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Patients' Attitudes (patient + attitude)

Distribution by Scientific Domains

Medical Sciences	94%
Psychology	5%

Distribution within Medical Sciences

Consumer Health General	32%
Psychiatry	14%
Dermatology	8%
Pediatrics	5%
11 Other Subdomains	41%

Selected Abstracts

Patient attitudes to topical antipsoriatic treatment with calcipotriol and dithranol

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2000
Tf Poyner
Abstract Objective Assessment of patient preference for antipsoriatic treatment with calcipotriol ointment or short-contact dithranol cream. Methods Two hundred and fifty-eight psoriatic patients treated with calcipotriol (n = 138) or dithranol (n = 120) for up to 3 months, assessed the acceptability of treatment, overall satisfaction with treatment, their treatment preference using the ,willingness to pay' principle and selected their treatment of choice. Results Overall satisfaction with calcipotriol was significantly better (72.7%, dithranol 60.3%; odds ratio 1.75, 95% CI 1.03, 2.99: P = 0.04). Patients considered calcipotriol a more acceptable treatment than dithranol in its appearance, smell, non-irritancy, method and ease of application and lack of staining. Dithranol was considered less sticky than calcipotriol. Patients were ,willing to pay' a mean of £12.16 monthly for calcipotriol and £10.66 monthly for dithranol. ,Willingness to pay' did not correlate well with overall treatment satisfaction and was not correlated with household income. Calcipotriol was the preferred treatment of choice (calcipotriol 63%, dithranol 24%). Conclusion Patients with psoriasis prefer treatment with calcipotriol ointment over short-contact dithranol cream. [source]

Association between feasibility of discharge, clinical state, and patient attitude among inpatients with schizophrenia in Japan

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2009
Yoshio Mino md
Aim:, There have been some studies on the feasibility of discharging mentally ill inpatients from mental hospitals. The purpose of the present study was to investigate how a psychiatrist judges whether an inpatient can be discharged. Methods:, A survey regarding such judgments on discharge was conducted involving 549 inpatients with schizophrenia with a hospital stay of ,1 year. Relationships between psychiatrist judgments on discharge and the Brief Psychiatric Rating Scale (BPRS), Scales for the Assessment of Negative Symptoms (SANS), Global Assessment Scale (GAS), patient attitude to discharge, and other variables were investigated. A similar analysis was conducted regarding patient attitudes toward discharge. Results:, After controlling for potential confounding factors using multiple logistic regression, the judgments showed significant relationships with BPRS-P, SANS, GAS, and age. Patient attitudes showed significant relationships with the length of the current hospital stay, SANS, and psychiatrists' judgments. Conclusion:, A psychiatrist's judgment regarding discharge is a comprehensive decision that takes into account psychiatric symptoms, social functioning, and age. Such a judgment could also affect a patient's own attitude toward discharge. [source]

Estimated Risk for Undiagnosed Diabetes in the Emergency Department: A Multicenter Survey

ACADEMIC EMERGENCY MEDICINE, Issue 5 2007
Adit A. Ginde MD
BackgroundOne third of the 21 million Americans with diabetes remain undiagnosed. The emergency department (ED) is a novel setting for diabetes screening. ObjectivesTo estimate risk factors for undiagnosed diabetes in the ED. MethodsThis was a cross sectional survey in five Boston EDs. The authors enrolled consecutive adults without known diabetes over two 24-hour periods at each site. The focus was on diabetes risk factors and estimated risk for diabetes on the basis of American Diabetes Association (ADA) criteria. The authors also examined prior diabetes testing and willingness to participate in ED-based diabetes screening. ResultsSix hundred four patients (70% of eligible) were enrolled. On the basis of ADA risk score, 33% (95% confidence interval [CI] = 29% to 37%) were high risk for undiagnosed diabetes, and an additional 42% (95% CI = 38% to 46%) had elevated risk. For example, 58% (95% CI = 54% to 62%) of participants were overweight or obese (body mass index of ,25). Among these at-risk participants without prior diabetes testing, 73% (95% CI = 66% to 80%) reported amenability to having additional blood drawn for ED diabetes screening, and 98% (95% CI = 96% to 100%) indicated that they would follow up for confirmation of abnormal screening. ConclusionsMany ED patients in the study had risk factors for undiagnosed diabetes. Patient attitudes toward ED-based diabetes screening support further exploration of this important and currently underutilized opportunity for public health intervention. [source]

The clinical and cultural factors in classifying low back pain patients within Greece: a qualitative exploration of Greek health professionals

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2007
Evdokia V. Billis MSc
Abstract Rationale, aims and objectives, Identifying homogenous subgroups of low back pain (LBP) patients is considered a priority in musculoskeletal rehabilitation and is believed to enhance clinical outcomes. In order to achieve this, the specific features of each subgroup need to be identified. The aim of this study was to develop a list of clinical and cultural features that are included in the assessment of LBP patients in Greece, among health professionals. This ,list' will be, utilized in a clinical study for developing LBP subgroups. Methods, Three focus groups were conducted, each one comprising health professionals with homogenous characteristics and all coordinated by a single moderator. There were: 11 physiotherapists (PTs) with clinical experience in LBP patients, seven PTs specialized in LBP management, and five doctors with a particular spinal interest. The focus of discussions was to develop a list of clinical and cultural features that were important in the examination of LBP. Content analysis was performed by two researchers. Results, Clinicians and postgraduates developed five categories within the History (Present Symptoms, History of Symptoms, Function, Psychosocial, Medical History) and six categories within the Physical Examination (Observation, Neurological Examination, Active and Passive Movements, Muscle Features and Palpation). The doctors identified four categories in History (Symptomatology, Function, Psychosocial, Medical History) and an additional in Physical Examination (Special Tests). All groups identified three cultural categories; Attitudes of Health Professionals, Patients' Attitudes and Health System influences. Conclusion, An extensive Greek ,list' of clinical and cultural features was developed from the groups' analysis. Although similarities existed in most categories, there were several differences across the three focus groups which will be discussed. [source]

Patients' Attitudes Toward Implanted Defibrillator Shocks

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 6 2000
MAHA AHMAD
In addition to its beneficial effect on patient survival, the implanted cardioverter defibriliator (ICD) changes a patient's life physically, socially, and psychologically. For improved patient management, it is important to understand the quality-of-life changes that accompany this mode of treatment. To this end, 119 patients were surveyed retrospectively and interviewed concurrently regarding their emotional, physical, and behavioral responses to ICD shocks and to the device itself. Most (55%) correctly estimated the total number of shocks they had received within a 10% margin. They found the shocks severe, 79% assigning a score between 3 and 5 on a scale of 1,5. Common descriptions of the shock sensation were a blow to the body or a spasm causing the entire body to jump. Most patients tolerated the shocks as life saving, but 23% dreaded shocks and 5% even said they would rather be without the ICD and take their chances. After a shock, 50% of patients called their physician and 42% continued their daily routine. Thirty percent went to a hospital emergency room or called a rescue service. Sixty-five percent had no preshock prodromes. Fifty-four percent were interested in the programmable option of a warning signal prior to a shock, while 31 % preferred no warning. Of the 74% who were advised not to drive after implantation, 29% drove anyway. Five patients were shocked while driving with no resulting accidents. We conclude that most patients find ICD shocks moderately uncomfortable, but they tolerate them because of the lifesaving protection provided by the device. [source]

Patients' attitudes to medicines and expectations for prescriptions

HEALTH EXPECTATIONS, Issue 3 2002
Nicky Britten MA MSc PhD
Abstract Background, Recent research has shown that patients' expectations for prescriptions influence doctors' prescribing decisions, but little is known of the antecedents of these expectations. Objectives, To test earlier qualitative research about patients' views of medicines; to describe the demographic characteristics of those holding orthodox and unorthodox views of medicines; to investigate the relationship between patients' ideal and predicted expectations for prescriptions; and to determine the relative effects of attitudinal, demographic, organizational and illness variables on these expectations. Design, Questionnaire survey of patients consulting general practitioners. Setting and participants, A total of 544 patients and 15 doctors in four general practices. Main variables studied, Patients' attitudes to medicines; patients' demographic characteristics; organizational variables; aspects of patients' presenting problems. Outcome measures, Patients' ideal and predicted expectations for prescriptions. Results, Orthodox and unorthodox attitudes to medicines can be measured quantitatively, and ethnicity was the only demographic variable associated with both. Ideal and predicted expectations for prescriptions were closely related to each other but differed in their antecedents. Both types of expectations were associated with attitudinal, demographic, organizational and illness variables. Ideal expectations were influenced by orthodox and unorthodox attitudes to medicines, while predicted expectations were only influenced by orthodox attitudes. Conclusions, Future studies of patients' expectations for health services should distinguish between ideal and predicted expectations, and should consider the range of possible influences on these expectations. In particular, the effect of the organization and context of health services should be investigated. [source]

Patients' attitudes to medicines and adherence to maintenance treatment in inflammatory bowel disease

INFLAMMATORY BOWEL DISEASES, Issue 6 2009
Rob Horne PhD
Abstract Background: Nonadherence has been reported in over 40% of patients taking maintenance therapies (MT) for inflammatory bowel disease (IBD). Studies in other illness groups have shown that nonadherence is related to negative attitudes to treatment. The aim of this study was to assess patients' attitudes to MT for IBD (beliefs about personal need for MT and potential adverse effects) and to identify whether such beliefs are associated with adherence to MT. Methods: A cross-sectional survey was conducted in which 1871 members of the National Association for Colitis and Crohn's Disease (NACC) completed validated questionnaires assessing beliefs about MT and adherence to MT. Results: Low adherence to MT was reported by 29% of participants and was associated with doubts about personal need for MT (odds ratio [OR] = 0.56; 95% confidence interval [CI]: 0.48,0.64; P < 0.001) and concerns about potential adverse effects (OR = 1.66; 95% CI: 1.42,1.94; P < 0.001). Attitudinal analysis showed that while almost half (48%) of the participants were "accepting" of MT (high necessity, low concerns), a large proportion of the sample (42%) were "ambivalent" about MT (high necessity, high concerns), 6% were "sceptical" (low necessity, high concerns) and 4% were "indifferent" (low necessity, low concerns). Compared to those who were "accepting" of MT, participants in all 3 other attitudinal groups were significantly more likely to be nonadherent. Conclusions: The way in which patients judge their personal need for MT relative to their concerns about MT can be a significant barrier to adherence. Interventions to facilitate optimal adherence to MT for IBD should address such perceptual barriers. (Inflamm Bowel Dis 2008) [source]

Patients' attitudes to rubber dam

INTERNATIONAL ENDODONTIC JOURNAL, Issue 10 2002
D. A. Stewardson
No abstract is available for this article. [source]

Influence exerted on drug prescribing by patients' attitudes and expectations and by doctors' perception of such expectations: a cohort and nested case-control study

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2008
Eugenia Lado BS
Abstract Rationale, aims and objectives, Although demand for medication is regarded as one of the most important factors in pharmaceutical expenditure, little is known about patients' influence on drug prescribing. This study assesses the influence exerted on drug prescribing by patients' attitudes and expectations, and by doctors' perception of such expectations. Method, We conducted a population-based cohort study covering 937 subjects attending a health centre in the northwest of Spain. Prescription-drug advertising directly targeted at patients is banned in Spain. We conducted home-based interviews at the start of follow-up to assess patients' attitudes, and monthly telephone interviews during the 1-year follow-up period to assess consumption of medical drugs and medical visits. Using nested case-control study covering 127 of the cohort subjects who attended the health centre, we assessed patients' pre-consultation expectations for prescriptions, doctors' perception of such patients' expectations, and the drugs actually prescribed. Results, Of the total sample, 69.3% answered the home-based questionnaire, 77.6% completed 11 or more months of follow-up, and 100% of cohort subjects who attended the health centre responded to the pre-consultation survey conducted in the waiting room. Patients' attitudes, though not associated with prescription (P > 0.1), were, however, associated with demand for medical consultation (P < 0.01), self-medication (P < 0.01) and prescription expectations (P < 0.01). Although doctors' perception of patients' expectations did indeed show an association with drug prescribing (P = 0.001), there was no association between patients' expectations and doctors' perception of such expectations (P > 0.1), as these tended to be overestimated by doctors. Conclusion, We conclude that, although doctors prescribe in accordance with what they believe their patients expect, in practice patients exert no influence on drug prescribing because their prescription expectations are misconstrued by doctors, who overestimate them. [source]

Patients' attitudes and beliefs about back pain and its management after physiotherapy for low back pain

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2007
Stephen May
Abstract Background and Purpose.,Contemporary guidelines for the management of low back pain often consider patient involvement and responsibility an essential component; however, there has been little exploration of patients' opinions about back pain and its management. Method.,A qualitative study of patients' perspectives of back pain in the UK; 34 semi-structured interviews were conducted with participants who had recently received physiotherapy for back pain; interviews were transcribed and analysed using framework analysis. A topic guide was used to steer the interview and themes were extracted from the data. Results.,Thirteen key themes were revealed; seven of these related to issues of satisfaction with physiotherapy and are described elsewhere. The six themes considered here dealt with the participants' experience of and attitudes to back pain and its management. Themes were: the impact of back pain on their life; perspectives about back pain; its management; their involvement in its management; what strategies they had for self-management; and expectations about the episode of physiotherapy beforehand. Conclusions.,In this group of participants with a history of back pain and physiotherapy treatment a common finding was a degree of acceptance of the back pain problem and the belief that patient involvement in management was essential. These findings would suggest that many patients with back pain may respond positively to the message of self-management. However, acceptance of this message was not automatic, but generally occurred gradually in line with patients' experience of back pain and treatment. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Gender differences in the factors related to physical activity among adults with diabetes

NURSING & HEALTH SCIENCES, Issue 4 2000
CCRNArticle first published online: 25 MAR 200, Ramesh B. Navuluri MSC(AGRI)
Abstract A descriptive correlational study was conducted to determine the gender differences in the relationship between health-related hardiness, patient attitude toward compliance, and self-care adherence to physical activity among 155 adults with diabetes. The two subcomponents of health-related hardiness, control and commitment/challenge, were included as separate variables. The correlations between commitment/challenge and self-care adherence to physical activity, and between total health-related hardiness and self-care adherence to physical activity, were significant among men (n = 52). The correlation between patient attitude toward compliance and self-care adherence to physical activity was significant among women (n = 103). Clinically, when compliance with self-care adherence to physical activity is the goal, a male patient may need hardiness instructions, while a female patient may need interventions to promote attitude toward compliance. Future research may include studying the relationships between other self-care practices such as diet management, medication compliance, and glucose monitoring and the variables of health-related hardiness and patient attitude toward compliance, which may help health-care professionals in appropriate care planning aimed at promoting self-management of diabetes. [source]

Association between feasibility of discharge, clinical state, and patient attitude among inpatients with schizophrenia in Japan

Experiences of oral care in patients with haematological malignancies or head and neck cancer

EUROPEAN JOURNAL OF CANCER CARE, Issue 3 2003
ASSISTANT PROFESSOR , K.E.O. ÖHRN RDH
The aim of the present study was to investigate cancer patients' experiences of oral hygiene information, oral care and self-care, information on oral complications, examination of the oral cavity, and ability to eat and drink during cancer treatment, and to explore patient attitudes to oral examination and oral hygiene. The sample consisted of 41 consecutive patients treated with radiotherapy for head and neck cancer (n = 18) or with chemotherapy for haematological malignancies (n = 23). Patients were interviewed at the end of radiotherapy or the second/third chemotherapy cycle. Compared with patients receiving chemotherapy, those who received radiotherapy had significantly more often visited hospital dentistry, been informed about oral complications and oral hygiene, received instructions in oral hygiene procedures, and been examined by hospital staff. More of the radiotherapy patients experienced oral symptoms and difficulties to eat and drink during treatment. There were no significant differences between the groups with regard to patient experiences of the oral hygiene procedures. Only one patient objected to having hospital staff discuss oral hygiene procedures, and three did not want hospital staff to examine their oral cavity. Patients undergoing radiotherapy or chemotherapy need to be monitored during treatment with regard to their oral status and oral symptoms and complications. There are no acceptable reasons for allowing patients to suffer from oral symptoms that can be reduced. [source]

More than technology and access: primary care patients' views on the use and non-use of health information in the Internet age

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2004
Anne Rogers MSc(Econ) PhD
Abstract Over the past decade, there has been considerable interest in the transmission of health information made available though the Internet with increasing confidence being placed in the potential power of the Internet to transform communication, clinical practice and relationships with patients. Subsequent to the failure of a primary-care-based initiative designed to provide free assistance and access to health information via the Internet, a survey was conducted. Findings from this survey suggested that facilitating access to e-information is necessary, but not in itself sufficient, to encourage current non-users to start exploring the Internet. The qualitative study reported here was aimed at exploring the way in which people use and perceive the utility of Internet information for managing health and illness and engaging with the health service system. Data was gathered from two sources. Interviews and observations of a sample who had used a free primary-care-based Internet service (n = 5) and interviews with a sample drawn from a survey of patient attitudes to using the Internet for health information (n = 12). The less-considered aspects of access and the use of e-information for health matters related to the varied existing relationships respondents had to computers, health information and health professionals. One of the main reasons why some respondents do not use the Internet to access health information is related to a lack of perceived utility and pertinence of such information for managing their healthcare. The optimal and equitable use of the Internet as a means of complimenting health-service utilisation will not emerge merely from increasing access to e-information. The potential for narrowing or increasing inequality between the information rich and poor needs to be viewed in a broader psychosocial context. The latter includes the nature of existing relationships which people have with the health service and the value that people place on their own capacity to make use of information in managing their healthcare. [source]

Patient-friendly hospital environments: exploring the patients' perspective

HEALTH EXPECTATIONS, Issue 1 2004
Calbert H. Douglas BSc MSc PhD
Abstract Objective, To investigate the perceptions and attitudes of patients to the built environments of NHS Trust hospitals, in order to inform design excellence so as to make future hospitals places and spaces responsive to patient needs. Design, An exploratory study of patients perceptions based on qualitative semi-structured personal interviews. Setting and participants, Fifty one-to-one interviews held with hospital in-patients across the four directorates of surgery, medicine, care of the elderly and maternity at Salford Royal Hospitals NHS Trust, Salford, UK. Results, The research found that there was much similarity in the priorities, issues and concerns raised by patients in each of the four directorates. Patients perceived the built environment of the hospital as a supportive environment. Their accounts in each area pointed to the significance of the factors that immediately impacted on them and their families. Patients identified having a need for personal space, a homely welcoming atmosphere, a supportive environment, good physical design, access to external areas and provision of facilities for recreation and leisure. Responses suggest that patient attitudes and perceptions to the built environment of hospital facilities relates to whether the hospital provides a welcoming homely space for themselves and their visitors that promotes health and wellbeing. Conclusions, The findings have important implications for capital development teams, clinical staff, managers and NHS Estates personnel. Although the study has immediate relevance for Salford Royal Hospitals Trust, findings and recommendations reported provide NHS Estates and other relevant stakeholders with evidence-based knowledge and understanding of patients' perceptions and expectations of and preferences for particular facilities and estates provision in NHS hospitals. [source]

Ineffectiveness of sun awareness posters in dermatology clinics

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 6 2010
GW Jung
Abstract Background, Although sun awareness posters have been used in doctors' offices and clinics for decades to promote sun protective behaviour, there is no evidence of their usefulness. Objectives, To investigate whether sun awareness posters lead to inquiry of skin cancer and sun protection measures. Method, Patients considered at risk for skin cancer seen at a dermatology clinic were randomly asked to complete a questionnaire designed to assess the effectiveness of three different sun awareness posters placed in patient rooms. The posters were selected on the basis of their catchy slogan and eye-appealing images, and included those featuring parental interest, sex appeal and informative advice. Results, Only half of the patients noticed the posters (50.6%). The poster with sex appeal garnered the most attention (67.8%), followed by the informative poster (49.2%) and the parental interest poster (35.8%) (P < 0.001). Although patients who noticed the sun awareness poster inquired about cutaneous cancers and sun protection practices twice as often as those who did not notice the poster, only one-tenth of such inquiries were attributed to the poster (,5% of the target population). As reported in the questionnaire, the posters themselves were less effective than the advice of physicians in influencing patient attitudes towards sun protection measures. Conclusion, Organizations that produce and disseminate posters should consider beyond focus groups when they design their posters and should consider field testing their products to ensure that they are reaching the targeted audience and are having the expected beneficial effect, otherwise their posters are simply decorative. [source]

Association between feasibility of discharge, clinical state, and patient attitude among inpatients with schizophrenia in Japan

Preferences for aspects of a dermatology consultation

BRITISH JOURNAL OF DERMATOLOGY, Issue 2 2006
J. Coast
Summary Background, General practitioners with special interests (GPSIs) are increasingly being used to provide dermatology services in the U.K. Little is known about U.K. dermatology patient attitudes to proposed variations in secondary care service delivery or the values they attach to aspects of the care they receive. Objectives, To quantify preferences for different attributes of care within dermatology secondary care services. Methods, Attributes of care that are important to dermatology patients were derived using in-depth qualitative interviews with 19 patients at different points in the care pathway. A discrete choice experiment using ,best,worst scaling' was sent by post to 119 patients referred to secondary care dermatology services and suitable for GPSI care who had agreed to participate in research. Results, Four attributes were derived from the qualitative work: waiting, expertise, thorough care and convenience. For the discrete choice experiment, 99 patients returned questionnaires, 93 of which contained sufficient data for analysis. All attributes were found to be quantitatively important. The attribute of greatest importance was expertise of the doctor, while waiting time was of least importance. Respondents were willing to wait longer than the current 3 months maximum to receive care that was thorough, 2·1 months to see a team led by an expert and 1·3 months to attend a consultation that is easy to get to. Conclusions, Although the need to reduce outpatient waiting times is a key policy driver behind the expansion of GPSI services, this does not appear to be the most important issue for patients. The thoroughness with which the consultation is provided and the expertise of the clinician seen are higher priorities. [source]

Correlates of breast reconstruction,

CANCER, Issue 11 2005
Results from a population-based study
Abstract BACKGROUND Immediate or early postmastectomy breast reconstruction is performed infrequently. To the authors' knowledge, little is known regarding surgeon or patient perspectives on reconstruction treatment decisions. The purpose of the current study was to identify patient attitudes and preferences associated with breast reconstruction, and whether these differed by race. METHODS A sample of women age , 79 years who were diagnosed with ductal carcinoma in situ and invasive breast carcinoma between December 2001 and January 2003 was identified from the Surveillance, Epidemiology, and End Results (SEER) registries of Detroit and Los Angeles. Eligible subjects completed a questionnaire at a mean of 7 months after diagnosis. The Wald chi-square test and logistic regression were used for data analysis. RESULTS Of the 1844 respondents, 646 underwent a mastectomy (35.0% of the total sample) and 245 of these patients received breast reconstruction (38.0%; of the mastectomy group). On multivariate analysis, younger patient age, higher educational levels, and earlier stage of disease were found to be significantly associated with breast reconstruction. Although 78.2% of women reported that breast reconstruction was discussed, only 11.2% correctly answered 3 basic knowledge questions regarding the procedure. The desire to avoid more surgery was the most common reason for not undergoing breast reconstruction. CONCLUSIONS The results of the current study found that the majority of women were aware of breast reconstruction but choose not to undergo the procedure. Lack of knowledge and a greater perception of barriers to the procedure were more common among African-American patients and women with a lower education level, suggesting a need for improved educational strategies. Cancer 2005. © 2005 American Cancer Society. [source]

Patient involvement in clinical decision making: the effect of GP attitude on patient satisfaction

HEALTH EXPECTATIONS, Issue 2 2006
Benedicte Carlsen Cand.
Abstract Objective, This study investigates general practitioners' (GPs) and patients' attitudes to shared decision making, and how these attitudes affect patient satisfaction. Background, Sharing of information and decisions in the consultation is largely accepted as the ideal in general practice. Studies show that most patients prefer to be involved in decision making and shared decision making is associated with patient satisfaction, although preferences vary. Still we know little about how the interaction of GP and patients' attitudes affects patient satisfaction. One such study was conducted in the USA, but comparative studies are lacking. Design, Questionnaire survey distributed through GPs. Setting and participants, The results are based on the combined questionnaires of 41 GPs and 829 of their patients in the urban municipality of Bergen in the western part of Norway. Main variables studied, The data were collected using a nine-item survey instrument constructed to measure attitudes towards patient involvement in medical consultations. The patients were also asked to rate their satisfaction with their GP. Results and conclusions, The patients had a strong preference for shared decision making. The GPs also generally preferred shared decision making, but to a lesser degree than the patients, which is the opposite of the findings of the US study. There was a positive effect of the GP's attitude towards shared decision making on patient satisfaction, but no significant effect of congruence of attitudes between patient and GP on patient satisfaction. The suggested explanation is that GPs that are positive to sharing decisions are more responsive to patients' needs and therefore satisfy patients even when the patient's attitude differs from the GPs' attitude. Hence, although some patients do prefer a passive role, it is important to promote positive attitudes towards patient involvement in medical consultations. [source]

Prevention of relapse and interventions for enhancing medication adherence in schizophrenia: An East Asian perspective

ASIA-PACIFIC PSYCHIATRY, Issue 2 2010
Salleh Mohd Razali MPM FAMM
Abstract Introduction: Studies investigating the efficacy of interventions for improving treatment non-adherence in schizophrenia have generated contrasting findings. The present review examined psychosocial interventions for improving medication adherence and prevention of relapse among patients with schizophrenia in developing countries in the Asia-Pacific. Methods: The relevant literature and systematic review were identified by computerized searches using keywords, and hand-searched for other selected articles. Results: The reasons for poor medication adherence were complex and heterogenous. Psychoeducation programs alone are ineffective in achieving good medication adherence because they do not lead to attitudinal and behavioral changes. The greatest improvement in adherence was seen with interventions employing a combination of educational, behavioral and cognitive strategies. Unfortunately, few relevant studies from this region were found. There were some interventions related to psychoeducation and compliance therapy (CT) that were successfully conducted by nurses. Patients in developing countries generally had better family support, but strong stigma towards mental illness and interference by traditional healers led to poor treatment adherence. Lack of facilities and shortage of medical professionals aggravated the situation. Discussion: Intervention to improve treatment adherence and prevention of relapse among patients with schizophrenia should be incorporated into existing psychiatric services. Adherence to treatment in patients with schizophrenia could be improved if continuously supported and monitored by caregivers and treating doctors, to facilitate a change in the patient's attitude. Paramedical personnel, such as psychiatric nurses, could be actively involved in intervention programs because of the shortage of medical professionals in this region. [source]

Procedural justice in the context of civil commitment: an analogue study,

BEHAVIORAL SCIENCES & THE LAW, Issue 6 2000
Michele Cascardi Ph.D.
Procedural justice theory posits that the process by which disputes are resolved influences perceptions of fairness and satisfaction with outcomes, even if the outcomes are unfavorable. Within the context of civil commitment, Tyler (1992) has suggested that enhancing respondents' perceptions of procedural justice (i.e., participation, dignity, and trust) during commitment proceedings might facilitate accommodation to an adverse judicial determination (i.e., commitment) and subsequently enhance therapeutic outcomes. The study reported here used videotapes of mock commitment hearings to examine whether patients committed for involuntary treatment are sensitive to procedural justice manipulations. Results suggest that patients are sensitive to procedural justice manipulations and, further, that such manipulations are likely to influence the patients' attitude toward psychiatric care. These findings suggest that the development of strategies to enhance patients' perceptions of procedural justice in commitment hearings may indeed have positive therapeutic implications and warrants further investigation. Copyright © 2000 John Wiley & Sons, Ltd. [source]

Dental beliefs: factor structure of the revised dental beliefs survey in a group of regular dental patients

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 6 2009
Kajsa H. Abrahamsson
The aim of this study was to investigate the factor structure of the revised dental beliefs survey (DBS-R) in a group of regular dental patients. The study group consisted of 278 patients (mean age 54 yr), 61% of whom were women. The DBS-R item mean value was 1.6. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were performed. The initial PCA among the 28 DBS-R items showed four factors with eigenvalues of > 1 explaining 67% of the total variance. Five different CFA models were tested. The final model revealed a four-factor solution with one second-order factor (i.e. a hierarchical CFA). Thus, the latent second-order variable, ,dental beliefs', explains the variance from all DBS-R items through the four first-order factors labeled ,ethics', ,belittlement', ,communication and empathy', and ,control and anxiety'. The results suggest a somewhat different factor structure of DBS-R than previously reported for dental-fear patients. Hence, the underlying factor structure of the DBS-R may differ between different patient groups. The results point towards the use of the original 28-item DBS-R and interpreting the scale as measuring an overall construct of ,dental beliefs' and thus patients' attitudes and feelings related to dentists and dentistry. [source]

What Do Patients With Migraine Want From Acute Migraine Treatment?

HEADACHE, Issue 2002
Richard B. Lipton MD
Migraine is a common chronic condition with an ever-expanding therapeutic armamentarium. As therapeutic options multiply, it is increasingly important to understand patients' attitudes and preferences regarding various treatment characteristics. Several strategies have evolved to establish treatment priorities in migraine and rationalize and prioritize end points and outcomes to meet the needs of patients. A survey of a population-based sample of migraineurs indicated that an overwhelming majority of patients consider complete relief of head pain, no recurrence, and rapid onset of action as important or very important attributes of acute migraine therapy. An analysis of the relationship between clinical end points and satisfaction found that more than 90% of patients who were pain-free at 2 hours were at least somewhat satisfied with treatment, but satisfaction was dependent on relatively rapid relief. Using a "willingness-to-pay" approach, results indicated that while patients will pay more for migraine treatment that produces rapid, consistent relief without adverse effects or recurrence, speed of complete relief is the most valued attribute. By assessing physician preferences and practices, degree of pain relief and rapid onset were identified as the most important attributes of acute therapy. Based on results from preference studies of triptans, 50% of patients cited more rapid pain relief as the most important determinant of treatment preference. Based on these various approaches, the consensus view is that both clinicians and patients desire a broad range of positive migraine treatment attributes, but rapid onset of complete pain relief is a particularly important priority. [source]

Patient involvement in clinical decision making: the effect of GP attitude on patient satisfaction

Patients' attitudes to medicines and adherence to maintenance treatment in inflammatory bowel disease

Influence exerted on drug prescribing by patients' attitudes and expectations and by doctors' perception of such expectations: a cohort and nested case-control study

Use of the Internet by parents of paediatric patients

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 9 2006
Brynn K Wainstein
Aim: We aimed to determine the rate of Internet use for obtaining medical information by health-care patients at a tertiary paediatric hospital, whether the Internet may influence patients' attitudes to health-care services and health-care providers and whether patients would prefer the assistance of a professional informatics officer. Methods: An anonymous questionnaire randomly distributed to 450 subjects at Sydney Children's Hospital, Sydney, Australia. Results: A total of 294 (65%) questionnaires were returned. Overall Internet use for medical information was 64% (189/294). Most (97%; 183/189) respondents reported ,wanting to know more' as the reason they sought information on the Internet. Eighty-eight per cent (167/189) of respondents reported that they trust their doctor more than the Internet. Twenty-one per cent (39/189) had presented their doctor with information about which he/she was unaware and 18% (34/189) had altered a health-care decision because of information found on the Internet. The Internet had influenced questions asked of doctors in 83% (156/189). Eighty-six per cent (252/294) of all respondents were in favour of professional assistance to obtain medical information. Conclusion: A large number of patients use the Internet to find information that influences their attitudes to health care. The services of a medical informatics professional would likely benefit both patients and doctors. [source]

Irritable bowel syndrome: patients' attitudes, concerns and level of knowledge

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2007
B. E. LACY
Summary Background Irritable bowel syndrome (IBS) is a common, chronic disorder that reduces patients' quality-of-life. Although highly prevalent, little is known about patients' understanding of this disorder. Aim To evaluate the knowledge, fears and concerns of IBS patients. Methods Seven hundred thirty-six IBS patients (Rome II criteria) were eligible for inclusion in this prospective study. Each patient received a validated questionnaire to evaluate knowledge, attitudes and fears regarding IBS. Results A total of 261 of 664 potential respondents completed the questionnaire (39.3%). 83% of respondents were women, with a mean age of 53.7 years, and mean duration of symptoms of 14.2 years. Patients frequently believed that IBS develops because of anxiety (80.5%), dietary factors (75.1%) and depression (63.2%). Few respondents (28.7%) recognized that abdominal pain is the cardinal symptom of IBS, and 40.6% stated that colonoscopy can diagnose IBS. One in seven patients stated that IBS turns into cancer, and 29.9% noted that IBS increases the risk of inflammatory bowel disease. Conclusions Many IBS patients have significant misconceptions regarding the nature of their disease and its prognosis. An overwhelming majority of IBS patients believe that anxiety, dietary factors and depression cause IBS. These findings are discordant with physicians' views and practices and highlight the need for patient-oriented educational programs. [source]

Does the presence of medical students affect quality in general practice consultations?

MEDICAL EDUCATION, Issue 4 2008
Richard Price
Context, Previous studies have suggested that the patient's experience of a consultation with a doctor is not affected by the presence of medical students. However, no study has looked at the effect of student presence on conventional UK general practice consultations. Objectives, This study aimed to measure the quality of the consultation as experienced by patients when students are present, to explore patients' attitudes to the presence of medical students, and to look at the relationships between these factors. Methods, We conducted a cross-sectional questionnaire study in general practices in north-east England. General practitioners (GPs) from practices teaching fourth and final year students administered questionnaires to patients who were seen in either teaching or non-teaching consultations. The questionnaire comprised previously validated measures of empathy and enablement as measures of quality, attitudinal statements regarding the presence of students, a scale rating pertaining to the patient's degree of acquaintance with the doctor, and items on demographic data. Results, Results showed no significant differences in enablement scores between the 2 groups. Consultations with student presence last longer. Empathy scores were significantly lower in the ,student present' group, but the size of the difference was small. Attitudinal statements regarding the presence of students showed a high proportion of positive responses, and some groupings of negative ones. Further analysis demonstrated some significant links between attitudinal statements and enablement and empathy scores. Conclusions, The quality of general practice consultations was not adversely affected by medical student presence. However, significant numbers of patients who agreed to be seen with a student present were resistant to the student's presence. [source]