PubMed Health⌕ Search

Biomedical subjects

T Choi

Publications and source records attributed to T Choi.

At least 37 records · Page 2Linked to original sources
PubMed1990

Barriers and motivators to prenatal care among low-income women.

Substantial evidence exists which links prenatal care to improved birth outcomes. However, low-income and nonwhite women in the United States, who are at greatest risk for poor birth outcomes, continue to receive the poorest prenatal care. The purpose of this study was to identify and compare barriers and motivators to prenatal care among women who lived in low-income census tracts. The stratified sample included recently delivered white, black and American Indian women who received adequate, intermediate, and inadequate prenatal care. Interviews were conducted which focused primarily on the women's perceptions of problems in obtaining prenatal care and getting to appointments. Results indicated that women with inadequate care identified a greater number of barriers and perceived them as more severe. Psychosocial, structural, and socio-demographic factors were the major barriers, while the mother's beliefs and support from others were important motivators. The predictive power of selected barrier variables was examined by a regression analysis. These variables accounted for 50% of the variance in prenatal care use. The results affirm the complexity of prenatal care participation behavior among low-income women and the dominant influence of psychosocial factors. Comprehensive, coordinated and multidisciplinary outreach and services which address psychosocial and structural barriers are needed to improve prenatal care for low-income women.

Adult↗
PubMed1988

Perinatal lethal osteogenesis imperfecta in transgenic mice bearing an engineered mutant pro-alpha 1(I) collagen gene.

Substitutions of single glycine residues of alpha 1(I) collagen have previously been associated with the inherited disease osteogenesis imperfecta type II. Transgenic mice bearing a mutant alpha 1(I) collagen gene into which specific glycine substitutions have been engineered show a dominant lethal phenotype characteristic of the human disease, and demonstrate that as little as 10% mutant gene expression can disrupt normal collagen function.

Amino Acid Sequence↗
PubMed1988

Changing criteria for hospital acquisitions.

This article presents models that explain differences between hospitals that were and were not acquired over a five-year period. Analyses show that there was not an overall model applicable to all years. Rather, out of a general set of environmental and organizational variables, several models were found necessary for different time periods. The need for multiple models reflects the changing dynamics of the environment that continuously confound health care institutions.

Decision Making↗
PubMed1986

Hospital cost savings: resembling business.

Hospitals, like other employers, offer health care benefits to their employees. Cost savings can be realized when hospitals offer packages that resemble those provided by business employers. Business packages explain variance in cost savings more than employee characteristics do.

Age Factors↗
PubMed1986

Effects on nurse retention. An experiment with scheduling.

Four randomly selected nursing groups were assigned to three experimental groups and one control group to test the relative impact of three experimental nursing schedules, using a before-after design. The three experimental treatments were straight shifts; regular schedule but with unlimited requests for changes; and individual station-designed schedules. Before treatment, score differences between the experimental and control groups were limited to one of 36 highly reliable scales specifically constructed and pretested to gauge effects of scheduling. This single difference was judged not to be significantly related to experimental outcomes. Because of a poor job market situation, retention was not affected significantly by any of the three treatments, but root causes of turnover were. Results of the experiment showed that individual station-designed schedules triggered the most changes that favor retention. In contrast, the other two treatments unexpectedly increased nurses' own sense of marketability and reduced teamwork among nurses. Reasons accounting for the results are discussed in the text.

Evaluation Studies as Topic↗
PubMed1986

Managing support services in publicly owned hospitals.

One of the most significant problem areas for publicly owned hospitals is the administration and control of support services. The location of the control of these services affects their responsiveness and efficiency.

Ancillary Services, Hospital↗
PubMed1985

Impact of environment on state university hospital performance. An explanatory model.

This article, by means of a path model, shows the impact of environment on state university hospital performance. The state environment is shown to affect systematically the intensity of local competition, the reputation of the medical school, the financial independence of the parent university, the allocation of indigent care dollars, the nature of governance and management, and the performance of the hospital. Results show that while certain environments are predictably more supportive of universities and university hospitals, these environments tend also to attract health care competition. Competition is shown to pressure hospitals into greater efficiency, but competition is shown also to hurt viability. But a hospital management that pays attention to the hospital environment is shown to help both efficiency and viability. The model explains respectively 37% and 46% of the variance in hospital efficiency and viability.

Data Collection↗
PubMed1984

Nutrition counseling in private practice: attitudes and activities of family physicians.

A community approach to cardiovascular disease control is advocated for the United States because of the high disease incidence and prevalence relative to other countries. The goal of this approach is to change nutrition behavior of all members of the community. As part of a program to identify barriers to physician participation, a survey of a random sample of family practice clinical faculty in a midwestern state was made to determine (a) if physicians agree that it is appropriate to give nutritional advice to a patient who came to the clinic for another reason, (b) the proportion of patients given nutritional advice, and (c) the barriers to giving nutritional advice. Most physicians report that giving nutritional advice to patients visiting them for other reasons is considered appropriate, but almost half the physicians give advice about dietary fat, dietary sodium, or dietary fiber to fewer than 20% of their patients. Only about 10% of physicians give advice to more than 80% of their patients. Absence of elevated risk factor levels or nutritional disease is the most common reason for not giving advice. Perceived lack of patient interest and expectation of patient nonadherence are also barriers. Unpalatability of the diet is occasionally a barrier. Cost of the diet is not a consideration. From these data it is concluded that family physicians consider it appropriate to give nutritional advice to patients who are not necessarily seeking it, but the perception that patients do not need or want, and would not follow, the advice inhibits physicians from delivering nutrition messages in private practice.

Adult↗
PubMed1984

Systematic impact of the state on CEO tenure.

Using information from the literature on both for-profit industrial corporations and nonprofit community hospitals, a path model is constructed to show the effect of the state on CEO tenure at state-owned university hospitals. Results indicate that CEOs' lack of managerial influence and control over competition adversely affects their tenure at these institutions, even when the financial viability of the university hospital is not at stake.

Economic Competition↗
PubMed1984

Feasibility of simulating physicians' judgments of patient severity.

This article reports on adopting Gustafson's multiattribute utility method to develop a specific momentary severity index (vis-à-vis severity over time) for nontraumatic chest pain patients. A panel of physicians identified an appropriate set of indicators for the index. Three mathematic models were generated on the basis of these indicators with each model predicting no less than 81% of the variance in overall scores of 96 simulated patients with chest pain. High interrater reliability (0.94) was demonstrated. Congruent validity coefficients between the three model scores and the overall scores vary between 0.71 and 0.92 depending on how the panel physicians are grouped. Results indicate the feasibility of simulating physician judgments regarding patient severity in chest-pain-related cases.

Acute Disease↗
PubMed1983

Perceived palatability of the prudent diet: results of a dietary demonstration for physicians.

"Product sampling" is an effective marketing strategy which lowers consumer buying resistance by providing a free sample of the product for the consumer to test. We used this strategy to demonstrate the palatability of the prudent diet (30-35% of calories from total fats, less than 10% from saturated fats, less than 3 g sodium, and increased fiber) to physicians attending a 5-day family practice continuing medical education conference. The effect of the intervention was evaluated with pre- and postintervention questionnaires and a 20% random sample of participants was surveyed 1 year later. The proportion of physicians who reported that they considered the diet to be "very palatable" rose from 26% before the demonstration to 64% after the demonstration. Only 5% of the physicians did not report a favorable response to the demonstration. Sixty-two percent of the physicians reported that the diet was better than expected, and 82% reported that the demonstration encouraged them to recommend the diet to their patients. One year after the intervention 60% considered the diet "very palatable" and 55% reported that the demonstration stimulated them to increase their dietary intervention activities. These data suggest that serving the prudent diet at continuing medical education programs helps to remove prejudices about the diet and encourages physicians to recommend the diet to their patients.

Attitude↗
PubMed1983

Health-specific family coping index for noninstitutional care.

We report on attempts to improve the Richmond/Hopkins Family Coping Index. Factor analysis showed that revised operational guidelines for using the index probably contributed to a significantly higher per cent of variance explained by the index (83 per cent versus 59 per cent). Interrater reliability was high (greater than or equal to .97). Correlation between this index and another coping index was also high (.94). Results support the continued use of the Family Coping Index--with new instructions--to assess patient/family coping.

Adaptation, Psychological↗
PubMed1980

Primary nursing in an organizational context.

This article analyzes primary nursing critically and comprehensively. Synthesizing past and present data, the authors suggest a new definition for primary nursing that takes the organizational context into consideration. They illustrate how organizations influence the effectiveness of primary nursing care. The documented information presented here will save nursing administrators hours of reading and analyzing, and will help them make informed decisions about primary nursing.

Humans↗