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Dr. Robert C. Smith MD Jennifer A. Mettler MA Bertram E. Stöffelmayr PhD Judith S. Lyles MA Alicia A. Marshall PhD Lawrence F. Van Egeren PhD Gerald G. Osborn DO Valerie Shebroe PhD 《Journal of general internal medicine》1995,10(6):315-320
OBJECTIVE: To evaluate an intensive training program’s effects on residents’ confidence in their ability in, anticipation of positive
outcomes from, and personal commitment to psychosocial behaviors.
DESIGN: Controlled randomized study.
SETTING: A university- and community-based primary care residency training program.
PARTICIPANTS: 26 first-year residents in internal medicine and family practice.
INTERVENTION: The residents were randomly assigned to a control group or to one-month intensive training centered on psychosocial skills
needed in primary care.
MEASUREMENTS: Questionnaires measuring knowledge of psychosocial medicine, and self-confidence in, anticipation of positive outcomes from,
and personal commitment to five skill areas: psychological sensitivity, emotional sensitivity, management of somatization,
and directive and nondirective facilitation of patient communication.
RESULTS: The trained residents expressed higher self-confidence in all five areas of psychosocial skill (p<0.03 for all tests), anticipated
more positive outcomes for emotional sensitivity (p=0.05), managing somatization (p=0.03), and nondirectively facilitating
patient communication (p=0.02), and were more strongly committed to being emotionally sensitive (p=0.055) and managing somatization
(p=0.056), compared with the untrained residents. The trained residents also evidenced more knowledge of psychosocial medicine
than did the untrained residents (p<0.001).
CONCLUSIONS: Intensive psychosocial training improves residents’ self-confidence in their ability regarding key psychosocial behaviors
and increases their knowledge of psychosocial medicine. Training also increases anticipation of positive outcomes from and
personal commitment to some, but not all, psychosocial skills.
Presented at the annual meeting of the Society of General Internal Medicine, Washington, DC, April 27–29, 1994.
Supported by the Fetzer Institute in Kalamazoo, MI. 相似文献
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Successful hematopoietic cell transplantation in a patient with X‐linked agammaglobulinemia and acute myeloid leukemia 下载免费PDF全文
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Protocolized Laboratory Screening for the Medical Clearance of Psychiatric Patients in the Emergency Department: A Systematic Review 下载免费PDF全文
Alyssa Conigliaro MA Roshanak Benabbas MD Eric Schnitzer DO Maria‐Pamela Janairo MD Richard Sinert DO 《Academic emergency medicine》2018,25(5):566-576
Objective
Emergency department (ED) patients with psychiatric chief complaints undergo medical screening to rule out underlying or comorbid medical illnesses prior to transfer to a psychiatric facility. This systematic review attempts to determine the clinical utility of protocolized laboratory screening for the streamlined medical clearance of ED psychiatric patients by determining the clinical significance of individual laboratory results.Methods
We searched PubMed, Embase, and Scopus using the search terms “emergency department, psychiatry, diagnostic tests, laboratories, studies, testing, screening, and clearance” up to June 2017 for studies on adult psychiatric patients. This systematic review follows the recommendations of Meta‐analysis of Observational Studies in Epidemiology (MOOSE) statement. The quality of each study was rated according to the Newcastle‐Ottawa quality assessment scale.Results
Four independent reviewers identified 2,847 publications. We extracted data from three studies (n = 629 patients). Included studies defined an abnormal test result as any laboratory result that falls out of the normal range. A laboratory test result was deemed as “clinically significant” only when patient disposition or treatment plan was changed because of that test result. Across the three studies the prevalence of clinically significant results were low (0.0%–0.4%).Conclusions
The prevalence of clinically significant laboratory test results were low, suggesting that according to the available literature, routine laboratory testing does not significantly change patient disposition. Due to the paucity of available research on this subject, we could not determine the clinical utility of protocolized laboratory screening tests for medical clearance of psychiatric patients in the ED. Future research on the utility of routine laboratory testing is important in a move toward shared decision making and patient‐centered health care.70.