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Biomedical subjects

M Rohrbaugh

Publications and source records attributed to M Rohrbaugh.

16 recordsLinked to original sources
PubMed1994

What did the doctor do? When physicians and patients disagree.

OBJECTIVE: A serendipitous finding in a study of routine clinical encounters was that physicians and patients frequently gave discrepant reports of what had happened during a clinic visit. This report examines the conditions under which these discrepant perceptions occurred. DESIGN: Five experienced physicians and 189 patients completed postencounter questionnaires immediately following visits to an academic family practice clinic. After each encounter, the physician and patient estimated the duration of the visit and reported whether each of seven clinical events had occurred. RESULTS: The most common disagreements concerned whether the physician had provided counseling or performed a treatment procedure. Multiple regression analyses suggest that patient characteristics contributed to specific forms of physician-patient disagreement but that overall discrepancy was greatest in cases in which the physician minimized the importance of psychosocial issues and/or felt relatively confident about understanding the patient's problem. CONCLUSIONS: Although correlation need not imply causality, the results raise the possibility that physicians can promote shared physician-patient understanding by paying more attention to psychosocial factors and being more circumspect in drawing conclusions about patients' problems.

Academic Medical Centers↗
PubMed1988

The time-line genogram: highlighting temporal aspects of family relationships.

The genogram, or family diagram, is an assessment tool widely used by clinicians to study family members and their relationships over several generations. The standard genogram format is limited, however, because it does not show temporal patterns directly. An alternative, the Time-Line Genogram (TLG), which plots time on the vertical axis to display life events and changes in relationships when they actually occurred, highlights temporal aspects of family history that the standard format sometimes obscures.

Birth Order↗
PubMed1987

Researching ethnic family stereotypes.

Ethnic stereotypes in the family therapy literature make intuitive sense, but are based on surprisingly little empirical data. In a questionnaire survey of the family experiences of 220 mental health professionals representing eight American ethnic groups, most items differentiated the groups as predicted. A smaller, partial replication study comparing samples from Holland, Ireland, and North America found fewer discriminating items, but the differences that did appear were again as predicted. Implications for therapy and research with ethnic families are discussed.

Adult↗
PubMed1986

DNA sequence analysis of a 5.27-kb direct repeat occurring adjacent to the regions of S-episome homology in maize mitochondria.

The DNA sequence of the 5270-bp repeated DNA element from the mitochondrial genome of the fertile cytoplasm of maize has been determined. The repeat is a major site of recombination within the mitochondrial genome and sequences related to the R1(S1) and R2(S2) linear episomes reside immediately adjacent to the repeat. The terminal inverted repeats of the R1 and R2 homologous sequences form one of the two boundaries of the repeat. Frame-shift mutations have introduced 11 translation termination codons into the transcribed S2/R2 URFI gene. The repeated sequence, though recombinantly active, appears to serve no biological function.

Amino Acid Sequence↗
PubMed1982

Attitudes toward cancer. II: A comparative analysis of cancer patients, medical students, medical residents, physicians and cancer educators.

The current investigation was designed to determine how cancer patients, medical students, medical residents, nononcologically oriented physicians, and cancer educators differ with respect to attitudes towards cancer. A total of 372 individuals completed the Cancer Attitude Survey. Cancer educators displayed more confidence in the patient's ability to cope with diagnostic and prognostic information than students, other physicians, and patients themselves. Patients and cancer educators favored aggressive therapy to greater extent than other physicians, students, and alumni. Among nononcologic physicians and students there were significant effects of respondent's sex and prior personal experience with cancer on the attitudes expressed. Cancer educators differed significantly by specialty with surgical oncologists most likely to favor aggressive therapy. When compared to physician groups studied in the 1960s, our overall physician group (residents, cancer educators, and other physicians) was more likely to exhibit: (1) confidence in the patient's coping ability; (2) skepticism about the efficacy of early diagnosis and the value of aggressive treatment; and (3) stronger beliefs in the patient's ability to prepare for and accept death. Comparisons of our medical student group with students studied by Haley and his colleagues revealed a similar picture. Implications of these findings for the education of medical students are discussed.

Attitude of Health Personnel↗
PubMedDate not supplied

MMPI correlates of menstrual distress.

The MMPI and Moos' Menstrual Distress Questionnaire (MDQ) were administered to 60 undergraduate women. Partial correlations between MMPI clinical scales and menstrual and premenstrual MDQ symptom scales were computed with intermenstrual (baseline) symptom reports and response set (Gough's F-K index) statistically controlled MMPI variables tended to correlate with some symptom scales (premenstrual pain, negative affect; menstrual behavior change) but not with others (water retention, arousal). Where correlations did occur, common MMPI scales (Sc, Hs, Hy, Pt) were involved. Results suggest that psychological factors are more closely associated with some areas of menstrual symptomatoloty than with others.

Adolescent↗
PubMedDate not supplied

Can experts predict health risk from family genograms?

BACKGROUND: The family genogram is sometimes used to aid diagnostic, therapeutic, and preventive care decisions. This study evaluated the efficacy of genograms for predicting health risk in comparison to predictions made using demographic and chart review data. METHODS: Six physicians with expertise in using genograms were asked to evaluate 20 actual patient cases and use three methods to predict the patients' chances, over the next three months, of: a) experiencing illness causing at least one disability day, b) making an unexpected physician visit for a new problem, or c) requiring hospitalization. The three methods were genogram evaluation, review of patient demographics, and review of patients' charts. Predictions from demographic data were always made first; the other two methods were used in varied order. Three months later, actual patient outcomes were reviewed and compared to predictions. RESULTS: Over the next three months, 44% of subjects experienced a disability day, 35% made an unexpected clinic visit, and none required hospitalization. Predictions of these events with genograms were no more accurate than predictions generated from chart review. The six genogram experts did not predict outcomes at better than chance levels. CONCLUSIONS: Genograms may be no more accurate than standard clinical chart review for predicting short-term (three month) health outcomes.

Family Health↗
PubMedDate not supplied

The SAGE-PAGE trial: do family genograms make a difference?

BACKGROUND: Despite enthusiastic promotion of family genograms, the impact of routine use of this tool on clinical practice has not been systematically examined. The present study investigated whether doing a genogram, or having one available, makes physicians more sensitive to psychosocial issues or in other ways affects the physician-patient relationship or the process of clinical care. METHODS: In a randomized clinical trial, patients visiting 5 physicians at an academic family practice center (n = 189) received a physician-administered genogram (PAGE); a self-administered genogram (SAGE), which the patient completed before seeing the physician; or no genogram. A fourth (baseline) group was tested without genograms prior to the randomized trial. RESULTS: Analyses of patients' and physicians' postencounter questionnaires showed no impact of genograms on how physicians think about and deal with clinical problems or how patients view the encounter with their physicians. Compared with control groups, neither patient- nor physician-administered genograms increased the physician's (self-defined) understanding of the patient or the importance the physician attached to psychosocial issues in the case. A positive finding was that physicians considered genograms more relevant when they did them themselves. On the other hand, physician-administered genograms also increased the length of the encounter and were substantially less complete (conveying less information) than genograms completed by patients. CONCLUSIONS: THe results leave open the possibility that genograms do make a difference when used routinely by residents or experts or in difficult cases when family assessment is indicated. While enthusiasm about genogram applications in family medicine is understandable, the clinical utility of this tool remains to be demonstrated scientifically.

Adolescent↗