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Biomedical subjects

L S Linn

Publications and source records attributed to L S Linn.

At least 73 records · Page 4Linked to original sources
PubMed1981

Physician-patient agreement about depression: notation in medical records.

Medical patients were prescreened for depression; their physicians were given the results of the screening to see if such intervention altered the frequency of the physicians' appropriate notations about depression in the medical record. As part of this study, physicians' and patients' global ratings of patient depression were examined in relation to Zung Self Rating Depression Scales (SDS) Scores and medical record notation. On their initial encounter in a University General Internal Medicine Clinic, physicians and patients were in close agreement about the extent to which patients felt sad or blue, and these global ratings correlated significantly with patients' self-reports on the SDS. In general, physicians tended to rate patients as more depressed than patients rated themselves. However, although medical record notations about depression were highly correlated with patient and physician global ratings of mood and with SDS scores, notations about depression appeared in only about 70% of charts where the physician assessed the patient's mood as being significantly depressed.

California↗
PubMed1980

The effect of screening, sensitization, and feedback on notation of depression.

Medical records of 150 medical ambulatory care patients randomly assigned to groups in which screening for depression, physician sensitization about depression, and informational feedback to physicians were systemically varied were reviewed for physician notations about depression and its treatment. Forty-two percent of the 100 patients screened with the Zung self-rating depression scale had scores outside the normal range. Chart notation about depression was effectively and appropriately increased by feedback and sensitization from 8 to 25 percent, but these procedures were less effective in increasing treatment interventions, which were noted for 12 percent of the entire sample. Physicians responded to patient information about depression presented to them in the format of a laboratory test, and such previsit screening devices may increase physician attention to psychological problems in general medical settings.

Depression↗
PubMed1980

Factors associated with relief from chest pain following emergency care.

A preliminary study was conducted to explore a range of factors that may be associated with relief from chest pain. Nonhospitalized ambulatory patients (N = 150) were interviewed in their homes shortly after seeking care at one of two hospital emergency rooms. Bivariate and multivariate analyses identified four factors positively correlated with symptom relief: whether someone accompanied the patient to the emergency room; whether the patient feared a heart attack or heart problem; whether the patient believed that providers are able to help their patients; and whether the patient was told that he had not had a heart attack. A fifth factor, the number of history and examination items recorded in the medical record, was found to be inversely related to pain relief. It is suggested that in addition to sociodemographic characteristics of patients and measures of medical care process which are frequently studied, social and psychologic factors be considered as important explanatory variables in studies of health status outcomes.

Adult↗
PubMed1980

Factors related to a communication style among medical house staff.

This study reports on some factors related to scores on a recently developed pencil-and paper measure of communication style among physicians in training. High scores on this measure (the Facilitating Response Index) indicate a greater preference by the responded to explore or clarify the thoughts or feelings of the patient in a nondirective, open-ended fashion. Higher scores were attained by physicians who had been exposed to interpersonal skills training, who were evaluated by their teachers as being more clinically competent, who planned to enter private practice sometime to the future and whose patients were less likely to fail to show up for follow-up appointments without first calling to cancel.

California↗
PubMed1979

Attitudes toward self-care among practicing physicians.

Self-care, although growing as a concept and a movement among providers and consumers, has not been studied systematically in any dimension. Because of the potential role of physicians in establishing the credibility and acceptability of self-care interventions and practices, an exploratory investigation was launched to develop an attitude instrument, to describe the degree to which practicing physicians in a community favor self-care, and to explore some of the correlates of the attitudes expressed. A 13-item attitude scale was developed. Physicians with the most favorable attitudes were most likely to have come from a Jewish religious background, to be under 46 years old, to have health beliefs which reflect an internal locus of control, and to be in a group practice or clinic. Physicians with the least favorable attitudes came from Protestant backgrounds, were 46 to 63 years old, had externally controlled health beliefs, and practiced medicine alone.

Activities of Daily Living↗
PubMed1977

The content of care provided by family nurse practitioners.

The content of care provided by 30 graduates of the UCLA Primex (Family Nurse Practitioner) program was examined. An encounter form similar to that used in the National Ambulatory Medical Care Survey was employed to code patients' complaints. These practitioners had been specifically trained to provide care for ambulatory patients. Data were collected one year after the completion of the university didactic phase of the program. We found that Primex practitioners spent more time with patients, more often employed traditional nursing functions, and more often used medical investigative procedures, such as x-rays and laboratory tests than did the physicians in the NAMC survey. Although the types of problems seen varied according to the organizational setting, these nurse practitioners were more often assigned routine health examinations and less often saw certain kinds of acute health care problems than had been anticipated in their training; 116 different types of symptoms or problems were presented, with a total of 1,170 encounters.

Ambulatory Care↗
PubMed1976

Patient acceptance of the family nurse practitioner.

Because of the limitations of published studies concerning patient acceptance of new health professionals and in the absence of published studies of patient acceptance of the family nurse practitioner, the present study compared levels of satisfaction among patients seeing a family nurse practitioner (Primex) with satisfaction levels among patients seeing traditional providers (doctors, nurses) withing the same setting. Based upon 1,912 patient-provider encounters using multiple evaluation criteria in ten ambulatory care settings, it was found that patient satisfaction with the Primex was equal to or more favorable than levels of satisfaction with traditional providers on four out of five measures.

Ambulatory Care↗
PubMed1975

Factors associated with patient evaluation of health care.

The purpose of this paper is to study the relationships among patient characteristics, characteristics of a health care encounter, and patients' evaluation of that encounter. On the basis of 1739 patient-provider encounters in eleven ambulatory care settings, three relatively independent correlates of patient satisfaction were found: age; community satisfaction; and the nature and degree of continuity of care which characterized the visit. Patients' sex, marital status, religion, and the number and kind of services provided were not related to the evaluations patients made. Greatest differences in patient satisfaction were from setting to setting, and these differences probably can be attributed to the types of patients which they recruit or service (i.e., age, level of community satisfaction) and setting policy and procedures regarding continuity of care.

Adolescent↗
PubMed1975

Primex trainees under stress.

In summary, it seems clear from the data presented in this report that nurses engaged in becoming a family nurse practitioner in the program studied undergo a considerable amount of social, physical, and psychological discomfort. However, the data on the first class trained does suggest that the psychological and to a lesser extent the physical stress students experience during formal training subsides during the preceptorship. Nevertheless, it is out contention that certain stressful periods in training cannot be avoided because of the nature and intensity of the course content as well as the role change necessary for becoming a responsible, dicisive practitioner. Yet, experience with training two classes does suggest that although high stress probably cannot be avoided, at least the length of intense periods can be shortened. In order to accomplish this, it is necessary to have a curriculum which is well-organized, clear in its purpose, and one which provides the opportunity for tension-release, discussion and development of role, and emotional support. Finally, with regard to the perisitence of social stress both during and after training, there appears to be a need to provide continued support to students during their preceptorship in order to assure that role change and development continues. In this regard, periodic continuing education sessions for students seem crucial as do discussions of role with both students and preceptors. As the family nurse practitioner role evolves, it becomes increasingly clear that at times these new health professionals are neither doctors or nurses and at other times they are both. However, nurse practitioners cannot meaningfully sustain their new and somewhat ambiguous role without the mutual cooperation and support of both the medical and nursing establishments in which they practice.

Adaptation, Physiological↗