Medicine and Health Sciences Commons^™

Enhancing Patient Adherence: Outcomes Of Medication Alliance Training On Therapeutic Alliance, Insight, Adherence, And Psychopathology With Mental Health Patients, Mitchell Byrne, Frank Deane

Mitchell K Byrne

The results of interventions to enhance patient adherence to medication have been inconsistent. This research investigated the utility of an enhanced adherence training programme to ascertain its effectiveness and the possible mechanisms of that effect. Forty-six clinicians were trained in 'medication alliance', and data were collected from 51 patients matched to the clinician. Data on clinician changes in skills, knowledge, and attitudes, in relation to enhancing patient adherence and patient changes in adherence, insight, and psychopathology were collected at baseline and at 6 and 12 months. The quality of the therapeutic relationship between the clinician and the patient was also …

Nurse's Beliefs And Knowledge About Medications Are Associated With Their Difficulties Using Patient Treatment Adherence Strategies, Mitchell Byrne, Frank Deane, Tim Coombs

Mitchell K Byrne

Background: The attitudes and beliefs of patients toward their treatment have been found to be an important factor in treatment outcome, particularly as it relates to treatment adherence. There are also suggestions that knowledge, attitudes and beliefs held by nurses about treatments may also be important influences on treatment outcome but there has been little research relating these to specific clinical behaviour. Aims: This study explored the knowledge and beliefs of nurses toward neuroleptic medications in the treatment of severe mental ill health with the view to identifying specific nurse training needs. Method: A convenience sample of 64 nurses was …

Predicting Influenza A And 2009 H1n1 Influenza In Patients Admitted To Hospital With Acute Respiratory Illness, Gerben Keijzers, Caleb Vossen, Ping Zhang, Deborough Macbeth, Petra Derrington, John Gerrard, Jenny Doust

Jenny Doust

Objective: To create a clinical decision tool for suspected influenza A (including 2009 H1N1) to facilitate treatment and isolation decisions for patients admitted to hospital with an acute respiratory illness from the emergency department (ED) during a 2009 H1N1 pandemic.

Methods: Cross-sectional study conducted in two hospitals in Queensland, Australia. All patients admitted to hospital from the ED between 24 May and 16 August 2009 with an acute respiratory illness were included. All had nasal and throat swabs taken. Data were collected from clinical chart review regarding clinical symptoms, co-morbidities, examination findings, pathology and radiology results. Influenza A …

Predicting Influenza A And 2009 H1n1 Influenza In Patients Admitted To Hospital With Acute Respiratory Illness, Gerben Keijzers, Caleb Vossen, Ping Zhang, Deborough Macbeth, Petra Derrington, John Gerrard, Jenny Doust

Gerben Keijzers

Objective: To create a clinical decision tool for suspected influenza A (including 2009 H1N1) to facilitate treatment and isolation decisions for patients admitted to hospital with an acute respiratory illness from the emergency department (ED) during a 2009 H1N1 pandemic.

Methods: Cross-sectional study conducted in two hospitals in Queensland, Australia. All patients admitted to hospital from the ED between 24 May and 16 August 2009 with an acute respiratory illness were included. All had nasal and throat swabs taken. Data were collected from clinical chart review regarding clinical symptoms, co-morbidities, examination findings, pathology and radiology results. Influenza A …

General Practitioners' Views On Patient Care Research., Ian Wilson, B Mcgrath, G Russell, C Bridges-Webb, C Hogan

Ian G Wilson

BACKGROUND: Little research has been undertaken into the factors affecting recruitment by Australian general practitioners of patients for clinical trials. Understanding the differences between recruiters and non-recruiters will assist researchers in better supporting general practitioners involved in such research. METHOD: A survey of general practitioners involved in recruiting patients for clinical trials for the RACGP Research Program was undertaken. RESULTS: Recruiters were more likely to be interested in learning more about research, to perceive involvement as worthwhile, to desire a good relationship with Research Program staff and to feel the doctor-patient relationship assists recruitment. DISCUSSION: Recruiters in general are average …

Depression In The Patient With Copd, Ian G. Wilson

Ian G Wilson

This paper explores the recent literature surrounding comorbid depression and COPD. The literature reveals a high prevalence of depression in patients with COPD and some evidence that the depression is a result of the disease. The literature highlights the negative impact of depression on quality of life and a possible impact on mortality. Depression also negatively impacts on compliance and smoking cessation. Treatment of depression in COPD, particularly by cognitive behavioral therapy, has positive impact on quality of life. Tricyclic antidepressants have a positive impact on mood and COPD, but side effects limit their use. The advent of the new …

A Patient With Neurosyphilis Presenting As Chorea, Alison Jones, I.A.D Bouchier

Alison L Jones

Despite the marked decline infrequency of neurosyphilis over the past three decades in the United Kingdom, new cases continue to appear both sporadically and as a complication of HIV infection. There is clinical evidence that neurosyphilis is becoming less typical. We describe a case of neurosyphilis presenting predominantly with choreoathetosis and associated hemiparesis in an otherwise healthy, immunocompetent patient. Only six cases of neurosyphilis presenting with features of basal ganglia damage have been reported in the recent literature, five of whom had HIV infection.

Pitfalls In The Management Of The Poisoned Patient, Mary Kerins, Paul Dargan, Alison Jones

Alison L Jones

Acute poisoning is a common problem worldwide. In the United Kingdom (UK) it accounts for an estimated 10–20% of acute medical admissions and 5–10% of the workload of Accident and Emergency (A&E) departments.1–4 Episodes of self-poisoning in the UK continue to rise, with the rates being among the highest in Europe.5–7 The severity of poisoning has decreased over the past decade with the introduction of safer drugs, such as the selective serotonin reuptake inhibitors, but the total number of deaths from poisoning in the UK remains unchanged at more than 3,000 per year.2 This paper will address common pitfalls in …

Pastoral Care: A New Model For Assessing The Spiritual Needs Of Hospitalized Patients, Douglas Robinson

Doctoral Dissertations and Projects

Hospitalized patients are at an elevated risk of suffering from spiritual distress. Patients value and expect having spiritual and emotional needs met when hospitalized. A direct correlation exists between spiritual and physical health, making spiritual assessment and care a pastoral priority. Research indicates a lack of proper training for pastors making hospital visits. The purpose of this project is to provide pastors with resources and understanding of spiritual assessment of hospitalized patients. This project also provides pastors with a template for a new model of spiritual assessment to aid with establishing a spiritual assessment tool to meet their ministry needs, …

Physician Assessment Of Patient Motivation: Influence On Disposition For Follow-Up Care, R Mcartor, Donald Iverson, D Benken, Valerie Gilchrist, L Dennis, R Broome

Don C. Iverson

This study of 3,318 outpatient visits evaluated the influence of the physician-assessed level of patient motivation on the level of physician involvement in follow-up care. Data collected included patient demographics, health risk factors, physician-assessed level of patient motivation, and the disposition for follow-up care (return office visit or self-care). Physicians more frequently scheduled patients for a return office visit, regardless of assessed level of patient motivation, when they presented with a traditional biomedical problem. Patients with health promotion-disease prevention problems were more frequently relegated to self-care; patients physicians judged to be poorly motivated were four times as likely to be …

The Older Patient, The Doctor And The Trainee: Patients' Attitudes And Implications For Models Of Care, Andrew Bonney, Sandra Jones, Donald Iverson

Don C. Iverson

Aims & rationale/Objectives Population ageing poses major challenges for health systems. Additionally, training future general practitioners in the management of older and chronically ill patients is potentially hampered by the reluctance of these patients to consult trainees for chronic care. This paper reports a cross-sectional study investigating the attitudes of older patients to trainees, to inform strategies to improve older patient-trainee interaction. Methods The survey instrument was distributed to 1900 patients aged 60 and over from 38 training practices from five Australian states using a stratified, randomised cluster sampling process. Generalised estimating equation models were used for analysis. Principal findings …

Does Being Cultured Pay? Racial And Language Concordance And Its Effect On Physician Income, Nayan Patel

Honors Theses

Issues surrounding race and ethnicity in healthcare have increased in number as racial disparities as well as minority physicians become more prevalent in the USA. One such issue is the concordance rate of race and language amongst physicians and their patients. The effect of racial concordance in physician patient relationships has been looked at to determine if it affects the perceived level of health quality. Saha et al. (1999) found that Black and Hispanic patients were more satisfied in their healthcare when treated by a physician of their own race. In this study, I establish whether or not the racial …

Provider And Patient Satisfaction With The Use Of Telemedicine In The Delivery Of Healthcare, Rohit Dhingra

Honors Theses

The objective of this thesis was to look at provider and patient satisfaction with the use of telemedicine in the delivery of healthcare. From the literature, it is clear that the providers and patients find different aspects of telemedicine to be appealing but have noted certain limitations with its use. Each study that was reviewed in the literature explored a different type of telemedicine, but in no way covered all of its current applications. In my study, I interviewed three patients and three providers. The patients all use a homecare telemedicine unit in which they can self-measure basic vital signs, …

Patient Safety Competencies In Rural Asn Students: An Evidence-Based Curricular Innovation, Janeen Berndt

Evidence-Based Practice Project Reports

Hospital clinical experiences are important events in prelicensure nursing education. Benefits include the opportunity for students to experience actual nursing responsibilities, immersion into environment, and professional socialization. However, challenges in finding appropriate clinical experiences include competition over clinical sites, decreasing patient acuity, and high student-faculty ratios. Rural schools of nursing have these challenges and those inherent in rural environments such as limited health care access, restricted critical access hospitals, and limited resources. The purpose of this evidence-based practice project was to plan, implement, and evaluate the use of a series of patient care simulations as an educational intervention to improve …

Care Of The Dying Patient: A Neglected Issue In Pakistani Context, Waris Qidwai

Department of Family Medicine

No abstract provided.

Children's Cancer And Transplant Hospital: A Micro Town Within A Bubble, Kimia Samimi

Masters Theses 1911 - February 2014

As the greatest considerations in health-care design have traditionally been functional —hygiene, efficiency, and flexibility for changing technology— hospitals have evolved to become dehumanizing spaces. In this thesis two specific groups of chronically ill children who have among the longest inpatient stays are studied: cancer and organ transplant patients. Being under immunosuppressive drugs, these children are physically vulnerable thus are kept completely isolated. These long stays and isolation can be very depressing for them.

This thesis undertakes the challenge of designing a fully isolated space that doesn’t feel like one or in other words “a micro-town within a bubble”. The …

Patient Perceptions Of Innovative Longitudinal Integrated Clerkships Based In Regional, Rural And Remote Primary Care: A Qualitative Study, Judith N. Hudson, Patricia J. Knight, Kathryn M. Weston

Graduate School of Medicine - Papers (Archive)

No abstract provided.

Patient Perceptions Of Anaesthesia Research Priorities - A Failed Study, Natalie A. Smith, D Martin

Graduate School of Medicine - Papers (Archive)

Professor Steven Shafer alerted conference delegates at a recent international meeting to the value of considering topics for future research in terms of what the most important questions are that remain to be solved1. He quoted from an issue of Science magazine, in which the editors reported questions they thought pointed to the greatest current scientific knowledge gaps2. Two of the top 25 related to anaesthesia in a broad sense: the biological basis of consciousness and how memories are stored and retrieved. Others have noted the relevance of asking patients what they considered research priorities to be3,4. We designed a …

The Role Of Health Literacy And Social Networks In Arthritis Patient's Health Information-Seeking Behaviour: A Qualitative Study, Janette Ellis, Judy Mullan, Anthony Worsley, Nagesh Brahmavar Pai

Graduate School of Medicine - Papers (Archive)

Background. Patients engage in health information-seeking behaviour to maintain their wellbeing and to manage chronic diseases such as arthritis. Health literacy allows patients to understand available treatments and to critically appraise information they obtain from a wide range of sources. Aims. To explore how arthritis patients’ health literacy affects engagement in arthritis-focused health information-seeking behaviour and the selection of sources of health information available through their informal social network. Methods. An exploratory, qualitative study consisting of one-on-one semi-structured interviews. Twenty participants with arthritis were recruited from community organizations. The interviews were designed to elicit participants’ understanding about their arthritis and …

A Patient Experiencing Pseudoseizures: A Case Report, F Joseph, J Quinlan

Faculty of Health and Behavioural Sciences - Papers (Archive)

Pseudoseizures are a relatively complex problem of unknown aetiology and prognosis. They can at times resemble genuine seizure attacks but they have no abnormal electroencephalograpic (EEG) activity. Understanding the patient's unique psychological background appears to be fundamental in managing seizure frequency. Pseudoseizures can be disruptive to a person's lifestyle, limiting their ability to function and progress in society, particularly when it comes to employment or social interaction. The case discussed involves a 59-year old man who presents with what is believed to be seizurerelated activity but through the course of clinical evaluation, this turned out to be pseudoseizures