Internal Medicine Setting Research Articles

A comparative study on the effect of psychosocial factors on patient-doctor relationship in different clinical settings of a General Hospital

Conclusions Unique patterns of interaction emerged in the separate settings, yet the adoption of a clinical style adhering to the general guidelines of the biopsychosocial model was appreciated by patients in internal medicine and surgical clinical settings alike, providing us with positive evidence to its value in modern-day therapeutics. from International Society on Brain and Behaviour: 3rd International Congress on Brain and Behaviour Thessaloniki, Greece. 28 November – 2 December 2007

The Use of Spirometry in a Primary Care Setting

OBJECTIVE To determine the use of spirometry in family practice, internal medicine, and pediatric outpatient settings. METHODS Data were collected from 45 outpatient offices in the central Pennsylvania area via phone survey that asked a set of four questions: 1) Do you have spirometry in your office? 2) Do you use spirometry for asthma patients? 3) In what situation do you use spirometry for? 4) Do you use spirometry more for chronic obstructive pulmonary disease (COPD) or asthma? RESULTS It was found that pediatricians used spirometry 66% of the time, family practitioners 47% of the time, and internal medicine practitioners 60% of the time. Of those who did not use spirometry, 94% stated that they refer to a hospital if they required spirometry and 6% referred to subspecialists if the patient required spirometry. 10% of pediatricians performed the test on each asthma visit, otherwise the others used it only for exacerbations or as a baseline. No internists used spirometry regularly for asthma patients, and 22% used it more for COPD. In family practice only 14% used spirometry routinely at each visit for asthma patients. CONCLUSIONS Pediatricians used spirometry more often in the outpatient setting than other specialists, followed closely by internal medicine physicians. Family practice physicians were the least likely to use spirometry. Multiple barriers seemed to prevent routine use of spirometry, but no one barrier accounted for the majority.

Borderline Personality Symptomatology and History of Domestic Violence Among Women in an Internal Medicine Setting

Borderline Personality Symptomatology and History of Domestic Violence Among Women in an Internal Medicine Setting

Borderline Personality Symptomatology and History of Domestic Violence Among Women in an Internal Medicine Setting

In this study of primary care patients, we examined the relationship between a history of domestic violence (measured with the Severity of Violence Against Women Scale [SVAWS]) and borderline personality (measured with the Self-Harm Inventory [SHI] and the Personality Diagnostic Questionnaire-4 [PDQ-4]). We elected borderline personality for examination because several diagnostic criteria sets describe relationship features suggestive of partner abuse. In this study, both measures of borderline personality were highly related to each other (r = .73, p < .001) as well as to the SVAWS (r = .70, p < .001, for the SHI; r = .73, p < .001, for the PDQ-4). Using diagnostic cutoff scores on the measures for borderline personality, 64.0% of those with histories of domestic violence scored in the positive range on either or both measures, while only 11.1% of nonabused women did. We discuss the clinical implications of these findings.

Childhood Trauma and Employment Disability

While the relationship between childhood trauma and employment disability has undergone very limited study, existing data suggest a possible correlation. In this study of 91 outpatients in an internal medicine setting, we surveyed participants and inquired about their childhood histories of sexual, physical, and emotional abuse, of physical neglect, and of witnessing violence. We also asked whether participants had ever been on employment disability, either psychiatric or non-psychiatric, and the length of that disability. Being or having been on disability was significantly related to childhood histories of emotional abuse, physical neglect, and witnessing violence. Being or having been on psychiatric disability was significantly related to childhood emotional abuse and physical neglect while being on non-psychiatric medical disability was significantly related to witnessing violence. The percent of one's lifetime on disability was significantly related to physical and emotional abuse as well as witnessing violence. Maltreatment in childhood appears to have a relationship to employment disability in adulthood. The authors discuss the implications of these findings.

11 Easy: Adherence to the national cholesterol education program (NCEP) guidelines in specialised medical settings: Observational study. Data from internal medicine settings

11 Easy: Adherence to the national cholesterol education program (NCEP) guidelines in specialised medical settings: Observational study. Data from internal medicine settings

A year of mentoring in academic medicine: case report and qualitative analysis of fifteen hours of meetings between a junior and senior faculty member.

We describe a specific mentoring approach in an academic general internal medicine setting by audiotaping and transcribing all mentoring sessions in the year. In advance, the mentor recorded his model. During the year, the mentee kept a process journal. Qualitative analysis revealed development of an intimate relationship based on empathy, trust, and honesty. The mentor's model was explicitly intended to develop independence, initiative, improved thinking, skills, and self-reflection. The mentor's methods included extensive and varied use of questioning, active listening, standard setting, and frequent feedback. During the mentoring, the mentee evolved as a teacher, enhanced the creativity in his teaching, and matured as a person. Specific accomplishments included a national workshop on professional writing, an innovative approach to inpatient attending, a new teaching skills curriculum for a residency program, and this study. A mentoring model stressing safety, intimacy, honesty, setting of high standards, praxis, and detailed planning and feedback was associated with mentee excitement, personal and professional growth and development, concrete accomplishments, and a commitment to teaching.

Rhe-3. Screening Heel Ultrasound in an Internal Medicine and Family Practice Setting: Effect on Osteoporosis

rhe-3. Screening Heel Ultrasound in an Internal Medicine and Family Practice Setting: Effect on Osteoporosis

Childhood trauma and adult somatic preoccupation by body area among women in an internal medicine setting: a pilot study.

This study was designed to explore the relationship between three types of abuse in childhood and their relationship to somatic preoccupation, in general and by body area, in adulthood. Eighty-five women in an internal medicine clinic completed self-report measures of childhood sexual, physical, and emotional abuse as well as the Bradford Somatic Inventory. Using simple correlations, all three types of abuse were positively related to current somatic preoccupation. Using multiple regression analysis that included demographic variables (education and age) and the three forms of childhood abuse, only the demographic variables and sexual abuse were uniquely predictive of somatic preoccupation. To determine the relationship between childhood abuse and somatic symptoms based on body area (head, chest, stomach, throat) and fatigue, a series of multiple regression analyses were performed. The chest and throat areas were significant, but no abuse variable was uniquely predictive. Among females in adulthood, all studied forms of abuse in childhood appear to contribute to general somatic preoccupation, as well as specific somatic symptoms in the chest and throat areas. Sexual abuse, specifically, is a unique predictor for general somatic preoccupation, but not necessarily specific body areas.

Focused Quality Improvement in Health Care

Service quality assessments are dominated by simple analyses of questionnaire data. Such methods generally lack validity and reliability. Moreover, they do not have a target side defining what actions patient satisfaction should lead to from a management point of view. The quality, satisfaction, performance method, a technique with high validity, was applied in an internal medicine setting. The method appears to offer a unique way to relate desired results of care to different processes and structures in the clinic as well as incentives to intervene to improve the quality of care.

Focused Quality Improvement in Health Care

Service quality assessments are dominated by simple analysis of questionnaire data. Such methods generally lack validity and reliability. Moreover, they do not have a target side defining what actions patient satisfaction should lead to from a management point of view. The quality, satisfaction, performance method, a technique with high validity, was applied in an internal medicine setting. The method appears to offer a unique way to relate desired results of care to different processes and structures in the clinic as well as incentives to intervene to improve the quality of care.