共查询到20条相似文献,搜索用时 31 毫秒
1.
Objective
The aims of this study are: (1) analysis of unidimensionality of the German version of the “Consultation and Relational Empathy” (CARE) measure and (2) identification of moderating variables affecting the scale structure.Methods
The CARE-measure was evaluated by means of Rasch-analysis in a sample of N = 326 cancer patients. Association of diagnosis and treatment as well as patients’ characteristics was analyzed by person-fit measures and Differential Item Functioning.Results
Nine of the original 10 CARE items fit to the Rasch-model. For breast and prostate cancer, as well as for patients taking complementary and alternative medicine treatment, item biases affect the scale structure. Furthermore, older patients and patients with higher social support exhibit substantial deviations from model predictions.Conclusions
Only the nine-item version of the CARE-measure allows for the unidimensional assessment of physician empathy. Especially for specific diagnosis and treatment groups, the CARE-items indicate variations in the underlying latent construct of physician empathy.Practice implications
The CARER-measure provides a theory-based and psychometrically sound basis for the assessment of PE. It can be used to enhance the fairness of the assessment and to further identify valuable information about the influence of patient characteristics on the structure of the construct PE. 相似文献2.
Harrison RL Mattson LK Durbin DM Fish AF Bachman JA 《Patient education and counseling》2012,86(2):270-276
Objective
To examine physiological and health-related quality of life (HRQOL) outcomes in community living adults attending a 12-week combined lifestyle wellness program.Methods
A sample of overweight and obese adults (n = 319) and a subgroup who also had diabetes (n = 46 of 319) were studied. The program focuses on dietary, physical activity, and behavioral strategies to promote cardiovascular health. Baseline and 12-week measures were obtained.Results
In the total sample, all physiological and HRQOL outcomes improved (p < .05), except HDL. High attendance was associated with the highest weight loss. In the diabetic subgroup, weight, steps/day, low density lipoprotein, and most aspects of HRQOL improved significantly.Conclusion
Physiological and HRQOL benefits can be gained from a 12-week combined lifestyle program; greater benefits were obtained with higher attendance. Although the diabetic subgroup was not large, positive outcomes were realized.Practice implications
The 12-week combined lifestyle program shows promise for improving outcomes in community living overweight and obese adults who may also be diabetic. By attending class, participants are reminded about strategies they are to apply during the 12-week program and, by program end, they are equipped with a tool kit of strategies for use in everyday life. 相似文献3.
Maylin S Laouénan C Martinot-Peignoux M Panhard X Lapalus M Nicolas-Chanoine MH Bedossa P Asselah T Marcellin P 《Journal of clinical virology》2012,53(1):43-47
Background
Correlation between hepatic HCV-RNA and serum HCV-RNA, severity of liver disease and response to therapy is poorly known.Objectives
To assess the influence of hepatic HCV-RNA level on severity of liver disease and response to therapy in a large cohort of chronic hepatitis C (CHC) patients.Study Design
HCV-RNA was measured in frozen liver biopsies and serum samples from 130 CHC patients the day of liver biopsy prior to treatment. Liver fibrosis was assessed by Ishaq scoring. A Sustained Virological Response (SVR) was observed in 52% of the patients, non-response (NR) in 34%.Results
Mean ± standard deviation hepatic HCV-RNA level was 7.69 ± 0.67 log10 copies/mg of liver. Mean serum HCV-RNA level was 6.21 ± 0.72 log10 copies/ml. There was a correlation between hepatic and serum HCV-RNA in genotype 1 and 4 (p = 0.008 and p = 0.03) and age (p = 0.006). Mean hepatic HCV-RNA was 7.70 ± 0.69 vs 7.67 ± 0.68 log10 copies/mg of liver, in patients with significant fibrosis vs those with mild fibrosis, respectively (p = 0.7); 8.04 ± 0.68; 7.44 ± 0.47; 7.43 ± 0.49 and 7.44 ± 0.71 log10 copies/mg of liver in genotypes 1, 2, 3 and 4, respectively (p = 0.0001); higher in women than in men (p = 0.04); 7.60 ± 0.63, 7.71 ± 0.54 and 7.96 ± 0.73 log10 copies/mg in SVR, relapsers and NR, respectively (p = 0.1). Multivariate analysis showed that high hepatic HCV-RNA level was independently associated with genotype and response to therapy was associated with genotype independently from hepatic HCV-RNA level.Conclusions
Hepatic HCV-RNA level was not associated with severity of liver disease. High level was strongly associated with HCV genotype independently from response to therapy. 相似文献4.
Eva Soelberg Vadstrup Anne FrølichHans Perrild Eva BorgMichael Røder 《Patient education and counseling》2011,84(2):185-190
Objective
To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes.Methods
We randomised 143 adult type 2 diabetes patients to either a 6-month multidisciplinary group-based rehabilitation programme or a 6-month individual counselling programme. Outcome measures included glycated haemoglobin (HbA1c), blood pressure, lipid profile, weight, and waist circumference.Results
Mean HbA1c decreased 0.3%-point (95% confidence interval [CI] = −0.5, −0.1) in the rehabilitation group and 0.6%-point (95% CI = −0.8, −0.4) among individual counselling participants (p < 0.05). Within both groups, equal reductions occurred in body weight, waist circumference, systolic blood pressure and diastolic blood pressure, but no significant between-group differences between occurred for any of the cardiovascular outcomes. The group-based rehabilitation programme consumed twice as many personnel resources.Conclusion
The group-based rehabilitation programme resulted in changes in glycaemic control and cardiovascular risk factor reduction that were equivalent or inferior to those of an individual counselling programme.Practice implications
The group-based rehabilitation programme, tested in the current design, did not offer additionally improved outcomes and consumed more personnel resources than the individual counselling programme; its broad implementation is not supported by this study.Trial registration Clinicaltrials.gov NCT00284609. 相似文献5.
Kim H Ku SY Kang JW Kim H Kim YD Kim SH Choi YM Kim JG Moon SY 《Molecular genetics and metabolism》2011,104(4):644-647
Background
The 8-hydroxydeoxyguanosine (8-OHdG) is widely used for determination of DNA damage since it is excised from oxidative damaged DNA with endonuclease repair enzymes coded by 8-oxoguanine DNA N-glycosylase gene (OGG1). The present study aimed at investigating whether hormone therapy (HT) may influence on the blood/urinary 8-OHdG levels and whether the level of 8-OHdG is different according to OGG1 S326C polymorphism in postmenopausal women receiving HT.Methods
In 102 postmenopausal women receiving HT, the 8-OHdG levels were measured in the blood and urine using high performance liquid chromatography (HPLC) before HT and 3 months after HT. The genotyping of the S326C polymorphism of the OGG1 was performed by polymerase chain reaction (PCR) and restriction enzyme fragment length polymorphism (RFLP) analysis.Results
After HT, mean blood 8-OHdG level significantly decreased compared to those before HT (P = 0.003), while urinary 8-OHdG level did not show any difference according to HT. Pre-HT level of 8-OHdG was not different according to OGG1 genotypes and similar finding was demonstrated in post-HT 8-OHdG concentration.Conclusions
These findings imply that hormone therapy can reduce blood 8-OHdG concentration, one of the markers of oxidative damage. Further study is needed to confirm this association in larger population. 相似文献6.
Objective
Exaggerated cardiovascular reactivity predicts cardiovascular morbidity and mortality. Some evidence suggests that omega-3 fatty acids improve cardiovascular function. The objective of this study was to examine the influence of an acute low dose of long-chain omega-3 fatty acids on young, healthy individuals.Methods
Participants (n = 34) were randomly assigned to either 21-days of omega-3 fatty acids (1.4 g EPA and DHA) or matched placebo. Cardiovascular measurements were obtained in the laboratory during baseline and during a standard mental arithmetic task, where participants were instructed to engage in serial subtractions by 17s from a four-digit number and cardiovascular reactivity to the task was calculated.Results
Mean arterial pressure reactivity was significantly reduced by supplementation (F(1,32) = 5. 12, p = .03, η2 = .144) but not by placebo.Conclusion
Supplementation of omega-3 fatty acids may reduce cardiovascular reactivity to stress. 相似文献7.
Lyles CR Karter AJ Young BA Spigner C Grembowski D Schillinger D Adler N 《Patient education and counseling》2011,85(3):e216-e224
Objective
We examined provider-level factors and reported discrimination in the healthcare setting.Methods
With data from the Diabetes Study of Northern California (DISTANCE) - a race-stratified survey of diabetes patients in Kaiser Permanente Northern California - we analyzed patient-reported racial/ethnic discrimination from providers. Primary exposures were characteristics of the primary care provider (PCP, who coordinates care in this system), including specialty/type, and patient-provider relationship variables, including racial concordance.Results
Subjects (n = 12,151) included 20% black, 20% Latino, 23% Asian, 30% white, and 6% other patients, with 2-8% reporting discrimination by racial/ethnic group. Patients seeing nurse practitioners as their PCP (OR = 0.09; 95% CI: 0.01-0.67) and those rating their provider higher on communication (OR = 0.70; 95% CI: 0.66-0.74) were less likely to report discrimination, while those with more visits (OR = 1.10; 95% CI: 1.03-1.18) were more likely to report discrimination. Racial concordance was not significant once adjusting for patient race/ethnicity.Conclusions
Among diverse diabetes patients in managed care, provider type and communication were significantly related to patient-reported discrimination.Practice implications
Given potential negative impacts on patient satisfaction and treatment decisions, future studies should investigate which interpersonal aspects of the provider-patient relationship reduce patient perceptions of unfair treatment. 相似文献8.
Petrara MR Cattelan AM Zanchetta M Sasset L Freguja R Gianesin K Cecchetto MG Carmona F De Rossi A 《Journal of clinical virology》2012,53(3):195-200
Background
Patients infected with HIV-1 are at high risk of developing Epstein-Barr Virus (EBV)-related diseases. Chronic immune activation is a hallmark of HIV-1 pathogenesis and may play a role in B-cell stimulation and expansion of EBV-infected cells.Objectives
The aim of the study was to define the relationship between parameters of immune activation and EBV load in HIV-1-infected subjects.Study design
A total of 156 HIV-1-infected patients were studied. EBV types 1 and 2 were quantified on peripheral blood mononuclear cells by multiplex real-time PCR. Plasma levels of cytokines and lipopolysaccharide (LPS) were determined by immunoenzymatic assays. B-cell activation was analyzed by flow cytometry.Results
EBV-DNA was detected in 114 patients, and in all but 3 was EBV type 1. The median [interquartile] EBV-DNA load was 43[1-151] copies/105 PBMC. EBV-DNA load was higher in patients with detectable HIV-1 plasma viremia, despite good immunological status (CD4 > 500 cells/μl), than in patients with undetectable HIV-1 plasma viremia regardless of immunological status (46[5-136] copies/105 cells vs 17[1-56] copies/105 cells, p = 0.008). Patients with high EBV-DNA load (>median value) had higher levels of LPS and proinflammatory cytokines (IL-6, IL-10 and TNF-α) than patients with low EBV load. Furthermore, percentages of activated B-cells correlated with EBV-DNA load (rs = 0.754; p < 0.001).Conclusions
Overall, these findings indicate a strong association between HIV-1 viremia, markers of immune activation and EBV load and suggest that persistence of HIV-1 viremia and immune activation, regardless of peripheral CD4 cell depletion/repopulation, may favor expansion of EBV-infected cells and onset of EBV-related malignancies. 相似文献9.
Mederacke I Potthoff A Meyer-Olson D Meier M Raupach R Manns MP Wedemeyer H Tillmann HL 《Journal of clinical virology》2012,53(2):110-115
Background
A quantitative HCV core antigen (HCVcoreAg) immunoassay has been developed for the confirmation of viremia in patients with hepatitis C.Objectives
We evaluated the correlation of HCV RNA and HCVcoreAg in different patient populations without HCV-specific treatment: HIV/HCV-coinfection, HBV/HCV-coinfection, and patients with end-stage renal disease.Study design
HCVcoreAg was quantified by a fully-automated immunoassay. Correlation of HCVcoreAg with HCV RNA was studied cross-sectionally in HIV/HCV- and HBV/HCV-coinfected patients, as well as before and after hemodialysis in patients with end-stage renal disease.Results
A concordant positive or negative test result for both HCV RNA and HCVcoreAg was observed in 68 of 71 (96%), 55 of 57 (96%), and in 109 of 109 (100%) samples of patients with HIV- or HBV/HCV-coinfection, and patients undergoing hemodialysis, respectively. HCVcoreAg showed high correlation with HCV RNA in samples from HIV/HCV-coinfected patients and HCV-infected patients undergoing hemodialysis (r = 0.97 and r = 0.94, p < 0.001). There was no overall correlation between HCVcoreAg and HCV RNA in HBV/HCV-coinfected individuals (r = 0.04, p = 0.822). Excluding patients with HCV RNA to HCVcoreAg ratios below 100 and above 10,000 kIU/fmol led to improved correlation (r = 0.53; p = 0.02), but remained worse than for the other cohorts. Overall, HCV RNA to HCVcoreAg ratios did not differ significantly between the different patient populations, though variation tended to be higher in HBV/HCV-coinfected patients. Patients with lower HCV RNA levels tend to have lower HCV RNA/HCVcoreAg ratios.Conclusions
HCVcoreAg represents a reliable marker of viral replication showing a good correlation with HCV RNA in various patient populations, with some limitations in HBV/HCV-coinfection. 相似文献10.
Saini B LeMay K Emmerton L Krass I Smith L Bosnic-Anticevich S Stewart K Burton D Armour C 《Patient education and counseling》2011,83(3):295-302
Objective
To assess any improvements in knowledge of asthma patients after a tailored education program delivered by pharmacists and measure the sustainability of any improvements. To ascertain patients’ perceptions about any changes in their knowledge.Methods
Ninety-six specially trained pharmacists recruited patients based on their risk of poor asthma control. A tailored intervention was delivered to patients based on individual needs and goals, and was conducted at three or four time points over six months. Asthma knowledge was assessed at the beginning and end of the service, and six and 12 months after it had ended. Patients’ perceptions of the impact of the service on their knowledge were explored qualitatively in interviews.Results
The 96 pharmacists recruited 570 patients, 398 (70%) finished. Asthma knowledge significantly improved as a result of the service (7.65 ± 2.36, n = 561, to 8.78 ± 2.14, n = 393). This improvement was retained for at least 12 months after the service. Patients reported how the knowledge and skills gained had led to a change in the way they managed their asthma.Conclusion
Improvements in knowledge are achievable and sustainable if pharmacists used targeted educational interventions.Practice implications
Pharmacist educational interventions are an efficient way to improve asthma knowledge in the community. 相似文献11.
Background
Immune cell infiltrate is a constant feature in normal prostate, benign nodular prostatic hyperplasia and prostatic adenocarcinoma. This study elaborates on the cells of the immune system present in normal prostate, benign nodular prostatic hyperplasia and prostatic adenocarcinoma.Hypothesis
Here, we hypothesized that “the development of benign nodular prostatic hyperplasia and prostatic adenocarcinoma is associated with numeric alterations of the immune cell infiltrate”.Materials and methods
A total of 50 transurethral prostatic resection specimens, each entailing normal prostate, benign nodular prostatic hyperplasia and high grade prostatic adenocarcinoma were evaluated for the density and phenotype of the immune cells using immunohistological methods and mouse monoclonal antibodies decorating T cells (CD3), histiocytes (CD68) and B lymphocytes (CD20).Results
Immune cell infiltrate was composed of T cells, histiocytes and B-lymphocytes. CD+3 T lymphocytes and CD68+ cells were the predominant cell populations. We observed variations in the density of the immune cells among the normal prostate, benign nodular prostatic hyperplasia and high grade prostatic adenocarcinoma. Compared with normal prostate, benign nodular prostatic hyperplasia had a statistically significant high density of immune cells (3.4 ± 0.4versus 13.5 ± 1.0, P < 0.00). In contrast, a significant decrease in the counts of these cells was observed in high-grade prostatic adenocarcinoma compared to benign nodular prostatic hyperplasia (13.5 ± 1.0 versus 5.2 ± 0.3, P < 0.01).Conclusions
The increased density of immune cells (predominantly CD+3 T cells) in benign nodular prostatic hyperplasia suggests that the initial response to cellular damage is mediated by cell-mediated immunity. The decreased density of immune cells in high-grade prostatic adenocarcinoma may reflect immunosuppression. The underlying mechanisms of these numeric variations are open for further investigations. 相似文献12.
Miller KM Brenner A Griffith JM Pignone MP Lewis CL 《Patient education and counseling》2012,86(2):189-194
Objective
To determine the feasibility and effectiveness of in-clinic decision aid distribution using a care assistant.Methods
We identified potentially eligible patients scheduled for upcoming appointments in our General Internal Medicine Clinic (n = 1229). Patients were deemed eligible for two decision aids: prostate cancer screening and/or weight loss surgery. Patients were approached to view the decision aid in-clinic. Our primary measures were the proportion of decision aids distributed to eligible patients, and the proportion of decision aids viewed.Results
Among 913 patients who attended their scheduled appointments, 58% (n = 525) were approached and eligibility was assessed by the staff member. Among the 471 who remained eligible, 57% (n = 268) viewed at least a portion of the target decision aid. The mean viewing time for patients who watched less than the complete decision aid was 13 min.Conclusions
In clinic viewing of decision aids may be a feasible and effective distribution method in primary care.Practice implications
In clinic distribution requires an electronic health information system to identify potentially eligible patients, and a staff member dedicated to DA distribution. Brief decision aids (less than 10 min) are needed so patients can complete their use prior to the visit to facilitate patient-physician decision making. 相似文献13.
Yvonne J.L. van Eijk-Hustings Lianne DaemenNicolaas C. Schaper Hubertus J.M. Vrijhoef 《Patient education and counseling》2011,84(1):10-15
Objective
Motivational Interviewing (MI) is a counseling approach to support behavioural change. The objective of the present study was to examine the uptake of MI in daily practice by health care professionals in a care management initiative for patients with diabetes in the region of Maastricht, the Netherlands.Methods
MI was implemented by means of a training. Directly and six months after the training, the application of MI was measured objectively (MITI) and subjectively (questionnaire). In focus interviews, MI-trained professionals (n = 10) and MI untrained professionals (n = 10) were asked about facilitators and barriers for implementation. Additionally, data on patient characteristics (n = 141) were collected.Results
Spirit of MI was present among professionals directly after the training and increased during follow-up. Mostly uncomplicated techniques were applied. Professionals stated the need for training and practice to be able to apply more complicated techniques.Conclusion
The applicability of MI in daily practice was found feasible, with various degrees of uptake. Relevant conditions to further improve the implementation of MI in daily practice were identified.Practice implications
In daily practice, a phased training in MI is recommended, with sufficient time and support by colleagues as essential conditions to profit most from the training sessions. 相似文献14.
Chambliss HO Huber RC Finley CE McDoniel SO Kitzman-Ulrich H Wilkinson WJ 《Patient education and counseling》2011,85(3):375-382
Objective
The purpose of this study was to develop and evaluate a 12-week weight management intervention involving computerized self-monitoring and technology-assisted feedback with and without an enhanced behavioral component.Methods
120 overweight (30.5 ± 2.6 kg/m2) adults (45.0 ± 10.3 years) were randomized to one of three groups: computerized self-monitoring with Basic feedback (n = 45), Enhanced behavioral feedback (n = 45), or wait-list control (n = 30). Intervention participants used a computer software program to record dietary and physical activity information. Weekly e-mail feedback was based on computer-generated reports, and participants attended monthly measurement visits.Results
The Basic and Enhanced groups experienced significant weight reduction (−2.7 ± 3.3 kg and −2.5 ± 3.1 kg) in comparison to the Control group (0.3 ± 2.2; p < 0.05). Waist circumference and systolic blood pressure also decreased in intervention groups compared to Control (p < 0.01).Conclusions
A program using computerized self-monitoring, technology-assisted feedback, and monthly measurement visits produced significant weight loss after 12 weeks. However, the addition of an enhanced behavioral component did not improve the effectiveness of the program.Practice implications
This study suggests that healthcare professionals can effectively deliver a weight management intervention using technology-assisted strategies in a format that may complement and reduce face-to-face sessions. 相似文献15.
Objective
Osteoarthritis (OA) is one of the most common sources of pain and disability among elderly people. Many genetic, demographic, and personal characteristics are involved in the risk of OA, of which obesity is one of the most important. This study evaluated the association between obesity and the prevalence of OA in elderly Korean women.Methods
We recruited participants (n = 3750) aged 50 years or older using stratified random sampling of Korean census blocks. Demographic and personal characteristics and a medical history of OA were collected from the participants by questionnaire.Results
We found that demographic variables, including age, education level, income, and personal characteristics (such as regular exercise), were important covariates associated with the prevalence of OA. In this study, body mass index (BMI) was an important demographic variable affecting the prevalence of OA. After adjusting for age, BMI was positively associated with the prevalence of OA [odds ratio (OR), obese vs. normal = 2.15; 95% confidence interval (CI), 1.82-2.54; p for trend <0.001]. This association persisted after adjusting for other demographic covariates (OR, obese vs. normal = 2.09; 95% CI, 1.76-2.47; p for trend <0.001).Conclusions
The results indicated that obesity and OA prevalence vary across groups with different demographic characteristics, and increased BMI was related to the risk of OA in elderly women. 相似文献16.
17.
Background
How is emotion disrupted in bipolar disorder? Two studies are presented that adopt a multi-method approach to investigate emotion reactivity and emotion recovery in bipolar I disorder.Methods
Across both studies, individuals with inter-episode bipolar disorder and healthy controls were shown three emotion-eliciting films (neutral, happy, and sad) and experiential and physiological responses were measured. In Study 1, bipolar (BD; n = 23) and non-clinical control (NC; n = 24) participants' emotional reactivity during film clips was assessed. In Study 2, a separate sample of BD (n = 23) and NC (n = 25) participants' emotion recovery was assessed after the film clips were assessed.Results
Results indicated that the BD group exhibited increased self-reported positive emotion and respiratory sinus arrhythmia across all films compared to the NC group. There were no group differences in emotion recovery.Discussion
Taken together, these results suggest that bipolar disorder is associated with increased positive emotion reactivity, but not emotion recovery, across contexts. 相似文献18.
Fried TR Redding CA Robbins ML Paiva A O'Leary JR Iannone L 《Patient education and counseling》2012,86(1):25-32
Objective
To develop measures representing key constructs of the Transtheoretical Model (TTM) of behavior change as applied to advance care planning (ACP) and to examine whether associations between these measures replicate the relationships posited by the TTM.Methods
Sequential scale development techniques were used to develop measures for Decisional Balance (Pros and Cons of behavior change), ACP Values/Beliefs (religious beliefs and medical misconceptions serving as barriers to participation), Processes of Change (behavioral and cognitive processes used to foster participation) based on responses of 304 persons age ≥ 65 years.Results
Items for each scale/subscale demonstrated high factor loading (>.5) and good to excellent internal consistency (Cronbach α .76-.93). Results of MANOVA examining scores on the Pros, Cons, ACP Values/Beliefs, and POC subscales by stage of change for each of the six behaviors were significant, Wilks’ λ = .555-.809, η2 = .068-.178, p ≤ .001 for all models.Conclusion
Core constructs of the TTM as applied to ACP can be measured with high reliability and validity.Practice implications
Cross-sectional relationships between these constructs and stage of behavior change support the use of TTM-tailored interventions to change perceptions of the Pros and Cons of participation in ACP and promote the use of certain Processes of Change in order to promote older persons’ engagement in ACP. 相似文献19.
Gretchen A. Piatt Thomas J. SongerMaria M. Brooks Robert M. AndersonDavid Simmons Trevor J. OrchardLinda M. Siminerio Mary T. KorytkowskiJanice C. Zgibor 《Patient education and counseling》2011,82(2):266-270