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Biomedical subjects

M C Gutmann

Publications and source records attributed to M C Gutmann.

8 recordsLinked to original sources
PubMed1999

Ethnicity, alcohol, and acculturation.

In the social and behavioral sciences there is a strong correlation alleged between alcohol abuse and ethnonational origins. Changes in drinking patterns and problem drinking among immigrants to the United States are often mistakenly attributed to acculturation, just as the etiology of alcohol abuse and alcoholism is often erroneously traced to the 'ethnic origins' of these men and women. In addition, and for the same reasons, researchers and practitioners may have thus unwittingly influenced the perceptions and understandings of this population with respect to the relationship between particular ethnic groups and alcohol consumption. This paper summarizes how the term acculturation has been employed recently in alcohol studies. Preliminary findings are reported from ethnographic fieldwork with Latin America-born men in the San Francisco Bay Area.

Acculturation↗
PubMed1990

Have you been taking your pills? The adherence-monitoring sequence in the medical interview.

This paper employs qualitative, sociolinguistic techniques to identify and describe the kinds of conversational strategies that primary care physicians use to assess patient adherence to antihypertensive regimens. Three general approaches are described: indirect inquiry, simple direct questions, and information-intensive inquiry. The strengths and weaknesses inherent in these discourse categories are discussed. Qualitative assessment, coupled with the results of a pilot study investigating the effectiveness of naturally occurring instances of these three general styles, leads to the conclusion that how one asks "Have you been taking your medications?" is consequential for the accurate diagnosis and management of adherence problems.

Female↗
PubMed1987

The activated patient: dogma, dream, or desideratum?

In this paper we critically review the active patient concept and place it in a broader social and historical context. We argue that as a reflection of core, Western European values, the active patient concept has not been adequately scrutinized. Very little research has been done that explicitly tests the claims that have been advanced on behalf of this ideal model of the clinician-patient relationship. The research that is available is far from definitive and does not support many of the assertions made by advocates of this approach to patienthood. We urge investigators to substitute theory driven research programs for those motivated by advocacy of a particular ideological stance.

Humans↗
PubMed1984

Role adoption in residency training.

Two hundred residents in training in Wisconsin during 1982 responded to a survey that assessed attitudes, stressors, and coping strategies in each of three areas: work environment, role adoption, and personal life. Results indicate that successful role adoption (making difficult decisions, displaying leadership, dealing with uncertainty, being personally responsible for patients' care) is the primary task of residency, balanced by increasing stress in maintaining social support systems in family and peer groups. Coping strategies are directed at promoting role adoption and preserving personal ties. Work factors that accentuate the tension between these two aspects create the most distress. The degree to which role adoption is accomplished, the stress imposed, and coping strategies employed differed significantly with gender, specialty, and program type.

Adaptation, Psychological↗
PubMed1982

Coronary artery bypass patients and work status.

Retrospective surgery data were obtained from 358 coronary artery bypass surgery patients 4-22 months (mean 12.5 months) after surgery. Before surgery, 69% of the subjects were working, 10% were unemployed, and 21% were retired. At follow-up, only 58% were working and 29% were retired. Employment before surgery was the most significant predictor of work status after surgery. Other factors that were positively related to returning to work include higher presurgery income and job classification, higher pre- and postoperative ejection fraction, and subjective improvement in tolerance for physical activity. Factors that were negatively related to returning to work were age, number of chronic medical problems, presence of cardiac symptoms, and receipt of disability compensation. Reported improvement in symptoms was not related to postoperative work status. Job classification, physical demands of the job, and time out of work before surgery were also related to how soon patients returned to work. Participation in an outpatient rehabilitation program was significantly related to postoperative work status for men employed before surgery. Questions were raised regarding the role of outpatient cardiac rehabilitation in altering patient perceptions and maintaining "work habits" that might facilitate work resumption after coronary artery bypass surgery. The results suggest that multiple physical, social and psychological factors interact to influence postoperative work status.

Adult↗
PubMed1980

Gastric bypass for morbid obesity: preoperative and postoperative psychological evaluation of patients.

Twenty consecutive patients undergoing gastric bypass for morbid obesity were evaluated psychologically preoperatively and postoperatively by Minnesota Mulitphasic Personality Inventory (MMPI) assessment, a Problem Index designed for the study, and semistructured interviews. Patients were classified into categories based on the extent of psychopathology demonstrated preoperatively, and into categories based on the presence or absence of postoperative complications. Eighty percent of the patients continue to do well or improve psychologically. Patients with postoperative complications showed no significant change in psychological status. Patients who did not experience postoperative complications showed significant improvement in depression, hysteria, poor morale, psychoticism, phobias, and health concerns. Psychological changes with surgery did not correlate with weight loss. All patients with complications were unmarried and more likely to be moderately or severely disturbed on preoperative MMPI assessment.

Female↗