Ethics, Medical ; Humans ; Physician's Role ; Physician-Patient Relations ; Practice Patterns, Physicians' ; Singapore ; Social Identification ; Social Responsibility ; Trust

No abstract available.
Aging ; *Attitude of Health Personnel ; Health Knowledge, Attitudes, Practice ; Humans ; *Physician's Practice Patterns ; Physicians ; Prostatectomy ; Risk Factors ; Urinary Bladder/physiology ; Urinary Incontinence/*epidemiology/*psychology ; Urination/physiology

BACKGROUND: This study aimed at finding out how much the rate of the JNC-7 guideline was carried out, and assessed the degree of evidence based clinical practice patterns and the validity of the new guideline by comparatively analyzing primary care practice patterns in hypertensive patients. METHODS: A questionnaire regarding the management of hypertension was conducted by mail between May 15 and July 15, 2005, to 1,008 of the Korean Association of Family Medicine listed in the address book. There were 195 respondents with a response rate of 19.4%. RESULTS: Among the total respondents, 91.1% were aware of the new guideline and had received information mainly through training lectures and seminars. They said that the biggest difference between the new guideline from the previous one was the inclusion of prehypertension (62.3%), and 61.1% were using the new term prehypertension in their practice. The most frequency advice given to patients related to lifestyle modification were in the order of smoking cessation (44.8%), exercise (41.7%) and weight reduction (38.0%). Calcium channel blocker was the most commonly used (60.9%) as the first-line agent. When physicians failed to control blood pressure with the first medication in cases of stage 1 hypertension, 67.7% added other agents. In treating stage 2 hypertension, 59.9% started with a single agent and gradually added other agents. CONCLUSIONS: Family physicians in primary care clinics had a good understanding of the JNC-7 guideline. However, the rate at which they applied it in treatment was low. To effectively apply the guideline in actual treatments, aggressive education of practitioners and improvement on medical system and treatment guidelines are needed.
Blood Pressure ; Calcium Channels ; Surveys and Questionnaires ; Education ; Humans ; Hypertension ; Lectures ; Life Style ; Physician's Practice Patterns ; Physicians, Family ; Postal Service ; Prehypertension ; Primary Health Care* ; Smoking Cessation ; Weight Loss

PURPOSE: Patient care based on asthma guidelines is cost-effective and leads to improved treatment outcomes. However, ineffective implementation strategies interfere with the use of these recommendations in clinical practice. This study investigated physicians' preferences for asthma guidelines, including content, supporting evidence, learning strategies, format, and placement in the clinical workplace. METHODS: We obtained information through a questionnaire survey. The questionnaire was distributed to physicians attending continuing medical education courses and sent to other physicians by airmail, e-mail, and facsimile. RESULTS: A total of 183 physicians responded (male to female ratio, 2.3:1; mean age, 40.4+/-9.9 years); 89.9% of respondents were internists or pediatricians, and 51.7% were primary care physicians. Physicians preferred information that described asthma medications, classified the disease according to severity and level of control, and provided methods of evaluation/treatment/monitoring and management of acute exacerbation. The most effective strategies for encouraging the use of the guidelines were through continuing medical education and discussions with colleagues. Physicians required supporting evidence in the form of randomized controlled trials and expert consensus. They preferred that the guidelines be presented as algorithms or flow charts/flow diagrams on plastic sheets, pocket cards, or in electronic medical records. CONCLUSIONS: This study identified the items of the asthma guidelines preferred by physicians in Korea. Asthma guidelines with physicians' preferences would encourage their implementation in clinical practice.
Asthma ; Consensus ; Surveys and Questionnaires ; Education, Medical, Continuing ; Electronic Health Records ; Electronic Mail ; Female ; Humans ; Korea ; Learning ; Patient Care ; Physician's Practice Patterns ; Physicians, Primary Care ; Plastics ; Surveys and Questionnaires

Non-disclosure in Paediatric Practice is a controversial issue. There was a time when the care of children was solely the responsibility of parents and any decision with respect to treatment or non-treatment would have been the joint responsibility of the parents and of the attending medical professionals. This practice, viewed as adopting a more paternalistic approach, has been challenged in many parts of the world. In essence what is being challenged is the notion that the sole responsibility of decision-making rests with parents.
Clinical Competence ; Communication ; Decision Making ; Ethics, Medical ; Humans ; Parent-Child Relations ; Patient Rights ; ethics ; Pediatrics ; ethics ; Physician-Patient Relations ; ethics ; Practice Patterns, Physicians' ; Truth Disclosure ; ethics

No abstract available.
Korea ; Physician's Practice Patterns

No abstract available.
Korea ; Physician's Practice Patterns

To examine attitudes and practice patterns of primary care physicians in health promotion and to probe factors associated with active involvement, a nation widecross-sectional postal questionnaire survey of randomly sampled Korean family physicians and internists was performed. The areas of health promotion examined were; smoking, alcohol consumption, stress, exercise, and diet. Overall response rate was 38.0% and an interview survey of sub-samples of non-responders found no differences in socio-demographic characteristics or survey results versus original responders, except for the rate of collecting information on smoking and diet. Smoking cessation was considered important by 92% of responders, while other lifestyle factors were considered important by less than 70%. Approximately 80% of responders believed in effectiveness of lifestyle counseling, except for stress. The frequency of collecting information, providing counseling, and the level of preparedness to undertake counseling were higher for smoking and alcohol than for other factors. Beliefs in effectiveness of health promotion and preparedness to undertake counseling were positively associated with frequency of information collection and providing counseling, even after adjusting for socio-demographic factors. Efforts should be made to change the physicians perception of effectiveness and importance of health promotion, and to improve physician's preparedness to actively intervene.
Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking ; *Attitude of Health Personnel ; Cross-Sectional Studies ; Diet ; Exercise ; Female ; *Health Promotion ; Human ; Korea ; Male ; Middle Aged ; *Physician's Practice Patterns ; *Physicians, Family ; Questionnaires ; Random Allocation ; Smoking ; Stress ; Support, Non-U.S. Gov't

This study aimed to evaluate current clinical assessments and management of obesity in the primary care setting in Korea since anti-obesity agents have become available. A questionnaire was sent to eligible primary care physicians selected from a national probability sample in two specialties: family physicians and internists. Of 939 randomly selected physicians, 452 (48.1%) replied. We found that 51.8% of physicians were aware of the definition of obesity, and 33.8% were aware of the definition of abdominal obesity proposed by Asia-Pacific guideline. When evaluating apparently obese patients, 50.0% of respondents measured body mass index (BMI) and 20.4% measured waist circumference. Fewer than 50% of physicians measured blood glucose or lipid profiles, both of which are risk factors for obesity. About 47.3% of physicians prescribed an anti-obesity medication without allowing sufficient time for nonpharmacologic therapy to take effect, and 68.8% of physicians prescribed anti-obesity medications to patients that requested them regardless of obesity status. The majority of respondents did not appropriately evaluate obesity and its risk factors, and were readily susceptible to prescribing anti-obesity medications. Our findings suggest that primary care physicians in Korea need additional education on obesity and its management.
Adult ; Age Factors ; Anti-Obesity Agents/*pharmacology ; Blood Glucose/metabolism ; Body Mass Index ; Family Practice/*methods ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Lipids/metabolism ; Male ; Middle Aged ; Obesity/metabolism/*therapy ; Physician's Practice Patterns ; Physicians, Family ; Questionnaires ; Risk Factors ; Weight Loss

PURPOSE: In order to gain insight into the physicians' awareness of and attitude towards management of overactive bladder (OAB) in males, we performed a nationwide survey of the current strategies that urologists use to diagnose and manage OAB in male patients. MATERIALS AND METHODS: A probability sample was taken from the Korean Urological Association Registry of Physicians, and a random sample of 289 Korean urologists were mailed a structured questionnaire that explored how they manage benign prostatic hyperplasia (BPH). RESULTS: A total of 185 completed questionnaires were returned. The consent rate in the survey was 64.5%. Eighty-one (44%) urologists believed that of all males with lower urinary tract symptoms (LUTS), 20% or more had OAB and 72 (39%) believed that 10-20% had OAB. Half of the urologists surveyed believed that the most bothersome symptom in male OAB patients was nocturia. Seventy-three percent of respondents reported that they prescribed alpha blockers with anticholinergics for first line management, while 19% of urologists prescribed alpha blocker monotherapy but not anticholinergics for OAB patients. Though acute urinary retention (AUR) was considered the anticholinergic adverse event of most concern, the most frequently observed adverse event was dry mouth (95%). CONCLUSION: The present study provides insights into urologist views of male OAB. There is a discrepancy between the awareness of urologists and actual patterns of diagnosis and treatment of male OAB. This finding indicates the need to develop further practical guidelines based on solid clinical data.
Adrenergic alpha-Antagonists/therapeutic use ; Cholinergic Antagonists/therapeutic use ; *Health Knowledge, Attitudes, Practice ; Humans ; Male ; Physician's Practice Patterns ; Physicians/*psychology ; Prostatic Hyperplasia/diagnosis/drug therapy/pathology ; Questionnaires ; Urinary Bladder Neck Obstruction/diagnosis/drug therapy/pathology ; Urinary Bladder, Overactive/*diagnosis/drug therapy/pathology ; Urinary Retention/diagnosis/drug therapy/pathology ; *Urology