Care Consultations (care + consultation)

Distribution by Scientific Domains
Medical Sciences85%

Kinds of Care Consultations

  • primary care consultation
    		•

    Selected Abstracts

    Patient Participation in Health Care Consultations: Qualitative Perspectives

    JOURNAL OF CLINICAL NURSING, Issue 14 2008
    Bodil Wilde-Larsson
    [source]

    Ethnic Differences in Pain Among Outpatients with Terminal and End-Stage Chronic Illness

    PAIN MEDICINE, Issue 3 2005
    Michael W. Rabow MD
    ABSTRACT Objective., To explore ethnic and country of origin differences in pain among outpatients with terminal and end-stage chronic illness. Design., Cohort study within a year-long trial of a palliative care consultation. Setting., Outpatient general medicine practice in an academic medical center. Patients., Ninety patients with advanced congestive heart failure, chronic obstructive pulmonary disease, or cancer, and with a prognosis between 1 and 5 years. Outcome Measures., Patients' report of pain using the Brief Pain Inventory and analgesic medications prescribed by primary care physicians. Differences in pain report and treatment were assessed at study entry, at 6 and 12 months. Results., The overall burden of pain was high. Patients of color reported more pain than white patients, including measures of least pain (P = 0.02), average pain (P = 0.05), and current pain (P = 0.03). No significant ethnic group differences in pain were found comparing Asian, black, and Latino patients. Although nearly all patients who were offered opioid analgesics reported using them, opioids were rarely prescribed to any patient. There were no differences in pain between patients born in the U.S. and immigrants. Conclusions., Pain is common among outpatients with both terminal and end-stage chronic illness. There do not appear to be any differences in pain with regard to country of origin, but patients of color report more pain than white patients. Patients of all ethnicities are inadequately treated for their pain, and further study is warranted to explore the relative patient and physician contributions to the finding of unequal symptom burden and inadequate treatment effort. [source]

    Role of the general practitioner in smoking cessation

    DRUG AND ALCOHOL REVIEW, Issue 1 2006
    NICHOLAS A. ZWAR
    Abstract This paper reflects on the role of general practitioners in smoking cessation and suggests initiatives to enhance general practice as a setting for effective smoking cessation services. This paper is one of a series of reflections on key issues in smoking cessation. In this article we highlight the extent that general practitioners (GPs) have contact with the population, evidence for effectiveness of GP advice, barriers to greater involvement and suggested future directions. General practice has an extensive population reach, with the majority of smokers seeing a GP at least once per year. Although there is level 1 evidence of the effectiveness of smoking cessation advice from general practitioners, there are substantial barriers to this advice being incorporated routinely into primary care consultations. Initiatives to overcome these barriers are education in smoking cessation for GPs and other key practice staff; teaching of medical students about tobacco and cessation techniques, clinical practice guidelines; support for guideline implementation; access to pharmacotherapies; and development of referral models. We believe the way forward for the role of the GPs is to develop the practice as a primary care service for providing smoking cessation advice. This will require education relevant to the needs of a range of health professionals, provision of and support for the implementation of clinical practice guidelines, access for patients to smoking cessation pharmacotherapies and integration with other cessation services such as quitlines [source]

    Identifying patterns in primary care consultations: a cluster analysis

    JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2009
    Joachim P. Sturmberg MBBS DORACOG MFM FRACGP PhD
    Abstract Background, A literature review revealed that little is known about the systems context of general practice consultations and their outcomes. Objectives, To describe the systems context and resulting underlying patterns of primary care consultations in a local area. Design, Cross-sectional multi-practice study based on a three-part questionnaire. Cluster analysis of data. Setting, Stratified random sample of general practices and general practitioners , NSW-Central Coast, Australia. Participants, A total of 1104 adults attending 12 general practitioners between February and November 1999. Results and Conclusions, The study identified seven subgroups within the study population uniquely defined by variables from the health system, individual doctor and patient, consultation and consultation outcomes domains. A systems approach provides a framework in which to track and consider the important variables and their known and/or expected workings and thus offer a contextual framework to guide primary care reform. [source]

    Theme-oriented discourse analysis of medical encounters

    MEDICAL EDUCATION, Issue 6 2005
    Celia Roberts
    Approach, Theme-oriented discourse analysis looks at how language constructs professional practice. Recordings of naturally occurring interactions are transcribed and combined with ethnographic knowledge. Analytic themes drawn primarily from sociology and linguistics shed light on how meaning is negotiated in interaction. Detailed features of talk, such as intonation and choice of vocabulary, trigger inferences about what is going on and being talked about. These affect how interactants judge each other and decisions are made. Interactions also have larger rhetorical patterns used by both patients and doctors to persuade each other. Examples, Two settings are used to illustrate this approach: genetic counselling and primary care consultations in multilingual areas. In genetic counselling, interactions are organised around the tension between the risks of knowing and the risks of occurrence. This can lead to a ,rhetorical duel' between health professionals and patients and their families. In intercultural primary care settings, talk itself may be the problem when interpretive processes cannot be taken for granted. Even widely held models of good practice can lead to misunderstandings under these conditions. Conclusion, Through discourse analysis, the talk under scrutiny can be slowed down to show the interpretive processes and overall patterns of an activity. Discourse analysts and health professionals, working together, can look at problems in new ways and develop interventions and tools for a better understanding of communication in medical life. [source]

    How should trainees be taught to open a clinical interview?

    MEDICAL EDUCATION, Issue 5 2005
    Alex Walter
    Aim, To characterise the opening of secondary care consultations. Method, We audio-taped 17 first consultations in medical clinics, transcribed them verbatim, and analysed verbal interactions from when the doctor called the patient into the consulting room to when she or he asked clarifying questions. Results, The interviews did not open with the sequence, reported by previous researchers, of ,doctor's soliciting question, patient's opening statement, interruption by the doctor'. Doctors (1) called the patient to the consultation; (2) greeted them; (3) introduced themselves; (4) made a transition to clinical talk; and (5) framed the consultation. They used a referral letter, the case notes, computer records and their prior knowledge of the patient to help frame the consultation, and did so informally and with humour. Conclusion, These 5 steps could help trainees create a context for active listening that is less prone to interruption. [source]