Stigmatizace duševních onemocnění je v České republice stále rozšířená. Iniciativa NA ROVINU vznikla v rámci implementace reformy péče o duševní zdraví a zaměřuje se na vytvoření destigmatizačních vzdělávacích programů pro šest předdefinovaných cílových skupin: uživatelé služeb péče o duševní zdraví, jejich rodinní příslušníci, zdravotníci, poskytovatelé sociálních služeb, úřady veřejné správy a komunity, které jsou v těsné blízkosti nově vybudovaných komunitních center pro duševní zdraví. Pro vytvoření konkrétních programů byla provedena situační analýza. Ta zahrnovala prozkoumání potřeb u každé cílové skupiny, mapování současných a minulých destigmatizačních programů v České republice a přehled světové literatury. Na základě toho byly vytvořeny a následně pilotovány programy pro každou cílovou skupinu. Za účelem evaluace byla sbírána kvalitativní a kvantitativní data. Kvalitativní data ve formě skupinových diskusí ukázala, že programy jsou přijatelné a použitelné pro dané cílové skupiny. Také na základě shromážděných kvalitativních údajů byly do programů implementovány změny. Implementace programů probíhá i nadále.
Stigma related to mental health is still widespread in the Czech Republic. The ON THE LEVEL initiative was created as part of the ongoing implementation of the mental health care reform in the Czech Republic and focuses on creating destigmatizing educational programs for six predefined target groups: users of mental health services, their family members, health professionals, social service providers, public office employees and communities that are in close proximity to the newly built community mental health centers. A situational analysis was undertaken to create the specific programs. This included an examination of the needs of each target group, a mapping of current and past destigmatization programs in the Czech Republic, and an overview of world literature. Based on this, programs were created and subsequently piloted for each target group. At the same time, qualitative and quantitative data were collected for evaluation purposes. Qualitative data in the form of focus group observations showed that the programs are acceptable and applicable to the target groups. On the basis of collected qualitative data, necessary changes were made to the programs. Implementation of programs is still ongoing.
OBJECTIVE: Russia's invasion of Ukraine in February 2022 triggered a huge wave of migration, with thousands of refugees arriving at Prague's Central Station. With no medical service available, medical students started to volunteer and were running an infirmary available around the clock. The research aimed to explore medical students' professional experiences, emotionally challenging situations, and coping strategies in this demanding setting. METHODS: The authors used a qualitative analysis of semi-structured in-depth interviews with 19 participants recruited through purposive sampling. Interviews took place between April and May 2022. Data were recorded, transcribed, and processed by using thematic qualitative analysis. RESULTS: The research identified five emotionally challenging situations: caring for traumatized refugees, refusal of treatment, disruption of everyday life, independent decision-making, and complexity of voluntary work. Students adopted both adaptive and maladaptive coping strategies for dealing with stress and trauma. Almost half the students reported signs of secondary traumatization and moral distress; however, no one asked for psychological help. CONCLUSIONS: Medical school curricula should cover trauma-informed approaches, healthy coping strategies, and destigmatization of psychological problems.
- MeSH
- dobrovolní pracovníci psychologie MeSH
- kurikulum MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- studenti lékařství * psychologie MeSH
- uprchlíci * psychologie MeSH
- zdravotní stav MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The pandemic due to COVID-19 brought new risks for depression of health care workers, which may have differently influenced men and women. We aimed to investigate (1) whether health care workers in Czechia experienced an increase in depression during the COVID-19 pandemic, (2) which factors contributed the most to this change, and (3) whether the magnitude of the associations differed by gender. We studied 2564 participants of the Czech arm of the international COVID-19 HEalth caRe wOrkErS (HEROES) Study. Online questionnaire was administered to health care workers in summer 2020 (wave 0) and spring 2021 (wave 1). Depression was defined by reaching 10 or more points on the Patient Health Questionnaire. Logistic regression investigated the association of participant ́s characteristics with depression and multivariable decomposition for non-linear models assessed, to what extent the characteristic explained the change in depression occurrence. The prevalence of depression increased twice during the pandemic (11% in wave 0 and 22% in wave 1). Stress accounted for 50% of the difference, experience of death due to COVID-19 for 15% and contact with COVID-19 patients for 14%. Greater resilience and sufficient personal protective equipment were strongly associated with lower occurrence of depression. The protective association of resilience with depression was stronger in men than in women. We conclude that interventions to promote mental health of health care workers in future health crisis should aim at decreasing stress and enhancing resilience. They should be delivered especially to individuals who have contact with the affected patients and may face their death.
- MeSH
- COVID-19 * epidemiologie MeSH
- lidé MeSH
- pandemie MeSH
- plži * MeSH
- úzkost MeSH
- zdravotnický personál MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Úvod: Pandemie COVID-19 byla globální krizí s extrémním tlakem na zdravotnické systémy. Zátěžové faktory byly shodné ve všech zasažených zemích, i když se mohly projevovat s různou intenzitou podle vyspělosti zdravotnictví. Většina publikovaných studií o dopadech na psychiku zdravotníků je kvantitativních a mapuje výskyt depresivní symptomatologie, příznaků vyhoření, míry zátěže a dalších faktorů. Naším cílem bylo pomocí kvalitativní analýzy zjistit, jaké potřeby mají pracovníci ve zdravotnictví. Metody: Na základě otevřených odpovědí ze tří vln dotazníkového šetření českého ramene mezinárodní studie HEROES z let 2020, 2021 a 2022 jsme analyzovali 1105 odpovědí z celkových 2880. Z dotazníku potřeb v rámci pilotní intervenční studie HEROES z roku 2023 jsme analyzovali 118 odpovědí. Použili jsme přístup obsahové analýzy. Po vytvoření kódovacího schématu byla data kódována v programu Atlas.ti. Kódy byly následně roztříděny do kategorií. Výsledky: Potřeby zdravotníků byly kategorizovány do následujících témat: pracovní podmínky, týmová spolupráce, podpora ze strany nadřízených a vedení, práce s pacienty, slaďování práce a osobního života a potřeby spojené s duševní pohodou. Závěr: Naše analýza prokázala, že zdravotníci začínají formulovat svoje potřeby jak v oblasti pracovních podmínek a organizace práce, ale i v kontextu celého svého života. Začínají klást důraz na vztahy na pracovišti, na zajištění psychologických potřeb a na rovnováhu mezi osobním životem a prací.
Introduction: COVID-19 pandemic was a global crisis with extreme pressure on healthcare systems. The stressors were the same in the affected countries even if they could manifest in different intensity due to varied development and resources in the healthcare systems. Most of the published studies about mental health consequences on healthcare workers are quantitative studies mapping the occurence of depressive symptoms, symptoms of burnout, level of stress and other facotrs. In the presented paper, our aim was qualitative analysis of needs of healthcare workers. Methods: We have analysed 1105 responses from a total of 2880 free answers in the three waves of the Czech HEROES study questionnaire from years 2020, 2021, 2022 and 118 responses from the survey of needs in the 2023 HEROES pilot intervention study. We used content analysis approach, and after creation of the code scheme, the data was coded in Atlas.ti programme. The codes were subsequently categorised. Results: The needs of healthcare workers were categorised in following themes: working conditions, teamwork, support from superiors and management, patient care, work-life balance, and needs of well-being. The details regarding each category and example quotes from the respondents are presented in the paper. Conclusion: Our analysis proved that healthcare workers start to exprress their needs not only in the field of working conditions and organization of their work but also in the context of their entire lives. They put emphasis on relations at the workplace, on support of their psychological needs and on work-life balance.
The definitions of the roles of peer support workers (PSWs) are unclear, creating one of the main challenges to PSWs' successful involvement in mental health care. In this empirical qualitative study conducted in the Czech Republic, four common roles of PSWs (N=15) were identified: friend, professional, staff member, and expert-by-experience. Conflicts were observed between the roles of friend and professional and between staff member and expert-by-experience. These conflicts may have a detrimental effect on the PSWs' well-being. The authors therefore call on organizations to prioritize regular supervision, team education, clear definition of the PSW position within an organization, and the destigmatization of people with mental illness in mental health services.
- MeSH
- duševní poruchy * terapie psychologie MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- poradenství MeSH
- služby péče o duševní zdraví * MeSH
- vyrovnaná skupina MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Cíl: O psychiatrii a dětskou a dorostovou psychiatrii je mezi absolventy lékařských fakult malý zájem. Cílem naší studie bylo porozumět faktorům, které ovlivnily rozhodování lékařů stát se psychiatry či dětskými a dorostovými psychiatry. Materiál a metoda: V tomto kvalitativním výzkumu jsme realizovali polostrukturované rozhovory s lékaři v předatestační přípravě oborů Psychiatrie a Dětská a dorostová psychiatrie v ČR. Výběr účastníků studie byl záměrný. Analytický rámec vycházel z konceptu dynamiky kariérní volby u studentů medicíny. Výsledky: Výzkumný soubor zahrnoval 21 lékařů: 14 v oboru Psychiatrie (8 žen a 6 mužů) a 7 v oboru Dětská a dorostová psychiatrie (4 ženy a 3 muži). Délka předatestační přípravy se pohybovala mezi 4 měsíci a 5 lety. Identifikovali jsme 15 faktorů, které jsme kategorizovali do 4 základních okruhů: charakteristiky a hodnoty lékařů, kariérní potřeby během rozhodování o výběru specializace, vnímání oboru psychiatrie / dětské a dorostové psychiatrie a faktory setrvání v profesi. Závěr: K základním motivačním faktorům patří práce s pacientem založená na komunikaci a navázání vztahu, dále komplexní povaha oboru, který propojuje somatickou, farmakologickou a psychoterapeutickou péči, a zahrnuje i sociální a soudní problematiku. Z praktického hlediska se psychiatrie během rozhodování zdála být oborem, kde je méně stresu, víc času na pacienta, diagnostiku a terapii, ale i na osobní život. Specifickým motivačním faktorem pro obor dětská a dorostová psychiatrie je vztah k dětem; s motivací pracovat s dětmi nastupují studenti často již na lékařskou fakultu. Dětští a dorostoví psychiatři oceňují zejména bezprostřednost a hravost dětí a to, že jsou na začátku vývoje a lze u nich dosáhnout velkých změn. Volbu dětské a dorostové psychiatrie ovlivnily i pragmatické důvody, a to pracovní uplatnění v situaci nedostatku dětských a dorostových psychiatrů. Dotazovaní oceňovali možnost intelektuálního rozvoje, jelikož dětská psychiatrie nabízí málo probádaná témata. Odrazujícími faktory jsou společenské předsudky, které jako reakci svých rodičů přiznala polovina dotazovaných bez ohledu na jejich profesi. Se stigmatizací ze strany pedagogů se lékaři setkávali již během studia medicíny. Zásadním problémem je nedostatečná informovanost o existenci samostatného atestačního oboru Dětská a dorostová psychiatrie, včetně prakticky nulové expozice tomuto oboru během studia na lékařské fakultě.
Introduction: There has been a low interest in pursuing career in Psychiatry and Child and adolescent psychiatry among medical school graduates. The aim of our study was to identify factors that influenced choice of these medical disciplines among psychiatric trainees. Method: In this qualitative study we conducted semi-structured interviews with purposively sampled trainees in Psychiatry and Child adolescent psychiatry programs in the Czech Republic. An analytical framework for this study is based on the concept of dynamics ofcareer choice among medical students. Results: Out of 21 respondents there were 14 trainees in Psychiatry program (8 women, 6 men) and 7 in Child and adolescent psychiatry program (4 women, 3 men). The length of their training was between 4 months and 5 years. We identified 15 factors, that were cathegorized into 4 groups: characteristics and values, career needs during decision making proces of specialty choice, psychiatry and child and adolescent psychiatry perception and factors of remaining in profession. Conclusion: Motivating factors were oportunity for working with patients based on communication and therapeutic relationship; complexity of psychiatry that includes somatic, pharmacological and psychological care as well as social and forencis aspects. From a practical point of view psychiatry seemed to allow better worklife balance and was viewed as less stresfull with more time available for doctor-patient interaction, including diagnostics and treatment. Specific factor for child psychiatry was relationship to children, which motivated respondents for entering medical school. Trainees in Child and adolescent psychiatry appreciated spontaneity and playfulness of children and early developmental phase of life with a chance for behavioral change. There were also pragmatic reasons, namely chance for finding a job. Another reason was opportunity for intelectual development as there are many possible topics for research. De-motivating factors included societal prejudice, which was indentified in parents of half of respondents, regardless of their profession. Students were exposed to stigmatizing comments by academic staff after declaring their interest in psychiatry during medical school. Fundamental problem was lack of information about the existence of Child and adolescent psychiatry as a unique speciality with training available right after graduation and practically no exposure to this medical speciality during medical school.
- MeSH
- dětská psychiatrie výchova MeSH
- lékaři psychologie MeSH
- lidé MeSH
- motivace MeSH
- odborná způsobilost MeSH
- psychiatrie adolescentů výchova MeSH
- psychiatrie * výchova MeSH
- rozhovory jako téma MeSH
- specializace MeSH
- studium lékařství MeSH
- studium vysokoškolské MeSH
- volba povolání * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
This study aimed to examine attitudes towards people with mental illness and psychiatry and interest in career choice in psychiatry among medical students from three medical schools in Czechia and Slovakia. A total of 495 medical students participated in a cross-sectional study. Participants completed (1) the Medical students' version of mental illness: clinicians' attitudes (MICA-2) scale, (2) the Reported and intended behaviour scale (RIBS), (3) the Attractiveness of working on a psychiatry-related position scale (P-ATTRACT), and (4) the Status of psychiatry scale (P-STATUS). Descriptive statistics, group comparisons and regression models were calculated. From 23 to 30% of students considered a specialization in psychiatry. However, only about 1% of them had a strong interest in psychiatry as a future career, moreover, students of higher years of study found psychiatry less attractive compared to those who are in the beginning of the study. The consideration of specialization in psychiatry was found to be statistically significantly associated with less stigmatizing attitudes and lower social distance towards people with mental illness. There were statistically significant differences in stigmatizing attitudes among medical schools, with a medical school emphasizing the education in psychiatry the most showing more positive attitudes. It is necessary to increase the interest in psychiatry and minimize stigma among medical students. Psychiatry curriculum in Central and Eastern European region should include more psychiatry-related courses, training in community and out-patient facilities, peer-lectors, and offer counselling after exposure to emotionally challenging clinical situations.
- MeSH
- dospělí MeSH
- duševní poruchy * MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- postoj zdravotnického personálu * MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- psychiatrie výchova statistika a číselné údaje MeSH
- studenti lékařství psychologie statistika a číselné údaje MeSH
- volba povolání * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- východní Evropa MeSH
OBJECTIVE: A survey among medical students of all medical schools in the Czech Republic was conducted to investigate attitudes and views of psychiatry and career choice of psychiatry. METHODS: A Czech version of the Attitudes to Psychiatry Scale (APS) and a questionnaire surveying demographic characteristics and choices of future specialty were distributed to all medical students of eight medical schools in the Czech Republic via the schools' internal communication systems in the form of an anonymous online questionnaire. RESULTS: Out of a total of 10,147 medical students in the Czech Republic (academic year 2019/2020), 2418 students participated in the survey (response rate 23.8%). Psychiatry as a non-exclusive career choice was considered by 31.3% respondents; child and adolescent psychiatry was considered by 15.4% respondents. Psychiatry as the only choice was considered by 1.6%, and child and adolescent psychiatry was not considered at all. The interest in both specialties was declining since the first year of study. The status of psychiatry among other medical specialties was perceived as low; students were rather discouraged from entering psychiatry by their families. They did not feel encouraged by their teachers to pursue career in psychiatry despite the fact that they were interested in psychiatry. They also felt uncomfortable with patients with mental illness. CONCLUSIONS: Despite high enthusiasm for psychiatry in the first year of medical school, only a small proportion of medical students consider to choose psychiatry, and especially child and adolescent psychiatry, as a career at the end of medical school.
- MeSH
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- postoj zdravotnického personálu MeSH
- postoj MeSH
- průzkumy a dotazníky MeSH
- psychiatrie * MeSH
- studenti lékařství * MeSH
- volba povolání MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Internalized stigma negatively affects lives and prognosis of individuals with psychosis. AIM: This study aimed to identify correlates of internalized stigma among individuals with psychosis in a sample of community care users in the Czech Republic. METHODS: A cross-sectional study was conducted among 133 community service users with psychosis. A shortened version of the Internalized Stigma of Mental Illness (ISMI-10) scale was used alongside the 5-level EQ-5D version (EQ-5D-5L), assessing health-related quality of life. Descriptive and linear regression analyses were performed in order to determine levels of internalized stigma and its correlates. RESULTS: High levels of internalized stigma were reported in 25% of participants. Lower internalized stigma levels were associated with better self-reported health status and being married, and higher internalized stigma with a longer period of time since initial contact with psychiatric care. CONCLUSION: Lower internalized stigma levels are associated with better self-reported health-related quality of life. In addition, clients having used psychiatric care for longer periods of time reported significantly higher internalized stigma levels. Therefore, authors suggest self-stigma reduction interventions based in a community setting with an emphasis on targeting clients with chronic psychosis.
- MeSH
- dospělí MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- lineární modely MeSH
- mladiství MeSH
- mladý dospělý MeSH
- průřezové studie MeSH
- průzkumy a dotazníky * MeSH
- psychometrie MeSH
- psychotické poruchy psychologie MeSH
- reprodukovatelnost výsledků MeSH
- sebepojetí * MeSH
- společenské stigma * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
