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Biomedical subjects

G R Parkerson

Publications and source records attributed to G R Parkerson.

18 recordsLinked to original sources
PubMed1992

Quality of life and functional health of primary care patients.

Quality of life and functional health were measured cross-sectionally for 314 adult ambulatory primary care patients in a rural clinic and found to be much better for patients with low severity of illness who required no confinement to home because of health problems, than for patients with high severity of illness who required confinement. Severity of illness was the strongest predictor for patient-reported physical health function and for patient quality of life when assessed by the health provider. Confinement was the strongest predictor for patient quality of life when assessed by the patient. There was very little agreement between patient-assessed and provider-assessed quality of life. Family stress was the strongest predictor of function in terms of mental health, social health, general health, self-esteem, anxiety, and depression. These data suggest that clinicians should direct increased attention to patient-assessed quality of life, patient-reported functional health status, and psychosocial factors such as family stress in an effort to improve medical outcomes.

Activities of Daily Living↗
PubMed1991

Development of the 17-item Duke Health Profile.

The 17-item Duke Health Profile (DUKE) was developed as a refined version of the 63-item Duke-UNC Health Profile (DUHP) using a methodology based upon a balanced clinical and statistical rationale. The result is a brief, valid functional health measure with 10 scales that compares well with the MOS Short-form and the COOP Charts. In addition to the five constructs (ambulation, emotional symptoms, activities with friends or relatives, health perception, and pain) which are measured by all three of the instruments, the DUKE quantitates cognition, social self-esteem, confinement, and somatic symptoms other than pain.

Adult↗
PubMed1991

Validation of the Duke Social Support and Stress Scale.

The Duke Social Support and Stress Scale (DUSOCS) was validated in 249 adult family practice patients using the Family Strengths, the Family Inventory of Life Events, and the Duke Health Profile (DUKE) as comparison instruments. Validity was supported in that the DUSOCS family support measure had the clinically expected positive associations with DUKE health measures (regression coefficients of +7.4 to +18.7) and negative associations with DUKE anxiety and depression measures (-2.0 to -17.2). DUSOCS family stress had negative associations with the health measures (-11.6 to -34.5) and positive associations with anxiety and depression (+18.9 to +32.1). Family and non-family stress contributed more than severity of illness to elevated levels of anxiety and depression and lowered levels of mental health, social health, and self-esteem, while these same stresses contributed only half as much as severity of illness to lowered physical health.

Adolescent↗
PubMed1990

The health status and life satisfaction of first-year medical students.

The self-reported health status and life satisfaction of 286 first-year Duke University medical students in four consecutive classes were measured at the beginning and end of the school year and compared statistically with relevant sociodemographic and behavioral factors. Health status, quantitated in terms of Duke Health Profile scores, was generally lower for women than for men. Although there was a definite trend of worsening along all parameters of health and satisfaction during the year for both women and men, the most marked change was the increase in depressive symptoms. The students who were very satisfied with life had fewer symptoms of depression and anxiety; higher self-esteem, better physical, mental, and social health; stronger social ties; more physical activity; more sleep; and fewer stressful life events. Strong social ties was the factor most positively related to better health and life satisfaction.

Depressive Disorder↗
PubMed1990

The Duke Health Profile. A 17-item measure of health and dysfunction.

The Duke Health Profile (DUKE) is a 17-item generic self-report instrument containing six health measures (physical, mental, social, general, perceived health, and self-esteem), and four dysfunction measures (anxiety, depression, pain, and disability). Items were derived from the 63-item Duke-UNC Health Profile, based upon face validity and item-remainder correlations. The study population included 683 primary care adult patients. Reliability was supported by Cronbach's alphas (0.55 to 0.78) and test-retest correlations (0.30 to 0.78). Convergent and discriminant validity were demonstrated by score correlations between the DUKE and the Sickness Impact Profile, the Tennessee Self-Concept Scale, and the Zung Self-Rating Depression Scale. Clinical validity was supported by differences between the health scores of patients with clinically different health problems. Patients with painful physical problems had a DUKE physical health mean score of 58.1, while patients with only health maintenance problems had a mean score of 83.9 (scale: 0.0 = poorest health and 100.0 = best health). Patients with mental health problems had a DUKE mental health mean score of 49.2, in contrast to 75.7 for patients with painful physical problems and 79.2 for those with health maintenance. The DUKE is presented as a brief technique for measuring health as an outcome of medical intervention and health promotion.

Adolescent↗
PubMed1989

Associations among family support, family stress, and personal functional health status.

The self-reported family support and stress of 249 ambulatory adult patients, aged 18-49 years, were studied relative to their self-reported functional health. Support from family members was found to be related positively with emotional function. Stress from family members was associated negatively with symptom status, physical function, and emotional function. Patients' severity of illness was related negatively to their symptom status, physical function, and social function, but not to their emotional function. During the study a new self-report instrument, the Duke Social Support and Stress Scale (DUSOCS), was developed to measure family and non-family support and stress. Also, a new chart audit methodology, the Duke Severity of Illness Scale (DUSOI), was designed to assess severity in the ambulatory setting. Reliability and validity of the DUSOCS and the DUSOI were supported. The importance of the patient's perception of health and its family determinants is emphasized.

Adolescent↗
PubMed1989

The effect of a telephone family assessment intervention on the functional health of patients with elevated family stress.

A randomized trial of a telephone family assessment intervention was conducted during a 2.5 month period on 224 ambulatory primary care patients, aged 18-49 years, who were selected according to self-report of elevated family stress levels. Family physicians conducted telephone interviews to collect information from patients on their supportive and stressful family members. The working hypothesis was that this process would lead to reduction in the patient's family stress and to improvement in family support and personal health status. Patients reported that the intervention caused them to think about their family support and helped them to feel better. Comparison of family factor and functional health scores before and after intervention also indicated a limited beneficial effect, but only for a small subset of black patients. These results suggest that the telephone family assessment alone is inadequate as an intervention and should be strengthened to include professional assistance to patients for the family problems that are identified by the assessment.

Adult↗
PubMed1979

Clinical experience of medical students with primary care career goals.

Two medical students with primary care career goals, in a medical school based at a university medical center, recorded demographic and medical problem information from their patients. They saw a total of 3,391 problems in 2,265 different patients, resulting in a clinical experience similar to that of students from a medical school not based at a university medical center and residents in two family medicine residency training sites. Almost 62.0 percent of problem contacts were seen outside of the medical center hospital, 66.7 percent on ambulatory patients, and 47.3 percent on non-credit rotations, reflecting the intensity of their personal motivation, the support of faculty with primary care backgrounds, and the flexibility of a clinical curriculum offering 50 percent electives. The study demonstrates that it is possible for students in a university medical center to obtain clinical experience with patient problems of the type encountered in the community.

Academic Medical Centers↗
PubMed1978

Labstand: a computerized system for reporting clinical laboratory data in standard units.

A computerized system, Labstand, is described which was developed to simplify the presentation of laboratory data for the clinician. It converts data into standard units (su) on a scale of 0 to 100, identical for all tests. Conversions are based on both normal and abnormal ranges, determined from clinical experience, to allow both immediate recognition of abnormality and estimation of the degree of abnormality. This paper reports the findings of a study using this system which involved 1,412 abnormal laboratory results. Overall, both recognition and follow-up rates were higher when Labstand was used, but not to a statistically significant level. However, significantly higher follow-up rates were found when Labstand was used by residents with lower than average Internal Medicine National Board scores. In contrast, follow-up was higher when normal range laboratory reports were used by residents with higher than average scores. These findings seem consistent with the fact that use of Labstand requires minimal knowledge of ranges and biological measurement units and may indicate that the lower scoring residents have a greater need for such a new system than do the higher scoring residents.

Clinical Laboratory Techniques↗
PubMed1978

Determinants of physician recognition and follow-up of abnormal laboratory values.

Potential determinants of physician recognition and follow-up of abnormal laboratory values were studied in the ambulatory primary care setting. Data support the hypothesis that a significant positive association exists between the clinical importance of a laboratory result and physician response. Clinical importance was indicated by degree of abnormality of the laboratory value, the type of test, and the indication for obtaining the test. Response was not significantly associated with type of laboratory report or resident's year of training, but a relationship was shown with resident's National Board scores. A model of 12 laboratory tests was found to be more appropriate for studying recognition and follow-up than one of 30 because of fewer repetitious tests and fewer results of doubtful clinical usefulness. With such a select model, recognition and follow-up of abnormals can be used as process measures of quality of medical care.

Adolescent↗
PubMed1978

Cost analysis of laboratory tests in ambulatory primary care.

The cost of laboratory tests in the ambulatory primary care setting was analyzed to study relationships among cost to the patient, degree of abnormality of results, and physician follow-up of abnormal results. Laboratory fees constituted 32 cents of the total dollar for office charges. Considering only that portion of patient money spent for laboratory blood tests, 20 cents of the dollar went for tests with normal results, 25 cent for abnormals that were followed up by physicians, and 55 cents for abnormals that were not followed up. Separate analysis including only the abnormals was performed using two methods that differed as to whether or not low degree abnormals were considered worthy follow-up. Even when considering follow-up of this group unnecessary, 30 cents of the patient's dollar for abnormals was spent on appreciably high abnormal tests that were not followed up. This represents a substantial cost to the patient, from which no benefit can be envisioned.

Ambulatory Care↗