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Biomedical subjects

L B Mauksch

Publications and source records attributed to L B Mauksch.

5 recordsLinked to original sources
PubMed2001

Mental illness, functional impairment, and patient preferences for collaborative care in an uninsured, primary care population.

OBJECTIVE: Our goal was to compare the prevalence of mental illness and its impact on functional status in an indigent uninsured primary care population with a general primary care sample. We also hoped to assess patient preferences about mental health and medical service integration. STUDY DESIGN: We compared a survey of consecutive primary care adults in April and May 1999 with a 1997-98 survey of 3000 general population primary care patients. Both studies used the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire and the 20-question Medical Outcomes Study Short Form. POPULATION: The patients were from a private nonprofit primary care clinic in Grand Junction, Colorado, that served only low-income uninsured people. We approached a total of 589 consecutive patients and enrolled 500 of them. MAIN OUTCOME MEASURE: The main outcomes were the prevalence of psychiatric illnesses and the relationship with functional impairment. We compared our findings with a more generalizable primary care population. RESULTS: This low-income uninsured population had a higher prevalence of 1 or more psychiatric disorders (51% vs 28%): mood disorders (33% vs 16%), anxiety disorders (36% vs 11%), probable alcohol abuse (17% vs 7%), and eating disorders (10% vs 7%). Having psychiatric disorders was associated with lower functional status and more disability days compared with not having mental illness. Patients indicated a preference for mental health providers and medical providers to communicate about their care. CONCLUSIONS: This low-income uninsured primary care population has an extremely high prevalence of mental disorders with impaired function. It may be important in low-income primary care settings to include collaborative care designs to effectively treat common mental disorders, improve functional status, and enhance patient self-care.

Adolescent↗
PubMed1999

Models of collaboration.

For primary care clinicians to address the complex needs of their patient population, they must be able to collaborate with mental health professionals. Collaborative health care represents the creation of a new health care paradigm, and collaborative health care delivery systems mirror the complexities of human suffering. Clinicians from multiple disciplines can combine resources and strategies to share responsibility for their patients and with their patients. A brief review of the history of mind/body split and the resulting professional separatism is followed by sections on the spirit of collaboration, the spectrum of collaboration, key ingredients for effective collaboration, and some thoughts about the future of collaboration. A special practical section on getting started and following through is included.

Communication↗
PubMed1995

Behavioral scientists' views on work environment, roles, and teaching.

BACKGROUND: In earlier years, the majority of behavioral scientists in family medicine were physicians. Recent data suggest that the vast majority now come from disciplines outside of medicine. Little is known about how behavioral scientists view their work environments, which roles and teaching approaches are used most often, and if these variables change among groups with different amounts of experience. METHODS: Data from a survey mailed to 384 family practice residencies addressed four objectives, to: 1) collect behavioral scientists' demographic data, 2) assess behavioral scientists' perceptions of their work environments, 3) measure frequency of use of teaching approaches, and 4) measure frequency of assuming different roles among groups with different amounts of experience. RESULTS: Behavioral scientists from 214 of the 384 surveyed programs responded, for a total response rate of 56%. An additional 15 program directors (4%) reported no behavioral scientist on their faculty. Relative time allocation for various roles was the same in the three experience groups; the most emphasis was placed on consultation and teaching. One-on-one teaching was the teaching modality used most frequently. Case-based teaching was used more in experienced groups. Behavioral scientists felt strongly supported by faculty and moderately supported by residents. CONCLUSIONS: This study's results offer insight into how behavioral scientists spend their time and the teaching approaches they use most frequently. The relationship between behavioral scientists' years of experience and teaching approaches is examined. Behavioral scientists stay in their jobs longer and feel more included than their earlier cohorts in family medicine.

Adult↗
PubMedDate not supplied

Disarming the family ghost: a family of origin experience.

A training method based on family of origin theory was designed to improve health care providers' interactions with difficult patients. The training is divided into five phases. First, leaders introduce participants to basic family of origin issues and the goals and format of the process. Second, participants discuss a difficult case, and, third, construct a family of origin genogram. Fourth, participants analyze the similarities between the two emotional systems. Leaders conclude with a discussion of the symptoms of fusion and develop strategies to avoid fusion during the therapeutic process. Within each phase, leaders present case examples and the participants in dyads proceed through the same process. By going through this process, participants will be better able to understand how family of origin dynamics affect the care they provide patients and why certain patients often prove to be difficult cases.

Family↗