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The purpose of this study is to identify psychiatric disorders and stress factors experienced by staff members in cancer hospitals who were referred to psychiatric consultation service, and to investigate the association between psychiatric disorders and stress factors.
Method:
A retrospective descriptive study using clinical practice data on staff members referred to psychiatric consultation service, obtained for 8 years, was conducted at two National Cancer Center Hospitals in Japan. Psychiatric disorders were identified according to DSM-IV. Stress factors were extracted from a chief complaint at the initial visit in medical charts, using a coding approach, and grouped as job stress or personal stress. The frequencies of the stress factors were determined by two coders who were unaware of the categorized procedure. Fisher's exact test was used to determine the association between psychiatric disorders and stress factors.
Results:
Of 8077 psychiatric consultations, 65 (1%) staff members were referred. The most common psychiatric disorder was adjustment disorder (n = 26, 40%), followed by major depression (n = 17, 26%). Eight stress factors were identified from 76 meaning units and were grouped into five job stresses and three personal stresses. Of the five job stresses, four were most frequently experienced in adjustment disorders, and “failure to adapt to job environmental change” was significantly associated (p = 0.014). Two of the three personal stresses were most frequently experienced in psychiatric disorders other than major depressive disorder and adjustment disorders, and “suffering from mental disease” was significantly associated (p = 0.001).
Significance of results:
We found that very few staff members were provided with psychiatric consultation service. A comprehensive support system for job stress might be needed to prevent adjustment disorders, as those are suggested to be the most common psychiatric disorders among staff members in cancer hospitals.
In recent years, the number of the relief efforts has increased, especially after the Marmara and Duzce Earthquakes that occurred in Turkey in 1999. The plight of the relief workers during and after disasters has been a main point of focus in Ministry of Health (MoH) and one of the major fields in disaster management.
Methods:
A questionnaire was developed pertaining to demographic information; range of relief workers'numbers, professions, training experience, and working experience in a disaster; stress factors and symptoms; self-help strategies during the disaster work; and the motivation sources of being a relief worker. This questionnaire was distrubuted to 551 medical rescue workers that participated in the 3rd National Medical Rescue Training and Practicing Programme held in Bursa, Turkey in 2007.
Results:
All the data were analyzed using SPSS Pocket Programme 11.5. The results showed that the ability to train and work under stress are the basic factors of being an adequate relief worker. The major stress factors are taking extreme risks and being an eyewitness to the death or injury of a relief worker.
Conclusions:
A supportive approach for relief workers should be a main component of disaster management. Identifying the expectations of relief workers is extremely important for effectively working in disaster area.