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Biomedical subjects

S Dobie

Publications and source records attributed to S Dobie.

13 recordsLinked to original sources
PubMed2001

Analgesia for colposcopy: double-masked, randomized comparison of ibuprofen and benzocaine gel.

OBJECTIVE: To evaluate pain relief effectiveness of oral ibuprofen and topical benzocaine gel during colposcopy. METHODS: In a double-masked, randomized controlled trial, women who attended a family medicine colposcopy clinic received one of four treatments, 800 mg of oral ibuprofen, 20% topical benzocaine, both, or placebos. Using visual analog scales, women recorded their pain after speculum placement, endocervical curettage (ECC), and cervical biopsy. Participants were 18-55 years old, spoke English, and were not taking other pain or psychotropic medications. Demographic and historical information was collected from each participant. RESULTS: Ninety-nine subjects participated. Twenty-five received oral ibuprofen and topical benzocaine (median pain scores on a 10-point scale for speculum placement, ECC, and biopsy were 0.75, 3.00, and 3.38, respectively), 24 received oral placebo and topical benzocaine (1.00, 3.75, and 2.63), 24 received oral ibuprofen and topical placebo (0.63, 3.75, and 2.25), and 26 received oral and topical placebos (0.75, 3.50, and 3.00). There were no statistically significant differences in patient visual analogue pain scale scores across the four groups (statistical power, ECC = 0.74, cervical biopsy = 0.62). Younger women and women who had pain with speculum placement were more likely to have increased pain during ECC. Increased pain during biopsy was associated with history of severe dysmenorrhea but no other demographic or historical factors. Women overall reported ECC and biopsy to be mildly painful, with median scores of 3.5 for ECC and 2.75 for biopsy on a 10-point scale. The range in pain scores was large, with some women reporting severe pain (for ECC minimum = 0.25, maximum = 10.0; biopsy: minimum = 0.0, maximum = 9.0). CONCLUSION: Colposcopy is perceived as somewhat painful, but oral ibuprofen and topical benzocaine gel, alone or together, provided no advantage over placebo in decreasing colposcopy pain.

Administration, Oral↗
PubMed1998

Obstetric care and payment source: do low-risk Medicaid women get less care?

OBJECTIVES: This study examined whether Medicaid-insured women at low risk receive less adequate obstetrical care than privately insured women. METHODS: Low-risk women who were cared for by a random sample of obstetrical providers in Washington State were randomly selected. Information on all prenatal and intrapartum services was abstracted from medical records. Service information was aggregated into standardized resource-use units. Results compared Medicaid-insured women with those who were privately insured. RESULTS: Medicaid-insured women were significantly younger (22.5 years vs 26.9 years) and averaged 6% fewer visits than privately insured women. Nonetheless, Medicaid status had no meaningful association with prenatal, intrapartum, or overall resource use. Some variation occurred in individual resources received. Medicaid-insured women had 38.8% more resources expended on testing for sexually transmitted diseases. Privately insured women had more resources expended on alpha-fetoprotein testing and on amniocentesis. There were no meaningful differences in birthweight or gestational age at delivery. CONCLUSIONS: In this study of women who entered obstetrical care at low risk, similar care and resources were expended on Medicaid-insured and on privately insured women.

Adult↗
PubMed1996

Why do the elderly seek or avoid care? A qualitative analysis.

BACKGROUND AND OBJECTIVES: This study attempts to understand why the elderly seek or choose not to seek health care. Most studies on barriers to health care have measured obstacles defined by the researchers. We attempt to define variables that are relevant to the elderly but have not yet been articulated. METHODS: Using grounded theory, open-ended interviews of 15 non-housebound elderly were conducted and coded. The data obtained were analyzed to discover and characterize the subjects' perceptions of barriers. RESULTS AND CONCLUSIONS: The major theme that emerged involved the interactions among autonomy, self-esteem, and the degree of illness or health. The study generated two hypotheses: 1) Self-esteem is directly correlated with the willingness of the elderly to seek care, especially as illness increases and autonomy decreases. 2) The individual's perception of health status, the perceived roles of the physician and the patient, the physician-patient relationship, and systems issues contribute to the dynamic paradigm that positions the elderly patient to seek or avoid seeking health care.

Aged↗
PubMed1991

A collaborative approach to a primary care preclinical preceptorship for underserved settings.

This study describes the first few years of a collaborative effort undertaken by the University of Washington School of Medicine (UWSM), the Washington-Alaska-Montana-Idaho (WAMI) Area Health Education Center program, the Washington Academy of Family Practice, and the Family Health Foundation of Washington to provide students with an early introduction to primary care practice in rural and urban underserved settings. Starting in 1988, these collaborators organized a summer preceptorship that offered placements in the WAMI region to 23 student volunteers who were between their first and second years at the UWSM in 1989 and to 51 such students in 1990. A preliminary evaluation of the program indicated that the students (73 of whom participated in the evaluation) were extremely satisfied with the program's ability to provide them with firsthand exposure to community medicine. In conclusion, the authors discuss the advantages of collaboration and make suggestions for identifying potential educational partners.

Alaska↗