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Physician Interview (physician + interview)
Selected AbstractsThe role of the inflammatory markers ferritin, transferrin and fibrinogen in the relationship between major depression and cardiovascular disorders , The German Health Interview and Examination SurveyACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2010B. T. Baune Baune BT, Neuhauser H, Ellert U, Berger K. The role of the inflammatory markers ferritin, transferrin and fibrinogen in the relationship between major depression and cardiovascular disorders , The German Health Interview and Examination Survey. Objective:, To determine levels of inflammation (ferritin, transferrin and fibrinogen) in major depression (MDD) and comorbid cardiovascular disease (CVD) in an adult population. Method:, In 4181 participants of the German Health Interview and Examination Survey MDD was assessed through the Composite International Diagnostic Interview (CIDI). Coronary heart disease, stroke, and hypertension were diagnosed by a computer-assisted physician interview. Analyses were performed using anova models stratified for gender. Results:, Ferritin, transferrin and fibrinogen levels showed opposing patterns in individuals with either CVD or MDD alone. In comorbidity analyses, male participants with MDD plus comorbid CHD or hypertension had lower levels of ferritin and lower fibrinogen levels in hypertension compared to men without MDD, while in women, results were inconsistent. Conclusion:, Opposing patterns of inflammatory markers in CVD or MDD alone were reversed when both conditions were present. MDD reduced levels of ferritin, transferrin and fibrinogen in CVD in a gender-specific way. [source] Postoperative confusion assessed with the Short Portable Mental Status QuestionnaireANZ JOURNAL OF SURGERY, Issue 9 2003Amirarsalan Eissa Background: Confusion is a common occurrence after cardiac surgery. However, there is great variability in the reported incidence of confusion in patients following cardiac surgery, mainly due to the diagnostic methods and instruments employed in assessing confusion. Methods: Forty-eight cardiac surgery patients were assessed for postoperative confusion by a non-structured physician interview, and by the short portable mental status questionnaire (SPMSQ) administered by a medical student. Results: The non-structured ward interviews detected confusion in one of the 48 patients (2%), whereas the SPMSQ diagnosed confusion in 15 of the 48 patients (31%). Conclusion: Unlike a subjective ward interview, the SPMSQ is a brief and objective diagnostic tool that can be used to measure accurately both the presence and severity of confusion in postoperative cardiac surgery patients. [source] Advance Directives in Skilled Nursing Facility Residents Transferred to Emergency DepartmentsACADEMIC EMERGENCY MEDICINE, Issue 12 2001Michael Lahn MD Abstract Objective: Ten years have passed since Congress enacted the Patient Self-Determination Act to promote the use of advance directives (ADs). This study was performed to determine the frequency, type, demographic distribution, and utility of ADs that accompany residents of skilled nursing facilities (SNFs) transferred to emergency departments (EDs). Methods: This was an observational, cross-sectional cohort of SNF residents, transferred to two urban, academic EDs. Chart review and physician interviews were conducted on consecutive patients arriving during 12-hour data collection shifts. Results: Among 715 patients entered, 315 [44%, 95% confidence interval (95% CI) = 40% to 48%] had an AD. Advance directives were significantly more prevalent among white (50%) than African American (34%) or Hispanic (39%) patients (p < 0.001), and varied from 0% to 94% among SNFs. Of the 315 patients with ADs, do-not-resuscitate (DNR) orders were the most prevalent (65%, 95% CI = 58% to 69%). Although 75% (95% CI = 69% to 81%) of the DNR orders addressed cardiopulmonary resuscitation (CPR), only 12% (95% CI = 8% to 16%) addressed intubation. Among 39 patients who required intubation or CPR, 44% had ADs, 82% (95% CI = 57% to 96%) of which were deemed useful. Conclusions: Despite a decade of legislation promoting their use, ADs are lacking in most SNF residents transferred to EDs for evaluation and in most settings in which a clinical indication exists for intubation or CPR. Variation in their prevalence appears to be associated with both ethnicity and SNF origin. Although about three-fourths of DNR ADs addressed CPR, only about one in ten offered guidance regarding intubation. When available, ADs are used in most instances to guide emergency care. [source] Caring for cancer survivors,CANCER, Issue S18 2009A survey of primary care physicians Abstract BACKGROUND: The number of long-term US cancer survivors is expected to double by the year 2050. Although primary care physicians (PCPs) provide the majority of care for long-term cancer survivors, to the authors' knowledge, few data to date have detailed PCP practice patterns, attitudes, and challenges in caring for long-term cancer survivors. METHODS: Self-administered surveys were mailed to 406 community- and academic-based general internal medicine physicians in Denver, Colorado. Survey development included in-depth physician interviews and pretesting. Of the 299 responses, 72 were ineligible; an analysis of the data from 227 surveys is presented. RESULTS: The response rate was 76%. Community-based PCPs comprised 70% of completed surveys. Reported care patterns were assessed to create a multidimensional care score reflecting levels of attention to 4 areas of survivorship care: monitoring for cancer recurrence, management of late effects, sexual functioning, and mental health. Only 24% of PCPs met criteria for routinely providing more multidimensional survivorship care. More recent medical school graduates reported providing less multidimensional survivorship care when compared with their more experienced colleagues. Approximately 82% of PCPs believed that primary care guidelines for adult cancer survivors are not well defined, and 47% of PCPs cited inadequate preparation and lack of formal training in cancer survivorship as a problem when delivering care to long-term survivors. CONCLUSIONS: Although PCPs provide the bulk of care for long-term survivors within the survivorship phase of the cancer trajectory, only a small subset have reported providing multidimensional survivorship care. Results underscore a need for substantially increased training in survivorship care to support the delivery of multidimensional primary care for long-term survivors. Cancer 2009;115(18 suppl):4409,18. © 2009 American Cancer Society. [source] Children are reliable reporters of common symptoms: results from a self-reported symptom diary for primary school childrenACTA PAEDIATRICA, Issue 7 2010C Lundqvist Abstract Background:, Collecting information on subjective symptoms in children by parental reports or physician's interview is indirect and not suited for prospective data collection over extended time periods. Aim:, To examine the reliability of a diary for symptom self-reports by primary school children. Methods:, Children aged 7,8 or 11,12 were recruited from primary school and a paediatric outpatient department. A picture-based symptom diary was completed individually. Children were asked about presence of 10 specified subjective symptoms for five time periods covering the previous 24 h. The diary was completed twice for test,retest and answers were compared with semi structured physician's interviews. Results:, Test,retest reliability for reporting a symptom during the previous 24 h gave reliable kappa values of 0.64,0.91. Comparison with physician's interview gave kappas of 0.18,0.68. Requiring correct time of day for each symptom reduced reliability and validity. Kappa values for test,retest and child-physician agreement for the individual symptoms were respectively: sneezing, 0.80 and 0.30; sore throat, 0.89, 0.30; tiredness, 0.88, 0.65; headache, 0.64, 0.66; runny nose, 0.91, 0.68; sore eyes, 0.67, 0.18; cough, 0.73, 0.58; stomach ache, 0.69, 0.45. Conclusion:, Our symptom diary gives reliable self-report data from primary school children. It may be used for prospective symptom monitoring. [source] | ||||||||||