<p style="text-align: justify;">Introduction: The 'first generation' physician gathers a lot of strength to venture into a world unknown to him. Unlike a physician born to a family of physicians who has a family to guide him, the 'first generation' physician only has himself to survive this endeavor. Through the life worlds of a select group of 'first generation' physician-in-training, this study seeks to answer the following central question: How do 'first generation' Filipino physicians collectively characterize their liminal spaces in transition from medical school to clinical practice?p><p style="text-align: justify;">Methodology: Anchored on the Theory of the Rites of Passage, this phenomenological inquiry, intends to surface the lebenswelt or essence of the experience of being the only physician in the family. Respondents comprised a purposive sample of physicians-in-training (residents and fellows), who are the only physicians in the family. Data were gathered using semi-structured interviews. Triangulation and member checking procedures were done to ensure the data reliability. Data were then subjected to cool (categorization) and warm analysis (thematization) using the Colaizzi's method.p><p style="text-align: justify;">Findings and Discussion: With all the transcribed experiences summarized and those with the same meaning analyzed, the following categories and themes were generated: The Intending Facet / Purpose: From Uncertainty towards Redefinition; The Thinking Facet / Process: From Perplexity towards Self-efficacy; The Relating Facet / People: From Isolation towards Integration; and The Transforming Facet / Power: From Vulnerability towards Empowerment. It was shown that a 'first generation' physician in this liminal space undergoes challenges and struggles during his training in medicine. This served as his Rite of Passage to transition him to someone dreaming only to become a physician, to become redefined with conviction, supported and integrated into the health system, empowered and transformed to the physician he is meant to be.p><p style="text-align: justify;">Recommendations: Physicians undergo a lot of challenges and mental stress and it means a lot for trainers to enter into the trainees' life-world, especially that of a 'first generation' physician, so that they can build socio-emotional learning and mentoring programs and counselling services that address different facets of liminal space that the trainees go through.p>
Physicians

Background : Caregiver burden and its impact on the quality of life is as important as determining the quality of life of children with epilepsy as these factors inl uence each other as well as the outcome of these children. Objectives : The primary objective of the study was to determine the association between caregiver burden and quality of life as well as anxiety and depressive symptoms among caregivers of Filipino children with epilepsy. Also, the study aimed to determine the prevalence rate of caregiver burden, impaired quality of life, anxiety, and depressive symptoms in an ambulatory care setting. Methodology : In this cross-sectional survey, adult caregivers accompanying their pediatric patients with epilepsy at a single tertiary center were recruited. Sociodemographic and clinical data were collected. The participants completed questionnaires for caregiver burden, quality of life, anxiety, and depressive symptoms. Results : Fifty-three caregivers participated with a mean age of 38 years. Most of them were females, married, unemployed, and at least college level. The mean age of their patients was 9.4 years and 71.7% of patients were on a single anti-epileptic drug. Lower educational level was less likely associated with caregiver burden. Although impaired quality of life and depressive symptoms were more likely associated with caregiver burden, this association did not reach statistical signii cance. Conclusion The prevalence rate of caregiver burden, impaired quality of life, anxiety, and depressive symptoms were 24.5%, 22.6%, 28.3%, and 9.4% respectively, among caregivers of Filipino children with epilepsy at a single tertiary center. Lower educational level was the only characteristic signii cantly associated with lesser odds of having caregiver burden
Caregiver Burden ; Quality of Life ; Anxiety ; Depression

<p style="text-align: justify;">OBJECTIVES: To compare the Clock Drawing Test (CDT) performance of Filipino patients with schizophrenia and normal subjects in detecting cognitive impairment and to determine the correlation of symptom severity using Brief Psychiatric Rating Scale (BPRS) and Positive and Negative Syndrome Scale (PANSS) with the CDT performance among schizophrenic subjects.
METHODOLOGY: A descriptive cross-sectional study using convenient sampling. Stable and compliant schizophrenic subjects were recruited at the psychiatry OPD of our institution from July to November 2004. Normal subjects were recruited from the community who were age,sex, and education matched. CDT and MMSE were administered to all the subjects and the scores of the two groups were compared using the two-tailed Student t-test. Symptom severity using BPRS and PANSS were correlated with CDT and Mini Mental Status Exam (MMSE) in schizophrenic subjects using the Pearson;s correlation coefficient.
RESULTS: A total of 66 subjects, 33 schizophrenic and 33 normal subjects were included in the study. Schizophrenic subjects performed poorly on CDT and MMSE compared to the normal subjects. The difference between the mean scores was statistically significant. The examination errors on the clock drawing test was more apparent among schizophrenic subjects. There were positive correlations between CDT and MMSE, and BPRS and PANSS. Negative correlations were observed between the cognitive performance and the symptom severity of schizophrenia.
CONCLUSION: Schizophrenic subjects performed poorly on CDT compared to the normal subjects, thus it is useful in detecting cognitive impairment. Likewise, CDT performance correlates well with symptom severity. Its availability and simplicity makes it very useful in detecting cognitive impairment in our clinical practice.p>
Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Brief Psychiatric Rating Scale ; Cognition ; Cognition Disorders ; Cognitive Dysfunction ; Cross-sectional Studies ; Neuropsychological Tests ; Psychiatry ; Schizophrenia

BACKGROUND: CIND is a common condition among the elderly population that has acquired clinical significance with the prevalence in elderly people about twice that of all forums of dementia gathered The concept of cognitive impairment with no dementia CIND has emerged as an important clinical entity because of its possible progression to dementia. Compared to patients diagnosed with no cognitive impairment, CIND patients have a 47% chance of developing dementia in 5 years. OBJECTIVES: This study aims to depict the Filipino patient diagnosed with CIND based on a consensus. It is further our goal to ascertain the prevalence of CIND among patients referred to the Memory Clinic for screening and assessment and also aims to determine if there is a relationship between the patient's profile and certain neuropsychological tests. METHODOLOGY: This is a research study which included all the patients (n=86) referred to the Memory Assessment Clinic of a tertiary hospital. Patients diagnosed with CIND were further evaluated and characterized based on the patient's profile such as general data, history of present illness, past medical history, family history, laboratories and ancillary procedures and neuropsychological examination. Relationship of patient's profile with various neuropsychological test was examined through linear and logistic regression and Spearman's correlation test. RESULTS: Out of the 86 patients evaluated by the Memory Clinic of a tertiary hospital, 17 (19.76%) were diagnosed with CIND. The mean age of the patients with CIND is 70.06 years, majority of whom are females (64.7&) and had 10 years of education. All are married with most of them residing in Metro Manila. All presented with progressive cognitive decline. Years of formal education showed that majority of patients had more than or equal to 10 years. Majority had co-morbid medical conditions. and majority are non-smokers and non-alcoholic beverage drinkers. Average MMSE is 25.88 points; the memory domain is greaty affected. Among the various neuropsychological tests, Verbal fluency and Maze tests were frequently impaired. The rest of the neuropsychological test such as Boston naming, Frontal assessment battery, Clock drawing test were frequently unimpaired. The ADAS Cog mean value was 16.37. MMSE and ADAS Cog showed no significant relationship with the patients profile based on linear and logistic regression as well as Spearman correlation.CONCLUSION: The prevalence of CIND in the memory Clinic of a tertiary hospital is 19.76%. The presentation of these patients is progressive cognitive decline so that careful clinical monitoring is essential. Majority of CIND patients have co-morbid medical conditions (76%). The identification of people at potential risk of dementia with a view to early therapeutic intervention is important, because it may lessen distress for both patient and family, minimize the risk of accidents, prolong autonomy, and perhaps even ultimately prevent the onset of the dementing process itself.
Human ; Male ; Female ; Dementia ; Nervous System Diseases ; Central Nervous System Diseases ; Brain Diseases ; Mild Cognitive Impairment ; Mental Disorders ; Delirium, Dementia, Amnestic, Cognitive Disorders ; Cognition Disorders ; Diagnosis ; Neuropsychological Tests ; Behavioral Disciplines And Activities ; Psychological Tests