PubMed Health⌕ Search

Biomedical subjects

E J Callahan

Publications and source records attributed to E J Callahan.

9 recordsLinked to original sources
PubMed1991

Development and validation of the Davis Observation Code.

Direct observation has demonstrated considerable power in the reliable and valid measurement of human behavior. A variety of direct methodologies have been applied to physician-patient interactions to answer different types of questions. This study describes the development and evaluation of a 20-item direct observation scale for physician-patient interactions, the Davis Observation Code (DOC). The study compared the rates of occurrence of four key physician behaviors measurable by both direct observation and chart audit: disease prevention, health education, health promotion, and compliance checking. Forty-nine videotaped physician-patient interactions were independently analyzed using the DOC. The medical record of each videotaped encounter was also reviewed. Reliability determined by inter-rater agreement regarding the presence/absence of each was acceptable for both direct observation and chart audit. Rates of occurrence of each target behavior differed between the two methods of review; chart audit consistently yielded lower rates. Nonparametric correlation analyses yielded phi values ranging from .12 to .49, suggesting low concurrent validity. Most of the discordance between the results of the videotaped observation and chart audit involved underreporting in the chart of observed behavior by the physician. Implications of the findings for health care delivery research are discussed.

Communication↗
PubMed1989

Preparation for cesarean delivery: a multicomponent analysis of treatment outcome.

We evaluated the effects of sensory information about cesarean delivery on prenatal maternal anxiety and on recovery subsequent to delivery by cesarean section. The 42 participants were recruited from a population of obstetric patients. Patients were assigned to either treatment or control groups and identified as sensitizers or repressors. Treatment groups viewed a slide/tape program presenting procedures involved in cesarean delivery. Control groups viewed a program presenting neutral information. Prepared patients classified as sensitizers showed less physiologic arousal during surgery and enhanced postsurgical recovery. Physiologic and self-report measures of anxiety indicated that the intervention itself was not a stressful event. The relations among arousal, subjective anxiety, coping styles, and treatment outcome are discussed and recommendations are made for further investigation.

Adaptation, Psychological↗
PubMed1975

Behavioral Effects of Reducing the Daily Frequency of Phenothiazine Administration.

After an 11-day base line of behavioral observations, 24 chronic female schizophrenics were assigned to two groups matched for alertness. In the first treatment phase, the administration of phenothiazine medication of one group was switched from a multiple-dose schedule (three to four times per day) to a single daily administration, while the total dosage per day was held constant. The second group continued on a multiple administration schedule for 11 days and then was switched to a single daily dosage. A multivariate analysis of variance showed that there was no overall effect (positive or negative) due to the schedule change; however, preplanned t tests showed transitory decreases in nonfunctional behavior. The results are discussed in terms of implications for the administration of phenothiazines and the experimental analysis of drug effects.

Adult↗
PubMedDate not supplied

A comparison of initial and established patient encounters using the Davis Observation Code.

BACKGROUND: Previous research has evaluated how communication during medical visits affects patient outcomes such as compliance, recall, and satisfaction. These prior studies generally did not control for new versus established patient visits. The objective of the present research was to explore differences between new and established patient encounters. METHODS: This research studied 62 new patient and 58 established patient encounters to a university-based family practice clinic. The Davis Observation Code was used to code and evaluate the encounters. RESULTS: Established patient encounters were shorter and involved more chatting, counseling, discussions of treatment effects, compliance checking, and requests for specific patient behavior changes regarding health promotion. On the other hand, established patient encounters involved less structuring of the interaction with the patient, less history taking, and fewer discussions regarding family information, smoking, and substance abuse. CONCLUSIONS: The results indicate that what takes place during the medical interview is highly dependent on physician-patient familiarity. Future research on physician-patient interactions should consider whether the interactions represent new or established visits.

Adult↗