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991.
A comparison of a Patient Enablement Instrument (PEI) against two established satisfaction scales as an outcome measure of primary care consultations 总被引:17,自引:8,他引:9
OBJECTIVES: We aimed to compare a new primary care outcome measure-the
Patient Enablement Instrument (PEI)-against two established satisfaction
measures [the Medical Interview Satisfaction Scale (MISS) and the
Consultation Satisfaction Questionnaire (CSQ)]. Specifically, we sought (i)
to test whether enablement and satisfaction are related or separate
concepts; and (ii) to assess whether the internal consistency of the PEI
might be enhanced by the inclusion of items from the satisfaction
instruments. METHODS: Questionnaire forms containing the three instruments
in a variety of combinations were distributed to a total of 818 patients
attending for routine surgery consultations in three urban general
practices of varying socio-economic mix. The main outcome measures were:
scores on the PEI; scores on the CSQ, the MISS and their individual
components; rank correlations between scores on the PEI and scores on the
CSQ, the MISS and their component subscales; and Cronbach's alpha
coefficient for the PEI. RESULTS: Overall mean scores, expressed as
percentages of maximum scores attainable, were 44.1% for the PEI, 76.9% for
the CSQ and 77.6% for the MISS. Rank correlations between PEI scores and
scores for the complete CSQ and MISS instruments were 0.48 (P < 0.01)
and 0.47 (P < 0.01), respectively. Correlations of PEI scores with
individual component scores on the CSQ were generally lower and ranged from
0.14 to 0.53; correlations of PEI scored with MISS component scores were
also generally lower and ranged from 0.21 to 0.53. Internal consistency of
the PEI items (assessed by Cronbach's alpha coefficient) was lowered when
items from the CSQ or MISS were added. CONCLUSIONS: The study shows that
'enablement' is a primary care outcome measure which is related to but is
different from general satisfaction.
相似文献
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The relation between platelet buoyant density and beta-thromboglobulin (beta-TG), a marker for platelet alpha-granule content, was assessed by three independent approaches. (1) Platelets were separated on iso- osmolar discontinuous Stractan density gradients into five fractions, ranging in density from 1.061 g/ml to 1.091 g/ml (20 degrees C). The beta-TG content (mean +/- SD, n = 17) increased with the platelet density from 27.8 +/- 8.6 micrograms beta-TG/10(9) cells (20% less- dense platelets) up to 65.6 +/- 15.5 micrograms beta-TG/10(9) cells (15% most-dense platelets). (2) Activation of platelets in platelet- rich plasma with thrombin, adenosine diphosphate, collagen, or epinephrine resulted in a decreased density of the platelets. This was only seen when there was simultaneous secretion of beta-TG. (3) The less-dense and the more-dense platelet fractions, after isolation by density gradient centrifugation, were separately treated with thrombin. After complete degranulation, the density distribution of the originally less-dense and more-dense platelets were identical and were much narrower than the density distribution of resting platelets. 相似文献
996.
Management of patients with angina pectoris by GPs: a study with standardized (simulated) patients in actual practice 总被引:1,自引:0,他引:1
BACKGROUND: Little is known about the management of patients with angina
pectoris by GPs. OBJECTIVE: The purpose of this study was to assess how a
group of GPs managed a patient with angina pectoris complaints in a
real-life practice setting during unbiased consultations with standardized
patients. METHODS: GPs were consulted during normal surgery hours by a
standardized patient portraying a patient with angina pectoris. The setting
was Trondheim, Norway. All 87 GPs in the city of Trondheim (Norway) were
informed by letter about a study with standardized patients and invited to
take part. They were asked to give consent to be visited during actual
surgery hours by standardized patients. The date, number and content of the
visits planned were not mentioned. They were not told that the study
focused on angina pectoris. For budgetary reasons it was decided to ask 24
physicians to participate. The GPs were consulted during normal surgery
hours by a standardized patient portraying a patient with angina pectoris.
The patients reported on the consultations using a checklist based on
guidelines for management of angina pectoris. Outcome measures were the
content and number of actions undertaken from the guidelines. RESULTS:
Twenty-eight GPs (32%) agreed to participate. Of these, 24 were selected
and visited. One doctor detected the standardized patient. The results
showed that the participating physicians met 76% of the guidelines used.
However, the GPs ordered 31 different types of laboratory test (mean = 7.9,
range = 1-18 per physician). In addition, the 23 consultations resulted in
seven referrals (two for chest X-rays, four for an exercise test and one
referral to a specialist in cardiology). Twenty-two of the 23 doctors made
the correct diagnosis and informed the patient accordingly. CONCLUSIONS:
When assessed in an unbiased situation in real practice, GPs performed well
against a pre- set standard for management of angina pectoris patients.
Much variation was found in the request for laboratory tests. These
real-life practice data suggest that there is a need for discussing
guidelines for effective ordering of laboratory tests in general practice.
相似文献
997.
To improve the efficiency of magnetic resonance imaging of the total spine, the authors developed a coil holder and marker system to accurately localize the level of the spine imaged. The patient's external auditory canal and the alignment light on the imager are lined up with marks on the coil holder. The spine is then imaged in three segments by using a 24-cm field of view. The device has been successful in 20 of the 23 patients in whom it was used. The three failures were due to technical problems. 相似文献
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