by Prof Dr Ramli Musa under Patient Education November 6 2008
Sebahagian besat pesakit kegagalan buah pinggang, kanser, angin ahmar, SLE dan lain-lain akan mengalami episod kemurungan. Mereka perlu dirujuk kepada pakar psikiatri. Liaison psychiatry adalah perkhidmatan yang ditawarkan untuk pesakit-pesakit serta keluarga yang mengalami masalah kesihatan ini
Liaison Psychiatry is my real passion. Due to this reason, I establish a new expansion of psychiatric services. This is what do we plan as Liaison Psychiatric Clinic in Nephrology Clinic HTAA. Stigma related to Psychiatry is a reality. Yet when we look at the prevalence of psychiatric morbidities particularly among medically ill patients is substantial. 40 to 60% of these patients suffer mostly depression and anxiety disorders. The main focus of Liaison Psychiatry is on the field of oncology and nephrology. This mainly related to the nature of the illnesses in Oncology and Nephrology. Due to stigma, they are not aware the need to have psychological helps from psychiatrists. To minimize the stigma, ideally the delivery of psychiatric services to patients and their families should be at their main setting. Psychiatric care providers should have a step ahead or outreach approach to get out from their comfort zone (psychiatric ward and clinic) to reach these patients.
With the help by Dr Mohd Ramli Seman, the head of department, HTAA Nephrology Unit, this clinic is established.
Medical students may also benefit on the aspect of psychiatric care among medically ill patients.
Running of the Liaison Clinic
The psychiatric clinic is scheduled once a month on every Tuesday second week of the month.
The time of this clinic is between 9 am to 1 pm.
At the beginning, the clinic can accommodate 4-5 new cases per day. Once it is established, 4-5 follow-up cases and 2 new cases will be scheduled per day.
All patients referred must be administered with 2 Psychological forms for depressive and anxiety. They are Depressive, Anxiety and Stress Scale (DASS) and Hospital Anxiety and Depressive Scale (HADS). These questionnaires will help the Nephrology doctors to have an idea on the severity of the depression or anxiety. Both questionnaires have been translated and validated for its Bahasa Malaysia version.
Appointment list must contain patient’s name, medical diagnosis and more importantly the contact number.
One assigned Nephrology staff nurse will be in-charged for the appointment book and oversee the smooth running of the clinic. She will be assisted by a nurse from Department of Psychiatry IIUM (SN Nur Hayati). However during normal psychiatric clinic day SN Nur Hayati will be stationed at Psychiatric Clinic Department of Psychiatry HTAA.
The cancellation of the clinic should be most tried to avoid. In unavoidable circumstances, the cancellation will be done by SN Nur Hayati.
In an ideal situation, 1 medical officer from Nephrology Unit with interest in psychology can attach with me during the clinic to learn on psychological aspect of chronic renal failure patients.
Psychiatric medicines mainly antidepressants will be dispensed at the Hospital Main Pharmacy or Pharmacy of Department of Psychiatry HTAA.
Liaison patients can also be referred to Psychiatric clinic Department of Psychiatry HTAA under my list or to the Private Clinic Indera Mahkota Campus UIA if Liaison clinic cannot accommodate anymore or patients require immediate follow-up for important reasons.
A talk on the topic of “Psychiatric Care among Chronic Renal Failure Patient” and the briefing on the Liaison clinic will be held to give overview to the staff and professional medical providers of Nephrology Unit HTAA.
One collaborative research between Nephrology Unit HTAA and Department Psychiatry on the topic of “Quality of Life and Psychological Disabilities among Chronic Renal Failure Patients” will be conducted.
The clinic day is scheduled as below:
Date 9/12/2008, 13/1/2009, 10/2/2009, March 10/3/2009