Biomedical subjects

Rebecca S Brienza

Publications and source records attributed to Rebecca S Brienza.

4 recordsLinked to original sources

PubMed2005

Evaluation of a women's safe shelter experience to teach internal medicine residents about intimate partner violence. A randomized controlled trial.

Although intimate partner violence (IPV) remains a major public health problem, physicians often fail to screen female patients. Reported IPV training approaches suffer from weak study designs and limited outcome assessments. We hypothesized that an educational experience for residents at a women's safe shelter would have significantly greater impact on IPV competencies, screening, and care for victims than a workshop seminar alone. In a pre-post randomized controlled trial, we compared residents exposed to the workshop seminar alone (controls) to residents exposed to these methods plus an experience at a women's safe shelter (cases). Competencies were assessed by written questionnaire and included knowledge, skills, attitudes, resource awareness, and screening behaviors. Of the 36 residents in the trial, 22 (61%) completed both pre- and postquestionnaires. Compared to controls, cases showed significantly greater pre-post improvement in the knowledge composite subscale. There were no significant differences between cases and controls in the subscales of skills, attitudes, or resource awareness. Cases increased their self-reported screening frequency but this did not differ significantly from the controls. Enhancing traditional IPV curriculum with a women's safe shelter educational experience may result in small improvements in residents' knowledge about IPV.

Adult↗

PubMed2002

Alcohol use disorders in primary care: do gender-specific differences exist?

OBJECTIVE: To describe how alcohol use disorders (AUDs) affect women, focusing on gender-specific implications for primary care physicians (PCPs). DESIGN: An overview of literature from 1966 to 2000 identified by a medline, PsychINFO and HealthSTAR/Ovid Healthstar database search using key words "women,""alcohol" and "alcoholism." MEASUREMENTS AND MAIN RESULTS: Although the prevalence of AUDs is greater in men than in women, women with AUDs are more likely to seek help, but less likely to be identified by their physicians. Psychiatric comorbidities (especially depression and eating disorders) are more common in women with AUDs than in men with AUDs. A past history of sexual and/or physical abuse places a woman at increased risk for AUDs. Women have a greater sensitivity to alcohol, have an accelerated progression from alcohol toxicity, and have increased mortality at lower levels of consumption compared to men. Women and men who are light-to-moderate drinkers have lower coronary artery disease mortality than do abstainers or heavy drinkers. Risk of breast cancer is increased in women who drink >or=1 drinks daily. Common barriers to treatment include: fear of abandonment by partner; fear of loss of children; and financial dependency. Brief interventions have been shown to be effective in reduction of alcohol consumption in women with at-risk drinking. It is unclear if women-only treatment programs improve outcomes. CONCLUSION: PCPs should be alert to gender-specific differences for women with AUDs.

Female↗

PubMedDate not supplied

Delay in obtaining conventional healthcare by female internal medicine patients who use herbal therapies.

The use of herbal products has been studied in the general population, but few studies have focused on the prevalence of herbal therapy use for treatment of symptoms or disease among female internal medicine patients or on predictors for delaying obtaining conventional care while using herbal therapy. Cross-sectional 34-item self-report surveys were mailed to female patients in two private practice internal medicine sites and interviewer administered to patients in a resident ambulatory clinic. The survey included sociodemographics, medical problems, use of herbal therapies, and whether conventional care was delayed while using herbal therapy. Of 354 patients, 220 (62%) participated. Their mean age was 51 years, and most were Caucasian (77%) and had more than a high school education (60%). Of these, 81 (37%) women used herbal therapies for treatment of symptoms or disease, and use did not differ by study site. Twenty-six (32%) delayed obtaining conventional care while waiting for an herbal product to work, although most eventually obtained conventional care. In multivariate analysis, predictors for delay of care included negative experience with prescription medicines, history of failed treatments, and desire for increased control over personal healthcare. Among female patients of general internists, there was a high prevalence of herbal therapy use for treatment of illness, and some women delay obtaining conventional care while using an herbal product. Predictors for delay may alert physicians to educate their patients before delaying care.

Age Distribution↗

PubMedDate not supplied

Influence of gender on the evaluation of internal medicine residents.

OBJECTIVE: To determine if gender of resident or faculty influences performance ratings of residents on general medicine ward rotations. METHODS: Secondary analysis from an observational cohort study of residents and faculty who participated in a randomized, controlled trial of a focused educational intervention on resident evaluations in two internal medicine residency programs. The study included 88 faculty and 160 residents (postgraduate years [PGY] 1-3) of the Yale University department of medicine assigned to inpatient general ward rotations in four different hospitals during academic year 1997-1998. The methods included a hierarchical linear model (HLM) with the male faculty-male resident dyad as reference comparison to investigate the influence of gender on numeric ratings in four domains of competence. RESULTS: Seventy male and 18 female faculty provided 262 resident evaluations during the study. Factor analysis identified four distinct domains of competence (interpersonal skills, teaching, clinical performance, overall performance). After adjustment for potential confounders, no significant gender influences in evaluation were found in any domain, and there was no consistent pattern of a gender effect on evaluation for the observed trends. CONCLUSIONS: Our results did not identify any gender effects influencing evaluation of residents rotating on a general medicine ward service. If gender influences are present within the evaluation process, identification will likely require more sophisticated methodology to tease apart. Future research incorporating direct observation and qualitative methods may be helpful in delineating potential gender influences on performance evaluation.

Cohort Studies↗