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Biomedical subjects

M J Whitfield

Publications and source records attributed to M J Whitfield.

At least 19 recordsLinked to original sources
PubMed1995

Women's knowledge of taking oral contraceptive pills correctly and of emergency contraception: effect of providing information leaflets in general practice.

BACKGROUND: About one third of all pregnancies are unplanned and 20% of all pregnancies end in abortion. More than 170,000 legal abortions are performed in the United Kingdom annually. Nearly all general practitioners provide contraceptive advice; the most commonly used form of reversible contraception is the oral contraceptive pill. AIM: The aim of this study was to determine factors associated with women's knowledge of taking the contraceptive pill correctly and of emergency contraception, and to investigate if their knowledge could be improved in general practice by providing women with Family Planning Association information leaflets. METHOD: An uncontrolled intervention study was performed in one rural and one urban English general practice, using a self-completion questionnaire that was initially administered to women attending their general practitioner for oral contraception over six months from 1 October 1992. The questionnaire asked for: sociodemographic information; knowledge of how late women can be taking an oral contraceptive pill and still be protected against unplanned pregnancy; for how many days after being late with a pill they need to use other precautions; sources and methods of emergency contraception; and for how long the methods are effective after the primary contraceptive failure. After completing the questionnaire women were given two leaflets: one about how to take their prescribed contraceptive pill correctly and one about emergency contraception. Three to 12 months later the same questionnaire was administered in the same manner. RESULTS: Of 449 women completing the first questionnaire, 233 (52%) completed the second questionnaire. Initially 71% of 406 women taking an oestrogen/progestogen combined pill knew about the '12-hour rule' and 17% knew about the 'seven-day rule'; giving women information about the pill they were taking increased the extent of knowledge about these rules among 212 respondents to 82% (P < 0.01) and to 25% (P < 0.05), respectively. The proportion of respondents who knew that they could obtain emergency contraception from their own general practitioner, from any general practitioner and from family planning clinics all increased after they had received the leaflets (from 84% to 92%, from 34% to 47% and from 82% to 90%, respectively, all P < 0.01). There were significant improvements in the proportion of women knowing the duration of effectiveness of emergency contraception. However, after receiving the leaflet on emergency contraception the majority of women still did not know for how long after unprotected intercourse the high-dose combined pill and the intrauterine contraceptive device were effective (80% and 93% of 233 women, respectively). Improvements in knowledge depended upon women's social class, previous use of emergency contraception and with which practice they were registered. CONCLUSION: Providing women with leaflets about taking the contraceptive pill correctly and about emergency contraception appears to improve significantly their extent of such knowledge. If such practice was adopted elsewhere this increased knowledge might reduce the number of unplanned pregnancies in the UK. The effect of general practitioners personally providing such leaflets, with or without verbal instruction, warrants further study.

Adolescent↗
PubMed1990

Towards a typology of general practitioners' attitudes to general practice.

Current knowledge about the origins of variations in general practitioners' (GPs') prescribing and referral behaviour is limited. Differences are as yet unexplained by demographic factors such as list size or geographic location. Drawing on social psychological theory it is suggested that attitudes towards general practice held by GPs may be predictive of GP behaviour. A classification of GP types on the basis of expressed attitudes may represent the first step towards this goal. This research demonstrates that GPs in Avon have identifiable attitudes to general practice which can be classified into separate types. Uses of such a classification and implications for further research are also discussed.

Adult↗
PubMed1989

HIV infection and South-West general practitioners.

General practitioners in the Severn Faculty of the Royal College of General Practitioners were asked about their knowledge and practice in dealing with HIV infected patients. 62% responded to our anonymous questionnaire. Overall, four-fifths of the doctors expressed confidence in their ability to advise HIV antibody positive patients on sexual activity, drug abuse and domestic activities. Only 61% were confident of their ability to advise such patients on pregnancy. Differences in screening policy and measures of awareness were related to location of practice by county within the Region and to the presence of HIV infected patients on individual lists. The findings are discussed in relation to previous surveys of general practitioners in the UK.

Acquired Immunodeficiency Syndrome↗
PubMed1989

GPs and consultants: is there agreement on patient management?

General practitioner attitude questionnaires were sent in May 1987 to 525 general practitioners (GPs) within Avon. A year later a section dealing with the management of clinical situations was sent to 198 Avon consultants, to determine how they would ideally expect a GP to respond to these situations. The majority of both the GPs and consultants held a common viewpoint, but significant differences were noted between the consultants and GPs in six out of the ten situations. Consultants with more than six months' GP experience had fewer significantly different views than their colleagues with little or no GP experience. GPs and specialists under the age of 45 years also had fewer significant differences in management than older GPs and specialists. The differences seem to reflect the clinical focus and interests of each professional group. We believe vocational training is a contributory factor to the differences and support the General Medical Council's proposal of a broader post registration training for all doctors.

Adult↗
PubMed1988

Contributions of patients to general practitioner consultations in relation to their understanding of doctor's instructions and advice.

126 patients of 6 general practitioners were tape recorded in consultation with their doctor and interviewed immediately afterwards, and 81 of the patients were interviewed again 2 days later. We related the accuracy of patients' accounts of the instructions and advice they were offered to two characteristics of patient's participation during their consultation: (i) the frequency of spontaneous comments or queries about diagnosis, cause, consequences or treatment of the problem presented, and (ii) the frequency of comments and queries which sought to clarify something said by the doctor. The incidence of the latter was unrelated to accuracy of patients' subsequent accounts. However, people who made errors or omissions in both immediate and home interviews in their accounts of instructions and advice offered, were more likely than those who gave accurate accounts to have produced spontaneous comments or queries during their consultation. Whether the doctor accepted, rejected or ignored these ideas was irrelevant to the incidence of post-consultation errors and omissions.

Family Practice↗
PubMed1987

Participation of patients during general practice consultations: comparison between trainees and experienced doctors.

Consultations with 494 patients were tape-recorded, transcribed and coded. The sample consisted of 168 patients of six experienced general practitioners from training practices, and 326 patients of six trainee general practitioners. Talk in the consultations of trainees and experienced doctors was similar in many respects, including total quantity of talk per consultation. However, twice as many patients of the trainees than those of the experienced doctors produced questions and comments which followed from something already said by the doctor. In addition, the trainees were more likely than the experienced doctors to ask the patients questions about the suggested treatment, rather than simply to offer instructions and advice. These features of doctors' and patients' behaviour were significantly correlated with each other for both the trainees and the experienced doctors. It is suggested that the strategy of engaging patients in discussion about treatment, used more by the trainees, encouraged patients to think of queries which otherwise might not have occurred to them during the consultation.

Family Practice↗
PubMed1985

Improving the efficiency of patients' comprehension monitoring: a way of increasing patients' participation in general practice consultations.

The aim of the investigations reported was to examine the effects of helping patients to check their understanding of instructions and advice given during their consultations with general practitioners. Three groups of patients were both tape recorded during their consultation and interviewed immediately afterwards. The groups differed in the written information they were given prior to their consultations. The 'Normal' group were informed only that the researcher was interested in how well doctors and patients understand each other. The 'Permission' group was explicitly invited to raise queries with the doctor during their consultation. The 'Guidance' group was asked to use two specified strategies to check their understanding of instructions and advice given by the doctor. We coded the frequency of questions and comments about treatment which patients produced during their consultations, and the accuracy and completeness of their subsequent accounts of the recommended treatment. The Normal and Permission groups did not differ in either respect. The Guidance group produced significantly more questions and comments than the Normal group and gave more complete and accurate accounts of the recommended treatment. A partial replication in a different practice produced consistent results.

Family Practice↗
PubMed1980

What do consultants think of general practice?

A simple questionnaire was completed by a group of young consultants and the results compared with the views of a group of general practitioners. Many significant differences were noted which suggest that recently appointed consultants have a limited knowledge of the work of general practitioners.

Attitude of Health Personnel↗