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Biomedical subjects

Sandra K Burge

Publications and source records attributed to Sandra K Burge.

10 recordsLinked to original sources
PubMed2006

Girl World: a primary prevention program for Mexican American girls.

Theories about women's health have not traditionally been extended to include the healthy development of young women. This article applies a women's health perspective to the implementation and evaluation processes of a gender-specific primary prevention program that worked with 9- to 14-year-old Hispanic girls in a low-income community. Although community-based after-school programs can be an important venue for education and girls' development, long-term effects are elusive to evaluate. The authors used ethnographic techniques to learn more about girls and their interactions with the program and to assess short-term program impact. Three themes were found: Program environment can contribute to girls' expression and behavior, issues of struggling families can slide girls into early adulthood, and mentoring can benefit both girls and adult women. Community-based primary prevention programs, although an essential part of a social safety net available to low-income girls, provide researchers with a unique set of evaluation challenges.

Adolescent↗
PubMed2006

Factors that predict how women label their own childhood sexual abuse.

Despite the psychological impact of child sexual abuse, many victims do not acknowledge that their experiences were "abuse". This study sought to identify factors that predict how women label their own experiences of childhood sexual abuse. This cross-sectional study was conducted in a family medicine clinic with adult female patients. Subjects completed structured interviews about their childhood environment and their sexual abuse history. Logistic regression analysis showed that labeling of abuse was dependent upon intercourse (beta = 7.43, p = .006), the frequency of abuse by the first perpetrator (beta = 5.08, p = .024), and paternal overprotection (beta = 6.69, p = .010). Findings suggest that the severity of abusive acts is most important and an over-protective father may enhance the victim's acknowledgment that sexual touching is abusive.

Adult↗
PubMed2005

Differences in childhood sexual abuse experience between adult Hispanic and Anglo women in a primary care setting.

The literature on racial and ethnic factors in childhood sexual abuse is limited. The purpose of this exploratory study was to document Hispanic-Anglo differences in childhood sexual abuse experiences and assess whether these differences may be explained by socio-demographic and family environmental differences. Adult Hispanic (n = 69) and Anglo (n = 19) women from a family medicine clinic waiting room reporting a history of childhood sexual abuse completed an in-depth survey concerning the sexual abuse experience and their childhood environment. In this study, Hispanics were more likely to report a family member as the perpetrator and to experience more self-blame as a result of the abuse. Hispanics were also more likely to take action in response to the abuse, especially those who were more acculturated to U.S. culture. However, most of the observed differences in this study could be explained by socio-demographic or family environment variables, not by ethnic background. Qualitative research on the family environments of Hispanic victims of child sexual abuse may further explicate the dynamics and risk factors for abuse by family members.

Adult↗
PubMed2005

Multiethnic perspectives on elder mistreatment.

PURPOSE: We conducted this study to understand the interpretations of elder mistreatment (EM) in multiethnic older adults. DESIGN AND METHODS: Focus group sessions were held with three ethnically homogenous groups (n = 18) and a group of elder care professionals (n = 6) eliciting responses to vignettes depicting various types of elder mistreatment. Qualitative analysis of focus group transcripts was performed to define EM occurrence, its severity, and to identify the perpetrator and victim. RESULTS: Four main categories emerged: social expectations, caregiver expectations, victim characteristics, and characteristics of the interaction. Themes included issues of gender roles, filial obligations, martial commitments, and ageism as features of the vignette discussions. Professional and lay caregiver issues were features of the caregiver expectations. Mental capacity, physical dependency, physical attributes, and complicity were the victim characteristics discussed. The characteristics of the interaction that were identified included resistance to care, retaliation, habitual occurrence, and perpetrator intent. IMPLICATIONS: Older adults identify multiple factors influencing the interpretation of elder mistreatment. These factors may determine strategies for future EM intervention.

Journal Article↗
PubMed2004

Prevalence and 3-year incidence of abuse among postmenopausal women.

OBJECTIVES: We examined prevalence, 3-year incidence, and predictors of physical and verbal abuse among postmenopausal women. METHODS: We used a cohort of 91,749 women aged 50 to 79 years from the Women's Health Initiative. Outcomes included self-reported physical abuse and verbal abuse. RESULTS: At baseline, 11.1% reported abuse sometime during the prior year, with 2.1% reporting physical abuse only, 89.1% reporting verbal abuse only, and 8.8% reporting both physical and verbal abuse. Baseline prevalence was associated with service occupations, having lower incomes, and living alone. At 3-year follow-up, 5.0% of women reported new abuse, with 2.8% reporting physical abuse only, 92.6% reporting verbal abuse only, and 4.7% reporting both physical and verbal abuse. CONCLUSIONS: Postmenopausal women are exposed to abuse at similar rates to younger women; this abuse poses a serious threat to their health.

Age Distribution↗
PubMed2004

The patient-physician relationship, primary care attributes, and preventive services.

BACKGROUND: The importance of a sustained relationship between patients and physicians is a defining characteristic of family medicine. This study examined whether there is an association among the length of the patient-physician relationship, various attributes of primary care, and the delivery of clinical preventive services to Medicare beneficiaries. METHODS: The data source for this study was the 1993 Medicare Current Beneficiary Survey. Primary care attribute scales were developed by conducting a factor analysis of 17 survey questions. Three clinical preventive services were measured as outcomes: influenza vaccination, mammography, and an eye examination for diabetics. Path analyses were used to test the relationships between length of relationship, primary care attributes, and delivery of clinical preventive services. RESULTS: As the length of the relationship increased, scores on communication, accumulated knowledge of the patient by the physician, and trust all improved. Length of relationship and communication predicted accumulated knowledge of the patient by the physician, accumulated knowledge predicted trust, and trust predicted delivery of preventive services. CONCLUSIONS: Among elderly Medicare beneficiaries, the ability to develop a sustained relationship with a provider is related to the realization of other important attributes of primary care. Trust was associated with delivery of important clinical preventive services. Efforts should be made to protect the ability of patients and physicians to sustain a relationship over time.

Aged↗
PubMed2002

Continuity and quality of care in type 2 diabetes: a Residency Research Network of South Texas study.

OBJECTIVE: We investigated the relationship between continuity of care and the quality of care received by patients with type 2 diabetes mellitus. STUDY DESIGN: We used a cross-sectional patient survey and medical record review. POPULATION: Consecutive patients with an established diagnosis of type 2 diabetes mellitus presented to 1 of 6 clinics within the Residency Research Network of South Texas, a network of 6 family practice residencies affiliated with the University of Texas Health Science Center at San Antonio. OUTCOMES MEASURED: Continuity was measured as the proportion of visits within the past year to the patient's usual primary care provider. A quality of care score was computed based on the American Diabetes Association's Provider Recognition Program criteria from data collected through medical record review and patient surveys. Each patient was awarded points based on the presence or absence of each criterion. RESULTS: The continuity score was associated significantly with the quality of care score in the anticipated direction (r =.15, P =.04). Patients who had seen their usual providers within the past year were significantly more likely to have had an eye examination, a foot examination, 2 blood pressure measurements, and a lipid analysis. CONCLUSIONS: Continuity of care is associated with the quality of care received by patients with type 2 diabetes mellitus. Continuity of care may influence provider and patient behaviors in ways that improve quality. Further research on how continuity contributes to improved quality is needed.

Academic Medical Centers↗
PubMedDate not supplied

Patients' advice to physicians about intervening in family conflict.

PURPOSE: We wanted to understand patients' views about physician interventions with family violence and conflict. METHODS: Clinic staff surveyed 253 male and female family practice patients in 6 member offices of the South Texas Ambulatory Research Network (STARNet). The survey instrument addressed demographics, relationship quality, intimate partner violence, and physician interventions with family conflict. Open-ended questions asked respondents to provide advice for "doctors who want to help patients with severe family problems." RESULTS: Among women in relationships, 10% reported being physically hurt by a partner in the past year and 39% in their lifetimes. Among men in relationships, 7% reported physically hurting their partner in the past year and 16% in their lifetimes. Nearly all respondents, including 100% of victims and perpetrators of violence, believed physicians should ask about family conflict (96%), and that physicians could be helpful (93%). Two thirds of the sample reported that their physician had never asked them about family conflict. Investigators used qualitative analysis to summarize patients' advice to physicians. Responses clustered around 3 general themes: communication, assistance, and cautions or encouragement. Patients want physicians to ask about family conflict, listen to their stories, and provide information and appropriate referrals. They raised some cautions and concerns, but also provided words of encouragement. CONCLUSION: Most patients are open to discussions about family conflict with their physicians. The skills they recommend to physicians are well within the domain of family medicine training.

Adolescent↗
PubMedDate not supplied

Improving firearm storage habits: impact of brief office counseling by family physicians.

BACKGROUND: Firearm injury is the leading cause of injury-related death among youth and second leading cause of injury-related death overall in the United States. Our objective is to determine the impact of brief office counseling by family physicians on patients' firearm storage habits. METHODS: Of the 1,233 patients who completed the enrollment questionnaire, 156 (13%) reported they had guns in their household and agreed to participate in the study. Postintervention survey instruments were completed by 127 (81%) of participants. Participants received either no counseling, verbal counseling alone, or counseling and a gun safety brochure from their physician. Firearm storage habits were measured at baseline and 60 to 90 days after intervention. RESULTS: At the postintervention interview, 64% of the group receiving verbal counseling and 58% of the group receiving verbal counseling plus written information made a safe change in gun storage compared with 33% of participants in the no-intervention group (P =. 02). A logistic regression model controlling for demographics and gun ownership showed that compared with the no-intervention group, intervention participants were three times more likely to make safe changes. CONCLUSIONS: Family physicians' brief counseling efforts made a significant positive impact in the firearm storage habits of their patients. With a verbal or written recommendation, a significant improvement was observed in firearm storage.

Counseling↗