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Biomedical subjects

R M O'Shea

Publications and source records attributed to R M O'Shea.

At least 19 recordsLinked to original sources
PubMed1999

Unlimited opportunities for environmental interventions with inner-city asthmatics.

The purpose of this study was to identify the asthmatics living in the Lower West Side (LWS) of Buffalo, New York, and then explore the relationship between urban asthmatic and nonasthmatic exposures to many common household aeroallergens. Eight hundred twenty-eight households were visited and 167 asthmatics and 161 nonasthmatics were identified for comparison. Specific self-reported household exposure prevalences were identified for environmental tobacco smoke, sources of molds, household pets, rats, cockroaches, and sources of dust. Sources of molds, pets, and cockroaches were more likely to be found in the homes of asthmatics compared to nonasthmatics (p < 0.05). Other aeroallergens studied, although highly prevalent, were not more likely to be found in either asthmatic or nonasthmatic homes.

Adult↗
PubMed1995

A data-generated basis for medical ethics education: categorizing issues experienced by students during clinical training.

PURPOSE: To use issues identified by students in order to establish an experience- and evidence-based approach to medical ethics education. METHOD: A total of 628 sophomore and senior students at the State University of New York at Buffalo School of Medicine and Biomedical Sciences were asked to identify incidents during their clinical training that had raised ethical concerns. The sophomores were surveyed during two time periods: 1979-80, and 1991-92 and 1992-93; the seniors were surveyed in 1991-92 and 1992-93. Responses were analyzed and categorized through content analysis. RESULTS: In all, 249 students (45% of the sophomores and 20% of the seniors) responded. The categories of issues identified were professional norms, limits of intervention, defensive shielding of professional colleagues, respect toward patients, communication, and student boundaries (situations where the student feels uncomfortable). The most frequently reported incidents reflected the students' perceptions of lapses in level of care (under- or over-treatment), communication, respect toward patients, and maintenance of professional norms. The seniors and the 1979-80 sophomores reported respect toward patients as an issue less often than did the 1991-92 and 1992-93 sophomores. The seniors most often identified concerns raised over limits of intervention and resource allocation. CONCLUSION: The differences between the responses of the sophomores and seniors tend to support other research suggesting a retardation of moral sensitivity in the course of medical education. It may be that clinical teaching and faculty behavior model values at odds with what is taught in the classroom. Ethics education should focus on issues relevant to students' experience.

Ambulatory Care↗
PubMed1994

Culture shock in a university health service: a case and commentaries.

The detailed experience of one international student provides a case history in the use of college health services. His journey through the campus health center and outside referrals reveals important facets of student healthcare. It also offers some insights into foreign students' feelings as they contrast their health encounters with expectations carried from home. Four commentaries on the case attempt to draw inferences and to explain from various points of view what the student found in the course of seeking a diagnosis for rectal bleeding.

Adult↗
PubMed1991

Dental students' treatment of anxious patients.

Patients' anxiousness over treatment is an important factor in the utilization, delivery, and outcome of health care. Patient anxiety over dental treatment is widespread and is a source of stress for both patients and dentists. This paper reports a study of how dental students cope with fearful patients they treat during training, and what tactics they believe are effective. Two classes of senior dental students at a state university (n = 127) completed a brief questionnaire that asked them to describe what they had done in a previous encounter with a nervous patient, and to assess the effect of their actions. Students estimated that almost a quarter of their patients were anxious; most believed that they themselves were made nervous by such patients. Virtually all were committed to using talk plus local anesthesia rather than more extensive, drug-oriented methods. The coping repertoire was extensive. Giving reassurance was the most prominent tactic, followed by providing information about the procedure; expressing empathy or identifying patient feelings and the source of fear; and presenting a calm manner. Most students believed their actions had at least some positive, if not a dramatic, effect. In rating the effectiveness of 10 actions a dentist can take to deal with patient anxiety, the large majority of students rated every behavior as being at least somewhat effective. The behaviors rated 'very effective' by half or more of the students included having a calm manner, demonstrating that what the patient says is taken seriously, being friendly, making the patient feel welcome, and giving moral support during the procedure.

Adaptation, Psychological↗
PubMed1991

Predictors of attempting and succeeding at smoking cessation.

This paper presents results of a prospective study which examined factors influencing self-initiated smoking behavior change in a cohort of smokers followed over 17 months. Employees of a cancer hospital and research center were surveyed about smoking habits, health status, attitudes about smoking and social-environmental factors. Seventeen months later, employees identified as smokers were resurveyed about their current smoking status, recent attempts at cessation and use of cessation aids in these attempts. Overall, 47% of subjects had not tried to stop smoking (non-stoppers, NS), 38% had attempted to quit but returned to smoking (recidivists, R) and 15% had successfully quit (SQ). Predictors of attempting cessation (R and SQ versus NS) included smoking fewer cigarettes daily, starting smoking at a later age, previous attempts at quitting, lower nicotine dependence, greater pressure to stop smoking and an expectation to quit in the near future. Amount smoked daily was the strongest predictor of successful quitting (SQ versus R). Findings from this study suggest intention to stop smoking is the most important factor differentiating smokers who attempt cessation from those who do not. Strength of smoking habit appears to be the strongest factor associated with successful quitting.

Adult↗
PubMed1991

Rural medicine and the closed society. Pregnancy outcomes among Amish and non-Amish women.

A rural family practitioner may be responsible for the general medical and obstetric needs of a closed population such as the Old Order Amish. Until recently, the Amish in southern New York State have preferred to receive obstetric care in the home from traditional Amish midwives. Acceptance of prenatal care and hospital deliveries by rural physicians appears to be increasingly frequent among Amish primiparas in southern New York State, while non-Amish in the area have been seeking these services for decades regardless of parity. This retrospective chart review examines first pregnancy outcomes of Amish (N = 39) and non-Amish (N = 145) women who delivered their babies at a rural hospital in southern New York State during a four-year period. Little difference was found between the two groups of women regarding the overall good health of their first babies. In the Amish population there was less variability in maternal age, season in which the birth occurred, labor duration, and birth weight of babies. The Amish had their first child an average of one year later than the non-Amish. While research on a larger sample will be necessary to fully explore Amish vs non-Amish variances, this study demonstrates the effect that traditions and customs of a closed society such as the Amish may have on obstetric practice.

Adult↗
PubMed1989

Smoking practices among nursing students: a comparison of two studies.

Findings of numerous studies that have explored the smoking practices of nurses reveal a high incidence of smoking that is incongruent with the health beliefs of the profession. Nurses who smoke are less likely to teach or positively influence patients who smoke. They may even undermine health teaching efforts of other health professionals. Studies of smoking practices of nursing students also reveal high incidences of smoking. Included among the determinants of this practice are lack of knowledge of the health effects of smoking, the academic setting, and the role that nursing education may play. In this comparison of two independent studies similar in design, smoking rates were similar to that of the female population and to registered nurses. Students who smoke either started smoking or increased their smoking in nursing school. They knew the health hazards of smoking and most had tried to quit in the past. Challenging opportunities exist for nurse educators to study and implement strategies to prevent smoking initiation and encourage cessation among future nurses.

Adolescent↗
PubMed1988

The dentist-patient relationship: perceived dentist behaviors that reduce patient anxiety and increase satisfaction.

This study relates perceived dentist behaviors to anxiety reduction in patients during treatment, and to satisfaction with the dental visit. The sample consisted of 250 adult patients, 110 men and 140 women, at two outpatient hospital dental clinics. Immediately after treatment, patients were asked to respond to a list of 25 dentist behaviors thought to be associated with positive dentist-patient interaction. Criterion measures obtained by patients were self-ratings of anxiety during treatment and satisfaction measures from the DVSS. Ten behaviors were significantly associated with anxiety reduction. A stepwise multiple regression analysis with anxiety reduction as the dependent variable indicated that to the patient, the dentist's explicit dedication to prevent pain was the most important dentist behavior, with friendliness, working quickly, being calm, and giving moral support, being important auxiliary behaviors. Most of the 25 dentist behaviors studied were associated with patient satisfaction. A stepwise multiple regression analysis indicated that the dentist's empathy and communicativeness were among important correlates of patient satisfaction. An experimental approach to causal analysis of anxiety reducing behaviors needs to be studied.

Adolescent↗
PubMed1986

Why patients change dentists: practitioners' views.

Dentists participating in a health screening at the 1984 annual session completed a brief questionnaire concerning patient turnover. In most dentists' opinions, patients more frequently leave a practice for reasons independent of the practice: they change residences and jobs. Patients' dissatisfaction with how they are treated, with the quality of care, and with pain and anxiety control also are believed to be among the factors "pushing" away patients. Lay referral is the major source of new patients, together with general community reputation and practice location.

Anxiety↗
PubMed1986

The dentist-patient relationship: mutual perceptions and behaviors.

The relationship between patients' characteristics and dentists' perceptions as well as the associations between these dimensions and specific dentist behaviors as perceived by patients are explored. Dentist perceptions of patient sophistication and anxiety were related to several patient characteristics, but perceptions of patient likability were unrelated to patient personal and social characteristics. Perceptions of patient likability were associated with more specific dentist behaviors than were other dentist perceptions noted by patients. The results suggest that dentists' views are influenced primarily by those patient characteristics manifested during treatment. In general, dentists like patients who are dentally sophisticated and not anxious.

Adolescent↗
PubMed1985

The dentist-patient relationship: perceptions by patients of dentist behavior in relation to satisfaction and anxiety.

This study relates perceived dentist behaviors to anxiety in patients during treatment and to satisfaction during the dental visit. The sample consisted of 231 adult patients, 107 men and 124 women, at a public hospital dental clinic. Immediately after treatment, patients were asked to respond to a list of 21 dentist behaviors thought to be associated with positive dentist-patient interaction. Criterion measures obtained were ratings of anxiety by patients during treatment and measures from the DVSS. None of the dentist behaviors was related to anxiety in patients in a way that would suggest that dentist behavior either reduced or increased anxiety. DAS scores obtained before treatment were the best predictor of anxiety in patients during treatment. Most of the dentist behaviors were significantly related to satisfaction in patients. Stepwise multiple regression analyses using DVSS scores as criterion variables indicated that those variables contributing most to satisfaction in patients were indicative of dentist communication that was accepting and caring. Anxiety in patients during treatment also was an important negative predictor of satisfaction. The results indicate that the dentist behaviors explored in this study were associated with satisfaction in patients, but were not clearly related to anxiety reduction.

Anxiety↗
PubMed1985

Dentists' management of patients' fear and anxiety.

Dentists participating in a health screening at the 1983 ADA annual session were asked to complete a brief questionnaire concerning their attitudes and methods of managing anxious patients. Most dentists see patient fear as an extremely important dimension of their practice and believe it to be the most important impediment to patient satisfaction. Behavioral methods such as "talking" appear to be the most frequently used methods of dealing with fearful patients. Finally, most dentists appear to learn their behavioral management methods through informal means.

Anxiety↗
PubMed1984

Development of a patient measure of satisfaction with the dentist: the Dental Visit Satisfaction Scale.

Although patient satisfaction has been studied in the traditional medical context, patient satisfaction with the dentist has received only minor attention. This paper reports the development of a 10-item Dental Visit Satisfaction Scale. This scale was designed to assess patient satisfaction with the dentist in the context of a specific visit. It provides three subscales--Information-Communication, Understanding-Acceptance, and Technical Competence--as well as an overall measure of satisfaction. Satisfactory internal consistency was obtained for all scale measures, and one assessment of construct validity is reported. Potential clinical and research applications are discussed.

Adult↗