OBJECTIVE: To characterize use of the Internet by patients and their families referred to general genetics clinics. PATIENTS AND METHODS: We developed a survey to assess Internet use among patients visiting urban and rural clinics in Colorado and Wyoming. One hundred eighty-nine surveys were distributed to patients and their family ...

Plastic surgeons' primary responsibility to patients is to inform them sufficiently to permit them to make the necessary decisions in the manner that best meets their own objectives. This makes adequate consultation a lengthy and often confusing experience for patients. One of the most confusing of these is also one ...

We describe a 20-year retrospective study of 58 patients with a cross-matched control group in one practice, who initially attended more than 12 times in 1975. The study establishes that frequent attendance is not consistent; the majority of high-attending patients in general practice revert over a short period of time ...

Internet has recently evolved as a versatile and influential repository of information including those pertaining to neurosurgery. This study was undertaken to find out whether there is good quality information currently available on the Internet for neurosurgery patients and their families. We surveyed the World Wide Web (www) for information ...

BACKGROUND: Literacy is a national and international problem. Studies have shown the readability of adult and pediatric patient education materials to be too high for average adults. Materials should be written at the 8th-grade level or lower. OBJECTIVE: To determine the general readability of pediatric patient education materials designed for ...

BACKGROUND: When patients fail to appear for scheduled appointments, the flow of patient care is interrupted, and clinic productivity declines. This study investigated the impact of failed appointments on a clinic by measuring time and money lost after taking into account same-day treatment patients (walk-ins). METHODS: Schedule information was retrieved ...

BACKGROUND: Teaching clinics are the heart of training programs in family practice. It is in these training clinics where residents develop their ambulatory practice habits. Yet, little is known about the efficiency of these teaching clinics. METHODS: We conducted a time-and-motion study of patient flow in a residency teaching clinic. ...

The aim of this study was to evaluate the participation of patients in classroom-based teaching within a pre-registration programme. The rationale for the research was based on the view that utilizing patients as active participants in teaching and learn ing experiences allows nurses to gain valuable insight into the patient's ...

OBJECTIVE: This article presents information on the important impact the lack of adherence to prescribed treatments has on the morbidity and mortality of asthma. After reading this article, readers should have an understanding of the significant role clinicians, as well as patients and their families, play in promoting adherence. DATA ...

PURPOSE: To examine patient preferences as well as physician perceptions of these preferences for decision making and communication in palliative care. PATIENTS AND METHODS: Medical decision-making preferences (DMPs) were prospectively studied in 78 assessable cancer patients after initial assessment at a palliative care outpatient clinic. DMPs were assessed with a ...

OBJECTIVE: To compare the prescribing pattern and attitude of general practitioners (GPs) in response to a clinic returning a patient referred for erectile dysfunction (ED) to the referrer by two different methods. METHODS: Referrals on a waiting list for an assessment of ED were reviewed and a subgroup of patients ...

Induction of labour is a common obstetric intervention. When the cervix is unfavourable ripening agents are used, commonly prostaglandin E2. There are several methods of administration of prostaglandin E2 and little comparative work has been performed as to their acceptability by patients. Patients undergoing induction of labour by prostaglandin E2 ...

The end user of all healthcare activity is the patient. But how do we know whether we are providing a good service? Do we take time to listen to our patients, or do we simply hide behind our professional title and pass the buck to someone else? In this, the ...

BACKGROUND: Clinic appointments in which patients do not appear (no-show) result in loss of provider time and revenue. Previous studies have shown variable effectiveness in telephone and mailed reminders to patients. METHODS: We conducted a randomized controlled trial of telephone reminders 1 day before the scheduled appointments in an urban ...

Medical expenses from intimate partner violence (IPV) total between $3 and $5 billion annually. Many abuse victims are exposed to serious injuries, and are likely to see their physicians more frequently than other patients. Practitioners must have a reliable and realistic approach to counseling patients who are victims of IPV. ...

BACKGROUND: Chronic reflex sympathetic dystrophy (RSD) is a painful and disabling disorder for which no treatment with proven effects exists. Physical therapy (PT) has been demonstrated to be effective for recently diagnosed RSD, but its value in chronic RSD has not yet been studied. OBJECTIVE: To find predictors for successful ...

Treatment with highly active antiretroviral therapy (HAART) decreases morbidity and mortality for persons with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and reduces costs of care. Yet many patients for whom HAART is indicated do not receive it. This study investigated the reasons why certain patients of a community health center ...

Senior CHF patients grow accustomed to automated voice technology. Internet-based tools may have a lot to offer, but they don't necessarily get the best results when used with a mostly elderly population. However, a telephonic system that uses automated voice technology has consistently produced first-rate compliance rates while slashing hospitalization ...

BACKGROUND AND OBJECTIVES: "Difficult-to-recruit" patients are sometimes less compliant with their care, are more reluctant to seek medical attention and less likely to survive than their "easy-to-recruit" counterparts. They also tend to be excluded from clinical trials. The aim of this paper was to evaluate whether such differences extend to ...

BACKGROUND: The Internet is becoming increasingly important as a way for patients to acquire medical information and as a means for patient-physician communication. Questions about appropriate use of this new technology have been brought to the fore by the many patients using the Internet to seek sildenafil prescriptions. OBJECTIVE: To ...

This article explores whether the experience of participating in a clinical trial was similar to what patient volunteers had expected, prior to agreeing to take part. It also considers patients' views on four aspects of participation that may help to determine whether the decision to become a research subject was ...

PURPOSE: Advance directives can assist in end-of-life decision-making. This study explores the factors that influence completion of advance directives. METHODS: Qualitative study using in-depth interviews of 10 patients over age 60 in a rural office practice. RESULTS: Major themes: (1) patient autonomy: the patient and family role as decision maker, ...

As a method to control patient flow to overburdened hospitals, effective emergency medical services (EMS) systems provide policies for ambulance diversion. The Maryland state EMS system supports two types of alert for general hospital use: red alert, aimed at limiting the delivery of patients who may require intensive care unit ...

The objective of this study is to provide a systematic review of studies on patient satisfaction with telemedicine. The review included empirical studies that investigated patient satisfaction with that telemedicine service. The search strategy involved matching at least one of 11 'telemedicine' terms with one of 5 'satisfaction' terms. The ...

In recent years, patient satisfaction in healthcare has been criticized as much as poor customer satisfaction in other industries. Many times, the financial problems that exist are used as an excuse for poor patient satisfaction. This excuse can never justify treating a patient rudely or with disrespect. Patients are the ...

CONTEXT: Hospice is designed to provide end-of-life care to patients who are terminally ill. However, some patients withdraw from hospice even though they are medically eligible. Little is known about these patients, and the factors associated with their withdrawal have not been described. OBJECTIVES: To identify predictors of withdrawal from ...

BACKGROUND: Patient education has been shown to affect physician performance profiles. It is not known whether census-derived measures of patient socioeconomic status (SES) show comparable effects. OBJECTIVE: The objective of this study was to compare the effects on physician profiles for patient satisfaction and physical and mental health of adjustment ...

OBJECTIVE: Lack of adherence to diabetic self-management regimens is associated with a high risk of diabetes complications. Previous research has shown that the quality of the patient-provider relationship is associated with adherence to diabetes treatment. This study attempts to improve understanding of both patient and provider factors involved in lack ...

Information on patient satisfaction is considered a way of including patients' perspectives in the planning and assessment of services. The study of patient satisfaction is a relatively new field, and despite the surge in popularity and use of satisfaction measures during the past three decades, different issues remain to be ...

OBJECTIVE: To pilot single patient trials designed to improve decision making about stimulant use for attention deficit hyperactivity disorder (ADHD) in general practice. METHOD: Patients previously stabilised on dexamphetamine were enrolled from a general practice. Each undertook a six week same patient randomised, double blind, placebo controlled crossover comparison of ...

Despite known hazards associated with their use, long-acting benzodiazepines are frequently used in the treatment of older adults. While such use has been linked to physician characteristics, the effect of patient factors has not been considered. To investigate this, data from 1423 Quebec community-dwelling subjects of the Canadian Study of ...

Emergency open chest cardiopulmonary resuscitation (OCCPR) is sometimes performed on patients with cardiopulmonary arrest (CPA), especially those resulting from trauma. Since OCCPR is frequently carried out without the permission of patients' families, we surveyed the opinions of the families. A total of 1058 CPA patients were transferred to our department ...

This article focuses on the role of stories told about a patient in geropsychiatric team meetings in the construction of an image of the patient. Using the narrative techniques described by Gee, Labov, and Riessman, three team meeting discussions about a geropsychiatric patient are analyzed. The role of stories and ...

A 'patient-centred' approach is increasingly regarded as crucial for the delivery of high quality care by doctors. However, there is considerable ambiguity concerning the exact meaning of the term and the optimum method of measuring the process and outcomes of patient-centred care. This paper reviews the conceptual and empirical literature ...

The objective was to assess sexual function at long-term follow-up after the Nesbit operation for Peyronie's disease. One hundred and fifty seven out of 213 patients treated between 1986 and 1998 using the Nesbit procedure were reassessed by means of IIEF-5 questionnaire together with two questions about residual deformity and ...

In this study, the relationship between (a) doctor's and patients' communication and (b) doctors' patient-centredness during the oncological consultation and patients' quality of life and satisfaction was examined. Consultations of 96 consecutive cancer patients were recorded and content analysed by means of the Roter Interaction Analysis System. Data collection (mailed ...

BACKGROUND: The use of open access endoscopy is increasing. Its effect on the adequacy of patient informed consent, procedure acceptance and the impact on subsequent communication/transfer of procedure results to the patient have not been evaluated. The aim of our study was to compare the extent of preknowledge of procedures ...

We investigated the congruence between emergency department (ED) personnel estimations of patient satisfaction and actual patient satisfaction. Actual patient satisfaction was assessed via telephone interview. Before the findings were disseminated, ED personnel were asked to "predict" the results by estimating the average rating they believed patients gave for each of ...

Debate continues on the preferred method of hysterectomy, usually focusing on economic implications and details such as length of inpatient stay and time to return to work. However, little published data exists on patients' level of satisfaction with hysterectomy. We performed a retrospective survey of patients' views after different methods ...

Actual implementation of probabilistic sensitivity analysis may lead to misleading or improper conclusions when it is applied to groups of patients rather than individual patients. The practice of combining first- and second-order simulations when modeling the outcome for a group of more than one patient yields an erroneous marginal distribution ...

BACKGROUND: Screening flexible sigmoidoscopy is an underused cancer prevention procedure. Physicians often cite patient discomfort as a reason for not requesting sigmoidoscopy, but patient experiences and attitudes toward sigmoidoscopy have not been well studied. OBJECTIVE: To measure patient satisfaction and the determinants of satisfaction with screening sigmoidoscopy. METHODS: An instrument ...

OBJECTIVE: We sought to assess the effect of resident involvement in flexible sigmoidoscopy on patient satisfaction and comfort. METHODS: Adults undergoing flexible sigmoidoscopy completed a previsit questionnaire on indication for procedure, GI-related history, and functional status. Immediately after the procedure, satisfaction and procedure comfort were assessed. Additional information collected included ...

Endodontics as a discipline has offered patients the opportunity to maintain their natural teeth. As the population expands and ages, the demand for endodontic therapy can be expected to increase as patients seek dental options to keep their teeth for a lifetime. New materials, techniques and instruments are entering the ...

Since October 1995 a Department of Psychooncology exists at the Herford Community Hospital. It was founded by a private foundation with the aim of supporting patients who suffer from cancer. The psychooncological section is an independent unit. This state of independence proved to be very useful and functional. The Herford ...

Two hundred thirty-six patient visits to a major university's ophthalmology clinic were studied to determine patient waiting time. The waiting time was studied as a function of attending physician and appointment time. Patient arrival behavior was also documented. Recommendations regarding strategies to reduce waiting times were developed based on the ...

OBJECTIVES: To identify the determinants of patient preferences for participation in medical decision making. METHODS: Data were analyzed for 2,197 patients from the Medical Outcomes Study, a 4-year observational study of patients with chronic disease (hypertension, diabetes, myocardial infarction, congestive heart failure, and depression). Multivariate logistic regression models estimated the ...

The relationship between right hemisphere dysfunction and attention-deficit/hyperactivity disorder (ADHD) remains controversial. We administered a random letter cancellation test to 58 carefully selected adult patients meeting DSM-IV criteria for ADHD and 29 age- and education-matched controls. Patients with ADHD had a higher mean omission rate on the left side than ...

RATIONALE: Physicians need information about their rehabilitation practices that shows the types of patients being seen and the outcomes for their rehabilitation programs. In order to obtain more information on secondary medical complications and prevention programs, and to provide the information to the spinal cord injury (SCI) rehabilitation team, an ...

A prospective, randomized study was carried out to investigate whether repeated hospital discharge information on audiotape at home could improve knowledge and rehabilitation in patients with first-time myocardial infarction. The study comprised 50 patients (12 females and 38 males) of up to 75 years of age. At discharge, 26 patients ...

The aim of this research was to study the potential influence and significance of Jewish and Christian patients' religion on their coping with cancer. After intensive methodological experimentation, the Interpretive Biography-approach, an inductive unstructured research method was applied to collect and analyse the data. In this way 100 Jewish and ...