No Abstract Available.

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

No abstract available.
Humans

No abstract available.

No abstract available.

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*

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: When physicians use the medical terms difficult to understand the meaning, patients regard it as an authority of the physician. It has negative influence on physician-patient relationship and hinders delivering accurate meaning to the patient. The purpose of this research is to investigate what kind of medical terms which meaning is difficult to understand (medical jargon) are used in medical interviews and survey the patients' understanding of the medical terms. METHODS: In the preceding study 67 cases of physicians' interviewing with patient were videotaped in the family medicine clinic of a university hospital and they were transcribed from August, 2005 to January, 2007. For this study 60 cases of the transcribed conversations, which interviewing was completely recorded, were assessed for analyzing the content and frequency of medical jargon. The author selected 10 medical terms used in this study's interviews and surveyed the patients' understanding of the medical terms, who visited the family medicine clinic, by questionnaires. RESULTS: In 26 of 60 interviews one or more medical jargon were used by the physician. In 39 of 73 terms (53.4%) the physicians explained meaning of the medical terms to the patient. 213 patients responded to the questionnaires. More than half (median, 55.4%; range, 11.7 to 75.1%) of the respondents expressed that they 'never know' or 'hardly know' the meaning of the medical terms if it was used without explanation. The scores of level of patients' understanding of 10 medical terms significantly increased according to increasing level of income, but the trend is not statistically significant according to increasing age, difference of sex, and level of education. CONCLUSION: The family physicians used medical jargon in 43.3% of medical interviews, and they explained meaning of the medical terms to the patients for more than half of the terms. More than half of the patients in a university hospital family medicine clinic responded that they never knew or hardly knew meaning of the medical terms if they were used without explanation.
Surveys and Questionnaires ; Delivery of Health Care ; Humans ; Physicians, Family