Medical Inspection – Health Blog

INTRODUCTION

The clustering of cardiovascular disease risk components found in persons with abnormal glucose tolerance (impaired glucose tolerance or diabetes mellitus) has been labeled variously as Syndrome X, the Insulin Resistance Syndrome, the Deadly Quartet, or metabolic syndrome (MS). The World Health Organization (WHO), has defined the syndrome to include a combination of impaired glucose regulation or diabetes, generic insulin resistance, raised arterial blood pressure, raised plasma triglycerides and/or low HDL-cholesterol, central obesity and/or BMI >30 kg nr² and microalbuminuria. Each component of the cluster conveys increased cardiovascular disease risk, but as a combination they become much more powerful. This means that the management of persons with MS should focus not only on blood glucose control but also include strategies for reduction of the other cardiovascular disease risk factors. There is evidence that insulin drug resistance may be the common etiological factor for the individual components of the syndrome. Vigorous early management of the syndrome may have a significant impact on the prevention of both diabetes and cardiovascular disease.

Read More…

The purpose of this study was to examine the interaction between chatting behavior and patient sociodemographic factors and patient satisfaction. Our work may be best placed in light of the DOPC study. We found that chatting was less prevalent than previously reported from the DOPC (61% vs. 69%) and there are two plausible reasons for this discrepancy. First, a difference in the methodology used to report chatting behavior could account for prevalence differences. The DOPC used a combination of direct observation of patient visits, patient exit questionnaires, and medical record reviews, while our study relied upon exit surveys as the sole means of data collection. This difference may account for an under-reporting of chatting behavior in our study, however, we were interested in the patient perspective of chatting during the encounter.

Read More…

A total of 105 eligible patients participated in the survey, and five patients refused. Overall, patients were satisfied with their visit with the provider; 75.6% rated their satisfaction as excellent, and 18.9% as very good. The summed satisfaction with provider score from the VRQ items was 23.40 (range 14-25) for the entire study sample, also indicating a high level of satisfaction. Table 1 depicts the characteristics of the study participants for both chatting and nonchatting groups. The patient group reporting chatting had a higher proportion of nonwhite patients; however, this was an insignificant difference (p=0.280). Sixty-three patients (61.2%) reported chatting from their immediate encounter, and Table 2 presents the themes that were discussed. Chatting behavior that was specific to the patient’s family or friends was the predominant topic, with 43% of patients identifying this theme. A greater percentage of nonwhite patients (30%) than white patients (13%) reporting chatting about family or friends (pO.001). Financial concerns and work-related issues were additional chatting themes not included on the survey but identified by three patients.

Read More…

This was a cross-sectional, descriptive study of adult outpatients who receive care at the family medicine clinic of an urban, academic health cen ter. A convenience sample of patients were given a self-administered exit survey, which included five items from the Patient Visit Rating Questionnaire (VRQ), in addition to items regarding specific chatting content areas and self-reported demographic information.

Read More…

INTRODUCTION

There is increased interest in addressing potential sources of racial and ethnic disparities within the clinical encounter. Communication studies suggest that patient sociodemographic factors are embedded within care events and either directly or indirectly impact patient expectations and judgments; provider cognitions; and decision-making;and outcomes, such as patient satisfaction and quality of life. Time use during the clinical encounter is an important component of patient satisfaction and may be one way to appraise the communication dynamic between physician and patient. For example, the Direct Observation of Primary Care (DOPC) Study found that increased patient satisfaction was associated with older patient age, white race, better-perceived health status, well-care visits, and chatting time during the encounter. In a subsequent analysis of the DOPC dataset, physicians were found to spend a lower proportion of time with African-American patients in treatment planning, providing health education, answering questions, and chatting when compared to white patients. Chatting behavior can be viewed as the verbal communication of topics unrelated to the diagnosis, treatment, or management of a medical or healthcare condition. Physician chatting has been suggested as one way to enhance patient satisfac­tion; however, little is known about chatting within the context of the clinical encounter, or of the interaction of chatting with patient sociodemographic factors and patient satisfaction. In addition, the potential contribution of physician chatting as a patient-centered communication behavior, such as data gathering, relationship building, partnering, and counseling, remains unclear.

Read More…

Although state and national health statistics ranked noninsulin-dependent diabetes mellitus as the most prevalent chronic disease among American adults—with African Americans disproportionately affected—and despite a community-based diabetes intervention effort that included mass screening and education initiated four years prior—none of the congregation leadership had ranked it as important at baseline. However, following an education providing the leadership with skills to prioritize health needs and plan health-promotion activities most beneficial to their congregations, diabetes was identified as the most serious health concern threatening the well-being of large- and medium-sized congregations. Moreover, most of the leaders had taken advantage of resources available, including Project DIRECT, within their own congregations and in the community to decrease the prevalence of known risk factors.

Read More…

At baseline, 21 of the 41 congregations identified agreed to participate, representing a variety of Christian and Muslim communities. These congregations served a total of about 9,600 persons, and congregation sizes ranged from 120 to 1,200 members. The follow-up period ranged from three-to-five years, although the median follow-up was four years.

Read More…