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B Estabrook

Publications and source records attributed to B Estabrook.

7 recordsLinked to original sources

Missed opportunities to impact fast response to AMI symptoms.

The potential for reducing cardiovascular disease mortality rates lies both in prevention and treatment. The earlier treatment is administered, the greater the benefit. Thus, duration of time from onset of symptoms of acute myocardial infarction to administration of treatment is important. One major factor contributing to failure to receive efficacious therapy is the delay time from acute myocardial infarction (AMI) symptom onset to hospital arrival. This paper examines the relationship of several factors with regard to intentions to seek care promptly for symptoms of AMI. A random-digit dialed telephone survey (n = 1294) was conducted in 20 communities located in 10 states. People who said they would wait until they were very sure that symptoms were a heart attack were older, reported their insurance did not pay for ambulance services, and reported less confidence in knowing signs and symptoms in themselves. When acknowledging symptoms of a heart attack, African-Americans and people with more than a high school education reported intention to act quickly. No measures of personal health history, nor interaction with primary care physicians or cardiologists were significantly related to intention to act fast. The study confirms the importance of attribution and perceived self-confidence in symptom recognition in care seeking. The lack of significant role of health history (i.e. those with chronic conditions or risk factors) and clinician contact highlights missed opportunities for health care providers to educate and encourage patients about their risk and appropriate action.

Adult↗

Health care providers' perspectives on patient delay for seeking care for symptoms of acute myocardial infarction.

To inform intervention development in a multisite randomized community trial, the Rapid Early Action for Coronary Treatment (REACT) project formative research was undertaken for the purpose of investigating the knowledge, beliefs, perceptions, and usual practice of health care professionals. A total of 24 key informant interviews of cardiologists and emergency physicians and 15 focus groups (91 participants) were conducted in five major geographic regions: Northeast, Northwest, Southeast, Southwest, and Midwest. Transcript analyses revealed that clinicians are somewhat unaware of the empirical evidence related to the problem of patient delay, are concerned about the practice constraints they face, and would benefit from concrete suggestions about how to improve patient education and encourage fast action. Findings provide guidance for selection of educational strategies and messages for health providers as well as patients and the public.

Aged↗

More power to you.

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Clinical Competence↗

Consumer perceptions of dental care in the health services program of an educational institution.

A consumer survey was used to evaluate the University of Massachusetts dental service, a program emphasizing an educational and preventive approach, comprehensive care, and consideration of some prepayment. Attitude and courtesy of staff, explanation of treatment, and the educational approach of the services were favorably assessed by the patients. Those who attended the dental education sessions reported higher levels of satisfaction with the service than those who did not. Mechanisms for financing and the philosophical emphasis on health education seem to have resulted in an extremely successful service.

Age Factors↗

Consumer impact of a Cold Self-Care Center in a prepaid ambulatory care setting.

A Cold Self-Care Center was developed to be an alternative to professional care and to encourage more active involvement of consumers in their own care. A sample of the self-selected user population (n = 74) was studied by comparison with a random sample of plan members (n = 104), and the program was evaluated for cost, consumer satisfaction, and impact on behavior, knowledge and attitudes. Users demonstrated higher levels of knowledge about cold care than non-users, indicated more dependency on professional resources, and differed in health-related attitudes and cold-care behavior. The Cold Self-Care Center appears to have had little impact on self-medication behavior. However, it did affect care-seeking behavior. Knowledge of criteria for seeking professional care was greater than in non-users; 20 per cent sought professional care, and 6 per cent anticipated seeking professional care for future colds. General satisfaction with the program was quite high. Speed and ease of use were cited most often as reasons for satisfaction. The Center also was demonstrated to have a favorable impact on clinic costs. A flexible system which is convenient to use and which retains access to professional care when appropriate both can relieve clinic overload and meet the needs of a large percentage of cold patients.

Common Cold↗