Taking the patient's view of health reform

To many, health reform seems to consist entirely of enormous changes in how the nation's medical bills will be paid. In reality, sweeping social changes will also accompany reform, including new ways of obtaining a patient's medical history and an end to traditional barriers to health care access. Changes must be made in the nonfinancial elements of the U.S. health system for reform to make a positive difference in patients' lives.     

A patient's view of asthma.

A medical consultation is seen as a meeting between cultures which have developed from different standpoints. These cultures are described, as are the ways in which they may contribute to, or impede a full understanding between the doctor and the patient with asthma, or concerned parent.     

The patient's view of hypertension and compliance.

Noncompliance has been identified as the predominant reason for failure of hypertension therapy. Patients may perceive hypertension as a symptomatic condition, and this view may affect compliance. In a cross-sectional study of outpatients attending a hypertension clinic, we assessed 125 veterans' understanding of hypertension, hypertension history, comorbidities, and pharmacy refills for hypertension medications. Though over 70% viewed hypertension as a symptomatic condition, symptoms were not significantly associated with pharmacy compliance. In univariate analyses, variables significantly associated with better pharmacy compliance were perceived lifetime treatment of hypertension, greater than 5-year history of medication use, perceived cause of hypertension other than diet, use of more than one hypertension drug, lack of reported departure from the prescribed medication regimen, absence of drug abuse history, and race (Caucasian). In multivariate analyses, the best predictive model of pharmacy compliance included three variables: drug abuse history, perceived cause of hypertension, and pattern of medication use. This type of information should be included in the assessment of medication compliance among hypertensive patients.     

专题小组讨论

专题小组讨论 (focusgroupdiscussion) ,又称焦点组访谈 ,是定性研究常用的方法之一。它不同于采访只针对一个访谈对象 ,而是把人们组织起来 ,就某一研究问题开展讨论。在讨论中不仅是研究者对访谈对象的提问 ,它更鼓励人们相互交流 ,相互提问。从一场组织成功的专题小组讨论会中得到的信息 ,应不仅有每个人对某一问题的观点 ,还有人们在讨论中 ,从别人的观点、体会、经历中得到的启发和感悟。由此可见 ,专题小组讨论从计划、实施以及主持等方面都有自己的特点。本文将对此做一些概括性的介绍。1　什么是专题小组讨论专题小组讨论是通过召集…     

The cancer chemotherapy experience in a patient's view

This study aimed to understand the meaning of chemotherapy from the patient's point of view, based on the postulates of interpretative anthropology and ethnographic case study. A breast cancer patient was selected on the basis of predetermined criteria, the most important of which was that the patient should be initiating the chemotherapy treatment in order to be followed. Data were collected by means of semi-structured interviews, observations and a field diary. Data analysis involved two phases: first, we identified the units of meaning; then, we organized the meaning attributed to the cancer chemotherapy experience in the patients' point of view, which was the "loss of life control". This meaning stressed the changes in the patient's social role, especially the difficulties to provide financial support to the family and the relationship with her children. This study highlights the importance of nursing care throughout the whole chemotherapy treatment, as well as the importance of nurses recognizing sociocultural influences and including them in the care plan.     

The patient's view on quality of life and eating disorders

OBJECTIVE: This study investigated the personal views of eating disorder (ED) patients on their quality of life (QOL). METHOD: The views of 146 current ED patients and 146 former ED patients on their QOL were studied using a self-report questionnaire. Patients were requested to name the most important aspects of their life and they subsequently rated themselves on these aspects. Qualitative analysis clustered items into meaningful categories. RESULTS: A sense of belonging was mentioned most often (93.0%) by the participants. Work or education, health and well-being were also mentioned frequently. Furthermore, participants stated a sense of self, disease-specific psychopathology, life skills, leisure activities, a sense of purpose, financial situation, living condition, and pets. Current ED patients more frequently mentioned disease-specific psychopathology than former ED patients. Current ED patients reported poor QOL on most domains, particularly on self-image and well-being. Former ED patients reported better QOL than current ED patients, but ratings were just above average. CONCLUSION: The views on QOL of ED patients broadens the scope of relevant domains of QOL. The assessment of these views may be a useful adjunct to the use of standardized QOL measures.     

"Focus groups can be fun": the use of activity-oriented questions in focus group discussions

Interest in focus group discussions has grown recently, and so has the recognition of them as a valuable method for qualitative data collection. Despite increasing popularity, they are not an easy option, and moderators must find appropriate ways to approach participants to achieve good-quality data. A path to reach this aim is the inclusion in the focus group agenda of some "exercises" (or activity-oriented questions) that are enjoyable and productive supplements to questions. Exercises provide a different way of gathering information and are beneficial, for instance, for more reflective participants. They can help focus the group's attention on the core study topic and also make subsequent comparative analysis more straightforward. They can also be helpful with young people and to discuss sensitive topics. The author describes and provides suggestions for use and examples of several exercises, illustrating their application in a research project investigating the cultural meaning of youth suicide in university students in Italy, India, and Australia.     

The patient's view of the acceptability of the primary care in Poland

OBJECTIVE: The aim of the study was to determine how the time factor affected the patients' perception of the acceptability of the primary health care system and to assess their satisfaction with family physician care. DESIGN: A series of cross-sectional studies was conducted in 1998, 2002 and 2006, using face-to-face interviews with structured questionnaires. SETTING: The study was performed in Gizycko, Poland, where family physician services were introduced in 1995. STUDY PARTICIPANTS: Three surveys were conducted, each involving 1000 subjects. Every time, random sample was taken, after selecting a subgroup of patients using medical service within the previous week. MAIN MEASURES: Acceptability of the primary health care system (accessibility, the patient-practitioner relationship, the amenities of care, patient's preferences), perception of the changes in primary care and overall satisfaction with family physician care. RESULTS: Between 1998 and 2002, an improvement was noted, lasting till 2006, in such accessibility components as the possibility of making an appointment by phone or at a definite hour. Some aspects of the patient-doctor relationship indicate that family physician care is directed at illness rather than health-oriented. The level of patient satisfaction was high. CONCLUSIONS: Generally, patients are satisfied with primary care reform and implementation of the family physician system. However, it is easier to improve accessibility of services than physician's personal qualities and the patient-practitioner relationship. Expressive functions of a physician (listening and reassuring) and activities regarding health promotion require special attention in the process of education of family physicians.     

Focus group interviews with seniors

The focus group interview technique provides in-depth information on a specific topic in a group discussion setting and can be effectively used with older adults. Successful focus group interviews include careful question preparation and participant recruitment as well as securing a capable moderator and comfortable setting. The technique is used as a preliminary research step to elicit feelings, attitudes and perceptions about a topic. However, results should not be generalized without further quantitative research.