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At least 973 records · Page 54Linked to original sources

PubMed1985

Building an effective doctor-patient relationship: from patient satisfaction to patient participation.

In this paper, the authors argue that patient satisfaction is an insufficient measure of the quality of the doctor-patient relationship. While shown to have a salutary effect on patient anxiety concerning illness and treatment, the only other significant outcome associated with levels of satisfaction is utilization behavior. This is not surprising, the authors argue, since prevailing conceptualizations of patient satisfaction fail to incorporate measures of patient participation in the therapeutic process. Evidence suggests that by encouraging patients to take an active role in their health care physicians can increase the effectiveness of their therapeutic activities. A method for involving patients is through incorporating their preferences into the physician's decision-making processes. An example of physician decision making which incorporates patient preferences is provided.

Attitude to Health↗

PubMed1991

Working group recommendations: measuring outcomes of care in geriatric evaluation and management units.

Issues related to measuring outcomes of care in geriatric evaluation and management (GEM) units were identified by the outcomes working group of the GEM evaluation conference. GEM units have as a major goal the improvement or maintenance of both physical and psychosocial function. Suggested outcome measures for physical health included survival, restricted activity days, general health perceptions, comprehensive physical function, and miscellaneous specific types of functioning. In the area of psycho-social function, the working group suggested measuring cognitive function, affect/life satisfaction, social function, and satisfaction with care. The patient's caregiver (eg, spouse or child) is often an important target of GEM care, and the group suggested measuring caregiver burden, life satisfaction, and assessment of patient behavior problems. While the primary goal of GEM units is to improve health status, their effects on the utilization and cost of health care are important to decisions about wide-spread implementation and funding. The group therefore suggested a comprehensive assessment of these outcomes. Among the large array of recommended outcomes, the most important were thought to be mortality, function, and cost.

Activities of Daily Living↗

PubMed2004

The Internet as a vehicle to communicate health information during a public health emergency: a survey analysis involving the anthrax scare of 2001.

BACKGROUND: The recent public health risks arising from bioterrorist threats and outbreaks of infectious diseases like SARS (Severe Acute Respiratory Syndrome) highlight the challenges of effectively communicating accurate health information to an alarmed public. OBJECTIVE: To evaluate use of the Internet in accessing information related to the anthrax scare in the United States in late 2001, and to strategize about the most effective use of this technology as a communication vehicle during times of public health crises. METHODS: A paper-based survey to assess how individuals obtained health information relating to bioterrorism and anthrax during late 2001. We surveyed 500 randomly selected patients from two ambulatory primary care clinics affiliated with the Brigham and Women's Hospital in Boston, Massachusetts. RESULTS: The response rate was 42%. While traditional media provided the primary source of information on anthrax and bioterrorism, 21% (95% CI, 15%-27%) of respondents reported searching the Internet for this information during late 2001. Respondents reported trusting information from physicians the most, and information from health websites slightly more than information from any traditional media source. Over half of those searching the Internet reported changing their behavior as a result of information found online. CONCLUSIONS: Many people already look to the Internet for information during a public health crisis, and information found online can positively influence behavioral responses to such crises. However, the potential of the Internet to convey accurate health information and advice has not yet been realized. In order to enhance the effectiveness of public-health communication, physician practices could use this technology to pro-actively e-mail their patients validated information. Still, unless Internet access becomes more broadly available, its benefits will not accrue to disadvantaged populations.

Ambulatory Care Facilities↗

PubMedDate not supplied

Recreating communities to support active living: a new role for social marketing.

The lack of routine physical activity has become an all too pervasive health threat in the United States. Social marketing can be used directly to promote increased physical activity among people who have access to active living options (e.g., safe and convenient sidewalks or bike paths). A second, albeit indirect, use of social marketing to promote physical activity--and the focus of this article--involves promoting behaviors that influence the built environment for the purpose of increasing people's access to active living options. This use of social marketing involves changing the behavior of consumers, developers, distribution channels (e.g., real estate agents) and policy makers. The approach offers public health and other organizations a disciplined, consumer-focused means of mobilizing their available resources in a manner that maximizes the odds of creating active living communities. These means include understanding the competition, understanding target markets, creating mutually beneficial exchanges, segmenting markets and targeting them based on anticipated return. This article identifies specific opportunities for applying the social marketing approach to create active living communities, and identifies opportunities at the state and national level that will enhance the effectiveness of local efforts.

Community Health Planning↗

PubMed1990

The impact of race on volunteer helping relationships among the elderly.

As programs solicit their help in providing transportation, shopping assistance, telephone reassurance, counseling, and information and referral to needy elderly people, older adults are going to fill increasingly important roles as volunteers in the social service system for this aging society. Little empirical work has been done on effective volunteer behavior. This article aims to increase understanding of this topic by exploring how race influences relationships between volunteers and the people they serve. This analysis reveals that race by itself does not affect volunteer helping behavior; black and white older adults perform similarly in volunteer roles on measures of time committed to service and satisfaction levels of clients. However, the racial composition of the dyad does have significant effects on the helping relationship; higher levels of contact and client satisfaction are reported when the volunteer and the client are of the same race. Professional training and support are necessary to overcome problems associated with racial differences between volunteers and their clients.

Black or African American↗

PubMed1981

Determinants of person-environment congruence in institutionalized elderly men and women.

This study was designed to obtain information potentially of value in understanding an modifying the impact of the social environment of the perceived quality of like among institutionalized aged persons. It was hypothesized that Person-Environment (P-E) congruence, as assessed by the Environmental Perception, Preference and Importance Scale (EPPIS), would be related to (1) sex integration/segregation makeup of the health related facility (HRF) living units, and (2) quantity of social interaction between staff and residents. Analysis of sex by unit sex-type interaction for 60 residents' Person-Environment (P-E) congruence scores revealed that elderly females on sex-integrated units reported a higher level of P-E congruence than those residing on female-only units; males on sex-integrated units, in contrast, reported a poorer level of P-E congruence than males on sex -segregated units. Furthermore, behavioral observations of staff-resident verbal interactions confirmed the hypothesis that residents living on units with high staff-resident interaction perceived the environments more congruent with their preferences than residents on units low in verbal interaction. The observed relationships between the P-E congruence measure, resident-staff interaction, and unit sex-type were taken as further support for the relevance and value of the EPPIS measure as a tool for assessing and improving the institutional milieu.

Aged↗

PubMed1983

Effect of deprivation on the grocery shopping behavior of obese and nonobese consumers.

The universal Product Code (UPC) checkout system was used to determine the type of unplanned purchases made by obese and nonobese in a supermarket under various levels of deprivation. The results show that deprivation differently affects the saliency of food-related cues for obese and nonobese. Obese individuals purchased more unplanned items when not deprived than when deprived. Moreover, the majority of the unplanned purchases were items that were on an end aisle or point-of-purchase display. The results are discussed in terms of previous research that have demonstrated that the obese and nonobese interpret and respond differently to internal and external cues of hunger.

Food Deprivation↗

PubMed1990

The longitudinal clinical effectiveness of osseointegrated dental implants: the Toronto Study. Part II: The prosthetic results.

Forty-six patients who had shown chronic maladaptive behavior in using complete dentures were treated with osseointegrated implant-supported prostheses. Forty patients needed mandibular treatment, three patients needed treatment in the maxillae, and three required treatment in both dental arches. At the most recent data collection (4 to 9 years after surgical placement of the implants), the 49 dental arches remained successfully treated with 44 implant-supported fixed partial dentures and five implant-supported overdentures. The efficacy of the osseointegration technique in maladaptive prosthetic patients is demonstrated in this descriptive study.

Adult↗

PubMed2003

Performance measures and their benchmarks for assessing organizational cultural competency in behavioral health care service delivery.

A project is described in which performance measures of cultural competency in behavioral health care were selected and benchmarked. Input from an Expert Panel representing the four major ethnic and racial groups in the U.S. and persons with extensive experience in implementing cultural competency in health care, along with survey data from 21 sites were used in the process. Measures and benchmarks are made specific to organizations that administrate care networks, and to service entities that deliver care. Measures were selected to parallel an implementation process, and benchmarks were set at "gold standard" levels.

Attitude of Health Personnel↗

PubMed2001

Redefining reference in an academic health sciences library: planning for change.

Deciding that changes in the pattern of questions at the reference desk required focused consideration, the reference librarians at the Health Sciences Library of the University at Buffalo held a planning retreat. Technology-induced changes in the information-seeking behavior and reference needs of the library's clientele caused a reassessment of how these needs could best be met and what is the best use of librarians' time. The librarians considered current trends in reference in other academic libraries, the specific needs of the clientele of the Health Sciences Library, and the strengths and expertise of the library staff. The results of this structured discussion produced ideas for redefining reference to provide customized services for the clients and environment.

Academic Medical Centers↗

PubMedDate not supplied

Childhood injury prevention in a suburban Massachusetts population.

A controlled population-based study of a childhood injury prevention program in four suburban Massachusetts communities was able to demonstrate a 15.3 percent decrease in injury rates for children ages 0-5 years. A substantial improvement was seen in the relative risk for injury in the intervention as compared with control communities. The major intervention was a pediatric counseling program taking place within a context of various community education efforts. Process data on patient satisfaction and physician compliance, and educational and behavioral outcomes from previously reported studies, when combined with injury incidence data in this report, support the hypothesis that physician counseling may be an important factor in the favorable results observed in these suburban communities. These data also suggest that a decrease in injury incidence may be possible when interactive physician counseling takes place within the context of community education programs. A comprehensive strategy that includes technological, legislative, and educational activities is suggested as the optimal approach to childhood injury prevention.

Accident Prevention↗

PubMedDate not supplied

Appointment-keeping behavior and patient satisfaction: implications for health professionals.

This study examines patient satisfaction with care received in a subspecialty clinic, appointment-keeping behavior in that clinic, and the interrelationships between satisfaction and appointment-keeping compliance. The implications for health education and patient counselling are also discussed. The setting is an outpatient clinic of a large university hospital that serves both an urban and rural population. A mailed questionnaire was returned by 150/270 (56%) patients. While satisfaction and compliance were not significantly related, satisfaction was significantly related to the patient's perception of benefit received as a result of care provided by the clinic.

Adult↗

PubMed2005

Employment-based health insurance: analysis of rural-urban differences in one state.

This study estimates the propensity of firms to offer health insurance in a simultaneous equation model to control for the endogeneity between wages and health insurance. Previous research finds differences in rural and urban employer behavior with respect to health insurance benefits fully explained by differences in wages and firm size. In contrast, this study finds residual unexplained differences in the propensity to offer coverage that may be attributable to differences in plan supply, plan distribution, or differences in availability of substitutes for coverage (safety net care). Rural worker participation in offered coverage is more responsive to wage level than is the participation decision of urban workers. Together, these results imply that some of the differences in health insurance coverage rates for rural workers could be amenable to policy interventions.

Adult↗

PubMed1980

The significance of patients' perceptions of physician conduct: a study of patient satisfaction in a family practice center.

The provision of high quality medical care and the insurance of patient satisfaction depend in part upon the ability and willingness of physicians to establish rapport with their patients and to develop effective physician-patient communication. In this study, patients' overall satisfaction with their physicians' care was assessed in relation to their perceptions of their physicians' (1) proficiency at communicating and listening to details of the illness and medical treatment, (2) capability of providing affective care, and (3) technical competence. Perceptions of physician behaviors were measured by a questionnaire administered to 329 patients of 54 residents in a family practice center. The relationship between the perceptions of patients and their satisfaction with medical care was examined both for the entire sample and among groups of patients with differing demographic characteristics. Results indicate an important link between patients' perceptions of socioemotional aspects of the physician-patient relationship and their reported satisfaction with medical care. Noticeable differences were found to exist in the importance that patients with different demographic characteristics placed on various aspects of their physicians' conduct.

Adult↗

PubMed2005

Nutritional content of foods advertised during the television programs children watch most.

OBJECTIVES: We sought to code food (nutritional content and food type and eating occasion) and character (cartoon and live action) attributes of food advertisements airing during television programs heavily viewed by children, and to represent and evaluate the nutritional content of advertised foods in terms of the nutrition facts label. METHODS: Food advertisements (n=426) aimed at general and child audiences were coded for food and character attributes. "Nutrition Facts" label data for advertised foods (n=275) were then analyzed. RESULTS: Convenience/fast foods and sweets comprised 83% of advertised foods. Snacktime eating was depicted more often than breakfast, lunch, and dinner combined. Apparent character body size was unrelated to eating behavior. A 2000-calorie diet of foods in the general-audience advertisements would exceed recommended daily values (RDVs) of total fat, saturated fat, and sodium. A similar diet of foods in the child-audience advertisements would exceed the sodium RDV and provide 171 g (nearly 1 cup) of added sugar. CONCLUSIONS: Snack, convenience, and fast foods and sweets continue to dominate food advertisements viewed by children. Advertised foods exceed RDVs of fat, saturated fat, and sodium, yet fail to provide RDVs of fiber and certain vitamins and minerals.

Advertising↗

PubMed1975

Dental health status of third grade children and their families within the context of a community's dental health care system.

Utilizing structure, process, and outcomes as conceptual dimensions of appraisal of quality, data were analyzed to present an evaluation of the quality of a community's dental health care system as reflected in a population subgroups' dental health status. Data were collected from 838 Caucasian third-graders and their parents through interviews, mail questionnaires, and dental screening examinations. Indicators of structure were: status of community water fluoridation in the study community, dentist to population ratio, and dental care resources in the public sector available to eligible residents. Process indicators of quality were: 1) screening, case finding, examinations, and quality of restorations as measures of provider behaviors, and 2) complaints, compliance, conditioned behaviors, level of dental health knowledge, and utilization of dental services as measures of client behaviors. Outcomes, subjected to analysis included indices indicative of dental disease experience. Variables operationally defined as indicators of the subgroup's dental health status were subjected to a descriptive analysis and were then crosstabulated with the socioeconomic status of the child's family to identify socioeconomic differences in the process of obtaining care and in dental health outcomes. Findings indicate which elements in a community's prevailing dental health care system function well and which would need alteration to maximize dental health for the subgroup.

Adult↗

PubMedDate not supplied

A randomized controlled trial of a computer-based physician workstation in an outpatient setting: implementation barriers to outcome evaluation.

OBJECTIVE: A research prototype Physician Workstation (PWS) incorporating a graphical user interface and a drug ordering module was compared with the existing hospital information system in an academic Veterans Administration General Medical Clinic. Physicians in the intervention group received recommendations for drug substitutions to reduce costs and were alerted to potential drug interactions. The objective was to evaluate the effect of the PWS on user satisfaction, on health-related outcomes, and on costs. DESIGN: A one-year, two-period, randomized controlled trial with 37 subjects. MEASUREMENTS: Differences in the reliance on noncomputer sources of information, in user satisfaction, in the cost of prescribed medications, and in the rate of clinically relevant drug interactions were assessed. RESULTS: The study subjects logged onto the workstation an average of 6.53 times per provider and used it to generate 2.8% of prescriptions during the intervention period. On a five-point scale (5 = very satisfied, 1 = very dissatisfied), user satisfaction declined in the PWS group (3.44 to 2.98 p = 0.008), and increased in the control group (3.23 to 3.72, p < 0.0001). CONCLUSION: The intervention physicians did not use the PWS frequently enough to influence information-seeking behavior, health outcomes, or cost. The study design did not determine whether the poor usage resulted from satisfaction with the control system, problems using the PWS intervention, or the functions provided by the PWS intervention. Evaluative studies should include provisions to improve the chance of successful implementation as well as to yield maximum information if a negative study occurs.

Adult↗

PubMed1983

The contribution of a cultural perspective in understanding and evaluating client satisfaction.

Increasing attention is being given to including measures of client satisfaction as a component in the evaluation of health care services. An understanding of cultural factors that may influence attitudes and behaviors in the health care situation can contribute to the theory and measurement of client satisfaction. Through an examination of some of the cross-cultural literature, this paper delineates dimensions of the health care situation in which clients have been shown to have distinctive preferences, behavioral patterns, attitudes, and treatment expectations. A knowledge of the beliefs and attitudes concerning health and illness that are espoused by a particular cultural group can be a valuable asset in understanding how members of that group will evaluate the delivery of health care services. The examination of how cultural and ethnic differences may affect client satisfaction outcomes points to the necessity of avoiding a global measure of client satisfaction without first examining those particular aspects of health care delivery and of the measurement context that may have a predictable influence on client satisfaction ratings.

Attitude to Health↗