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Humans

No Abstract Available.

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Evidence-Based Medicine* ; Primary Health Care*

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Child* ; Humans

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*

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: Positive spousal support is considered to be effective for successful smoking cessation. In this study, interaction behaviors of spouses for smoking cessation and association of characteristics of spousal relationship with smoking cessation outcome was assessed. METHODS: Self-quitters who visited a family medicine clinic or a health promotion center were inquired on their smoking status and the relationship with their spouse by using the PIQ (partner interaction questionnaire). In a follow-up period of 3 and 6 months, current smoking status of each patient was assessed again by tele phone. RESULTS: The smoking cessation rate among the subjects was 14.1%. There were significant differences between the successful quitters group and the failed group in age and smoking years (P<0.05). For the mean PIQ scores based on 71 persons, the mean total PIQ score was 42.9 (SD 12.8), the mean positive PIQ score was 18.8 (SD 7.7), and the mean negative score was 24.1 (SD 6.9). We analyzed the association of PIQ scores with continuous abstinence at 3- and 6-month follow-ups. And there was no relationship between negative behaviors and abstinence at 3 and 6 months. Also, there was no relationship between the positive/negative score ratio and continuous abstinence at 3 and 6 months. CONCLUSION: The self quitters' partners were fairly interactive, but more of the interactions were negative in nature. Our data suggest that frequency of positive and negative interactions are not significantly related to the success rate of smoking cessation at 3- and 6-month follow-up periods.
Follow-Up Studies ; Health Promotion ; Humans ; Smoke ; Smoking ; Smoking Cessation* ; Spouses