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Biomedical subjects

R Peppiatt

Publications and source records attributed to R Peppiatt.

15 recordsLinked to original sources
PubMed2001

Is videotaping of consultations acceptable to patients attending a hospice day centre?

The use of a videotape recorder to analyse consultations in UK general practice is accepted, well established and has been extensively researched. The technique has potential in palliative medicine for training and the continuing assessment of communication skills as part of peer review. However, there have been no published studies on whether or not videotaping of consultations would be acceptable to a hospice population. Using a semi-structured questionnaire, we interviewed 31 patients who had agreed to have their consultation with a doctor videotaped. Although 30 (97%) did not regret having given permission and would 'definitely' or 'possibly' agree to another recording in the future, three (10%) felt that the procedure had been inadequately explained to them, six (19%) felt that they were 'possibly' or 'definitely' not given sufficient notice of the recording and one patient felt under pressure to agree to the recording. These findings suggest that if videotaping of consultations in the hospice setting is to be undertaken, more advanced notice than that usually given in general practice is required and strict safeguards should be in place to protect vulnerable patients.

Ambulatory Care↗
PubMed1992

Eliciting patients' views of the cause of their problem: a practical strategy for GPs.

One thousand consecutive consultations with one general practitioner were studied to determine the value of seeking the patients' ideas about the cause of their condition. The diagnosis was an issue in 543 of the consultations. A total of 150 patients spontaneously volunteered a clear cause. When the remainder were asked to express their ideas about cause, 266 were able to do so. There were no significant age or sex differences between those who were able to express a cause compared with those who were unable to. The most common ideas expressed were infection, injury, anxiety and allergy. Thirty per cent of ideas were valuable to the doctor in reaching a deeper understanding of the patient's concerns over the condition and 20% helped determine the most likely cause of the condition. There were no significant differences in the value to the doctor between the causes spontaneously volunteered and those given as a result of questioning. The most valuable ideas to the doctor were cancer, anxiety, age, occupation, and heart disease. This study suggests that in the half of general practitioner consultations in which diagnosis is an issue, it is worthwhile seeking the patients' ideas as to cause of their condition.

Diagnosis↗
PubMed1991

A survey of the health of British missionaries.

The results of medical examinations carried out on 212 missionary personnel from one missionary society returning on leave to the UK are presented. The great majority of missionaries worked in developing countries. They served in 27 countries altogether and for a total of 488 person years. The commonest illnesses reported overseas were malaria (87.3 per 1000 person years at risk), diarrhoea (63.5), anxiety (63.5), depression (41.0) and giardiasis (38.9). More illnesses were reported from West Africa (698 per 1000 person years at risk) than from any other region. Ten people (4.7%) were repatriated for health reasons and 10 relatives also returned as a consequence. Sixty per cent of those returning did so because of psychiatric illness. The highest rates of immunization achieved were for yellow fever (100% of those travelling to affected countries), tetanus (93%), polio (85%), typhoid (71%) and tuberculosis (53%). The results of urinalysis (100% of adults), full blood counts (78% of adults) and stool tests (74% of all people) are reported. The study shows that the history and psychiatric examination are an important part of the medical examination of people returning from overseas. Physical examination and urinalysis did not contribute much information, although the full blood count and absolute eosinophil count were useful tests.

Adolescent↗
PubMed1990

Risk factors for malaria among British missionaries living in tropical countries.

Thirty-two episodes of malaria (10 confirmed by laboratory tests) were reported by 162 people living in 18 developing countries under the auspices of one British missionary society. Malaria was endemic in all countries involved, and a total of 367 person-years were observed. The overall incidence rate for malaria was 87.3 per 1000 person-years at risk. Important factors identified were residence in West Africa compared with elsewhere (relative risk (RR) = 13.0, P less than 0.001), being in the 20-39 year age group (RR = 3.2, P less than 0.002), history of gastroenteritis (RR = 3.1, P less than 0.002) and living in a rural area (RR = 1.7, n.s.). Chemoprophylaxis was taken by 119 people (73.5%).

Adolescent↗
PubMed1981

Vocational training: work in a developing country and British general practice.

I present evidence from my personal experience of vocational training followed by 18 months' work in an African hospital, to show that:1. By extending and reinforcing vocational training, my time abroad was relevant to my future career as a British general practitioner.2. Vocational training is a good preparation for any doctor intent on spending a limited time working in a developing country.

Education, Medical, Graduate↗
PubMed1978

Blood alcohol concentrations of patients attending an accident and emergency department.

The prevalence of detectable blood alcohol in all new adult patients attending an accident and emergency department was 10.3%. The mean concentration was 20.9 mmol/1 (96 mg/dl). There were significantly more patients with detectable alcohol in the following groups: male patients; patients aged under 35 years; patients attending on Saturdays; patients attending between 21.00 and 08.59 hours; patients involved in road traffic accidents; patients presenting because of drug overdosage, and head injuries. Those with detectable blood alcohol were more likely to be admitted, probably because of their associated reason for attendance. Patients referred by their general practitioner were less likely to have detectable blood alcohol.

Accidents↗