Faculty Bibliography

OBJECTIVE:Aggression from patients and families on health care providers (HCP) is common yet understudied. We measured its prevalence and impact on HCPs in inpatient and outpatient settings. METHODS:Four thousand six hundred seven HCPs employed by a community teaching hospital received an anonymous survey with results analyzed. RESULTS:Of 1609 HCPs (35%) completing the survey, 88% of inpatient staff reported experiencing different types of aggression compared to 82% in outpatient setting. Almost half did not report it to their supervisor. Younger staff were more likely to report abuse. Negative impacts on productivity and patient care were reported. A third of all responders' indicated negative effects on mental health. CONCLUSIONS:Despite negative impacts on staff wellbeing and productivity, patient/family aggression toward HCPs is highly prevalent and underreported. Our healthcare system needs measures to address staff security and wellness.

Living with end stage organ failure and transplantation has implications for physiological, psychological, and social well-being. The development of anxiety or depressive disorders are common with demoralization, another psychological syndrome, a topic of interest in psychiatry. To feel demoralized is to lose hope, courage, or confidence, which upsets normal functioning. While depression may co-exist with demoralization, they are 2 distinct entities, with the former characterized by an inability to experience pleasure and the latter characterized by helplessness and avoidance coping. In an effort to more adequately address the psychological stress in organ transplant patients, it is important to distinguish between demoralization and depression. Demoralization has prognostic implications such as negative disease outcomes such as treatment nonadherence and an increase risk of suicide. Medication for depression is not effective for demoralization syndrome. Therapeutic interventions include cognitive behavioral techniques that focus on exploration of attitudes toward hope and meaning in life.