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Pathology imaging on the Web - Extending the role of the pathologist as educator to patients

CLINICS IN LABORATORY MEDICINE 1999年第4期19卷 849-+页

作者： Dawson, R Gilbertson, J Kim, S Becich, M Univ Pittsburgh Sch Med Dept Pathol Pittsburgh PA 15213 USA

The increasing role of patients in medical decision making and the growing availability of medical information are changing the physician-patient relationship. One aspect of this change is that patients are searching for medical information on the Internet and are visiting sites, including pathology sites, that were not originally intended for patient use. This article describes evidence for this activity and how the University of Pittsburgh Medical Center Department of Pathology has evolved mechanisms to handle patient use of its web site.

关键词：诊断显像/统计学和数值数据诊断显像/发展趋势健康知识态度实践因特网/统计学和数值数据因特网/发展趋势因特网/利用病理学/教育病理学/统计学和数值数据病理学/发展趋势病人参与/方法病人参与/统计学和数值数据病人参与/发展趋势人类

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Increasing response rates to a smoking survey for US Navy enlisted women

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EVALUATION & THE HEALTH PROFESSIONS 2000年第2期23卷 172-181页

作者： Woodruff, SI Conway, TL Edwards, CC San Diego State Univ San Diego CA 92182 USA

This study examined the effectivencss of several persistent strategics to increase the response to a smoking survey among newly enlisted U.S. Navy women. The stepped approach, which included the use of incentives, repeated mailings, alternative survey administration modes, and reminders, war evaluated in terms of effects on response rates and response bias. Demographic and baseline smoking-related characteristics were compared for those responding on time to the initial mailed follow-up survey, reluctant respondents who did not respond initially but eventually completed a survey after further prompting, and nonrespondents. Results showed that incentives and persistent efforts were effective in substantially increasing the response among 2,231 eligible participants, more than doubling the response rate (from 24.9% to 52.7%). The characteristics of ontime, reluctant, and nonrespondents did not differ significantly in terms of sociodemographic characteristics. On the other hand on-time respondents were different from both reluctant respondents and nonrespondents in terms of smoking-related behaviors. (C) Sage Publications, Inc.

关键词：方差分析队列研究随访研究健康调查军事人员/统计学和数值数据病人参与/统计学和数值数据问卷调查研究设计吸烟/流行病学戒烟美国/流行病学妇女卫生成年人女(雌)性人类

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Factors associated with patients' participation in rehabilitation services: a comparative injury analysis 12 months post-discharge

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DISABILITY AND REHABILITATION 2000年第8期22卷 358-362页

作者： Horn, W Yoels, W Bartolucci, A Univ Alabama Injury Control Res Ctr Birmingham AL 35294 USA Univ Alabama Dept Sociol Birmingham W Midlands England Univ Alabama Dept Biostat Birmingham AL 35294 USA

Purpose: To determine key characteristics or factors associated with rehabilitation participation during the first year following discharge for persons with either traumatic brain injury (TBI), spinal cord injury (SCI), intra-articular fracture (IAF), or burn injury (BURNS). Method: Medical records and longitudinal survey [telephone questionnaire] data were collected for persons in the four injury groups and analyzed using hierarchical logistic regression procedures for each domain of factors. Results. The only significant predictors with odds ratios greater than one were those for vocational rehabilitation participation. TBI patients lacking private insurance were 2.6 times more likely to participate in vocational rehabilitation;older SCI and TBI patients are about twice as likely to participate in vocational rehabilitation;and finally those with IAF or BURNS who are married at 12 months post discharge are 11.5 and 4.4 times respectively more likely to participate in vocational rehabilitation. Conclusion : Those lacking valuable socio-economic resources, such as private insurance (for TBI) and social support systems provided by marriage (for BURNS and IAF patients) are much more likely to be referred to vocational rehabilitation. This is true for older SCI and TBI patients as well. Lacking such resources, patients may be viewed by referral agents as less likely to benefit from in or outpatient rehabilitation.

关键词：亚拉巴马门诊医疗/利用卡方分布数据收集 Logistic模型纵向研究病人参与/统计学和数值数据物理治疗技术/利用概率心理学危险性评估危险因素抽样研究社会经济因素创伤和损伤/康复成年人女(雌)性人类男(雄)性

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Addressing cultural competency in research: Integrating a community-based participatory research approach

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ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH 2003年第8期27卷 1361-1364页

作者： Shiu-Thornton, S Univ Washington Sch Publ Hlth & Community Med Dept Hlth Serv Seattle WA 98195 USA

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Coping in cyberspace: The impact of Internet use on the ability of HIV-positive individuals to deal with their illness

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JOURNAL OF HEALTH COMMUNICATION 2000年第1-sup1期5卷 47-59页

作者： Reeves, PM Univ Georgia Coll Educ Dept Counseling & Human Dev Serv Athens GA 30602 USA

The human immunodeficiency virus (HIV) poses one of the greatest health threats of modem times. The Internet provides unparalleled access to resources that can assist individuals coping with HIV infection. Despite the promise of online resources to help individuals manage and cope with their illness,few studies have investigated the impact of their use. Those that have looked primarily at Internet use from a group perspective. These studies were usually "bounded" as well, focusing on electronic support groups or highly structured computer-based support systems that offer select users prescribed resource options. Little is known about how individuals who are "on their own"-without access to these services-use the vast, unstructured array of resources available through the Internet. The purpose of this study was to investigate the impact of Internet use on the coping ability of HIV-positive individuals. This research study employed a descriptive qualitative design that used in-depth, semi-structured, face-to-face interviews for data collection. The sample of 10 purposefully selected HIV-positive individuals reflected diversity in gender, age, race, education, employment, number of years living with HIV, and Internet use. Data analysis guided by the constant comparative method revealed that the impact of Internet use on coping ability, involved three themes: The Internet promotes empowerment, augments social support, and facilitates helping others.

关键词：适应心理学信息交流 HIV血清阳性/心理学卫生保健调查健康教育健康知识态度实践因特网/利用病人参与/心理学病人参与/统计学和数值数据社会支持人类

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User fees and patient behaviour: Evidence from Niamey National Hospital

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HEALTH POLICY AND PLANNING 1995年第4期10卷 350-361页

作者： Weaver, M WASHINGTON UNIV DEPT HLTH SERVSEATTLEWA

Evidence is presented on the effects of price changes on the delay before seeking care and on referral status in a sample of hospital patients in Niger. Price changes are measured as differences across patients at one hospital in whether or not they pay for care, rather than as differences in prices across several hospitals. User fees are charged, but the fee system allows exemptions for some payor categories such as government employees, students, and indigent patients. Evidence is also presented on the effect of income on the delay before seeking care and referral status. The analysis demonstrates a technical point on whether household consumption or current income is a more appropriate measure of income. The analysis shows that user fees affect patient behaviour, but the effects are not the same for outpatients and inpatients. Outpatients who pay for care wait longer before seeking care, but inpatients do not. Inpatients who pay for care are more likely to be referred, but outpatients are not. Patients with more income wait less time to seek care and are less likely to be referred than other patients. Further, household consumption explains patient behaviour better than current income.

关键词：数据收集发展中国家卫生服务易得程度/经济学卫生服务易得程度/统计学和数值数据卫生服务研究/方法医院收费/统计学和数值数据医院公立/经济学医院公立/统计学和数值数据医院公立/利用住院病人/统计学和数值数据最小二乘法分析尼日尔门诊病人/统计学和数值数据病人参与/经济学病人参与/统计学和数值数据转诊和会诊时间因素人类

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Self-direction in home care for older people: A consumer’s perspective

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Home Health Care Services Quarterly 1997年第1-2期16卷 41-54页

作者： Glickman, Lillian L. Stocker, Kathy B. Caro, Francis G. Massachusetts Executive Office of Elder Affairs Gerontology Institute and Center College of Public and Community Service University of Massachusetts Boston Boston MA 02125-3393 100 Morrissey Boulevard United States University of Massachusetts Boston Gerontology Institute and Center College of Public and Community Service University of Massachusetts Boston Boston MA 02125-3393 100 Morrissey Boulevard United States

Interest among elder home care consumers in playing a stronger role in planning and supervising their own care was examined. Elder home care consumers were surveyed to determinetheir willingness to assume more responsibility for their home caresuch as in the hiring, paying, scheduling, supervising and/or firing oftheir home care worker. Telephone interviews were conducted of 883 home care clients in the Massachusetts Home Care Program which is administered through 27local, private, non-profit Home Care Corporations (HCC) and whichcurrently serves 33, 000 clients. Respondents reported high levels ofsatisfaction with their home care services and home care worker. However, a substantial minority of respondents reported a willingnessto assume more responsibility for their own home care services. Aquarter to a third of the respondents indicated that they could takegreater responsibility for supervising a home care worker and neededless assistance from a case manager, Multiple regression analyses revealed that prior experience in directing an in-home worker, greater lcngth of receipt of home care services, greater current involvement in directing a home care worker, and lowcr levels of satisfaction with home care services were associated with a willingness to assume responsibility for directing a home care worker. Pilot projects are needed that develop and test options for oldcr people with disabilities to exercise greater control over their own personal assistance. © 1997 by The Haworth Press, Inc. All rights reserved.

关键词：病例管理数据收集决策卫生保健调查家庭医疗保健服务/标准马萨诸塞病人参与/统计学和数值数据病人满意度/统计学和数值数据问卷调查老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Why are Elderly People Not Using Advance Directives?

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Journal of Aging and Health 1993年第4期5卷 497-515页

作者： High, Dallas M. University of Kentucky United States

Although advance directives for health care are widely advocated, usage rates among the elderly are low. Reported is a study testing comparative educational strategies to increase the use of advance directives among elderly persons ages 65 to 93. Follow-up interviews (n = 293) with intervention participants and controls showed that only 1 of 6 different strategies increased use. Neither lack of information nor simple procrastination were found as primary barriers to completion of advance directives. Most intervention participants preferred to defer to family surrogates and avoid executing advance directives. Level of education was a factor in use. Proposed is a restructuring of the advance directives process to accommodate elderly persons' wishes to authorize family members for surrogate health decision making, a policy that would assist the majority of people, including those who either wish to avoid or fail to execute advance directives. © 1993, Sage Publications. All rights reserved.

关键词：提前医护计划预先指示/统计学和数值数据对死亡的态度健康知识态度实践肯塔基病人参与/心理学病人参与/统计学和数值数据方案评价社会经济因素老年人人类

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Coping Effectiveness in Nursing Home Residents: The Role of Control

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Journal of Aging and Health 1992年第4期4卷 551-563页

作者： Shaw, Rebecca J. University of Illinois College of Nursing United States

The purpose of this study was to investigate the role of perceived control in the selection and effectiveness of coping strategies used by nursing home residents. A path analysis of a model of coping effectiveness was conducted using a cluster sample of 100 nursing home residents. Respondents were assisted in completing the Importance, Locus, and Range of Activities Checklist, the Jalowiec Coping Scale, two self-anchoring ladders measuring coping effectiveness, and an item measuring perceived health. Mental status was measured with the Pfeiffer Short Portable Mental Status Questionnaire. Results demonstrated that mental status and functional ability were positively related to perceived control (p <.01). Perceived health and the use of secondary control (e.g., prayer, getting help from family, and depending on others) were the only two variables positively influencing coping effectiveness (p <.01 and p <.05, respectively). Longitudinal studies are recommended to investigate these relationships as they evolve. © 1992, SAGE Publications. All rights reserved.

关键词：日常生活活动适应心理学数据收集评价研究体内外控制模型心理学医护疗养所/统计学和数值数据病人参与/心理学病人参与/统计学和数值数据生活质量美国西南部老年人女(雌)性人类男(雄)性

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THE WELL-YEAR OF LIFE AS A BASIS FOR PATIENT DECISION-MAKING

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PATIENT EDUCATION AND COUNSELING 1989年第3期13卷 281-295页

作者： KAPLAN, RM ATKINS, CJ UNIV CALIF SAN DIEGO DEPT COMMUNITY & FAMILY MEDLA JOLLACA 92093 UNIV CALIF SAN DIEGO DEPT HLTH SCILA JOLLACA 92093

Medical decision-making requires the integration on costs, risks, and benefits of treatment. Clinical side effects and benefits are typically expressed in terms of symptoms and clinical states of diseases. Integrating probabilistic information about different categories is often difficult from both the patient's and the clinician's perspectives. We offer a General Health Policy Model that expresses the benefits and side effects of treatment within a common unit. The model takes into consideration mortality, function (morbidity), and preference for health states. In addition, the model uses probability information to describe the prognosis or likelihood of transition among states over the course of time. The output of the model is a well-year which is defined as the equivalent of a completely well-year of life. The well-year is a comprehensive expression of benefits minus side effects that may be useful for individual patient decision-making.

关键词：日常生活活动分类决策高血压预期寿命模型统计学结果与过程评价(卫生保健)/统计学和数值数据病人参与/统计学和数值数据生活质量人类

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