Journal of general internal medicine
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To assess the content and extent of HIV risk assessment by primary care physicians across a diverse panel of patients with unidentified HIV risk behaviors. ⋯ Our data suggest that primary care physicians do not routinely perform HIV risk assessments with patients who have risk behaviors for HIV infection. Methods are needed to develop, standardize, and disseminate better screening techniques to identify patients with or at risk of developing HIV infection, such as written HIV risk screening questions for use in medical intake forms.
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To assess the level of involvement patients want in decision making related to the acceptance or rejection of an invasive medical intervention and whether their preference for decision making is related to their preference for qualitative (verbal) or quantitative (numeric) information about the risks of the procedure. ⋯ Male veterans consistently preferred shared patient-physician decision making in the context of invasive medical interventions.
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The purpose of this study was to determine how vision problems affect health status. The information was collected in 1990 from 2,249 household heads and spouses over 50 years of age during an annual survey of a nationally representative sample that was adjusted for attrition and nonresponse. ⋯ Regression analyses found a significant relationship between "trouble seeing" and each of five health-status domains. We conclude that it may not be appropriate to require specific functional limitations as a precondition for cataract surgery and that instruments for measuring functional disabilities related to vision should include more general questions.
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To evaluate whether laxatives and fiber therapies improve symptoms and bowel movement frequency in adults with chronic constipation. ⋯ Both fiber and laxatives modestly improved bowel movement frequency in adults with chronic constipation. There was inadequate evidence to establish whether fiber was superior to laxatives or one laxative class was superior to another.
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Randomized Controlled Trial Clinical Trial
Assessing patients' expectations in ambulatory medical practice. Does the measurement approach make a difference?
To compare three different approaches to the measurement of patients' expectations for care, we conducted a randomized controlled trial. Medical outpatients (n = 318) of a small (six-physician), single-specialty (internal medicine), academically affiliated private practice in Sacramento, California, were contacted by telephone the night before a scheduled office visit and enrolled over a 5-month period in early 1994. Patients were randomly assigned to receive: (1) a self-administered, structured, previsit questionnaire combined with a postvisit questionnaire; (2) an interviewer-administered, semistructured, previsit interview combined with a postvisit questionnaire; or (3) a postvisit questionnaire only. ⋯ In conclusion, studies of patients' expectations for care must content with a substantial "method effect." In this study from a single group practice, patients checked off more expectations using a structured questionnaire than they disclosed in a semistructured interview, but both formats predicted visit satisfaction. Asking patients about interventions received in relation to their previsit expectations added little to simply asking them directly about omitted care. The interaction of survey method with ethnicity and other sociodemographic characteristics requires further study.