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At least 1,063 records · Page 59Linked to original sources
PubMed1996

Doctor-patient interactions in oncology.

Studies which apply content analysis techniques to the cancer consultation are few. This descriptive study examines the structure and content of the bad news cancer consultations of 117 outpatients newly referred to the Medical Oncology Department of a large London teaching hospital. From previous communication research three main hypotheses are formed: (i) the cancer consultation is clinician-dominated rather than patient-centred; (ii) the level of psychosocial discussion between clinicians and patients is low and (iii) patient characteristics such as sex, age and prognostic category influence clinician behaviours. Each patient had two consultations with one of 5 oncologists. Both these were audiotaped with the patients' consent. The tapes were content coded using the Roter Interaction Analysis System. Results showed that clinicians tended to use closed rather than open questions. Patients asked few questions and were seldom given space to initiate discussion. Thus, the level of patient-centredness was low. Despite the fact that consultations concerned life threatening disease and often contained information regarding toxic treatment which is known to provoke psychological dysfunction, the number of questions relating to patients' psychological health were few. The amount of discussion concerning medical topics from both parties was 2.5 times greater than the amount of psychosocial discussion. Although there was a suggestion in the data that 3 clinicians showed variations in behaviour according to patient age and prognostic group, the number of patients for each doctor was small. Patients were well informed about their diagnosis, prognosis and treatment options, but their emotional well-being was rarely probed.

Adult↗
PubMed2005

Understanding primary care physicians' propensity to assess elderly patients for depression using interaction and survey data.

OBJECTIVE: The objective of this study was to examine primary care physicians' propensity to assess their elderly patients for depression using data from videotapes and patient and physician surveys. STUDY DESIGN: An observational study was informed by surveys of 389 patients and 33 physicians, and 389 videotapes of their clinical interactions. Secondary quantitative analyses used video data scored by the Assessment of Doctor-Elderly Patient Transactions system regarding depression assessment. A random-effects logit model was used to analyze the effects of patient health, competing demands, and racial and gender concordance on physicians' propensity to assess elderly patients for depression. RESULTS: Physicians assessed depression in only 14% of the visits. The use of formal depression assessment tools occurred only 3 times. White patients were almost 7 times more likely than nonwhite patients to be assessed for depression (odds ratio [OR], 6.9; P < 0.01). Depression assessment was less likely if the patient functioned better emotionally (OR, 0.95; P < 0.01). The propensity of depression assessment was higher in visits that covered multiple topics (OR, 1.3; P < 0.01) contrary to the notion of competing demands crowding out mental health services. Unexpectedly, depression assessment was less likely to occur in gender and racially concordant patient-physician dyads. CONCLUSIONS: Primary care physicians assessed their elderly patients for depression infrequently. Reducing the number of topics covered in visits and matching patients and physicians based on race and gender may be counterproductive to depression detection. Informed by videotapes and surveys, our findings offer new insights on the actual care process and present conclusions that are different from studies based on administrative or survey data alone.

Aged↗
PubMed1999

The concept mapping method. An alternative to focus group inquiry in general practice.

BACKGROUND: The concept mapping rationale and process are explained step by step. The concept mapping method produces a two dimensional conceptual map of ideas produced by the group which can be analysed at the level of individual statements, clusters of statements, and groups of similar clusters. An example of concept mapping conducted with four general practitioner (GP) groups from different practice types and demographic locations is provided. A total of 51 participating GPs were asked to complete an 'evaluation questionnaire' at the end of each group session. The majority of GP participants (68%) rated the method as highly useful. OBJECTIVE: To describe the concept mapping method and its interpretation for use in general practice research. To report on its perceived usefulness and acceptability by general practitioners. DISCUSSION: Concept mapping is a very useful method combining benefits from qualitative and quantitative approaches for exploring the breadth of a topic in its entirety, especially for abstract concepts. GPs found the concept mapping method to be efficient for group inquiry, rating it high on utility. There is scope to refine the method, reducing time spent in some stages of the session, and substituting more time on final analysis.

Australia↗
PubMed1991

Socio-cultural factors in adolescent septic illicit abortions in Ilorin, Nigeria.

One hundred and ninety-two adolescents (aged 12-18 years) with septic illicit abortions were interviewed to assess socio-cultural factors associated with illegally induced septic abortions at Ilorin, Nigeria. They were mostly unmarried schoolgirls who were ignorant of contraception. Inadequate parental supervision contributed largely to unplanned pregnancies, while poor economic state of these patients influenced the occurrence of illegal septic abortions. Wide-spread availability of an acceptable family-life education, with improved socio-economic state of the adolescents would most probably reduce the socio-cultural factors favouring illicit septic induced abortions in this community.

Abortion, Illegal↗
PubMed1997

The use of the psychological laboratory to study sensitive survey topics.

Maximizing the tendency of the survey respondent to answer truthfully when sensitive questions are presented is critical issue in survey methodology. A recent development devoted generally to the reduction of response error in survey data is the use of cognitive laboratory techniques during the survey development phase. The chapter categorizes and describes the various cognitive techniques that have been applied, by Federal agencies and other researchers, to the study of sensitive questions. Based on this analysis and review, a number of recommendations are made concerning specific aspects of survey design, when sensitive questions are administered.

Cognitive Science↗
PubMed1999

[Interviews in historical nursing research].

In this article the method of interviewing is discussed in its context with historical nursing research. In the first part the development of the academic discipline of history and historical nursing research are outlined briefly. A discussion on the research method interview follows and the concept of oral history is described. Lastly, examples in historical nursing research using the method interview are examined.

Autobiographies as Topic↗
PubMed2006

Knowledge of sexual partner's HIV serostatus and serosorting practices in a California population-based sample of men who have sex with men.

OBJECTIVES: To describe knowledge of primary and secondary sexual partner's HIV serostatus and sexual practices, including serosorting, among men who have sex with men (MSM) living in California. METHODS: Men who self-identified as gay/bisexual in the 2001 California Health Interview Survey, a statewide biennial random-digit-dial survey interviewing more than 50,000 adults on a variety of health topics, were recontacted in 2002 and interviewed by telephone about injection drug use, their own and partner's HIV serostatus, and sexual risk behaviors. RESULTS: Among 220 men who reported a primary partner, 86% [95% confidence interval (CI): 77-92] knew their primary partner's serostatus; 62% (95% CI, 52-70) of the 250 men who reported a secondary partner knew their most recent secondary partner's HIV serostatus. Knowledge of one's most recent secondary partner's HIV serostatus was inversely related to history of injecting recreational drugs (odds ratio, 0.22; P < 0.01), and reporting a primary partner in the past year (odds ratio, 0.37; P < 0.05). Two-fifths (41%) of HIV-positive men and three-fifths (62%) of HIV-negative men engaged in serosorting (serocordant unprotected anal intercourse) with their primary partners, whereas 33% HIV-positive men and 20% HIV-negative men did so with their most recent secondary partners. CONCLUSIONS: This population-based survey documented the extent to which MSM know their partners' serostatus and practice serosorting behaviors. The findings emphasize the need for studies to report serocordant and serodiscordant unprotected anal intercourse separately, as the former presents significant lower risk of HIV transmission.

Adult↗
PubMed1979

Child abuse.

Child abuse is an emotional topic, and one which features frequently in newspapers. Newspapers, however, tend to report only the most serious cases and those which have been the subject of court hearings. The reporting tends to concentrate on lurid details. In fact, there is a wide spectrum of child abuse encompassing physical abuse, sexual abuse, emotional abuse and neglect, and ranging in severity from the most minor incident through to injuries sufficient to cause death.

Adult↗
PubMed1988

Long term home care for the elderly: perceptions of nurses, physicians, and primary caregivers.

A qualitative research study was conducted to gain an understanding of the perceptions of nurses, physicians, and elderly caregivers regarding the experience of long term home care. The sample included 2 discharge planning nurses, 4 home health nurses, 4 geriatric physicians, and 12 nonprofessional spouse caregivers older than age 60. Analysis of the data revealed three distinct major topic areas: making decisions about home care, the nature of long term home care, and caregivers' concerns and needs. In general, most spouses want to provide home care for their partners but are often discouraged from doing so by their children and/or by health professionals. Caregivers receive little preparation for their roles, and most have little or no contact with the formal health care system.

Aged↗
PubMed1999

Prevalence of sexualized violence among women. A population-based study in a primary healthcare district.

In order to estimate the prevalence of sexual and physical abuse, postal questionnaires were sent to a random sample of 251 adult women in a primary care district. Three yes/no-questions were asked on these topics, and a fourth inquired into effects on health. Space was left for open-ended answers in which yes-responders were invited to write about their experiences. A total of 175 women (70%) answered, and 25 (14%) of these reported abuse. Nine (5%) had experienced women battering. Thirteen (7.5%) reported sexual abuse as an adult, and 12 (7%) as a child. Many told their stories. Methodological shortcomings in this study might explain why the rates are somewhat lower than in other investigations. However, our figures verified that abuse of women is a common social phenomenon. They also confirmed abuse as a major health problem for women. One-third of respondents explicitly reported effects on health. Others, though negating such effects, described them in written narratives. In order to study this contradiction, in-depth interviews with abused women are recommended.

Adolescent↗
PubMed2001

The association between racism and high blood pressure among African Americans.

National attention is currently being directed toward assessing the association between racism as a stressor and high blood pressure (HBP) among African Americans. Within this context, however, very little research is designed to elucidate the viewpoints of African Americans with HBP on this topic area. The purpose of this article is to explore, critique, and elaborate upon the study of racism as it relates to HBP research. The first portion of this paper reviews the existing literature in this field. Limitations of the current research are outlined. Insights gained as 30 African Americans with HBP talked about racism as a stressor and how it affected their health are subsequently highlighted. Lastly, suggestions for future studies on racism and HBP are postulated.

Black or African American↗
PubMed1990

Antenatal care and educational problems of unmarried teenage mothers in Nairobi.

Part of a detailed analysis of 864 unmarried teenage mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital is presented. Teenage pregnancy amounted for 42.3% of all deliveries of unmarried mothers. Most teenage patients were above 16 years of age, had a religious background of wide coverage, had low quality antenatal care and low education. 94.6% were found to be primigravidas. This dominance has also been found by other workers.

Adolescent↗