Izu Nwachukwu - Academia.edu (original) (raw)

Papers by Izu Nwachukwu

JMIR Research Protocols, Apr 17, 2020

Background: Burnout is an increasingly common and insidious phenomenon experienced by workers in ... more Background: Burnout is an increasingly common and insidious phenomenon experienced by workers in many different fields, although it is of particular concern among physicians and trainees due to the nature of their work. It is estimated that one-third of practicing physicians will experience burnout during their career, and this rate is expected to continue to increase. Burnout has significant implications, as it has been identified as a contributor to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide. Objective: This study will evaluate the prevalence and impact of burnout on physicians, residents, and medical students in Alberta. Methods: Quantitative and qualitative data collected through self-administered, anonymous, online questionnaires will be used in this cross-sectional provincial study design. Data collection tools were developed based on published literature and questions from previously validated instruments. The tools capture relevant demographic information, mental health status, and rates of burnout, as well as factors contributing to both burnout and resilience among respondents. We anticipate a sample size of 777 medical students, 959 residents, and 1961 physicians to represent the respective ratios of trainees and practicing physicians in the province of Alberta. Results: Study recruitment will begin in September 2020, with 4 weeks of data collection. The results of this study are anticipated within 12 months from the end of data collection. It is expected that the results will provide an overview of the prevalence of burnout among those training and working in medicine in Alberta, identify contributors to burnout, and help develop interventions aimed at reducing burnout. Conclusions: This study's aim is to examine burnout prevalence and contributing factors among medical trainees and physicians in Alberta. It is expected that the results will identify and examine individual and organizational practices that contribute to burnout and help develop strategies and interventions focused on mitigating burnout and its sequelae.

Trends in drug prescription of young psychiatrists and trainees

Die Psychiatrie, 2009

SummaryA Pan-European group of psychiatric trainees conducted a semi-structured web-based survey ... more SummaryA Pan-European group of psychiatric trainees conducted a semi-structured web-based survey of factors influencing decision-making in relation to antipsychotic, antidepressant and mood stabilizer prescribing. The acceptance of such a survey is in itself a positive result. In the current climate of evidence based medicine and guidelines, preliminary results from this survey suggest that, when asked regarding treatment choice for themselves, psychiatry trainees preferred second-generation atypical antipsychotic medication, based on perceived efficacy. The results for mood stabilisers were less striking. The relevance of this survey, in the context of recent evidence, may relate to trainees’ perceptions as opposed to evidence base.

European Psychiatry

IntroductionBurnout in the medical profession has garnered a lot of attention over the recent yea... more IntroductionBurnout in the medical profession has garnered a lot of attention over the recent years. While it is reported across all specialties and all stages of medical education; resident physicians in particular are at high risk for burnout throughout their years of training.ObjectivesThis study aimed at evaluating the prevalence and correlates of burnout among resident physicians in Alberta.MethodsThrough a descriptive cross-sectional study design, a self-administered questionnaire was used to gather data from resident physicians at two medical schools in Alberta, Canada. Maslach Burnout Inventory was used as an assessment tool. Chi-squared and multivariate binary logistic regression analyses were used.ResultsOverall burnout prevalence among residents was 58.2%. Working more than 80 hours/week (OR= 16.437; 95% CI: 2.059 – 131.225), being dissatisfied (OR= 22.28; 95% CI: 1.75– 283.278) or being neither satisfied nor dissatisfied with a career in medicine [(OR= 23.81; 95% CI: 4.8...

International Journal of Environmental Research and Public Health, Sep 13, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

International Journal of Environmental Research and Public Health, Feb 19, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

International Psychiatry, 2010

Alcohol is widely consumed in many societies. It is estimated to be responsible for 4% of the glo... more Alcohol is widely consumed in many societies. It is estimated to be responsible for 4% of the global disease burden, and is third only to tobacco and hypertension as a leading cause of death in high-income countries. Ireland has one of the highest levels of alcohol use per capita in the world. According to Barnardos (a children's charity) there was a 48% increase in alcohol consumption per capita in Ireland between 1986 and 2006 (Barnardos, 2008). The Irish government endorsed the European Charter on Alcohol in 1995 but, in spite of this, the negative health consequences of alcohol consumption have increased (Mongan et al, 2002). About 28% of all injuries presenting to emergency departments in Ireland are alcohol related (Hope, 2008) and the number of hospital discharges related to alcohol increased by 92% between 1995 and 2002 (Mongan et al, 2002). Hope (2008) found that alcohol was implicated in 36.5% of road traffic fatalities in 2003 in Ireland, and was also a contributory f...

International Psychiatry, 2009

BMC Health Services Research, 2022

Background Individuals discharged from inpatient psychiatry units have the highest readmission ra... more Background Individuals discharged from inpatient psychiatry units have the highest readmission rates of all hospitalized patients. These readmissions are often due to unmet need for mental health care compounded by limited human resources. Reducing the need for hospital admissions by providing alternative effective care will mitigate the strain on the healthcare system and for people with mental illnesses and their relatives. We propose implementation and evaluation of an innovative program which augments Mental Health Peer Support with an evidence-based supportive text messaging program developed using the principles of cognitive behavioral therapy. Methods A pragmatic stepped-wedge cluster-randomized trial, where daily supportive text messages (Text4Support) and mental health peer support are the interventions, will be employed. We anticipate recruiting 10,000 participants at the point of their discharge from 9 acute care psychiatry sites and day hospitals across four cities in Al...

Change management is now considered a core managerial competency. Under the fiscal and regulatory... more Change management is now considered a core managerial competency. Under the fiscal and regulatory environment that currently applies, healthcare managers and professionals must be competent in initiating, guiding and managing change to drive efficient and effective delivery of care. This dissertation describes a successful journey through a planned change effort. An evidence-based approach to monitoring adverse effects of clozapine was implemented in a Community (Adult) Mental health Team. Clozapine has the sole license for treatment-resistant schizophrenia, but has been associated with several potentially life-threatening adverse effects. Accumulating evidence suggests that not enough attention is paid to recognising and addressing these adverse effects, a finding replicated in an internal audit of practice within this service. Additional external regulatory imperatives provided further impetus for change. The change was implemented using the HSE change model as a guiding tool. A r...

Clubhouse Model and Its Impact on Psychiatric Hospitalization in Canada: A Cohort Study

Canadian Journal of Community Mental Health, 2021

We investigated the relationship between membership in an accredited Clubhouse for mental health ... more We investigated the relationship between membership in an accredited Clubhouse for mental health support and psychiatric hospitalization in Canada using linked administrative data. Results show that Clubhouse members were less likely to be hospitalized after enrollment and after longer-term enrollment, and younger members diagnosed with schizophrenia and/or bipolar disorders were at increased risk of hospitalization compared to older members without such diagnoses. These findings provide evidence of the possible benefits of Clubhouses in Canada and the characteristics of members who may benefit from support.

Irish Journal of Psychological Medicine, 2021

Objective: To examine the impact of relationship status on levels of stress, anxiety, and depress... more Objective: To examine the impact of relationship status on levels of stress, anxiety, and depression during the coronavirus (COVID-19) pandemic to identify relationship status groups who are at greater risk of mental health difficulties. Methods: The sample was drawn from individuals who subscribed to the Text4Hope program, a cognitive behavioral therapy inspired text messaging service developed to support Albertans during the COVID-19 pandemic. A survey link was sent to the subscribers to ascertain their relationship status and assess psychopathology using the Perceived Stress Scale-10 (PSS-10), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9). Data analysis was carried out using SPSS-26 for descriptive statistics. Results: Within the first 6 weeks of the pandemic, 8267 of 44·992 subscribers responded to the online survey giving a response rate of 19.4%. Mean scores on the PSS, GAD-7, and PHQ-9 were highest among those who were single an...

The Canadian Journal of Psychiatry, 2020

International Journal of Environmental Research and Public Health, 2020

Background: The spread of COVID-19 along with strict public health measures have resulted in unin... more Background: The spread of COVID-19 along with strict public health measures have resulted in unintended adverse effects, including greater levels of distress, anxiety, and depression. This study examined relative presentations of these psychopathologies in different age groups in a Canadian cohort during the COVID-19 pandemic. Methodology: Participants were subscribers to the Text4Hope program, developed to support Albertans during the COVID-19 pandemic. A survey link was used to gather demographic information and responses on several self-report scales, such as Perceived Stress Scale (PSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9). Results: There were 8267 individuals who completed the survey, giving a response rate of 19.4%. Overall, 909 (11.0%) respondents identified as ≤25 years, 2939 (35.6%) identified as (26–40) years, 3431 (41.5%) identified as (41–60) years, 762 (9.2%) identified as over 60 years, and 226 (2.7%) did not id...

BACKGROUND Burnout is an increasingly common and insidious phenomenon experienced by workers in m... more BACKGROUND Burnout is an increasingly common and insidious phenomenon experienced by workers in many different fields, though is of particular concern amongst physicians and trainees due to the nature of their work. It is estimated that one third of practicing physicians will experience burnout during their career and this rate is expected to continue to increase. Burnout has significant implications, as it has been identified as a contributor to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide. OBJECTIVE This study will evaluate prevalence and impact of burnout on physicians, residents, and medical students. METHODS Quantitative and qualitative data collected through self-administered anonymous online questionnaires will be used in this cross-sectional provincial study design. Data collection tools were developed based on published literature and questions from previously validated instruments. Tools used capture relevant dem...

Irish Journal of Psychological Medicine, 2009

The goal of undertaking postgraduate training in psychiatry is to become a competent specialist, ... more The goal of undertaking postgraduate training in psychiatry is to become a competent specialist, and the educational model under which one is trained and assessed is crucial in achieving this goal. Over the years, traditional training models have emphasised what trainees know, over a given period of time, with outcomes assessed mainly by simple recall of knowledge. While these traditional approaches have met with varying levels of success, they are less than optimal when the goal is to train individuals to perform specific, job-related skills. This recognition has led to a global move towards competency based training models where the focus of training and assessment is the mastery of specific knowledge and skills as well as the conduct of the doctor in day-to-day clinical situations. In this article, a general overview of competency-based training in psychiatry is followed by a review of recent developments in Ireland in a global context.

Irish Journal of Psychological Medicine, 2012

Anorexia Nervosa (AN) has the highest rates of morbidity and mortality of any psychiatric disorde... more Anorexia Nervosa (AN) has the highest rates of morbidity and mortality of any psychiatric disorder. Psychiatrists in Ireland have reported difficulties in managing patients with AN, particularly those with severe levels of illness. This paper explores these management difficulties, including the financial and organisational impediments to service provision, and the legal and ethical dilemmas involved in dealing with those patients who refuse treatment.

Irish Journal of Psychological Medicine, 2011

We report two cases of acute onset and rapid resolution of psychotic symptoms, the first followin... more We report two cases of acute onset and rapid resolution of psychotic symptoms, the first following oral ingestion and the second following intravenous injection of some head shop products (HSPs). Both were associated with autonomic instability and negative results on urine toxicology screening using standard techniques. They highlight the potential dangers of managing such cases in acute stand-alone psychiatric units. Recent advance in characterising some HSPs by toxicology screening is also discussed.

A Cultural Perspective on Psychiatry in Ireland. Barrett E., Nwachukwu I., Ambikapathy A., Poster Presentation. European Federation of Psychiatric Trainees Annual Meeting, Gothenburg, June 2008

Legal Highs”: Case Report on two psychiatric presentations linked with “head shop products

Irish journal of psychological medicine

The challenges of managing severe anorexia nervosa in Ireland

Irish journal of psychological medicine

JMIR Research Protocols, Apr 17, 2020

Background: Burnout is an increasingly common and insidious phenomenon experienced by workers in ... more Background: Burnout is an increasingly common and insidious phenomenon experienced by workers in many different fields, although it is of particular concern among physicians and trainees due to the nature of their work. It is estimated that one-third of practicing physicians will experience burnout during their career, and this rate is expected to continue to increase. Burnout has significant implications, as it has been identified as a contributor to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide. Objective: This study will evaluate the prevalence and impact of burnout on physicians, residents, and medical students in Alberta. Methods: Quantitative and qualitative data collected through self-administered, anonymous, online questionnaires will be used in this cross-sectional provincial study design. Data collection tools were developed based on published literature and questions from previously validated instruments. The tools capture relevant demographic information, mental health status, and rates of burnout, as well as factors contributing to both burnout and resilience among respondents. We anticipate a sample size of 777 medical students, 959 residents, and 1961 physicians to represent the respective ratios of trainees and practicing physicians in the province of Alberta. Results: Study recruitment will begin in September 2020, with 4 weeks of data collection. The results of this study are anticipated within 12 months from the end of data collection. It is expected that the results will provide an overview of the prevalence of burnout among those training and working in medicine in Alberta, identify contributors to burnout, and help develop interventions aimed at reducing burnout. Conclusions: This study's aim is to examine burnout prevalence and contributing factors among medical trainees and physicians in Alberta. It is expected that the results will identify and examine individual and organizational practices that contribute to burnout and help develop strategies and interventions focused on mitigating burnout and its sequelae.

Trends in drug prescription of young psychiatrists and trainees

Die Psychiatrie, 2009

SummaryA Pan-European group of psychiatric trainees conducted a semi-structured web-based survey ... more SummaryA Pan-European group of psychiatric trainees conducted a semi-structured web-based survey of factors influencing decision-making in relation to antipsychotic, antidepressant and mood stabilizer prescribing. The acceptance of such a survey is in itself a positive result. In the current climate of evidence based medicine and guidelines, preliminary results from this survey suggest that, when asked regarding treatment choice for themselves, psychiatry trainees preferred second-generation atypical antipsychotic medication, based on perceived efficacy. The results for mood stabilisers were less striking. The relevance of this survey, in the context of recent evidence, may relate to trainees’ perceptions as opposed to evidence base.

European Psychiatry

IntroductionBurnout in the medical profession has garnered a lot of attention over the recent yea... more IntroductionBurnout in the medical profession has garnered a lot of attention over the recent years. While it is reported across all specialties and all stages of medical education; resident physicians in particular are at high risk for burnout throughout their years of training.ObjectivesThis study aimed at evaluating the prevalence and correlates of burnout among resident physicians in Alberta.MethodsThrough a descriptive cross-sectional study design, a self-administered questionnaire was used to gather data from resident physicians at two medical schools in Alberta, Canada. Maslach Burnout Inventory was used as an assessment tool. Chi-squared and multivariate binary logistic regression analyses were used.ResultsOverall burnout prevalence among residents was 58.2%. Working more than 80 hours/week (OR= 16.437; 95% CI: 2.059 – 131.225), being dissatisfied (OR= 22.28; 95% CI: 1.75– 283.278) or being neither satisfied nor dissatisfied with a career in medicine [(OR= 23.81; 95% CI: 4.8...

International Journal of Environmental Research and Public Health, Sep 13, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

International Journal of Environmental Research and Public Health, Feb 19, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

International Psychiatry, 2010

Alcohol is widely consumed in many societies. It is estimated to be responsible for 4% of the glo... more Alcohol is widely consumed in many societies. It is estimated to be responsible for 4% of the global disease burden, and is third only to tobacco and hypertension as a leading cause of death in high-income countries. Ireland has one of the highest levels of alcohol use per capita in the world. According to Barnardos (a children's charity) there was a 48% increase in alcohol consumption per capita in Ireland between 1986 and 2006 (Barnardos, 2008). The Irish government endorsed the European Charter on Alcohol in 1995 but, in spite of this, the negative health consequences of alcohol consumption have increased (Mongan et al, 2002). About 28% of all injuries presenting to emergency departments in Ireland are alcohol related (Hope, 2008) and the number of hospital discharges related to alcohol increased by 92% between 1995 and 2002 (Mongan et al, 2002). Hope (2008) found that alcohol was implicated in 36.5% of road traffic fatalities in 2003 in Ireland, and was also a contributory f...

International Psychiatry, 2009

BMC Health Services Research, 2022

Background Individuals discharged from inpatient psychiatry units have the highest readmission ra... more Background Individuals discharged from inpatient psychiatry units have the highest readmission rates of all hospitalized patients. These readmissions are often due to unmet need for mental health care compounded by limited human resources. Reducing the need for hospital admissions by providing alternative effective care will mitigate the strain on the healthcare system and for people with mental illnesses and their relatives. We propose implementation and evaluation of an innovative program which augments Mental Health Peer Support with an evidence-based supportive text messaging program developed using the principles of cognitive behavioral therapy. Methods A pragmatic stepped-wedge cluster-randomized trial, where daily supportive text messages (Text4Support) and mental health peer support are the interventions, will be employed. We anticipate recruiting 10,000 participants at the point of their discharge from 9 acute care psychiatry sites and day hospitals across four cities in Al...

Change management is now considered a core managerial competency. Under the fiscal and regulatory... more Change management is now considered a core managerial competency. Under the fiscal and regulatory environment that currently applies, healthcare managers and professionals must be competent in initiating, guiding and managing change to drive efficient and effective delivery of care. This dissertation describes a successful journey through a planned change effort. An evidence-based approach to monitoring adverse effects of clozapine was implemented in a Community (Adult) Mental health Team. Clozapine has the sole license for treatment-resistant schizophrenia, but has been associated with several potentially life-threatening adverse effects. Accumulating evidence suggests that not enough attention is paid to recognising and addressing these adverse effects, a finding replicated in an internal audit of practice within this service. Additional external regulatory imperatives provided further impetus for change. The change was implemented using the HSE change model as a guiding tool. A r...

Clubhouse Model and Its Impact on Psychiatric Hospitalization in Canada: A Cohort Study

Canadian Journal of Community Mental Health, 2021

We investigated the relationship between membership in an accredited Clubhouse for mental health ... more We investigated the relationship between membership in an accredited Clubhouse for mental health support and psychiatric hospitalization in Canada using linked administrative data. Results show that Clubhouse members were less likely to be hospitalized after enrollment and after longer-term enrollment, and younger members diagnosed with schizophrenia and/or bipolar disorders were at increased risk of hospitalization compared to older members without such diagnoses. These findings provide evidence of the possible benefits of Clubhouses in Canada and the characteristics of members who may benefit from support.

Irish Journal of Psychological Medicine, 2021

Objective: To examine the impact of relationship status on levels of stress, anxiety, and depress... more Objective: To examine the impact of relationship status on levels of stress, anxiety, and depression during the coronavirus (COVID-19) pandemic to identify relationship status groups who are at greater risk of mental health difficulties. Methods: The sample was drawn from individuals who subscribed to the Text4Hope program, a cognitive behavioral therapy inspired text messaging service developed to support Albertans during the COVID-19 pandemic. A survey link was sent to the subscribers to ascertain their relationship status and assess psychopathology using the Perceived Stress Scale-10 (PSS-10), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9). Data analysis was carried out using SPSS-26 for descriptive statistics. Results: Within the first 6 weeks of the pandemic, 8267 of 44·992 subscribers responded to the online survey giving a response rate of 19.4%. Mean scores on the PSS, GAD-7, and PHQ-9 were highest among those who were single an...

The Canadian Journal of Psychiatry, 2020

International Journal of Environmental Research and Public Health, 2020

Background: The spread of COVID-19 along with strict public health measures have resulted in unin... more Background: The spread of COVID-19 along with strict public health measures have resulted in unintended adverse effects, including greater levels of distress, anxiety, and depression. This study examined relative presentations of these psychopathologies in different age groups in a Canadian cohort during the COVID-19 pandemic. Methodology: Participants were subscribers to the Text4Hope program, developed to support Albertans during the COVID-19 pandemic. A survey link was used to gather demographic information and responses on several self-report scales, such as Perceived Stress Scale (PSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9). Results: There were 8267 individuals who completed the survey, giving a response rate of 19.4%. Overall, 909 (11.0%) respondents identified as ≤25 years, 2939 (35.6%) identified as (26–40) years, 3431 (41.5%) identified as (41–60) years, 762 (9.2%) identified as over 60 years, and 226 (2.7%) did not id...

BACKGROUND Burnout is an increasingly common and insidious phenomenon experienced by workers in m... more BACKGROUND Burnout is an increasingly common and insidious phenomenon experienced by workers in many different fields, though is of particular concern amongst physicians and trainees due to the nature of their work. It is estimated that one third of practicing physicians will experience burnout during their career and this rate is expected to continue to increase. Burnout has significant implications, as it has been identified as a contributor to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide. OBJECTIVE This study will evaluate prevalence and impact of burnout on physicians, residents, and medical students. METHODS Quantitative and qualitative data collected through self-administered anonymous online questionnaires will be used in this cross-sectional provincial study design. Data collection tools were developed based on published literature and questions from previously validated instruments. Tools used capture relevant dem...

Irish Journal of Psychological Medicine, 2009

The goal of undertaking postgraduate training in psychiatry is to become a competent specialist, ... more The goal of undertaking postgraduate training in psychiatry is to become a competent specialist, and the educational model under which one is trained and assessed is crucial in achieving this goal. Over the years, traditional training models have emphasised what trainees know, over a given period of time, with outcomes assessed mainly by simple recall of knowledge. While these traditional approaches have met with varying levels of success, they are less than optimal when the goal is to train individuals to perform specific, job-related skills. This recognition has led to a global move towards competency based training models where the focus of training and assessment is the mastery of specific knowledge and skills as well as the conduct of the doctor in day-to-day clinical situations. In this article, a general overview of competency-based training in psychiatry is followed by a review of recent developments in Ireland in a global context.

Irish Journal of Psychological Medicine, 2012

Anorexia Nervosa (AN) has the highest rates of morbidity and mortality of any psychiatric disorde... more Anorexia Nervosa (AN) has the highest rates of morbidity and mortality of any psychiatric disorder. Psychiatrists in Ireland have reported difficulties in managing patients with AN, particularly those with severe levels of illness. This paper explores these management difficulties, including the financial and organisational impediments to service provision, and the legal and ethical dilemmas involved in dealing with those patients who refuse treatment.

Irish Journal of Psychological Medicine, 2011

We report two cases of acute onset and rapid resolution of psychotic symptoms, the first followin... more We report two cases of acute onset and rapid resolution of psychotic symptoms, the first following oral ingestion and the second following intravenous injection of some head shop products (HSPs). Both were associated with autonomic instability and negative results on urine toxicology screening using standard techniques. They highlight the potential dangers of managing such cases in acute stand-alone psychiatric units. Recent advance in characterising some HSPs by toxicology screening is also discussed.

A Cultural Perspective on Psychiatry in Ireland. Barrett E., Nwachukwu I., Ambikapathy A., Poster Presentation. European Federation of Psychiatric Trainees Annual Meeting, Gothenburg, June 2008

Legal Highs”: Case Report on two psychiatric presentations linked with “head shop products

Irish journal of psychological medicine

The challenges of managing severe anorexia nervosa in Ireland

Irish journal of psychological medicine