for problems encountered in a general hospital ward or specialty clinic. When psychosocial problems arise in individuals or groups comprehensive liaison programs are designed based on an analysis of needs that consider the psychosocial dynamics of patients, their family, nursing staff, and medical staff of that particular ward or clinic. These programs are created and implemented by a multidisciplinary team of psychiatrists, social worker, nurse, OT/PT, and consultee physician. Liaison Programs have been set up at the Trophoblastic Disease Ward and the Cancer Institute of the Philippine General Hospital. Among the interventions set up are regular group therapy sessions for patients and their relatives, expressive therapy including visual art therapy, and music, relaxation techniques, meditation, and guided imagery activities, and activity therapy. For the nursing and medical staff seminars and workshops were held to aid in the detection and early intervention-of behavioral problems. Group therapy sessions were also done when interpersonal problems and burn-out were detected; Individual psychotherapy was done when the need arose. At the Trophoblastic Disease Ward, the physiological, psychological and social domains of the WHO-DOH Quality of Life questionnaire were administered to in-patient before instituting the Liaison Program, and six months after. A comparison of the pre-test and post-test scores showed a significant improvement in all the domains a p-0.05 level of significance. A Purpose-in-life test was also administered to the bantays of these patients which showed significant improvement in their scores after six months at p-0.05 level of significance. Subjective evaluations done on the ward staff showed an improvement in interpersonal relationships with other staff, patients and their bantays. We endorse Psychiatric Liaison Programs as effective interventions in dealing with the psychosocial problems of cancer patients, their bantays, and the ward staff.
TROPHOBLASTIC NEOPLASMS

OBJECTIVES: The aim of this study is to assess the psychosocial needs of persons with disability of the Rehabilitation Sheltered Workshop (RSW) of the DSWD as well as screen for psychiatric illness.
METHODOLOGY: There were 38 persons with various disabilities enrolled at the RSW. They were interviewed and screened using the Self Reporting Questionnaire (SRQ).
RESULTS: About a third (34.21%) were married and 28.94% were single. Fifty percent were physically disabled i.e. amputees or with deformities of the extremities; 34.21% were blind the remaining 15.78% had a variety of disabilities e.g. deafness, facial deformity or speech impairment. The mean age was 45.5 years old. Based on the SRQ 38.64% of the visually disabled clients scored positive for mood/anxiety while 53.84% scored positive for psychosis; while 52.63% of the orthopedic clients scored positive for mood/anxiety and an even higher 73.68% scored positive for psychosis. For the other handicapped clients,33.33% scored positive for mood/anxiety and 50.00% scored positive for psychosis.
CONCLUSION: Majority (63.16%) of the 38 clients at the RSW were psychotic and only 44.73% were found to have mood/ anxiety symptoms, thus the need for psychiatric follow up as well as initiation of psychopharmacological and psychotherapeutic interventions for these clients.

Human ; Male ; Female ; Psychiatry ; Morbidity ; Psychotic Disorders ; Anxiety ; Questionnaires

OBJECTIVES: This study looked into the relationship between stress and the level of job satisfaction among the Burnt Unit staff of UP-PGH. Emphasis was placed in identifying the common stressors that the Burn Unit Staff of UP-PGH experience as a result of their day to day work in a critical care setting.The level of job satisfaction among staff was also determined.
METHODOLOGY: Questionnaires assessing stress and job satisfaction were handed out to all the 31 participants of the study. The study population included 10 doctors and 21 nurses who had worked at the Burn Unit during the period of March to September 2007. Odds ratios were computed to determine if the presence of stress affects the level of job satisfaction among the Burn Unit Staff of UP-PGH. The resulting odds ratios were further tested for statistical significance using Fisher exact test and confidence limits.
RESULTS: Of the 31 survey forms initially handed out to the Burn Unit staff, only 28 forms were completed and returned to the investigator at the end of the study period. Two items in the Stressful Situations Questionnaire were rated to be "stressful" by majority (>50%) of the respondents. Twenty-five percent of the respondents obtained positive scores in the Job Dissatisfaction Scale and were classified as being "dissatisfied" with their jobs. Twenty-two situations in the Stressful Situations Questionnaire were found to be significantly associated with job dissatisfaction among the Burn Unit staff of UP-PGH. These situations concerned the following areas: relationship with patients, family rejection, identification with the patient, deterioration and complications, job criticism, workspace, daily work, and therapeutic decisions.
CONCLUSIONS: From the results of the study, recommendations were made to promote a system of stress-reduction for the Burn Unit staff. Regular group psychosocial processing sessions can be provided to allow the staff to ventilate their thoughts and feelings regarding personal and professional concerns. Team building activities for the staff can likewise be scheduled regularly to help solidify the group and resolve interpersonal conflicts among them. Future researchers could explore if a difference exists between the nurses and surgery residents in terms of their perceived stressors and their level of job satisfaction with their work in the Burn Unit.

Human ; Male ; Female ; Job Satisfaction ; Nurses ; Critical Care ; Questionnaires

Objective: This survey identifies the psychosocial aspects of caring for spinal cord injury (SCI) patients at the Philippine Orthopedic Center (POC). Specifically it aims to determine the demographic profile, psychiatric morbidity, and perceived social support of this population. Methodology: This cross-sectional study describes the psychological impairment and perceived social support of 42 SCI patients, which were assessed through the Self-Reporting Questionnaire and Norbeck Social Support Questionnaire. Results and Conclusion: A mean age of 35.3 years was noted, with males accounting for 74 percent of the SCI patients studied. Most of them were skilled workers who had reached high school. About 66 percent had complete spinal cord transection. 57.1 percent of the study population had a score of 5 or more on SRQ items 1 to 20 which screen for anxiety and depressive symptoms, while 23.8 percent had a score of one or more SRQ items 21 to 24 which screen for psychotic symptoms. The spouses (33 percent) and the nursing staff (31.7 percent) were the most supportive.
Human ; Male ; Female ; Adult ; Young Adult ; Adolescent ; SPINAL CORD INJURIES ; SOCIAL SUPPORT

OBJECTIVES: The aim of this study is to determine the prevalence of depression and phantom limb pain among amputated patients at the Philippine Orthopedic Center (POC) from April to May 2001, as well as describe the characteristics of such patients. This study also seeks to determine if there is an association between phantom limb pain and depression among the amputated patients at POC. METHODS: This is a cross sectional study where 48 in and out patients from 18-61 years old were interviewed using the McGill Pain Questionnaire (MPQ) to evaluate the presence of phantom limb pain and Beck Depression Inventory (BDI) to evaluate the presence of depression, for the time period between April and May 2001. RESULTS: Eighteen (37.5 percent) patients were noted to be depressed, while only eight (16.7 percent) reported experiencing phantom limb pain. Among the 18 depressed patients, majority (68.8 percent) did not experience any pain but about one third (33.3 percent) admitted to phantom limb pain. Among the 8 who experienced phantom limb pain, 6 (75 percent) were depressed as compared to only 30 percent of those without phantom limb were depressed. Depression was more severe among those who were amputated due to a medical illness (24 percent) and interviewed within a year after their amputation (27.3 percent). CONCLUSION: Depression was more prevalent than phantom limb pain among amputees of the POC. Using the Fisher test for independent variables and Mann-Whitney 2 sample test, an association between phantom limb pain and depression was observed among the amputated patients in this study. Depression may also be more evident within the first year after amputation and more prevalent among those with medical illness.
Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; PHANTOM LIMB ; DEPRESSION ; AMPUTEES

Human ; Male ; Female ; Methamphetamine ; Philippines ; Pharmaceutical Preparations

OBJECTIVE: This study describes the utilization pattern of psychiatric consultation services at the UP-PGH from 1999 - 2008 by reviewing the demographic data of patients referred, describing the Axis I (Clinical Disorders and Other Disorders That May Be a Focus of Clinical Attention) and Axis III (General Medical Conditions) diagnoses of referred patients, and by identifying the sources of, and reasons for the different referrals.
METHODS: Relevant data from the annual census of the Consultation - Liaison (CL) Psychiatry Section from 1999 - 2008 was reviewed according to age, sex, civil status, reasons for referral, DSM-IV TR Multi-axial diagnoses and sources of referrals.
RESULTS: The percentage of referrals to consultation psychiatry has increased from 1.03% in 1999 to 1.77% in 2008. There is equal distribution between males and females. Majority of the consultation referrals were married and belonged to the 21-40 age group. The top five referring services were general medicine, surgery and trauma, obstetrics-gynecology, otorhinolaryngology and orthopaedic departments. The top three reasons for referring patients were mood problems, agitation and restlessness, and suicide attempts/behaviour. Majority of the axis I diagnoses were adjustment disorder, depressive disorders, and psychological reactions to illness. According to Axis III diagnoses, majority of the referrals were associated with poisoning and injury, neoplasms, and endocrine, nutritional, metabolic and immunity disorders.
CONCLUSION: The referral rate to the CL-Psychiatry Section at the UP-PGH has increased throughout the period studied. This may be attributed to programs and activities that improve efficiency in the delivery of psychiatric knowledge and skills, and better personnel supervision. The referral rate of 1.03% to 1.82% was consistent with those in other countries.

Human ; Male ; Female ; Adjustment Disorders ; Attention ; Censuses ; Depressive Disorder ; Diagnostic And Statistical Manual Of Mental Disorders ; Gynecology ; Neoplasms ; Obstetrics ; Orthopedics ; Otolaryngology ; Psychiatry ; Psychomotor Agitation ; Referral And Consultation ; Suicide, Attempted

OBJECTIVE: This paper presents the experiences of, and lessons learnt from, a seven-year government-academe-civil society collaboration in the development, implementation, and evaluation of a training program for Filipino physicians and rehabilitation practitioners on the management of drug dependence.

METHODS: Review of memoranda, records, and reports relevant to the initiation and implementation of the training activity. Where relevant, we also perused internal notes and minutes of meetings written by the authors, who are also members of the training team.

RESULTS: A tripartite collaboration between government, academe, and professional organizations developed a training program on the management of drug dependence for physicians and rehabilitation practitioners. Learner-centered approaches to education were adopted in the delivery of training content. Participation in the training is a prerequisite for government accreditation as rehabilitation professionals. A ladderized approach to the training was adapted, with participants first obtaining a broad introduction to the program, followed by in-depth focus on the assessment and management of drug dependency. This was done as a response to the perception that a single, two-week training program is insufficient to fully capacitate physicians and rehabilitation practitioners with the requisite knowledge and skills necessary to manage persons with drug dependence. Future plans include an executive course for established practitioners, and a course on community-based management of drug dependency.

CONCLUSION: The current perspective on drug use and dependence is transitioning from a politico-legal issue to a public health concern. Attaining the sustainable development goals in 2030 will necessitate the development of a cadre of professionals who are, among others, capable of assessing and treating persons who suffer from drug dependence. The Philippine experience may serve as a model for other countries struggling with the drug menace.

Human ; Substance-related Disorders ; Substance Abuse Treatment Centers ; Philippines

Background and Objectives: Tuberculosis (TB) remains a public health problem in the Philippines despite trends indicating a decline in the burden of disease. Persons who use drugs who are confined in government-retained drug abuse treatment and rehabilitation centers (DATRCs) face an increased risk for TB because of the congestion in the facility coupled with the absence of guidelines on TB management specific to DATRCs. Thus, this study was conducted to document the current case finding and case holding practices as well as TB treatment pathway in six (6) Luzon-based, government-retained DATRCs.

Methods: Key informant interviews were conducted with DATRC personnel involved in TB diagnosis and management in six selected DATRCs in Luzon, Philippines. Interviews were transcribed and coded for thematic analysis. We compared the DATRC practices with the provisions of the 2014 National TB Control Program (NTP) Manual of Procedures. Results were validated through a workshop with (a) a group of physicians and rehabilitation practitioners assigned in other DATRCs; and (b) a group of experts who have experience in managing or overseeing DATRCs in the country.

Results: Two physicians and four nurses participated in the interviews. Variations in case finding and case holding practices in six DATRCs have been found. National guidelines exist for congregate settings but are more specific to jails/prisons, which are administratively and operationally different from DATRCs.

Conclusion: Development of special guidelines for TB case finding and case holding in DATRCs as well as staff training on the latest NTP Manual of Procedures are recommended. However, gaps and inequities posed by the current set-up underscore the need to address health system-wide factors affecting the practice and performance of these facilities.

Key Words: tuberculosis, case finding, case holding, drug abuse treatment and rehabilitation centers, Philippines

Tuberculosis ; Rehabilitation Centers