4 results
Development of ethical competences in mental health and psychiatry: simulation with nursing students
- R. Lopes, I. Moreira, M. Neves, C. Brás, R. Rodrigues
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S878-S879
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Introduction
Simulation as a pedagogical strategy contributes to improving the acquisition, consolidation and retention of knowledge and is very attractive for students.
In simulation learning, students come into contact with real clinical practices, allowing them to develop personal, psychosocial, ethical and clinical skills, facilitating learning for decision-making.
The creation of different and complex simulation scenarios within the scope of Mental Health and Psychiatry (MHP) allows the empowerment of nursing students, through the anticipation and prevention of errors and the creation of training opportunities, which culminate in the development of critical thinking and reflective on the ethical dimension of caring for people experiencing mental illness.
ObjectivesTo analyze the simulation as a strategy to develop ethical competences in MHP; To reflect on respect for autonomy, capacity for self-determination and dignity of the person; To reflect on care practices that promote respect and dignity for people experiencing mental illness.
MethodsAfter the careful design of the situation simulation scenario in MHP, the steps are as follows:
Prebriefing - transmit generic information about the scenario to the participants/students; request the participation of some students to assume the role of actors in the context they will encounter and prepare to start the case; explain to observers what will happen and the goals of the scenario.
- Scenario development.
- Debriefing - ask observers to analyse and reflect on positive aspects of performance; lead participants to analyse and reflect on their actions; investigate the basis of gaps/errors.
- Reflection - facilitating students’ structured thinking (reflection-in-action and reflection-on-action); review learning.
- Assessment - focus group interview; observation and/or filming.
ResultsThe evaluation revealed that the use of a simulation scenario allows the connection between the theoretical contents of ethics (principles, dignity of the person, human rights, informed consent, …) with what they saw and experienced in the scenario; facilitates understanding of concepts, helps to internalize knowledge and retain information; favors reflection, development of critical thinking through discussion and argumentation; makes it easier to understand the relationship between the subject taught and reality; and the discussion of the situation helped to structure the thought.
The diversity of scenarios is interesting and useful, it allows understanding the different role of nurses in the hospital context and in the context of primary care.
ConclusionsIt is concluded that the use of a simulation scenario in MHP is of great interest and usefulness for the development of ethical competences, allowing reflection on care practices that promote respect and dignity of the person with experience of mental illness.
Disclosure of InterestNone Declared
A Challenging Sexsomnia Seen as a Deceptive Case of Depression
- J. Brás, M. Meira e Cruz, C. Teixeira, R. Andrade, A. P. Costa
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1103
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Introduction
Sleep related sexual behaviors or sexsomnias are unconscious behavioral activities that occur during sleep (e.g. parasomnias). Behaviors could range from sexual vocalizations, orgasms, sexualized movements, masturbation, or full sexual intercourse with a subsequent amnesia. Early epidemiological studies showed a prevalence of 7.1%, with a male predominance. While intended as a rare condition, leads to important physical and psychological consequences for both the patient and their bed partner. For our knowledge this is the first case of sexsomnia reported in Portugal.
ObjectivesTo report the clinical and psychosocial impact of a Sexsomnia case in a young woman which was misdiagnosed with depression.
MethodsPatient´s clinical files consultation and literature review using Pubmedâ and the keywords: sexsomnia.
ResultsA 18-year-old female referred to a psychiatric consultation to be assessed and treated from a diagnostic of depressive disorder. This was a young woman with a previous history of sleepwalking during childhood, with no recurrent episodes since adolescence. A familiar positive history for sleepwalking was confirmed (mother). She reported the beginning of her sleep related sexual behavior six months before the consultation, conflicting with the moment in which she started pharmacological therapy for Chron Disease, diagnosed at that time.
After she slept with her boyfriend, she was told by him about the recurrence of masturbatory activity during sleep. These episodes were told to occur as often as 1 to 2 times a night, shortly after falling asleep, with posterior amnesia for the event.
As for medical or psychiatric history, only Chron’s disease is highlighted, being under control with azathioprine. Likewise, he took 1mg of melatonin/night.
Pittsburgh Sleep Quality Index at presentation was 7/21 and the STOP-Bang questionnaire revealed a low risk of Obstructive Sleep Apnea.
A Type I Polysomnographic study was performed revealing decreased sleep efficiency and fragmented sleep presenting an alternating cyclic pattern. The existence of significant respiratory events during sleep, as well as periodic movements, was excluded.
Cognitive behavioral therapy by means of highlighting the need of improvement on sleep hygiene measures was prescribed and the dose of melatonin was increased up to 3mg. Despite the good clinical response, the patient discontinued the melatonin treatment mainly due to familiar and personal reasons and failed to comply with the prescribed hygienic measures, with a further worsening of the clinical condition.
ConclusionsThis particularly challenging case representing the emerging medicolegal issues and psychosocial aspects related with the still poorly understood sleep disorders like sexomnia, shows up how much awareness is required from psychiatric team members to better assist and refer patients, promoting both an assertive diagnostic and an effective management.
Disclosure of InterestNone Declared
Sleep Quality in Medical Students of a Portuguese University: a cross-sectional Study
- R. Gonzaga, J. Brás, A. P. Costa, C. Peixoto, J. Fialho
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S266
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Introduction
Sleep is a complex physiological process present in all living beings, performing essential functions for various biological functions. The prevalence of sleep disorders has increased exponentially, as well as studies relating to sleep patterns of the general population.
University students are especially vulnerable to a decrease in sleep quality, particularly medical students. Even so, the literature on sleep quality in medical students is scarce, especially when referring to Portugal, where studies are almost non-existent.
ObjectivesTo evaluate sleep quality in medical students and to analyze the differences in sleep quality according to age, sex, cohabitation and physical activity. It is also intended to compare the sleep quality of medical students throughout the various phases of the medical course.
MethodsThis is a cross-sectional study involving medical students at the University of Beira Interior, Covilhã, Portugal. All medical students were invited to complete the Pittsburgh Sleep Quality Index (PSQI), which has been validated for the portuguese population. First, the scores obtained in each of the components of the PSQI and the global PSQI score were analyzed for the global population. Lastly, the global PSQI score was correlated with each of the sociodemographic variables to verify the existence of a statistically significant relationship.
Results296 students completed the instrument. Of these, 62.2% classify their sleep quality as good; 42.4% scored 2 in the sleep latency component; 50% reported sleeping 6 to 7 hours; 73.9% stated an adequate sleep efficiency; 85.5% mentioned few or no sleep disturbances; 83,8% said they never used sleep medication; and 60.8% had low or no sleepiness or daytime dysfunction.
As for the overall PSQI score, 72.6% of the students had a score greater than 5, indicating a poor quality of sleep. 74.7% of female respondents have a low quality of sleep, as well as 67.7% of male respondents. Likewise, 91.3% of students who live alone have poor sleep quality, as well as 76.8% of those living with family members and 69.8% of those living with colleagues.
Regarding the course year, 82.4% of the first-year students report a poor quality of sleep, as well as 77.5% of the second-year students, 72.1% of the third-year students, 77.8% of the fourth-year, 65.8% of the fifth-year students and 71.4% of the sixth-year students.
ConclusionsMedical students seem to be more likely to have poor sleep quality, especially when compared to other university students. Thus, further studies are needed to prove this susceptibility as well as therapeutic interventions aimed at improving sleep parameters.
Disclosure of InterestNone Declared
2005 – Sexual Dysfunction In Patients With Schizophrenia Treated With Antipsychotics
- C. Mendonça, A. Brás
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- Journal:
- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E1228
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Introduction
The relationship between sexuality and schizophrenia is complex. The prevalence of sexual dysfunctions is higher in persons with mental disorders and may be related to both the psychopathology and the pharmacotherapy. On one hand the negative symptoms of schizophrenia limit the capability for interpersonal and sexual relationships; on the other hand several mechanisms can cause sexual dysfunction during antipsychotic therapy. Although it is a troublesome side effect, information on antipsychotic-induced sexual dysfunction is limited. The aim of this study was to evaluate the sexual dysfunction and its impact in patients with a psychotic disorder treated with various antipsychotics under routine clinical conditions.
MethodsSubjects included were sexually active male and female patients 18 years of age or older with the diagnosis of Schizophrenia, Schizophreniform disorder, Schizoaffective disorder or other psychotic disorder. In addition to sexual functioning, was recorded demographic data, psychiatric diagnosis and medication history. The instrument of evaluation used was the Pyschotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SalSex).
ResultsAll the analyses were performed in the 101 evaluable patients. Most patients were males (76%) and the most common diagnosis was Schizophrenia.Overall, the patients exhibited sexual dysfunction according to the assessment with the SalSex. Among the patients exhibiting sexual dysfunction, a third reported to have poor tolerance to the disturbance.
ConclusionsSexual dysfunction is very common in patients receiving long-term treatment with antipsychotics and it is associated with a great impact in a substantial proportion of patients.