Hospitalization trends for pneumonia among older persons.
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Biomedical subjects
Margaret R Helton
Publications and source records attributed to Margaret R Helton.
The changing nature of women's sexual health concerns through the midlife years.
OBJECTIVE: Information about the sexual health care needs for midlife women is limited. This study compares and contrasts the nature and prevalence of sexual concerns for women as they progress through life and into menopause and the interest and experience these women have in discussing sexual concerns with their physicians. METHODS: Questionnaires were mailed to 2073 eligible women at military medical clinics in the early 1990s. Main outcome measures are self-reported sexual concerns and interest and experience in discussing these concerns with their physicians. RESULTS: Over 98% of women reported one or more sexual concerns. Type and intensity of sexual concerns changed as women aged. Most women had not had the topic of sexual health ever raised by their physicians. CONCLUSIONS: The sexual health concerns of women change as they age. Women desire to address their sexual health care needs with their physicians. Physicians should be aware of the common sexual concerns of women, and be comfortable in initiating discussion to address them.
Adult↗
A cross-cultural study of physician treatment decisions for demented nursing home patients who develop pneumonia.
PURPOSE: We wanted to explore factors that influence Dutch and US physician treatment decisions when nursing home patients with dementia become acutely ill with pneumonia. METHODS: Using a qualitative semistructured interview study design, we collected data from 12 physicians in the Netherlands and 12 physicians in North Carolina who care for nursing home patients. Our main outcome measures were perceptions of influential factors that determine physician treatment decisions regarding care of demented patients who develop pneumonia. RESULTS: Several themes emerged from the study. First, physicians viewed their patient care roles differently. Dutch physicians assumed active, primary responsibility for treatment decisions, whereas US physicians were more passive and deferential to family preferences, even in cases when they considered families' wishes for care as inappropriate. These family wishes were a second theme. US physicians reported a perceived sense of threat from families as influencing the decision to treat more aggressively, whereas Dutch physicians revealed a predisposition to treat based on what they perceived was in the best interest of the patient. The third theme was the process of decision making whereby Dutch physicians based decisions on an intimate knowledge of the patient, and American physicians reported limited knowledge of their nursing home patients as a result of lack of contact time. CONCLUSION: Physician-perceived care roles regarding treatment decisions are influenced by contextual differences in physician training and health care delivery in the United States and the Netherlands. These results are relevant to the debate about optimal care for patients with poor quality of life who lack decision-making capacity.
Adult↗