Karki Utkarsh, Rai Yugesh, Dhonju Gunjan, Sharma Eesha, Jacob Preeti, Kommu John Vijay Sagar, Seshadri Shekhar P
1Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India.
Essex Partnership University NHS Trust, Colchester, UK.
Child Adolesc Psychiatry Ment Health. 2020 Apr 6;14:13. doi: 10.1186/s13034-020-00319-5. eCollection 2020.
Nepal is a developing low-income country in Southeast Asia. There is a huge burden of child and adolescent mental health (CAMH) in Nepal which has a population of around 29 million and 40-50% of the population comprises of children and adolescents. Child and Adolescent Psychiatry (CAP) has not been formally recognized as a subspecialty in Nepal and there is no standardized curriculum for CAP training. The objectives of the survey were to identify the current status of training, shortfalls and to explore the training experiences of early career psychiatrists (ECPs) in Nepal.
The participants were ECPs in Nepal. An online questionnaire was created consisting of 20 questions including 3 questions requiring an answer indicating a level of agreement scored on a ten-point scale. Questionnaire using google form was e-mailed with the uniform resource locator (URL). Respondents anonymously answered the questions. The survey was open from 01/01/2019 to 01/04/2019.
Response rate was 83.69%. Around 42% (n = 32) were trainees in Doctor of Medicine (MD) Psychiatry and 58% (n = 45) of respondents had completed their MD Psychiatry. More than half of the ECPs had not received formal training specific to CAP. Seventy percent (n = 54) ECPs reported that their current workplace did not have a specific unit to address psychological problems in children and adolescents. However, 62% (n = 48) of ECPs came across 10 CAP cases per week. On a ten-point scale, mean score of ECPs confidence in diagnosing, management and overall confidence in CAP cases were 5.18 ± 1.56, 4.58 ± 1.59 and 4.67 ± 1.62 respectively. Fifty-four percent (n = 42) of respondents rated their training as limited and 74% (n = 57) of them wanted additional training in CAP. Psychological intervention, psychotherapy and a fellowship course were the additional training most of the ECPs wanted to receive.
Despite significant exposure to CAP patients in daily practice, ECPs self-evaluated their training as inadequate and there is no standardized CAP training program in Nepal for ECPs. The desire of ECPs to receive additional training in CAP is highly encouraging and positive. We advocate for the development and incorporation of CAP training in current psychiatry training to fulfill these unmet training needs in Nepal.
尼泊尔是东南亚的一个发展中低收入国家。尼泊尔约有2900万人口，其中儿童和青少年占40 - 50%，儿童和青少年心理健康（CAMH）负担沉重。儿童和青少年精神病学（CAP）在尼泊尔尚未被正式承认为一个亚专业，且没有CAP培训的标准化课程。该调查的目的是确定培训的现状、不足，并探索尼泊尔早期职业精神科医生（ECP）的培训经历。
参与者为尼泊尔的早期职业精神科医生。创建了一份包含20个问题的在线问卷，其中3个问题要求回答表明在十分制量表上的同意程度。使用谷歌表单的问卷通过统一资源定位符（URL）通过电子邮件发送。受访者匿名回答问题。调查于2019年1月1日至2019年4月1日开放。
回复率为83.69%。约42%（n = 32）是医学博士（MD）精神病学专业的学员，58%（n = 45）的受访者已完成MD精神病学专业学习。超过一半的早期职业精神科医生未接受过特定于CAP的正规培训。70%（n = 54）的早期职业精神科医生报告称其当前工作场所没有专门处理儿童和青少年心理问题的单位。然而，62%（n = 48）的早期职业精神科医生每周会遇到10例CAP病例。在十分制量表上，早期职业精神科医生对CAP病例的诊断信心、管理信心及总体信心的平均得分分别为5.18±1.56、4.58±1.59和4.67±1.62。54%（n = 42）的受访者认为他们的培训有限，74%（n = 57）的人希望接受CAP方面的额外培训。心理干预、心理治疗和进修课程是大多数早期职业精神科医生希望接受的额外培训。
尽管早期职业精神科医生在日常实践中大量接触CAP患者，但他们自我评估培训不足，且尼泊尔没有针对早期职业精神科医生的标准化CAP培训项目。早期职业精神科医生希望接受CAP额外培训的愿望非常令人鼓舞且积极。我们主张在当前的精神病学培训中开发并纳入CAP培训，以满足尼泊尔这些未得到满足的培训需求。
