No Abstract Available.

No abstract available.
Evidence-Based Medicine* ; Primary Health Care*

No abstract available.
Humans

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No abstract available.
Child* ; Humans

No abstract available.

BACKGROUND: The quality of specimen for Papanicolaou smear depends on the sampling methods of uterine cervix. This study was designed to test specimen adequacy and the detection of disease using t,wo cervical cytological sampling methods. pastic spatula plus Cytobrish and Cervex-Brush. METHODS: Research subjects were t.he exarninee for screening for cevical cancer in Farnily Practice Center and Health Promotion Center of University Hospital. Research sub jects were classified to two groups randomly. 5 physicians used each device at random. A group 80 test smples(plast,ic spatula plus Cytobrush) were compared with B group test samples(Cervex Brush) for the presence rate of endocervial cells and specimen adequacy. The laborat.ory was blind to the sampling met,hods. RESULTS: The plastic spatula plus Cytobrush and Cervex-Brush were comparable in cap- turing in endocervical cells. But the capturing rates of both methods were high(over 70%). Both the pastic spatula plus Cytobrush and Cervex-Brush produced adequate samples, and the adequacy scores between two methods were not different. significantly. CONCLUSIONS: Use of the plastic spatula puls Cytobrush and Cervex-Brush produced adequate smear for interpretation.
Cervix Uteri ; Female ; Health Promotion ; Humans ; Mass Screening ; Papanicolaou Test ; Plastics ; Research Subjects

BACKGROUND: Which component of physician's interviewing process affects the patient- physician relationship and clinical outcomes can be studied by videotaping conversations in an exam room. The purpose of this study was to record resident physicians' conversations, describe the frequency and the content of the observed patient- centered utterances in interviews, and analyze the correlation between the presence of observed patient- centered utterances and the level of satisfaction. METHODS: Ten interactions for each of the 6 resident physicians were videotaped. The utterances of physicians were coded directly from video tapes and transcribed partially. Uttering to explore a patient's standpoint, uttering emotionally to mention directly about patient's feeling, and uttering to counsel a patient for coping skills were considered as indicators of patient- centered conversations. RESULTS: The average number of physician's utterances per interaction was 32 (range 9~67). The mean time of an interaction was 8 minutes and 23 seconds (range: 1 min and 55 sec~20 min and 20 sec). Among the total 1,792 physicians' utterances, there were 29 social talks, 1,228 utterances for diagnosis, 376 utterances for treatment, 147 directive utterances, and 12 family-centered utterances. Among the utterances for diagnosis or treatment, there were 88 patient-centered utterances including 59 utterances for exploring a patient's standpoint, 23 emotional utterances, and 6 utterances for counseling. Fifty two patients responded to a questionnaire to assess satisfaction after an interaction. Sixteen respondents (30.8%) were very satisfied, 26 respondents (50.0%) were satisfied, 6 respondents (11.5%) were little satisfied, one respondent (1.9%) was unsatisfied, and 3 respondents (5.8%) were reserved to respond. There was no significant correlation between the presence of observed patient- centered utterances and the level of satisfaction (P>0.05). CONCLUSION: Most of the resident physicians' utterances consisted of asking physician-centered questions and offering informations. The patient-centered utterances were observed 1~2 times per interaction in average, and they were brief. This study reveals that the presence of patient-centered utterances in interviews was not correlated with the level of patients' satisfaction.
Adaptation, Psychological ; Counseling ; Surveys and Questionnaires ; Diagnosis ; Humans ; Patient-Centered Care ; Personal Satisfaction ; Physicians, Family*

BACKGROUND: Patients' Illness experiences are described in the 4 categories; meanings or patients' thoughts, patients' feelings, patients' expectations, and influence of illness on patients' lives. The purpose of this study is to collect patients' stories when they are interviewed in a family medicine clinic, and analyze to make a systematic database of the patients' illness experiences. METHOD: We recorded and analyzed illness narratives of the 19 alcohol abuse patients. One of the researchers interviewed the patients directly to collect narrative data by using a semi-structured questionnaire. RESULTS: The meanings that they had in alcohol abuse were making a social relationship, vitality, forgetting, anesthetic drugs to relief emotional pain, means to relief thirst, hunger, depressed mood. They told that the physical effects of alcohol drinking were gastrointestinal disturbance and change in body weight. Psychosocial or behavioral changes were sleep disturbance, loss of memory, drinking alone, absence from work after drinking, avoidance of related persons and guilty feeling. The patients concerned about their chronic drinking habit, physical symptoms, behavioral changes, deterioration in physical health, withdrawal in social roles, and sick persons among their families, As for the expectations for a physician's support patients told that they had to stop by himself, and some patients talked about good medicines or strong medicines, or checking blood tests. CONCLUSION: In conclusion the patients had the positive reasons for alcohol drinking, but they had also negative experiences after drinking. Deducing from the expressed denials, we can guess that the negative experiences might have no effect on the patients' behavior change.
Alcohol Drinking ; Alcoholism* ; Anesthetics ; Behavioral Symptoms ; Body Weight ; Chronic Disease ; Denial (Psychology) ; Drinking ; Hematologic Tests ; Humans ; Hunger ; Memory ; Thirst ; Surveys and Questionnaires