Marco Miniotti

Personality and attitudes towards dying patients: An Italian pilot study among medical students

13 said they provided training, only 8 made this compulsory. Six provided a formal qualification in Sign Language or deaf awareness and 10 (63%) offered no formal qualification. Teaching methods included seminars, workshops, role plays and small group work. Time spent in training ranged from 1–2 hours to 6 weeks. Eleven schools involved relevant professionals, including audiologists, hearing advisors, speech and language therapists and staff from local deaf centres. Only one involved Action on Hearing Loss, though 13/16 involved a deaf person as a tutor in training delivery. Deaf awareness training can have a positive effect on patients, healthcare staff and medical students (Steinberg et al. 2006). Whilst such basic training can never result in sign language fluency, and make communication completely straightforward, deaf and hard of hearing people do feel positively about staff receiving training. Lack of expertise can prevent medical schools from running training courses. Six respondents expressed an interest in developing deaf awareness training, stating that information about how to create and run such a course would be useful. Practical guidelines and illustrative course materials have therefore been incorporated in a DVD, available on request to all health educators and also online at www.med.qub.ac.uk/ DeafAwareHealth/index.html. Further research is needed to gauge the effectiveness of training and to elucidate the experiences, attitudes and skills development and retention of students who have completed such training courses.

Attitudes of Medical Students Toward the Care of the Dying in Relation to Personality Traits Harm Avoidance and Self-Directedness Make a Difference

Caring for dying patients requires specific attitudes. Medical students often feel unprepared to cope with issues related to end-of-life care. Little is known about the relationships between personality and attitudes toward the dying; consequently, it is difficult for medical educators to devise training that is best suited to prepare students for practicing palliative medicine. The study aimed to investigate the role of personality in predicting students’ attitudes toward the care of the dying. The study findings suggest a significant link between more self-directed and less harm-avoidant personality profiles and more developed attitudes toward the dying. Personality assessment in medical curricula is important, not merely to help teachers plan tailored training but also to foster in future doctors the propensity to develop a patient-centered practice.

Medical Students Reflections Toward End-of-Life: a Hospice Experience

In this study, we want to investigate the personal reflections toward care of the dying cancer patients among second year medical students. Two hundred fifty second year medical students attended an elective short course on end-of-life care and a brief training at the hospice Valletta, in Turin. After group discussion, the students explained their reflections about their experience. Two different supervisors of the study analyzed themes of the students and subdivided them in categories according to the frequency. The most recurrent themes were symptoms, coping skills, distress, hospice, and insight. Each theme is subdivided in categories. In 95 of 250 transcriptions, students talked about symptom (38%), 60 transcriptions (24%) were focused on coping skills. In 45 transcriptions (18%) students described emotional distress, and in the other 30 (12%) transcriptions, they pinpointed hospice philosophy. Finally, 20 recorded data (8%) were characterized by insight theme. These results have emphasized the need to integrate the clinical training with an experiential training that prepares future doctors for dealing with suffering and death. The qualitative analysis of the reflections showed that the students gained a deep appreciation of the human identity of hospice patients and the relevance of a humanistic approach to care as future physicians.

Harm Avoidance and Self-Directedness Characterize Fibromyalgic Patients and the Symptom Severity

Objective: Evidence in the literature suggests peculiar personality traits for fibromyalgic (FM) patients, and it has been suggested that personality characteristics may be involved in patients’ different symptomatic events and responses to treatment. The aim of the study is to investigate the personality characteristics of Italian FM patients and to explore the possibility of clustering them considering both personality traits and clinical characteristics. Design: The study used a cross-sectional methodology and involved a control group. A self-assessment procedure was used for data gathering. The study included 87 female FM patients and 83 healthy females. Patients were approached and interviewed in person during a psychiatric consultation. Healthy people were recruited from general practices with previous telephone contact. Main Outcome Measures: Participants responded to the Hospital Anxiety and Depression Scale, the Temperament and Character Inventory, the Fibromyalgia Impact Questionnaire and the Short-Form-36 Health Survey. Results: FM patients scored significantly different from healthy participants on the Harm avoidance (HA), Novelty seeking (NS) and Self-directedness (SD). Two clusters were identified: patients in Cluster1 (n = 37) had higher scores on HA and lower scores on RD, SD, and Cooperativeness and reported more serious fibromyalgia and more severe anxious–depressive symptomatology than did patients in Cluster2 (n = 46). Conclusion: This study confirms the presence of certain personality traits in the FM population. In particular, high levels of HA and low levels of SD characterize a subgroup of FM patients with more severe anxious–depressive symptomatology. According to these findings, personality assessment could be useful in the diagnostic process to tailor therapeutic interventions to the personality characteristics.

Emotional distress and health-related quality of life among cutaneous melanoma follow-up outpatients: the role of self-perception of body image and surgical scarring

Figure 1. Nail modifications during chemotherapy treatment. A) Beau lines, onycholysis and subungual hyperkeratosis with fingertip scaling (Grade 2). B) Severe onycholysis with marked thinning and fragility of the nail plate associated with eczematoid changes of the dorsum of the finger (Grade 2). C) Painful haemorrhagic onycholysis and nail plate abnormalities (Grade 2). D) Multiple bands of longitudinal melanonychia in several fingernails. Note the associated bands of transverse leukonychia (Grade 1). E) Paronychia associated with pyogenic granulomas of the proximal and lateral nail folds of the toenails (Grade 2). F) Paronychia and pyogenic granulomas of several fingernails (Grade 3).