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E Phipps

Publications and source records attributed to E Phipps.

10 recordsLinked to original sources

How gastroenterologists inform patients of results after lower endoscopy.

OBJECTIVE: Little is known about how gastroenterologists communicate endoscopic findings and biopsy results to their patients. We sought to determine the factors that may influence this behavior. METHODS: A survey questionnaire was developed and mailed to the 80 members of the Delaware Valley Society for GI Endoscopy. Information was obtained on the demographic characteristics and responses to six case vignettes prepared to examine communication patterns. We determined possible influences of conscious sedation and the benignity or severity of findings on communication practices. RESULTS: Sixty-one surveys (76%) were completed and analyzed. Endoscopists immediately inform patients of normal results. For abnormal results, 92% would immediately inform nonsedated patients versus 79% that would inform sedated patients (p < 0.008). Analysis of responses to the case vignettes indicated that 82% of endoscopists would immediately reassure the patient about a benign appearing (< 1 cm) polyp, but only 70% would do so for a polyp > 2 cm (p < 0.01). In contrast, when presented with a frank malignancy, 94% would inform the patient. Eighty-four percent of endoscopists would telephone results of a benign pathology report, but only 34% would telephone report a dysplastic lesion (p < 0.001). There was no correlation between the response rate and various demographic parameters such as physician age, type of, or length of time in practice. CONCLUSIONS: Gastroenterologists usually report normal findings immediately, but are less likely to do so after use of sedation or encountering abnormal findings. Most of those surveyed would use the telephone to communicate abnormal findings.

Adult↗

Setting the referral process in motion: a case study with teaching objectives.

Pediatric collaboration with mental health professionals is necessary due to the high prevalence of behavioral and emotional disorders in this population. Clinicians frequently encounter parental resistance to acceptance and follow-through on recommended mental health services. In addition, physicians may have difficulty recognizing and referring psychosocial problems due to inadequate training or experience. The case presented of a 10-year-old girl with enuresis illustrates the process of referring a patient with a behavioral problem from a general pediatrician to a mental health specialist. The behavioral pediatrician plays a critical role in providing linkage between medical and psychosocial care.

Child↗

A pilot study of cancer knowledge and screening behaviors of Vietnamese and Cambodian women.

Breast and cervix cancer screening behaviors, while suboptimal in all Americans, are of particular concern in minority females. Little is known about cancer knowledge and screening behavior in Southeast Asian populations in the United States. We interviewed 38 Southeast Asian women of Cambodian or Vietnamese origin living in the Philadelphia, Pennsylvania, area. A telephone interview was conducted by bilingual/bicultural interviewers. Seventy-one percent (95% confidence interval [CI], 54% to 85%) of women in the study did not know what cancer was and 74% were unable to identify a cancer prevention strategy. Greater knowledge about cancer and identification of preventive measures were associated with employment outside the home, more years of education, and age, but not with length of time in the United States. Cancer education programs need to identify the patient's level of knowledge about cancer, elicit and respectfully address beliefs about causality and prevention, and ensure that health information is provided in a language understandable to the patient.

Adult↗

Physician-patient power struggles: their role in noncompliance.

Physicians have tended to label the patient who doesn't follow their advice as resistant and noncompliant. However, compliance studies have not identified the physician's sometimes unwitting complicity in the noncompliance. Some physician-patient partnerships are marked by an intensifying power struggle which may have more to do with the emotional needs of each party than with the specific content around which the struggle is focused. This article discusses how these power struggles can be activated and what the physician can do to defuse the struggle and work effectively with noncompliant patients.

Humans↗