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Results for “Patient Participation”

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At least 19 recordsLinked to original sources
PubMed1977

Patient participation in the patient-provider interaction: the effects of patient question asking on the quality of interaction, satisfaction and compliance.

The purpose of this study was to investigate the effectiveness, dynamics, and consequences of a health education intervention designed to increase patient question asking during the patient's medical visit. Data were collected at a Baltimore family and community health center which provides outpatient services to a low income, predominantly black and female population. The majority of the study participants were, in addition, elderly and chronically ill. A total of 294 patients and 3 providers took part in the study. The study design included random assignment of patients to experimental and placebo groups with two non-equivalent (non-randomized) control groups. Findings included: (1) The experimental group patients asked more direct questions and fewer indirect questions than did placebo group patients. (2) The experimental group patient-provider interaction was characterized by negative affect, anxiety, and anger, while the placebo group patient-provider interaction was characterized as mutually sympathetic. (3) The experimental group patients were less satisfied with care received in the clinic on the day of their visit than were placebo patients. (4) The experimental group patients demonstrated higher appointment-keeping ratios (an average number of appointments kept divided by an average number of appointments made) during a four-month prospective monitoring period.

Consumer Behavior↗
PubMed1978

Behavioral contracting in a burn care facility: a strategy for patient participation.

Behavioral contracting is a valuable tool for resolving persistent behavioral problems interfering with the treatment and recovery of severely burned patients. Coercive bidding of the patients for more control occurs in an environment where they experience extreme forms of loss of control and associated enforced regression. The ensuing conflicts between patient and staff often lead to breakdown in mutual cooperation, with deleterious effects on patient-staff morale. Staff experience highly ambivalent feelings toward a problem patient and may wish to withdraw from him, feeling threatened in their image of themselves as competent professionals. Beyond reducing disruptive conflicts on the ward, behavioral contracting aims to mobilize patient and staff around common and explicit goals, and to maximize patient cooperation and productive control in the recovery process. Contracts are valuable because: 1) they facilitate productive communication about issues which underlie patient-staff conflict; 2) they facilitate solutions to problem interactions between patients and staff; 3) they afford both patients and staff a sense or self-control. We provide a rationale for behavioral contracting and discuss the indications for initiating contracts with hospitalized burn patients, and describe methods for developing, implementing, and managing behavioral contracts in order to improve communication and effectiveness in patient-staff interactions.

Adolescent↗
PubMed1978

Patient participation in a hypertension control program. Hypertension Detection and Follow-up Program Cooperative Group.

In the Hypertension Detection and Follow-up Program, the largest standardized hypertension detection, follow-up, and treatment program to date in the United States, participation rates have been high at all stages. More than 75% of those with suspected hypertension at screening attended follow-up rescreening, and more than 80% of the 5,314 hypertensive patients assigned to program treatment remained active at the end of one year. Differences in participation rates were generally small. To accomplish this, intensive efforts were required to maximize attendance, and the program was shaped to reduce known barriers to initial attendance and long-term adherence. Against the background of a high overall program response rate for all sex-race groups, factors that might be associated with variations in response were examined: age, socioeconomic characteristics, health status, and appointment schedule.

Black People↗
PubMed1976

Patient participation in the problem-oriented system: a health care plan.

The problem-oriented system can be used to encourage the involvement of the patient in his health care. A Health Care Plan is described, the purposes of which include facilitation of provider-patient communication, and emphasis on the shared responsibility of provider and patient in problem solving and health maintenance. The Health Care Plan is not designed to supplant other parts of the system such as the problem list or audit.

Community Participation↗
PubMed1979

Response of patients to participation in psychiatry board examinations.

The patient who volunteers to be a subject for Part II of the certifying examination in psychiatry and neurology is an indispensable but surprisingly invisible participant in a highly controversial process. A survey of the attitudes of 78 patients toward this experience revealed that although they experienced a significant degree of stress, the overwhelming majority viewed their participation in strongly positive terms. The patient's loyalty to the host institution and the manner in which the patient is prepared for the experience appear to be the major factors in determining a positive outcome.

Adult↗
PubMed1977

The Credit-Incentive system: motivating the participation of patients in a day hospital.

The Credit-Incentive System, a modified token economy, is a means of motivating the participation of day hospital patients in therapeutic activities through the use of contingent rewards. Credits are earned by patients for engaging in a wide variety of prosocial tasks and activities and can be spent for coffee, a free lunch, special time with professional staff, recreational events, and time off from the treatment centre. The receipt of credits is accompanied by social approval and recognition from the staff and other patients. Evaluations have shown that the credit system doubles the participation rate of patients in a partial hospitalization programme. The system also enhanced group cohesiveness, provides practice and feedback for cognitive re-integration, and offers opportunities of learning self-management. The results of two experiments suggest that the symbolic and social rewards mediated by the credits are the most important components of their effectiveness.

Adolescent↗
PubMed1978

Imprisonment of patients in the course of rehabilitation.

The patient carries the major responsibility and plays the most significant role in the rehabilitation process. It is appropriate to continuously examine rehabilitation management techniques to determine the degree to which they facilitate or inhibit patient participation. Of 213 consecutive inpatients on the rehabilitation service of an urban municipal hospital serving a black community, 53 requested discharge before the team considered it advisable. Thus, one patient in four differed with the staff on the decisive issues of functional ability within the environment and readiness for discharge. These "imprisoned patients" were confined against their wills. Improved communication between patients and staff, patient education and mutual goal-setting would yield greater patient participation on the decision-making process.

Adolescent↗
PubMed1975

Therapeutic groups for patients with spinal cord injuries.

A preliminary study was conducted to determine the effectiveness of therapeutic patient groups in a rehabilitation setting. A spinal cord knowledge "Inventory" test was designed to evaluate the success of the group method in disseminating information to patients. The first part of this test assesses the patient's knowledge about body physiology and functioning, health care, and community resources. The second part attempts to evaluate the patient's feelings regarding his body image, sexual attractiveness, and family relationships. The test was administered to 31 spinal cord injured patients upon admission and again just prior to discharge. Eighteen patients participated in a therapeutic patient group, which met twice a week for a month. The other group did not participate in such sessions. The purpose of the meetings was to help the patient adjust to his disability by exchanging commonly needed information and discussing experiences and feelings. Initial results suggest that therapeutic groups can provide an effective means for imparting information to patients. The test also indicates that many patients experience changes in their attitudes and feelings around such sensitive areas as personal worth and self-esteem.

Adolescent↗
PubMed1977

Lost subjects. Source of bias in clinical research?

This report describes a study of subject refusal as a source of bias limiting the generality of psychiatric research results. Fifty psychiatric patients who refused to participate in a battery of research interviews and psychological tests were compared with 50 participant patients. Between-group comparisons were made on an extensive and detailed set of clinical, treatment, and demographic data. Results revealed a remarkable lack of difference between the participant and refusal groups in demographic features, type or duration of hospitalization, and type or degree of pathology as defined by symptoms, prognostic measures, and diagnoses. These results and a review of related studies suggest that sample bias in psychiatric research resulting from loss of eligible subjects by refusal depends on the amount of institutional contact and the severity of disorder in the sample studied.

Adolescent↗
PubMed1979

The community meeting: a comparative study.

In this study of two identical open wards, the author found that in ward 1's highly structured meetings a higher proportion of patients participated, and they distributed their participation in more direct proportion to the relative numbers of each present than in the open meetings on ward 2, where patients directed their participation disproportionately to staff. Staff on both wards disproportionately directed their participation to patients, but less so in the structured meetings. The implications of these observations are discussed in terms of the executive ego deficits of the patients involved and their need for structure in the external milieu in order to compensate for these deficits.

Adult↗