Articles: pediatrics.
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Randomized Controlled Trial Clinical Trial
Impact of education for physicians on patient outcomes.
This study was conducted to assess the impact of an interactive seminar based on self-regulation theory on 1) the treatment practices and communications and education behavior of physicians, 2) the health status and medical care utilization of their pediatric patients with asthma, and 3) the satisfaction with care of the subjects' parents. ⋯ The interactive seminar based on theories of self-regulation led to patient-physician encounters that were of shorter duration, had significant impact on the prescribing and communications behavior of physicians, led to more favorable patient responses to physicians' actions, and led to reductions in health care utilization.
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Randomized Controlled Trial Clinical Trial
Intervention to improve physician documentation and knowledge of child sexual abuse: a randomized, controlled trial.
To determine if written feedback improves the chart documentation and knowledge of physicians doing evaluations for child sexual abuse and to learn what other factors are associated with better documentation and knowledge. ⋯ Tailored feedback to the physician with directed educational materials did not seem to improve most aspects of documentation and knowledge of child sexual abuse, although notable improvement was seen during the time period studied. This study suggests that chart audits may not be the best use of resources for trying to improve physician behavior; credits in continuing medical education and use of structured records may be more likely to be beneficial.
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Randomized Controlled Trial Comparative Study Clinical Trial
Development and evaluation of a CD-ROM computer program to teach residents telephone management.
Under managed care, telephone management is crucial to pediatric practice, but an effective method is needed to teach residents telephone skills. Our objective was to design an interactive CD-ROM program to teach residents an organized, consistent approach to telephone complaints and to determine whether use of the program was associated with better subsequent telephone management than reading the same information. ⋯ Use of this CD-ROM telephone management program was associated with better postintervention telephone management. The program augments faculty instruction by teaching a consistent, general approach to telephone management.
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Anesthesia and analgesia · Nov 1997
Randomized Controlled Trial Clinical TrialTeaching the use of fiberoptic intubation for children older than two years of age.
In 144 anesthetized children aged 2-9 yrs, the safety and feasibility of orotracheal fiberoptic intubation, with and without an airway endoscopy mask, were assessed and compared with laryngoscopic intubation. Eight anesthesia residents with experience in adult fiberoptic intubation, but who were beginners in pediatric anesthesia, participated in this study. In a randomized fashion, each resident intubated 18 children (6 in each group). The time (mean +/- SD) to achieve successful intubation was different for laryngoscopic and fiberoptic intubation (34 +/- 17 s and 80 +/- 39 s, respectively; P < 0.001). The use of the airway endoscopy mask further prolonged fiberoptic intubation (167 +/- 121 s, P < 0.001). Spo2 values remained >95% in all patients during conventional laryngoscopy and fiberoptic laryngoscopy with a mask, whereas Spo2 decreased below 95% in 2 of the 48 patients during fiberoptic intubation without a mask. Both patients promptly recovered during ventilation via a face mask. We conclude that teaching the use of fiberoptic intubation in healthy, anesthetized children aged 2-9 yrs is safe and feasible. ⋯ Fiberoptic intubation is a valuable technique of airway management. We studied the feasibility and safety of a training program that could be used for children more than 2 yrs old. This study demonstrates that fiberoptic intubation can be effectively practiced in pediatric patients without increased risk of side effects.
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J Dev Behav Pediatr · Oct 1996
Randomized Controlled Trial Clinical TrialThe effects of hypnosis/guided imagery on the postoperative course of children.
Hypnosis, guided imagery, and relaxation have been shown to improve the postoperative course of adult surgical patients. Children have successfully used hypnosis/guided imagery to significantly reduce the pain associated with invasive procedures and to improve selected medical conditions. The purpose of this study was to examine the effect of hypnosis/guided imagery on the postoperative course of pediatric surgical patients. ⋯ Significantly lower postoperative pain ratings and shorter hospital stays occurred for children in the experimental group. State anxiety was decreased for the guided imagery group and increased postoperatively for the control group. This study demonstrates the positive effects of hypnosis/guided imagery for the pediatric surgical patient.