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Biomedical subjects

C Cuthbertson

Publications and source records attributed to C Cuthbertson.

7 recordsLinked to original sources
PubMed2006

Evaluating information on oral contraceptive use: a randomized controlled trial to assess missed pill instructions.

BACKGROUND: Instructions for what women should do when they miss oral contraceptive pills are complex and vary according to the quantity and the timing of missed pills. METHODS: A randomized controlled trial was conducted to assess the comprehensibility of four types of instructions rendered in both 21- and 28-day versions, as well as in graphic and text formats. Interviews were conducted with 864 current and past pill users in Kingston, Jamaica. Each was provided with scenarios of missed pills and one version of the instructions; they were then asked what they should do to avoid pregnancy. RESULTS: More than 60% of respondents knew what to do when one pill was missed, but most did not give correct answers for missing two or more pills in a row, regardless of the instruction type. CONCLUSION: Women generally do a poor job of identifying steps to take when multiple pills are missed. Graphic instructions are easier to understand than text-only instructions and less information is better. Findings suggest that rendering missed pill instructions in graphic format while scaling back on the breadth of medical information results in better comprehension.

Contraceptives, Oral↗
PubMed1981

A five-day ward as part of a comprehensive surgical service.

The role of a five-day ward was examined as part of an audit of the work of a general surgical unit. The four levels of care for elective operations were main ward, five-day ward, major day care, and minor day care. In a prospective study 2000 consecutive patients were followed through their hospital courses from the first referral to the surgical clinic to the postoperative follow-up visit. The aim was to measure the surgical needs of this population and to determine the rates of success or failure in carrying through the planned care. One thousand and forty-five (52%) of the referred patients were put on waiting lists, and of these, 975 (93%) completed their hospital course within the two years of the study. The surgeons chose five-day ward care for 28% of the patients, major and minor day care for 8% and 33% respectively, leaving only 30% who were judged to require care in the main ward. Selections were validated by postoperative interview, which showed that 82% had followed the expected hospital course, and by monitoring deviations from planned care. Four per cent of the five-day ward patients required transfer to the main ward and 3.3% required readmission. Patients managed in the five-day ward were on average younger and the conditions less urgent than those in the main ward. We conclude that a five-day ward can fulfil a large and important part of a general surgical service provided that its function is closely integrated with other parts of the service and that patients are accurately assessed in the outpatient clinic.

Adult↗
PubMed1981

Surgical decision making.

The decision-making process in a general surgical outpatient clinic has been studied by following the course of 2000 consecutive newly referred patients of whom 1045 were put on surgical waiting lists. Surgeons were asked to record their reasons for selection for each of four levels of care: main ward, 5-day ward, day bed unit or minor outpatient surgery. Selections were influenced by social and psychological factors in 12 per cent of patients, the remaining 88 per cent were determined by the medical history or physical condition. The decision was assessed by monitoring the progress in hospital and the outcome at a follow-up clinic. In 84 per cent of patients arrangements had gone according to plan. Eleven (1.75 per cent) of 5-day or day care patients were transferred to a higher level of care and 13 (1.4 per cent) of the total series were re-admitted. Surgeons were asked to forecast the duration of postoperative stay. Thirty-six per cent were discharged on the day forecast, 63 per cent within 24 h and 75 per cent within 48 h. Forecasts of length of stay for hernias and varicose veins were accurate but were usually underestimated for major surgery. It is concluded that for the majority of general surgical patients the selection of the level of care and the forecast of postoperative stay were sufficiently reliable to allow confident and definite advice to be given to the patient and to allow resources to be efficiently used.

Decision Making↗
PubMed1978

Day care after operations for hernia or varicose veins: a controlled trial.

Alternative systems of care after operations for varicose veins or hernia were compared in a total of 360 selected patients, of whom 121 were allocated to be managed in an acute ward for 48 h, 122 in a convalescent hospital for 48 h and 117 to be discharged directly home to the care of the district nursing sister and general practitioner. There were no deaths or major complications. Anaesthetic or surgical problems caused 5 patients (3 convalescent and 2 day care) to be retained in hospital on the day of operation. Minor complications were recorded in approximately one-third of the patients. The majority of these were effectively dealt with by the district nursing sister and only one-third of the complications needed the attention of the general practitioner. Two of the ward patients and 1 of the convalescent patients required readmission to hospital (1 per cent in all). No significant difference was demonstrated in the medical outcome between the three groups after operation. Day care was the most economical of the three systems of care. Inquiry into the patients' opinions elicited the highest proportion of favourable responses in the day care group.

Clinical Trials as Topic↗
PubMed1978

Consumer acceptability of day care after operations for hernia or varicose veins.

The opinions of patients and of caring persons (usually relatives) were sought in this trial of different methods of providing care for 360 patients after operations for hernia or varicose veins. Analysis of patients' opinions suggested that day care was the most acceptable of the three types of care examined. The reactions of caring persons did not reveal any major criticisms or disadvantages.

Aftercare↗