Biomedical subjects

L J Nesvacil

Publications and source records attributed to L J Nesvacil.

3 recordsLinked to original sources

PubMed1997

Premature ejaculation: a psychophysiological review.

This review examines the most common male sexual dysfunction, premature ejaculation (PE). The prevalence, classification, neurophysiology, neuropharmacology, and psychological studies that offer evidence useful for understanding and clinically evaluating PE are reviewed. It is proposed that there are two basic kinds of PE: biogenic and psychogenic. Studies reporting pharmacological aspects of ejaculation offer some suggestions regarding the mechanisms of ejaculation as well as possible pharmacologic aid for some premature ejaculators. The traditional assumption among sex therapists that PE is almost universally caused by psychological features, and easily treated with sex therapy behavioral techniques, is drawn into question. Based on the limited available results from systematic investigations, behavioral treatments for PE remain beneficial to only a minority of men three years after treatment ends, suggesting that this male dysfunction is difficult to treat effectively. The mediocre results reported in treatment outcome studies may be due, in part, to reports on heterogeneous groups of premature ejaculators, for whom treatment has been generalized rather than targeted to the specific type of PE. We propose a biological and psychological etiology. With more discriminating assessment and more specific diagnosis of PE, and with treatment designed to address the particular type of PE, long-term outcome should improve for this common sexual dysfunction.

Antidepressive Agents↗

PubMed1989

Patient education by a family nurse as a model for training residents.

There is need for a practical model of patient education in the primary care setting that can also be used as a method for teaching primary care residents about patient education. This project modified a previously established and well-defined role for a family nurse in order to provide such a patient care-based learning experience for a family practice residency. Evaluation of the 18 month project showed that an average of 72 patient visits per month with charges of $482 were provided by this nurse at the same time that she was undertaking many improvements in the residency clinic's patient education system. Before and after surveys of the clinic staff and residents showed a rise in their perception of the quality of patient education (11% and 25% respectively thought it good or outstanding before, while 90% and 100% did so at the end of the project). There was also an increase in the residents' perceptions of having good personal patient education knowledge (from 50% to 88%) and skills (from 70% to 82%). The residents agreed that the family nurse role had been very valuable (76%) and that they would be interested (35%) or very interested (53%) in having such a person in their future practice, since it appeared to them to be cost-effective (69%). This model appears to be a feasible and acceptable way to deliver and teach patient education.

Cost-Benefit Analysis↗

PubMedDate not supplied

Differences and similarities between patient and physician perceptions of patient pain.

A reasonably accurate perception of pain severity by physicians can be a useful tool in effectively managing acute pain. This study measured the similarities and differences between patient and physician ratings of patient pain through the use of a linear analogue scale of pain severity. A total of 401 patients presenting with acute pain of up to seven days' duration were studied. Data were gathered from patients presenting to the seven family practice clinics associated with the Department of Family Practice and Community Health at the University of Minnesota. Whereas the physician mean rating of patient pain was found to be significantly lower than the patient mean rating (3.52 vs. 4.37, P = 0.001), raw ratings by physicians and patients were found to have a relatively strong and significant correlation (R = 0.66, P = 0.001). The difference in mean ratings between patients and physicians remained the same regardless of physician or patient gender, patient age, whether or not a diagnosis was made, organ system category in which the pain was located, or training level of physician. The physician mean ratings were always significantly lower than the patient mean ratings, and there was no significant difference in the mean differences in ratings among the subgroups compared.

Acute Disease↗