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At least 19 recordsLinked to original sources
PubMed1994

Information use, information perceptions and information flows in primary care medical practice.

A research project funded by the Welsh Office and undertaken by the Department of Information and Library Studies, University of Wales, Aberystwyth examined the information systems in place in a sample of general medical practices in Wales. Shortcomings were identified in patient records, the supply of medical information for patients, staff training and staff communications. Practices lacked coherent information management strategies to relate information to practice goals and to define responsibility and protocols for information tasks. Unless rectified, these deficiencies will inhibit the viability of primary care data as a basis for medical research, audit and for identifying the health needs of communities.

Attitude of Health Personnel↗
PubMed1992

[Information systems for health and social care planning. Information basis and information channels in the municipalities].

The Norwegian Government has started to develop a new system for a better exchange of information between the central and the local authorities when planning health and social services. The plan is to base the system on nationwide collection and delivery of standardized indicators which will signal trends and enable comparisons. Several conclusions from an interview survey indicate that the new information system will not be particularly useful. Local authorities believe that their information is good enough already, and have little confidence in statistics prepared by the central authorities. On the other hand many of them called for more statistics that would enable comparisons between neighbouring municipalities, and several had themselves taken the initiative to collect data on various local needs and activities.

Health Planning↗
PubMed1994

Developing a clinical information system: the role of the chief information officer.

BACKGROUND: Chief information officers (CIOs) must play a pivotal role in the formation and implementation of a clinical information system, the subset of an organizational information system that deals specifically with support of clinical care activities. MAJOR ELEMENTS OF A CLINICAL INFORMATION SYSTEM: Major elements include the applications software, technology and data architecture, databases, and analysis. The organizational structures and processes that manage the development of improvement activities, including the clinical information system itself, are just as vital to the design of an information system as the hardware and software. THE ROLE OF THE CIO: To develop, sustain, and advance an information infrastructure, the CIO must help establish certain organizational precursors, such as medical staff involvement, experience with quality improvement, and ability to meet data needs. The CIO must then work with the senior administrative and medical leadership in developing a vision for the information system. The CIO must also create new roles and knowledge for information system and medical staff members. Interaction between information services and medical staff is vitally important to the success of a clinical information system. Organizational committees and structures that Brigham and Women's Hospital in Boston put in place to formalize the relationship between information systems and medical staff include the Clinical Initiative Development Program and the Center for Applied Medical Information Systems Research. CONCLUSION: Improving the clinical management of care and the efficacy of care processes involves complex changes in organizational culture and processes, medical practice and information system applications, technologies, staff, and data.

Academic Medical Centers↗
PubMed1995

Informed consent for phase I studies: evaluation of quantity and quality of information provided to patients.

BACKGROUND: The process by which patients are informed and their consent is obtained in phase I trials has thus far been only marginally studied. Since 1986 we have followed an oral procedure, consisting of three consecutive conversations in which the investigator responsible for phase I studies, the research nurse and the patients' relatives and/or friends also participate, followed by the patients signing of a written consent form. It is required that six items of information considered essential by our staff be conveyed to patients by the responsible investigator. Meerwein's model, which defines three main dimensions of the informing process (the information itself, the emotional and interactive aspects), has been studied to ascertain whether it can be applied to evaluate the quality of the information proffered. METHODS: Thirty-two conversations were taped, transcribed and evaluated by one psychiatrist and one psychologist. A quantitative analysis of information was performed by calculating the number of patients to whom the essential items of information had been conveyed. The qualitative analysis was performed by rating on a five-point scoring system, from 1 (very bad) to 5 (excellent), the three dimensions of the informing process for each patient and by calculating for each dimension the mean score of the constituent items. RESULTS: Complete information about the characteristics of the phase I drug and the modalities of the treatment and follow up was given to almost 80% of the patients. All but one of the items of the information dimension scored 3.5 or higher, with the one related to the assessment by the doctor of the patient's understanding at the end of the consultation scoring less than 3 in 53% of the patients. All items of the emotional dimension scored higher than 3.5. Greater difficulty was encountered by the physician with the interactive dimension, the lowest mean scores being reported on the items related to the doctor's awareness of the indirectly expressed anxieties of the patients. In 71% of the consultations the three dimensions of information scored more than 3 and balanced one another, indicating a successful consultation by the Meerwein model. CONCLUSIONS: The informed consent procedure applied was satisfactory from a quantitative point of view, and the main items of information were acceptable to the patients. Meerweins's model proved to be applicable and useful for identifying pitfalls in communication. Greater attention should be paid to the indirect messages and implied criticisms of the patients to improve their participation in decision making. Physicians should become more skillful in providing adequate information and improve their methods of communication.

Adolescent↗
PubMed1987

Kepiński's information metabolism, Carnot's principle and information theory.

The generalized Carnot principle introduced by Brillouin provides a link between negentropy and information, but does not take into account the information stored in the brain, which is clearly excluded by the author. Further step in the generalization of Carnot's principle, which includes information turnover in the brain was accomplished by Kepiński in his theory of the metabolism of energy and information. According to Schrödinger, life processes require a supply of negentropy rather than energy stored in the food, more precisely, e.g., in glucose utilized by the brain, since energy is conserved, whereas negentropy is dissipated. The information (communication) channel transmits maximum information when the band width of the transmitted frequency is limited, and much less information when the restriction concerns the transmitted power, or energy. This can explain a considerable decrease in the information metabolism observed in depressive patients, whose life dynamics and, consequently, the amount of energy available for information metabolism is severly lowered. Thus, the fall in information metabolism is more pronounced in depression than in not too late phases of schizophrenia. As appears from Fonberg's studies the amygdaloid nucleus is responsible for the life dynamics. In different types of neuron code change is a significant parameter, which was so strongly stressed by Kepiński. Other problems discussed in the paper include: selection of information and its structural localization, localization of particular phases of information metabolism and their phylogenetic significance.

Brain↗
PubMed1975

A biomedical information source: the National Clearinghouse for Alcohol Information.

The National Clearinghouse for Alcohol Information (NCALI) is an information resource developed by the National Institute on Alcohol Abuse and Alcoholism of the U.S. Department of Health, Education, and Welfare. It provides numerous alcohol-related information services to professionals in a wide spectrum of biomedical and other disciplines, services that are designed to aid information users in the discrimination and selection of useful literature from the volumes of available information. One such service will provide the biomedical professional, working in an alcohol-related field, with announcements of recent information in categories that he selects from 110 possible fields of interest. Another information service is the quality evaluation of technical documents. The quality evaluation system, which is under continuing development and refinement, serves the literature user by providing a literature quality prescreening process designed to aid users in their literature review and monitoring activities. Additional information services provided by the clearinghouse include Grouped Interest Guides, Subject Area Bibliographies, a quarterly magazine and a periodic general interest information service, and a wide range of special publications. Reference services provide a suitable depth of response to information requests through services that range from assemblages of standard information materials, such as pamphlets and similar publications, to automated data base searches for more technically oriented information requests.

Alcoholism↗
PubMed1989

Patients' and general practitioners' satisfaction with information given on discharge from hospital: audit of a new information card.

OBJECTIVE: To determine the attitudes of patients discharged from hospital and their general practitioners to a new information card giving details about admission, diagnosis, and treatment and to assess the completeness of the information on the card. DESIGN: Consecutive patients discharged from the care of three consultant physicians over 16 weeks. SETTING: One general medical ward in a large teaching hospital. PATIENTS: A total of 275 consecutive discharges of 258 patients were studied. The mean age of patients was 60 years and mean duration of admission five days. INTERVENTION: At discharge from the ward all study patients received an information card and a copy of the card in the form of an interim discharge letter to be delivered to their general practitioner. Patients and general practitioners were asked to complete a questionnaire giving their views on the legibility, helpfulness, quality, and quantity of the information they received. Copies of all the information cards were scrutinised for completeness. MAIN RESULTS: The results were based on 208 (76%) forms returned by patients and 214 (78%) forms returned by general practitioners. Information was considered very helpful or quite helpful according to 170 (83%) forms from patients and 197 (92%) forms from general practitioners; sufficient information was provided according to 160 and 182 forms. Most patients and nearly all general practitioners thought it was a good idea to provide this information for patients at discharge. According to 125 forms from patients and 188 from general practitioners the information card was very easy or quite easy to read; 155 patients had read it at least twice and 149 were likely to refer to it again. OTHER RESULTS: The written information about the patient, the diagnosis, and what the patient had been told was generally well completed, although the date of discharge was omitted from 42 (15%) cards. Details of drugs prescribed at discharge were generally thorough. CONCLUSIONS: Giving an information card to all patients at discharge was feasible and favoured by most patients and their general practitioners. Having made minor changes in design, we think that we have produced an information card that is a convenient size and will improve communication between patients, their general practitioners, and hospital doctors. We now issue this card routinely to all patients discharged from our ward and hope that it might be widely adopted.

Attitude of Health Personnel↗
PubMed1994

AIDS hot lines and information agencies. The consistency of their information.

OBJECTIVES: To determine the consistency of responses given by acquired immunodeficiency syndrome (AIDS) hot lines and AIDS information agencies to a standard set of questions related to human immunodeficiency virus (HIV) infection and to investigate the training of workers in these telephone information agencies. DESIGN: A two-part questionnaire that addressed issues of HIV transmission and testing (part 1) and sexual behavior, diet, alcohol use, and partner notification (part 2). SETTING: Thirty-three AIDS telephone information agencies. PARTICIPANTS: Information specialists at these agencies were contacted on multiple occasions over a 1-year period. INTERVENTION: Initially, 48 calls were made to these agencies. Responses were recorded in the words of the information specialists, categorized, and assessed for consistency. Two additional surveys using the same questionnaire were also performed, examining the variability of responses within an individual agency and the variability of responses from six agencies, three with and three without formal training of their information specialists. RESULTS: The initial survey revealed inconsistencies and inaccuracies in responses from AIDS telephone information agencies particularly in the areas of HIV testing, risk factor assessment, safe-sex recommendations, and life-style changes for infected persons. The second survey revealed variability in responses from six information specialists within a single agency. The third survey revealed that, overall, agencies with and without formal training of workers were equally inconsistent in their responses. CONCLUSIONS: There are identifiable deficiencies in the quality and consistency of information given by some AIDS telephone information agencies. Training procedures of information specialists at these agencies are variable and may be inadequate.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Informed consent: study of quality of information given to participants in a clinical trial.

OBJECTIVE: To determine whether the participants in a clinical trial had perceived adequate information about the trial according to the guidelines of the Declaration of Helsinki. DESIGN: About 18 months after the end of a gynaecological clinical trial the participants received a questionnaire by post, which focused on the quality of the information given to them before entering the trial. Neither researchers nor participants were aware in advance that the trial would become the subject of this follow up investigation. SETTING: Eight different centres in Sweden. SUBJECTS: 43 women out of the 53 who completed the trial (mean (range) age 23 (16 to 35) years) returned the questionnaire. MAIN OUTCOME MEASURES: Adequacy of the information (based on requirements of the Declaration of Helsinki) to enable the following: understanding of the aims of the study; awareness of what participation meant; and awareness of the possibility of withdrawing from participation at any time. Motives for agreeing to participate, and a subjective evaluation of the given information were also recorded. RESULTS: All but one of the participants had been aware that they were taking part in a research project. Five women stated that they had not been aware that a second laparoscopy was performed only for research reasons. Seven women reported that they had not been aware of the meaning of participating in the project and 17 that they had had no information about the possibility of withdrawing from the study whenever they wanted. In the subjective rating 22 women considered the information given as good or very good. There was a systematic variation in the quality of the given information among the eight centres. CONCLUSION: Although all but one of the participants had been aware that they were taking part in a clinical trial, the quality of the information understood and recalled by participants varied, and in many cases clearly did not meet the guidelines of the Declaration of Helsinki. Variations among centres in participants' perception of information suggest that deficiencies in perception may be caused by informers rather than the participants.

Clinical Trials as Topic↗
PubMed1978

Community, hospital and clinical pharmacists and drug information centers as physician drug information sources.

The use of drug information centers and clinical, hospital and community pharmacists by university and community practice physicians in North Carolina was examined. Questionnaires were sent to 674 nonfederal physicians with a response rate of 203 (35.5%). Approximately half of the sample were staff members of a university hospital. The questionnaire covered eight types of drug information. Significant results were reported at the p = 0.05 level. Physicians sought specific drug information approximately one to four times a month. University hospital-affiliated physicians rated clinical and hospital pharmacists significantly higher than community pharmacists for six subject areas, and they also ranked clinical pharmacists over hospital pharmacists on four subject areas and considered them more reliable than other pharmacy drug information sources. Physicians associated with community hospitals ranked hospital pharmacists over community pharmacists as sources of information for four areas and rated them more reliable than other pharmacy drug information sources; this group preferred to use community pharmacists for information on product availability. It appears that clinical pharmacists are used by university-associated physicians as drug information sources. Use in community hospitals of the hospital pharmacist as a drug information source is better than the literature might suggest.

Attitude of Health Personnel↗
PubMed1990

What information for the patient? Large scale pilot study on experimental package inserts giving information on prescribed and over the counter drugs.

OBJECTIVE: To compare the acceptability and the degree of understandability of two drug information leaflets on three over the counter and two prescribed drugs. DESIGN: Prospective observational study. SETTING: Random sample of municipal pharmacies throughout Italy. SUBJECTS: A total of 6992 clients of the pharmacies who requested the study drugs over a period of four months. INTERVENTION: Exposure of patients to two information leaflets, one approved by the Ministry of Health, and the other an experimental sheet prepared by the research working group. MAIN OUTCOME MEASURES: The degree of acceptability of the information was assessed by using a pretested questionnaire. Comments concerning information needs were also encouraged and collected. RESULTS: 6992 Clients responded to the questionnaire. Non-metropolitan (urban and rural) areas had the highest rate of participation. The participants strongly preferred the experimental leaflets to the approved leaflets, both with respect to accessibility of the contents (overall preference 78.1% v 17.8%) and ease of understanding the contraindications of drug use (90.2% v 73.7%). Basic attitudes related to the use of written information were similar among clients of different age groups, educational levels (though emerging people with primary school or lower educational levels showed slightly lesser understanding), and geographic areas. Up to 50% of those who took over the counter drugs indicated a disposition to change their drug seeking behaviour on the basis of the information in the experimental leaflet. The comments provided a useful complementary set of data on the information needs expressed by participants. CONCLUSIONS: The results of this pilot study indicate that patients will enter active programmes to investigate the provision of problem oriented drug information. Their information needs seem to concern both prescribed and over the counter drugs. More extensive and systematic work is required to develop an improved consumer oriented language for widely used drugs.

Adolescent↗
PubMed1990

Meeting information needs of significant others: use of the Cancer Information Service.

Although significant others (spouses, relatives and friends) of cancer patients play an important role in providing support and assistance to the patient, their need for information regarding the disease is frequently overlooked by the health care system. This analysis examines information needs of (1) diagnosed cancer patients, (2) significant others of diagnosed cancer patients and (3) the general public, as reflected in their calls to the Cancer Information Service (CIS), a national toll-free telephone inquiry service. Major focus is on the types of cancer-related subjects significant others inquire about, as well as how they first found out about the CIS. Results indicate that significant others are similar to diagnosed cancer patients in their need for additional information on specific cancer sites, treatment, and referrals for second opinions, but differ in their request for information on counseling services and clinical trials. Additionally, significant others and cancer patients are similar in how they find out about the CIS. In contrast, significant others differ from the general public in their information requirements, as well as in their source of referral to the CIS. While the CIS appears to be a channel of communication capable of addressing the dynamic information needs of significant others, further research concerning the effectiveness of the CIS and other channels of cancer information in satisfying the information requirements of significant others is recommended.

Adult↗
PubMed1987

The AIDS information crisis: confluence of the roles of information creator, seeker, and provider.

The dramatic increase in the number of cases and deaths from AIDS since 1981 has been accompanied by an information explosion on the topic. The government, health professionals, service organizations, consumers, and the media are each vital links in both formal and informal AIDS information networks. New information sources and systems have emerged from these five sectors, and their roles as information creators, seekers, and providers have come together. The need for integrative or synthesizing databases and systems which reflect the sectors' interdependence and acknowledge their roles in the information process is discussed. Databases and systems which reflect a multi-sector approach, such as the Computerized AIDS Information Network (CAIN), are suggested as potential solutions to the AIDS information problem.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Use of information sources at a university hospital drug information service.

The frequency of use of various sources to answer drug information requests in a university hospital drug information service was studied. All of the drug information requests received by the University of Minnesota Drug Information Service (UMDIS) between November 1, 1983, and January 27, 1984, were included in the evaluation. A total of 1448 requests from health-care professionals and consumers were reviewed. The 10 most frequently used information sources in order of most to least often used were Facts and Comparisons, previous knowledge or experience of the UMDIS staff, Drugdex, Martindale: The Extra Pharmacopoeia, USP DI, the UMDIS files, information from pharmaceutical manufacturers, Goodman and Gilman's the Pharmacological Basis of Therapeutics, and Meyler's Side Effects of Drugs. Forty percent of the requests were from consumers. Pharmacists should characterize the type and number of drug information requests they receive and should consider the accessibility of a drug information service and biomedical library when deciding which references to purchase.

Catalogs, Drug as Topic↗
PubMed1995

[Information to cancer patients prior to participation in clinical trials. Evaluation of a structured information program].

Informing patients before starting of antineoplastic treatment is important due to the legal aspects of clinical trials and the anxiety and uncertainty felt by the patients. This study evaluates a structured information programme used in a clinical trial. Thirty-four women were interviewed three months after receiving information about trial, using a tape-recorded structured interview. Results showed that the information was well remembered. The patients were glad to have brought a relative to the two consultations, and the time for deliberation in between was well received. The patients viewed written information as an important source of reinformation. The information provided was positively evaluated. Open and detailed information did not undermine the doctor-patient relationship. Instead it allowed patients to understand and participate in treatment decision and helped to reduce their pre-therapy anxiety and uncertainty. The results support expanding structured information programmes to include not only those patients asked to participate in the clinical trial, but all patients beginning longlasting cancer therapy.

Attitude to Health↗