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Biomedical subjects

R Pill

Publications and source records attributed to R Pill.

At least 37 records · Page 2Linked to original sources
PubMed1997

Qualitative research interviewing by general practitioners. A personal view of the opportunities and pitfalls.

OBJECTIVE: This study looked look at the role of the GP as a qualitative research interviewer and aimed to illustrate areas of methodological difficulty using personal observations made during a qualitative study in general practice. METHODS AND RESULTS: The recently published literature on qualitative research in general practice was reviewed by the author to inform her own qualitative study looking at how women decide how to feed their babies. Some women in the study were patients of the author; some knew that she is a GP but were registered at another practice and some did not know that she is a doctor. In-depth and semi-structured interviews were tape recorded and transcribed. Observations about combining general practice and qualitative research were recorded by the author in a research diary. CONCLUSION: Qualitative research is being advocated as a methodology appropriate for general practice, yet there are many unanswered questions about methodological detail. There are no guidelines to help GPs to decide whether it is appropriate for them to do the interviewing, the practicalities of doing it, and whether they should use their own patients. There is clearly a need for more methodological research to look at how these decisions influence the data and to inform GPs who are considering a qualitative study.

Breast Feeding↗
PubMed1997

A review of recently published qualitative research in general practice. More methodological questions than answers?

OBJECTIVE: This study aimed to review published papers which use qualitative interviewing in general practice as their methodology. To look specifically at the detail of how the methodology is presented to the reader, with particular emphasis on the clarity of detail about recruitment, the relationship of the interviewer to the respondents, the setting and how the research was presented to the respondents. METHODS AND RESULTS: A systematic search using Medline and hand searching the British Journal of General Practice, Family Practice and Social Science and Medicine identified 29 recent papers using qualitative interviewing techniques in general practice. The papers were analysed for eight methodological criteria by the author. A second analysis, blind to the results of the first analysis was performed by the author 6 weeks later. An independent assessor analysed 12 randomly selected papers. There was 98.3% intra-assessor agreement and 89.6% inter-assessor agreement about whether the eight criteria were met. Overall 140 of a possible 232 criteria were met (60.3%). CONCLUSION: Published papers using qualitative interviewing in general practice often lack explicit methodological detail about the relationship between the interviewer and the respondents, the setting, who did the recruiting and how the research was explained to the respondents. This methodological detail is important for the critical appraisal of qualitative research, where the context of the research can influence the data.

Family Practice↗
PubMed1996

Patterns of help-seeking behaviour for toddlers from two contrasting socio-economic groups: new evidence on a neglected topic.

OBJECTIVE: This descriptive study aimed to assess patterns in help-seeking behaviour for common childhood symptoms. METHOD: Clinic attenders aged 9-18 months of two child health clinics on Tyneside, UK, one with substantial economic deprivation, were studied. Outcome measures were parental reporting of common symptoms, utilization of professional advice and general practitioner records of consultations. RESULTS: Children in the affluent area had had fewer general practitioner consultations (mean 7.3) than those in the poorer area (mean 15.1; 95% CI for difference 4.3-11.4). They were less likely to present with an episode of diarrhoea or cold but were as likely as the poorer group to present with fever. Behaviour problems were reported less frequently (23% versus 47%), but if present, this was far more likely to result in help seeking than in the poorer group (86% versus 33%; P < 0.05). CONCLUSIONS: Variations in help-seeking behaviour between two economically contrasting groups were identified; this has implications for clinical understanding and service provision in primary care.

Chi-Square Distribution↗
PubMed1995

Social class and preventive health behaviour: a British example.

STUDY OBJECTIVE: To test the relationship between social class and preventive health behaviour in a British national sample and identify which set of more specific socioeconomic factors best "explained" any observed relationship(s). DESIGN: Secondary analysis from a national cross sectional survey of the health attitudes and health behaviour of men and women aged 18 years and over living in private households in England, Scotland, and Wales. A selection of addresses was made randomly from the electoral register using a three stage design, and then one individual in each household was sampled. A total of 12,254 addresses yielded interviews with 9003 individuals, a response rate of 73.5%. Compared with the census population, the single and divorced/separated are slightly under-represented but otherwise sources of bias are small. PARTICIPANTS: The subset selected was 1671 women and 1026 men aged between 20-45 years with at least one child under 17 living at home. MAIN RESULTS: Social class was strongly associated with the health practices index (HPI, used as a measure of health behaviour) both for women and men (p < 0.001). The set of factors identified for both sexes as having an impact on this relationship were education, tenure, residential overcrowding index, and salience of lifestyle. In addition, their partner's employment status and household income were relevant for women only. These groups of factors did not totally explain the observed relationship but the proportion of variance in HPI attributable to social class was considerably reduced. CONCLUSIONS: Descriptions of the association between social class and health behaviour(s) are of little use to those wishing to mount more effective interventions in health promotion. Multivariable analysis can indicate which specific factors account for much of the social class effect on health behaviour and thereby assist better understanding and targeting of resources.

Adult↗
PubMed1993

Factors associated with health behaviour among mothers of lower socio-economic status: a British example.

The Health and Lifestyle Survey is the first survey in the U.K. to compare with the databases available in North America. For the first time detailed information on the health status, beliefs, attitudes and behaviour of a representative sample of the British population is available to compare with the findings drawn from smaller locally based samples. Here the focus is on the factors associated with the performance of more low-risk health behaviours among mothers of low socio-economic status (social class IV and V), specifically on whether the findings from a South Wales survey could be generalised to the equivalent group in a national sample. The outcome measure used was the Health Practices Index, developed by the Alameda County Researchers. Seventeen factors were modelled, using multi-way analyses of variance, to produce a final set of statistically independent factors related to health behaviour. The most striking findings were the importance of the association between type of tenure and health behaviour in both the local and the national sample for this social class group; the lack of any association between education and health behaviour in the national sample; the failure, now well recognised, to find statistically independent associations between measures of attitudes/beliefs and health behaviour. Finally, the implications of the results are discussed in the light of recent and current trends in health education and promotion.

Adult↗
PubMed1993

How important is health behaviour to the health of mothers of lower socio-economic status?

Secondary analysis of the data available from the national sample in the Health and Lifestyle Survey allowed two samples of mothers from Social Classes III Manual and IV+V to be selected and the relationships investigated between two measures of health and a range of potential explanatory variables, including voluntary health behaviour. Analysis of variance was used to establish which sets of factors were significantly and independently associated with each of the measures of health within the two samples. Health behaviour was identified as making an independent, albeit small, contribution in three out of the four analyses.

Adolescent↗
PubMed1993

Potential of using simulated patients to study the performance of general practitioners.

A review of the literature on the use of simulated patients is presented. While simulated patients have become established for the education of medical undergraduates, international work suggests that they may also be of value for studying the performance of established general practitioners. A preliminary study is described in which simulated patients were used at practices in Cardiff. Roles were developed which would stimulate a discussion focusing on health risks. No particular practical problems were encountered but concerns were expressed about the validity of the data. Suggestions are made for the further development of the use of simulated patients.

Clinical Competence↗
PubMed1988

Management of cystitis: the patient's viewpoint.

Two years after a microbiological study of the urethral syndrome 32 sufferers and 26 controls were asked what they felt caused 'cystitis' symptoms, what they did to prevent recurrences and how they managed acute episodes. Doctors may feel that they have discharged their clinical responsibility by excluding pathogens but the patient is often confused and frustrated by the mismatch between her own ideas on causation and the paradoxical ideas of her doctor. The findings indicated that both patient groups think in a divergent and largely non-biomedical manner about their symptoms. Medical advisers were unlikely to explore lay ideas on cystitis or reinforce self-help measures. Clinicians would be well advised to take lay ideas into account and, where appropriate, to capitalize on them in negotiating management.

Cystitis↗
PubMed1988

The Open University pack on coronary heart disease: reactions of Welsh general practitioners.

The introduction of the new Open University distance learning pack on coronary heart disease to a selected group of Welsh general practitioners has been evaluated. The most commonly perceived disadvantages were the amount of time required to study the pack, the cost of buying it and the work involved in implementing its study in a practice by the whole primary-care team. Despite a relatively high level of awareness among the group, only 17% declared a positive intention to introduce the pack and another 17% thought they 'probably' would. Contact with primary care facilitators and informal feedback from colleagues appeared to distinguish those general practitioners who were motivated to try innovative postgraduate learning methods in their practices from the rest of the sample. The implications of trying to disseminate novel kinds of teaching material to general practitioners are considered.

Adult↗
PubMed1988

Invitation to attend a health check in a general practice setting: comparison of attenders and non-attenders.

A sample of 1570 men and women aged 20-45 years registered with an inner-city Cardiff practice were offered the opportunity by their general practitioner to have a health check at the surgery. The demographic characteristics, attitudes, beliefs and preventive health behaviour and past contact with the practice were compared for a sample of 259 non-attenders and 216 attenders. The results showed that attenders were generally better educated, better motivated to look after their health, had fewer ties and commitments, performed more healthapproved practices, had had more recent contact with their own practice and accepted the legitimacy of a general practitioner's interest in his patients' lifestyle. Offering cohorts of patients additional screening services is unlikely to be efficient or effective since it is the low-risk people already known to the doctor who are most likely to attend. The onus lies on primary health care to provide services in a way which permits appropriate screening of the high-risk groups as they attend for other reasons.

Adult↗
PubMed1988

Invitation to attend a health check in a general practice setting: the views of a cohort of non-attenders.

Two hundred and fifty-nine men and women aged 20-45 years who did not respond to an offer from their general practitioner for a health check were interviewed at home to explore the reasons for non-response. There was no support for the view that the invitation aroused anxiety or that the administrative arrangements had been a barrier to acceptance. Many subjects were not really interested (44%) or just forgot to attend (24%). Crises at work or home (26%) and current attendance at a doctor (16%) were other reasons offered, while 11% felt screening to be in appropriate. There is little that can be done to change these rates except by a shift of public opinion to more consumer demand for health checks or by more opportunistic health checks when people attend their doctors for other reasons. The dangers of marketing health checks to increase consumer demand are discussed in the light of these findings and other work.

Adult↗
PubMed1987

Production of hemopoietic growth factors and gamma-interferon by large granular lymphocytes from patients with T gamma lymphocytosis.

Two patients with T gamma lymphocytosis in whom expanded large granular lymphocyte (LGL) populations were detected in peripheral blood and bone marrow are described. The surface antigen phenotypes of the LGL from these patients were similar with a major portion of cells carrying T3, T8, T11 and Leu7 markers. However, whereas fresh LGL from both patients demonstrated antibody-dependent cell cytotoxicity (ADCC), natural killer (NK) cell function was present in one case but absent in the other. Supernatants from enriched suspensions of the LGL unstimulated by exogenous antigen or mitogens were shown to contain significant amounts of hemopoietic growth factors colony-stimulating activity (CSA) and burst-promoting activity (BPA). In one case gamma-interferon was also detected. This study contributes to the accumulating evidence that LGL are able to generate factors which have the capacity to influence the proliferation of hemopoietic progenitor cells in vitro.

Colony-Forming Units Assay↗