1.Families’ Sense of Discrepancy between the Explanations of Group Practice Doctors Providing Home Medical Care: A Cross-Sectional Study
Takuma Kimura ; Teruhiko Imanaga ; Makoto Matsuzaki ; Tohru Akahoshi
General Medicine 2014;15(2):100-109
Background: Group practices with multiple physicians are preferred for promoting home medical care, but the explanations to patients and families given by the visiting doctors may differ. That could sometimes lead to confusion in patients and families.
Methods: We conducted a cross-sectional mail survey of families of Japanese patients who had previously received home medical care. Multivariable adjusted logistic regression for families’ sense of discrepancy between the explanations by doctors in a group practice was performed using eleven explanatory variables including: (1) number of doctors; (2) interval between the doctors’ visits; (3) duration of the doctor’s stay; (4) doctors’ frequent use of technical terminology; (5) doctors’ interruption of family’s talking, etc.
Results: Among 271 families who were mailed surveys, 227 responded (83.8%). The final sample for the analyses was 139. Responses were divided into two groups: families who had experienced a sense of discrepancy about explanations by different doctors (“Experienced”, 30 families, 21.6%) and those who had not (“Non-experienced”, 109 families, 78.4%). Families’ sense of discrepancy between the explanations by doctors in group practice was significantly associated with a longer time interval between doctors’ visits (OR: 1.103, 95% CI: 1.008–1.208, p = 0.03) and doctors interrupting families while they were talking (OR: 2.559, 95% CI: 1.166–5.615, p = 0.02).
Conclusions: Visiting doctors need to understand that families may have a sense of discrepancy about explanations given by different doctors. This sense of discrepancy was associated with less frequent doctors’ visits and doctors’ interrupting families while they are talking.
2.A Report of Successful Treatment of an Infectious Pseudoaneurysm after Graft Replacement of the Ascending Aorta.
Kenji Matsuzaki ; Norihiko Shiiya ; Toshifumi Murashita ; Shigeyuki Sasaki ; Yoshiro Matsui ; Makoto Sakuma ; Keishyu Yasuda
Japanese Journal of Cardiovascular Surgery 1998;27(3):184-187
A 74-year-old woman was admitted to our hospital with a diagnosis of a pseudoaneurysm 5 months after graft replacement of the ascending aorta, and underwent re-replacement employing left ventricle venting through a left anterior thoracotomy. Culture of the thrombi in the pseudoaneurysm revealed Psuedomonas infection. On the 11th postoerative day, a single-stage procedure of irrigation, debridment, and immediate closure with omental transposition was performed. Although the chest CT scan 1 month after the omental transposition revealed a residual abcess, it was completely obliterated after 2 months without further operation.