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1
Fulginiti, John Vincent 1959. "Reliability of the Arizona Clinical Interview Rating Scale: A confirmatory study." Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/276763.
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Reliable measurement of student capability for a skill allows educators to verify student mastery. A major part of a physician's ability to gather information involves patient interviewing, and instruction of this skill is a substantial portion of a medical curriculum. Since 1974, the University of Arizona College of Medicine has employed patient-instructors (PIs), lay persons who function in the roles of patient and teacher for training of interview skills in the Preparation for Clinical Medicine (PCM) program. PIs provide "real" patient-interview experiences and immediate feedback to the students. The PCM program currently has four topic areas: Adult, Pediatric, Geriatric, and Psychiatric. The Arizona Clinical Interview Rating (ACIR) Scale was developed in 1976 to measure the technical performance aspects of interviewing. This study was undertaken to determine reliability of the ACIR. Implication of the results are discussed and suggestions made for the continued application of the ACIR Scale. (Abstract shortened with permission of author.)
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Grant, Elzaan. "Validity and accuracy of self-reported drug allergies." Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/3295.
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Purpose: Pharmacists must ensure the safe and effective use of medication, but often have only the documented patient history to guide assessment of therapy. There is a lack of information on the incidence of claimed drug allergies or the validity of these self-reported drug allergies in the South African population. Mislabelling of patients as being allergic to medication often deprives them of important therapeutic drugs and alternative agents may be more dangerous, less effective and more costly (Hung et al., 1994). The aim of the research was therefore to determine the incidence of drug allergies in patients admitted to a private hospital and to assess the validity of these self-reported drug allergies. Methods: A descriptive, non-experimental study design was used. Data was collected using a concurrent, cross-sectional approach and collected from patients admitted to hospital using Medical Chart Reviews and researcher-led, questionnaire based interviews. During the seven month sampling period, 693 patients were identified with one or more self-reported drug allergies. A subset of 99 patients (14.2%) consented to a researcher-led interview. The allergies were assigned to one of three groups based on the history: (i) High probability: signs and symptoms typical of an immunological reaction. (ii) Low probability: signs and symptoms of the reaction were predictable reactions or side effects of the drug. (iii) Unknown status: no information concerning the reaction history was available. Results: A total of 953 allergies were identified in the 693 patients, with a ratio of drug allergy to patient of 1.4:1. The majority of claimed allergies were to penicillin (39.2%), opioid analgesics (17.6%), other antimicrobials, including co-trimoxazole (13.5%), NSAIDs (9.9%) and unspecified “sulphur” allergy (8.7%). Descriptions of the “allergic” reactions were only recorded on 8.9% (62, n=693) of the reviewed charts. Only 56.5% (35, n=62) of the symptoms recorded as “allergy” were indicative of the event being allergic or immunological in nature. In total, 1.3% (9, n=693) of the patients with a self-reported allergy received the allergen while in hospital. In three cases this was the result of a pharmacist overlooking the recorded allergy, and dispensing the allergen to the patient. A total of 118 allergies were identified in the 99 interviewed patients, with a ratio of drug allergy to patient of 1.2:1. Inaccurate allergy history was found in 9.1% (9, n=99) of the interviewed patients. Overall, the majority of self-reported drug allergies (67.8%) had a “high probability” of being a true drug allergy. Allergies that were assigned into the high probability group were: penicillin (74.1%), co-trimoxazole (91.7%), NSAID‟s (55.6%) and 75.0% of opioids. Conclusion: In summary, the validity of self-reported drug allergies need to be determined before excluding medication from a patient‟s treatment options. Detailed descriptions can assist in the evaluation of self-reported allergies which would be advantageous to both prescribers and patients. Pharmacists need to play a bigger role in ensuring accurate documentation of drug allergy history, with detailed descriptions, in order to ensure safe and effective drug use within the hospital environment.
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Rutledge, Thomas. "Psychological response styles and cardiovascular health : confound or independent risk factor?" Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0002/NQ34622.pdf.
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Kaufman, David R. "Representation and utilization of information during the clinical interview in medicine." Thesis, McGill University, 1987. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59603.
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This study evaluated the ability of subjects at 3 levels of expertise, expert physicians, residents and medical students, in the acquisition, representation, and utilization of patient information in the context of solving a complex medical problem. Each subject interviewed a volunteer medical outpatient and was subsequently requested to provide a differential diagnosis. The doctor-patient dialogue was analyzed using cognitive methods of discourse analysis. These methods were used to characterize differences in the content and nature of the history-taking process and in the development of problem representations. The study characterized differences at two levels of representation, observations and findings. Observations are the minimal semantic units of the doctor patient discourse. Findings are higher order units that derive meaning in specific medical contexts.Differences were found between groups of subjects in the accuracy of diagnoses and in the qualitative nature of representations. These differences were manifested most clearly in terms of a series of efficiency measures designed to characterize the ability of subjects to generate findings. In general, the expert physicians were more selective in the elicitation and processing of critical and relevant findings. An attempt is made to characterize these differences in terms of the strategies used to acquire and represent patient information.
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Park, Yujong. "Analyzing medical discourse the organization of doctor-patient interaction in Korean primary care settings /." Diss., Restricted to subscribing institutions, 2009. http://proquest.umi.com/pqdweb?did=1835448471&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Nukaga, Yoshio. "The visual transcription of "family disease" : a comparison of the use of medical pedigrees in genetic counseling practices in Canada and Japan." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23729.
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In recent years, with the development of DNA tests and genetic knowledge, there has been a growth of genetic counseling services and research in Canada and Japan. Although the uniqueness of genetic services in medicine lies in the preliminary assessment of the entire family rather than a single patient, few attempts have been made by social scientists to examine the technical and social construction of family trees and medical pedigrees. The purpose of this thesis is to analyze how the family data taken by genetic counselors are transcribed as medical pedigrees and used by associated health care workers in different cultural settings. The comparative analysis was based on an ethnographic approach that included participant-observation in genetic counseling sessions, interviews with clinical workers, and content-analysis of medical textbooks. The findings include three major points: (1) cultural views of the family are taken for granted by genetic counselors; (2) the process of documenting family data consists of four stages: primary transcription, secondary transcriptions, combination and publications; (3) the clinical workers' use of medical pedigrees results in the construction of family history as part of the present family illness.
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Leduc, Cassandra. "The development of a family history collection tool for use in a pediatric practice a pilot study /." Waltham, Mass. : Brandeis University, 2009. http://dcoll.brandeis.edu/handle/10192/23240.
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Clark, Diane E. "Screening for medical referral attitudes, beliefs, and behaviors of physical therapists with greater than 10 years experience /." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2007. https://www.mhsl.uab.edu/dt/2009r/clark.pdf.
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Pierce, Lynn Margaret. "Physicians who write about talking with patients : the interview." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=56935.
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This thesis critically reviews medical journal literature on the physician-patient interview. The review focuses on literature which is written by and for physicians, in Canadian and American, English language medical journals. Articles, essays and letters to the editor are examined as a cultural exchange amongst physicians that both shapes and is shaped by the values of the medical profession. Chapter One presents literature concerning physician-patient communication in general. The following Chapters Two, Three and Four ("The Physician as Medical Interpreter," "Physician and Patient: in Conflict and in Silence," and "The Patient as Narrator,") focus on themes in the medical journal literature written by physicians on the clinical interview. These Chapters examine the values, explicit and implicit, of this literature. The values are examined for possible epistemological origins in traditional medical ethics, philosophical bioethics, contemporary social movements for the dignity and rights of the individual, and other sources. Thematic shifts in these values over the past twenty years, and the sources of these shifts, are also examined. Finally, the Conclusion evaluates the significance of this literature for the development of a medical morality.
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Mangual, Rebecca Bonilla. "Characteristic differences between parents/guardians who keep immunization records and those who do not." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2201.
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Viana, Danilo Vilela 1975. "Historia familial de cancer nos pacientes com diagnostico de cancer de colon e reto no Hospital de Clinicas da Unicamp." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309743.
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Orientador: Iscia Teresinha Lopes-Cendes, Carmen Passos LimaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-06T07:38:24Z (GMT). No. of bitstreams: 1 Viana_DaniloVilela_M.pdf: 17449794 bytes, checksum: 5628cf41f1e3b3dae3d2ad85bb64f5d4 (MD5) Previous issue date: 2006
Resumo: O câncer de cólon e reto é a quinta causa de mortalidade por câncer no Brasil. Sua taxa de mortalidade vem apresentando um aumento contínuo desde 1979. Entre os fatores de risco mais importantes para essa doença está a história familial de câncer de cólon e reto ou de pólipos adenomatosos. O propósito do presente estudo foi investigar a qualidade das histórias familiais (HF) registradas nos prontuários médicos e estimar a freqüência dos agregados familiais e das síndromes hereditárias de câncer nos pacientes com diagnóstico de câncer de cólon e reto atendidos no Hospital de Clínicas da UNICAMP. Um estudo retrospectivo foi delineado para avaliar os prontuários dos pacientes que tinham confirmação histopatológica do diagnóstico de adenocarcinoma de cólon ou reto. Inicialmente, 415 prontuários que apresentavam codificação para a doença foram selecionados a partir do livro de cirurgias e de uma lista de pacientes atendidos nos ambulatórios de oncologia clínica, radioterapia e proctologia. Foram excluídos 104, sendo realizada a revisão de 311 prontuários. Numa segunda fase do estudo todos esses pacientes foram convocados para um entrevista com médico geneticista para obtenção de nova história familial, e comparação subseqüente dos dados, na qual a história familial previamente registrada foi classificada como completa ou incompleta. Dentre os 311 prontuários revisados, 193 (62%) tinham HF de câncer registrada. No total, 95 pacientes compareceram à entrevista, dos quais 66 tinha HF registrada no seu prontuário para que fosse feita comparação. Dessas 66 HF, 21 (32%) puderam ser consideradas completas e 45 (68%) incompletas. Pelo menos um critério clínico para câncer hereditário foi preenchido por 39 pacientes. Agregação familiar de CCR foi encontrada em 19% dos indivíduos entrevistados. Estes achados demonstram que a coleta e o correto preenchimento das histórias familiais nos prontuários dos pacientes com câncer são freqüentemente negligenciados, o que poderia influenciar negativamente na qualidade da assistência médica a eles prestada. As formas hereditárias de câncer hereditário, em especial a síndrome de Lynch (câncer colorretal hereditário sem polipose - HNPCC), são subdiagnosticadas, impossibilitando que medidas preventivas e diagnóstico precoce sejam oferecidos às suas famílias.
Abstract: Colorectal cancer is the 5th mortality cause by cancer in Brazil, and has been showing a continuous increase in mortality since 1979. Among the most important risk factors for this disease is family history of CRC or adenomatous polyps. The purpose of the present study was to investigate family histories (FH) recorded in medical charts for completeness and accuracy and to estimate the frequency of cancer aggregates and cancer syndromes in colorectal cancer patients treated in a general hospital. A retrospective study was assembled to evaluate archived charts of patients with pathological diagnosis of colorectal adenocarcinoma. Four hundred and fifteen medical records with ICD-10 coding of colorectal cancer were selected from the list of pacients who had had consultation in the clinical oncology, radiation oncology or proctology clinics, from which 104 were excluded because of misclassification or unconfirmed diagnosis. 311 charts were fully reviewed, and these patients invited for a personal interview by a medical geneticist. FH obtained from chart reviews were compared to data obtained from personal interviews and subsequently classified as complete or incomplete. Among the 311 charts, 193 (62%) had FH of cancer recorded. Overall, 95 patients attended the interviews, 66 of whom had a FH recorded in their hospital charts allowing accuracy comparisons. Of these, 21/66 (32%) FH could be considered complete and 45/66 (68%) incomplete. Thirty-nine patients met at least one criterion for hereditary cancer. Familial aggregates of colorectal cancer were found in 18 families (19%). In conclusion, the data in this study showed that FH in medical charts were often flawed or carried important omissions, which could influence negatively medical attention delivered to patients, and that hereditary forms of cancer, especially hereditary non-polyposis colorectal cancer, were underdiagnosed, making it impossible to extend the benefits of early diagnosis and preventive measures to at risk family members.
Mestrado
Genetica Medica
Mestre em Ciências Médicas
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Eisenberg, Dana J. "Information Amount and Patient Empowerment: Participation in the HPV Vaccination Decision-Making Process." Columbus, Ohio : Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1243830226.
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Zary, Nabil. "Virtual patients for education, assessment and research : a web-based approach /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-272-9/.
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Bugüeño, Araya Claudia. "El feedback dialógico y su efectividad en la adquisición de competencias clínicas del nutricionista: una experiencia en estudiantes de nutrición y dietética de la Universidad Católica del Norte." Doctoral thesis, Universitat de Barcelona, 2020. http://hdl.handle.net/10803/669987.
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INTRODUCCIÓN: Actualmente existe la necesidad de asegurar la adquisición de competencias clínicas de los estudiantes en Ciencias de la Salud, para lo cual las prácticas clínicas son esenciales, pero muchas veces son inefectivas. La investigación sugiere que la retroalimentación utilizada en educación médica es poco útil, por algunas prácticas improductivas, ya que se centra en como los profesores “hacen llegar” el feedback al estudiante, lo cual necesita un cambio de enfoque hacia una retroalimentación sostenible que contribuya a la adquisición de competencias y desarrolle en los estudiantes un aprendizaje autorregulado.
OBJETIVO: Evaluar la efectividad de la implementación de feedback dialógico en la adquisición de competencias de los estudiantes de Nutrición y Dietética de la Universidad Católica del Norte, de la Región de Coquimbo, Chile.
METODOLOGÍA: Estudio cuasiexperimental y longitudinal de cohorte prospectivo con uso de técnicas mixtas (cuali-cuantitativas), realizado en 13 estudiantes de Nutrición y Dietética de la Universidad Católica del Norte, Coquimbo. El seguimiento se realizó entre años 2016 y 2018, evaluando con una rúbrica el nivel de competencias clínicas en
4 instancias (Diagnóstico, Inicio y Final de intervención, y finalmente en el Internado), con un desfase de 4 a 6 meses. La intervención consistió en incluir feedback dialógico al finalizar las cuatro experiencias clínicas y tuvo carácter formativo. También se evaluó la percepción de la calidad del proceso de feedback a través de un cuestionario y un focus group.
RESULTADOS: Después de los diferentes análisis descriptivos y comparativos, existen diferencias significativas (p=0,001) entre el nivel de competencia alcanzado por los estudiantes en Diagnóstico v/s Final de experiencias clínicas e Internado, y por otra parte entre Inicio de experiencias cínicas y Final de experiencias clínicas. También se presentan diferencias en distintos criterios de desempeño evaluados. Por otra parte, los estudiantes valoran positivamente el grado en que el proceso de feedback estimuló el diálogo, el contenido del mensaje y en que facilita el proceso de autorregulación, autoevaluación y reflexión.
CONCLUSIÓN: El feedback dialógico contribuye a la adquisición de las competencias clínicas y es valorado positivamente por los estudiantes. Se sugiere que el proceso de feedback sea cíclico y motivado por los profesores, finalizando cuando se produce la acción del estudiante (retroalimentación interna), la cual es necesaria para desarrollar la capacidad de pensar y convertirse en aprendices independientes y autorregulados.INTRODUCTION: There is currently a need to ensure the acquisition of clinical skills of students in Health Sciences, for which clinical practices are essential, but often ineffective. The research suggests that the feedback used in medical education is not very useful, due to some unproductive practices, since it focuses on how teachers “send” the feedback to the student, which needs a change of focus towards sustainable feedback that contributes to the acquisition of skills and develop in students a self-regulated learning. OBJECTIVE: To evaluate the effectiveness of the implementation of dialogic feedback in the acquisition of skills of Dietitians students of the Universidad Católica del Norte, in Coquimbo, Chile. METHODOLOGY: Quasi-experimental and longitudinal study of prospective cohort with use of mixed techniques(qualitative-quantitative), conducted in 13 Dietitians students of the Universidad Católica del Norte, Coquimbo. The follow-up was carried out between 2016 and 2018, evaluating with a rubric the level of clinical competences in 4 instances (Diagnosis, at the beginning and end of Intervention, and finally in the Internship), delayed between of 4 to 6 months. The intervention consisted of including dialogic feedback at the end of the four clinical experiences and was formative. The perception of the quality of the feedback process was also assessed through a questionnaire and a focus group. RESULTS: After the different descriptive and comparative analyzes, there are significant differences (p = 0.001) between the level of competence achieved by the students in Diagnosis v/s Final clinical experiences and Internship, and on the other hand between Beginning of clinical experiences and End of clinical experiences. There are also differences in different performance criteria evaluated. On the other hand, students positively value the degree to which the feedback process stimulated dialogue, the content of the message and how it facilitates the process of self-regulation, self-evaluation and reflection. CONCLUSION: Dialogic feedback contributes to the acquisition of clinical competencies and is positively valued by students. It is suggested that the feedback process be cyclical and motivated by teachers, ending when the student's action occurs (internal feedback), which is necessary to develop the ability to think and become independent and self-regulated learners.
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Hayashi, Juliana Yuki. "Desenvolvimento e avaliação de um prontuário virtual da disciplina de Cirurgia da Faculdade de Odontologia da Universidade de São Paulo." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/23/23149/tde-24102009-115820/.
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A importância dos serviços de assistência odontológica prestada pela Faculdade de Odontologia da Universidade de São Paulo reflete nos dados obtidos do Anuário Estatístico da Universidade de São Paulo. Somente na disciplina de Cirurgia, foram realizados 1075 atendimentos cirúrgicos, no ano de 2000 saltando para 5686 em 2007. A cada paciente gera-se um prontuário que contém informações de cunho pessoal, da história médica, odontológicas, e de imagens que lhe atribui alto valor legal e de pesquisa. Com a alta procura pelos serviços oferecidos pela faculdade, o número de documentos gerados por paciente cresce proporcionalmente e constata-se que o arquivamento dos prontuários de toda a faculdade é frágil e sujeito à ocorrência de eventos que poderiam danificar o material. A morosidade na busca por dados dos pacientes, a perda de informações, e a dificuldade em realizar estudos epidemiológicos levaram à motivação para o desenvolvimento e avaliação de um prontuário virtual e seu respectivo Banco de Dados da disciplina de Cirurgia da Faculdade de Odontologia da Universidade de São Paulo. Um modelo de ficha para transcrição eletrônica, com os mesmos itens da ficha clínico-cirúrgica, foi elaborado e utilizado para a transcrição das informações dos pacientes atendidos no ambulatório de Cirurgia, no curso noturno, no ano de 2008. Um protótipo de prontuário virtual foi desenvolvido e os dados coletados de 417 pacientes foram inseridos e armazenados localmente num Banco de Dados desenvolvido para WEB, visando uma nova forma de acesso à informação. A partir dos testes de uso retrospectivo e prospectivo, concluímos que o protótipo do prontuário virtual representa uma importante ferramenta baseada em tecnologias de informação, de uso epidemiológico, de pesquisa e de avaliação dos requisitos necessários para o desenvolvimento de um prontuário virtual com mais robustez e flexibilidade.The importance of the dental aid services offered by the School of Dentistry of the University of São Paulo reflects on the data from the Statistical Yearbook of the University of São Paulo. In the discipline of Oral Surgery by itself, 1075 surgical appointments were done in 2000, which has increased greatly to 5686 in 2007. To every new patient admitted by the service, a record file is created and contains personal information, health and dental history, and images, thus setting a high legal and research value on the patient record file for the institution. With the high demand for these dental services, the number of documents by patient proportionally augments and it can be seen in the entire institution fragility of the files archiving and risk of events occurrence that could damage the material. The slowness of retrieving patient data, lack of information, and difficulties motivate the development and evaluation of an electronic health record and its respective database in the discipline of Oral Surgery of the School of Dentistry of the University of São Paulo. A sheet form for electronic transcription, with the same content of the surgical-clinical questionnaire form, was elaborated to transcript the health information of the patients admitted at the Oral Surgery Service, in the nocturnal graduation course during 2008. A prototype of an electronic health record was created and the collected data were processed and stored in a web-based local database, aiming to an innovative access mode to information. By the tests of retrospective and prospective use of the electronic health record, we concluded the prototype of the electronic health record represents an important tool based in technologies of information, useful to epidemiology, research and evaluation of required features to development of an electronic health record more robust and flexible.
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"Medical intelligent teaching system: history taking." Chinese University of Hong Kong, 1992. http://library.cuhk.edu.hk/record=b5886974.
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Cheng Po Chu.Thesis (M.Sc.)--Chinese University of Hong Kong, 1992.
Includes bibliographical references.
ABSTRACT --- p.1
Chapters
Chapter I. --- BACKGROUND --- p.2
Chapter II. --- OVERVIEW OF HISTORY-TAKING EXPERT SYSTEMS --- p.3
Chapter II.1 --- Structure of Diagnostic systems --- p.3
Chapter II.2 --- Present Design --- p.4
Chapter III. --- LOGICAL APPROACH TO HISTORY TAKING --- p.5
Chapter III.1 --- Objectives of Taking a Medical History --- p.5
Chapter III.2 --- Process of History Taking --- p.6
Chapter III.3 --- The Art of Asking Questions --- p.8
Chapter III.4 --- Implementation Problems --- p.9
Chapter III.4.1 --- Question of Users --- p.9
Chapter III.4.2 --- Question of the End Point --- p.10
Chapter III.4.3 --- Analysis Problems --- p.10
Chapter IV. --- DESIGN OF THE SYSTEM --- p.11
Chapter IV.1 --- DATA REPRESENTATION --- p.11
Chapter IV.1.1 --- Diagnosis --- p.11
Chapter IV.1.2 --- Symptoms --- p.12
Chapter IV.1.3 --- Patient History --- p.14
Chapter IV.2 --- KNOWLEDGE --- p.15
Chapter IV.3 --- INFERENCE ENGINE --- p.19
Chapter IV.4 --- TEACHING MECHANISM --- p.24
Chapter IV.4.1 --- Diagnostic Module --- p.24
Chapter IV.4.2 --- Teaching Module: --- p.24
Chapter V. --- STATISTICAL STUDY --- p.26
Chapter VI. --- SAMPLE RUNNING OF THE PROGRAM: --- p.27
Chapter VI.l. --- DIAGNOSTIC MODULE --- p.28
Chapter VI.1.1 --- "Demographic Data, Chief Complaint and History of Present Illness" --- p.28
Chapter VI.1.2 --- Related Symptoms --- p.30
Chapter VI.1.3 --- Symptom Descriptors --- p.30
Chapter VI.1.4 --- Deduction and Ask Cycle --- p.30
Chapter VI.1.5. --- Summary --- p.31
Chapter VI.1.6 --- Record in casebook --- p.32
Chapter VI.2 --- THE TUTORING MODULE --- p.32
Chapter VI.2.1 --- Demographic Data and Chief Complaint --- p.32
Chapter VI.2.2 --- Advises and History of Present Illness --- p.33
Chapter VI.2.2.1 --- Advises --- p.33
Chapter VI.2.2.2 --- Summary --- p.34
Chapter VI.2.2.3 --- History of Present Illness --- p.34
Chapter VI.2.2.4 --- Advises again --- p.35
Chapter VI.2.2.5 --- History of Present Illness again --- p.36
Chapter VI.2.2.6 --- Advises again --- p.36
Chapter VI.2.2.7 --- Summary again --- p.37
Chapter VI.2.2.8 --- History of Present Illness again --- p.37
Chapter VI.2.2.9 --- Offer of advice and Summary again --- p.38
Chapter VI.2.3 --- Termination --- p.38
Chapter VI.3 --- RETRIEVING CASES AND SUMMARIZING --- p.39
Chapter VII. --- PERFORMANCE OF THE SYSTEM --- p.43
Chapter VIII. --- FURTHER DEVELOPMENT --- p.44
CONCLUSION --- p.46
REFERENCES: --- p.46
ACKNOWLEDGMENT: --- p.46
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Campos, João Pedro Oliveira. "A new mobile application for medical history taking by medical students." Master's thesis, 2015. https://repositorio-aberto.up.pt/handle/10216/89025.
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Campos, João Pedro Oliveira. "A new mobile application for medical history taking by medical students." Dissertação, 2015. https://repositorio-aberto.up.pt/handle/10216/89025.
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Lindahl, Michaela G. "Development of an integrated patient history intake tool : a Delphi study." Thesis, 2003. http://hdl.handle.net/1957/31580.
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Objective--Identify patient history intake questions common to four fields of
medicine - allopathic, naturopathic, chiropractic and Traditional Chinese Medicine to
be included in an Integrated Patient History Intake Tool.
Background--The use of complementary and alternative medicine (CAM) is on the
rise in the United States. 80% of those who used CAM therapies in 1990 did so in
conjunction with allopathic medicine, and 70% of those who used CAM therapies did
not tell their conventional practitioner. Lack of awareness of patients' use of CAM
therapies may hinder practitioners' ability to provide adequate healthcare.
Methods--A three-round modified Delphi technique was utilized to generate
consensus among 106 Oregon health care practitioners on the importance of specific
patient history intake questions. A panel of faculty members from Oregon Health and
Sciences University, the National College of Naturopathic Medicine, the Oregon
College of Oriental Medicine, and Western States Chiropractic College identified 321
patient history intake questions, which then were distributed to the Oregon healthcare
practitioners. The healthcare practitioners were asked to rate the importance of each
question through a series of two surveys over the period of eleven weeks. Suggestions
for additional intake questions also were invited.
Results--The Delphi process narrowed the 321 initial questions plus 150 additional
suggested questions down to a list of 52 intake questions to be included in the
Integrated Patient History Intake Tool. There was an overall response rate of 47% with
a 64% response rate to SURVEY I, and a 74% response rate for SURVEY II.
Discussion--The patient history intake questions have been identified for use in an
Integrated Patient History Intake tool. This Delphi study illustrated the differences that
are held unique for each paradigm of medicine. Determining unique characteristics of
complementary and alternative medicine from allopathic medicine is an important
aspect of building collaboration among allopathic and CAM providers within the state
of Oregon. The proposed model of an integrated patient history intake form provides a
platform from which to build further cooperation and awareness.Graduation date: 2003
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Wood, James Hunter. "Interventional narratology form and function of the narrative medical write-up /." Diss., 2005. http://etd.library.vanderbilt.edu/ETD-db/available/etd-01282005-100236/.
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Sibanyoni, Nhlanhla Andrew. "Activity analysis of health record systems : a case of a district hospital." 2008. http://encore.tut.ac.za/iii/cpro/DigitalItemViewPage.external?sp=1000420.
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Thesis (MTech. degree in Business Information Systems.)--Tshwane University of Technology, 2008.This study is about exploring and understanding the collective work activity involved in medical record keeping for patients within a district hospital. The unit of analysis was the activity of medical record keeping as a system.
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Hough, Philip. "Validation of the Afrikaans versions of the Roland Morris Disability Questionnaire and the Oswestry Disability Index." Thesis, 2011. http://hdl.handle.net/10210/3730.
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M.Tech.Objective: Translation and validation of the Afrikaans version of the Roland Morris Disability Questionnaire and the Oswestry Disability Index. Methods: The English questionnaires were translated into Afrikaans. The translations were then scrutinized by a focus group in order to determine its face validity. After face validity was established, the content validity was determined by two subject experts. Both the original and the translated versions of the questionnaires were given to a study group to complete on two separate occasions. The results from the study group were then put through various psychometric evaluations in order to determine its concurrent validity and reliability. Results: Results indicated that the Oswestry Disability Index had a significant level of reliability (α=0.830) and although the reliability of the Roland Morris Disability Questionnaire was below a significant level (α<0.7) it was still deemed reliable as it corresponded with its English counterpart. Both the Roland Morris Disability Questionnaire and Oswestry Disability Index indicated significant levels of concurrent validity; however the Roland Morris Disability Questionnaire seemed to have a higher level of concurrent validity. Conclusion: Both the Roland Morris Disability Questionnaire and the Oswestry Disability Index were translated successfully and can now be used within the Afrikaans population as an alternative to the English versions. Low back pain is a very common medical problem with a great impact on a patient’s health and quality of life. According to a review conducted by Papageorgiou et al. (1995), 60-80% of the general world population will suffer from low back pain in some stage of their life. In South Africa, De Wet, Losco and Moodley (2003) conducted a study on the incidence and prevalence of low back pain on 355 ABSA Bank and Unibank employees. The results of the study showed that the lifetime incidence of low back pain was 63%, the 6 month prevalence of LBP was 41% and the point prevalence of LBP was 9.6%. Treatment was sought by 46.94% of the sample population primarily from pharmacies, chiropractors, medical doctors, and physiotherapists. In addition, the study also showed that this condition is costing the South African economy millions each year due to lost working days as a result of absenteeism. As a result, disability questionnaires are increasingly used for clinical assessment, outcome measurement of treatment of low back pain. However, the use in different cultural groups has led to the need for the translation and the cross-cultural adaptation of these questionnaires to aid practitioners in the accurate assessment of low back pain.
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Matlala, Benga Sidwell. "Non-divulgence of patients who use traditional medicine in the critical care units of a West Rand Mine Hospital." Thesis, 2014. http://hdl.handle.net/10210/9979.
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M.Cur.(Medical & Surgical Nursing: Critical Care General)The majority of Africans use traditional medicine, but do not divulge this information to the nurses and doctors when admitted to critical care units. For this reason, patients develop complications, and these makes it difficult for nurses and medical doctors in critical care units to assess and to provide comprehensive quality care, as they treat only the visible clinical manifestations. The purpose of this study was to explore and describe the factors leading to non- divulgence by patients who used traditional medicines in critical care units of a Westrand mine hospital, in order to describe strategies to facilitate divulgence. The researcher used a qualitative, exploratory, descriptive and contextual research design. The population was composed of the patients who were envisaged to have used traditional medicines in the critical care unit of a Westrand mine hospital. Twelve participants were purposively selected from the critical care unit register because these patients displayed the symptoms of having used traditional medicine. Semi-structured individual interviews were conducted. Ethical principles were adhered to. Trustworthiness was ensured by using namely; credibility, transferability, dependability and confirmability. A qualitative open coding method of data analysis was used according to Tesch’s protocol. The following theme and subthemes emerged from the data analysis: Fear and anxiety as the main theme. Subthemes were 1. Fear to divulge secrets. 2. Fear of negative attitudes from nurses and 3. Fear to lose rights, norms and values. It is recommended that the strategies described be used in clinical practice, nursing education and for further research regarding divulgence of the use of traditional medicine to the nurses and doctors, in order to provide a comprehensive assessment and treatment of the patients in critical care units.
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Cele, Reginah Jabulisile. "Assessment of the use of the new maternity case record in improving the quality of ante-natal care in eThekwini District, KwaZulu-Natal." Thesis, 2015. http://hdl.handle.net/10321/1253.
Full textAbstract:
Submitted in fulfillment of the requirements for the Degree of Master of Technology in Nursing, Durban University of Technology, 2014.Brief background to the study The national guidelines for maternity care in South Africa recommend that a standardised maternity case record be used by all facilities at all levels of care in order to improve the quality of care for pregnant women. According to the National Department of Health, this will facilitate continuity and quality of care for women during pregnancy, labour and post-partum. Aim of the study The aim of the study was to assess whether the implementation of the new maternity case record has improved the quality of care for pregnant women. Methodology An exploratory, descriptive study using both quantitative and qualitative design was used to conduct the study. Data was collected through a retrospective record review using a checklist for the quantitative strand, and from midwives using unstructured interviews for the qualitative strand. The quantitative data set was analysed using the Statistical Package for the Social Sciences version 21.0 and the qualitative strand was analysed using the Tesch’s method of data analysis. Results The results of the record review revealed that although the recording was done fairly well, there were a number of activities and interventions that were recorded poorly or not recorded at all in some primary health care clinic. The midwives verbalised that many mistakes and mismanagement of ante-natal care clients emanated from the structure and the design of the new maternity case record. Recommendations Recommendations include the following: communication of policies and protocols to the midwives should be done timeously, provision of in-service education and/or updates on new developments, strengthening of supportive supervision, the Nursing colleges be kept up-to-date with new developments in nursing practice and that a broader study involving other districts and provinces be conducted.
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Fisher, Mark J. "A brief intervention to improve emotion-focused communication between newly licensed pediatric nurses and parents." Thesis, 2014. http://hdl.handle.net/1805/3811.
Full textAbstract:
Indiana University-Purdue University Indianapolis (IUPUI)Parents have increasingly participated in their children’s bedside care. Parental participation has led to more provider-parent interactions and communication during such stressful events. Helping parents through such stressful events requires nurses to be skilled communicators. Brief methods of training emotion-focused communication with newly licensed nurses are needed, but as yet are rare. The purpose of this study was to evaluate the impact of a validated brief communication (Four Habits Model) training program for newly licensed pediatric nurses. The intervention focused on ways to improve nurses’ emotion-focused conversations with parents. Information processing and Benner’s novice to expert informed this study. The intervention is based on the four habits model, with “habits” providing a structure for nurses to organize their thinking and behavior during emotion-focused conversations with parents. Thirty-five pediatric nurses with 0–24 months of nursing experience at a large mid-western children’s hospital participated in the study. Mixed methods provided data for this experimental study, using a group-by-trials repeated measures ANOVA design. Participants randomized to the intervention group participated in a one-hour three-part training: adapted four habits model content, simulated nurse-parent communication activity, and debrief. Participants randomized to the control group observed a one-hour travel video. Key outcome variables were Preparation, Communication Skills, Relationships, Confidence, Anxiety, and Total Preparation. Compared with the controls, the intervention group improved significantly in the following areas: Preparation, F(1,33) = 28.833, p < .001; Communication Skills, F(1,33) = 9.726, p = .004; Relationships, F(1,33) = 8.337, p = .007; Confidence, F(1,33) = 36.097, p < .001; and Total Preparation, F(1,33) = 47.610, p < .001. Nurses’ experience level had no effect, with the exception of Anxiety. Nurses with more experience (≥ 12 m) showed a greater reduction in Anxiety, when compared to nurses with less experience (< 12 m), F(1,31) = 5.733, p = .023. Fifty-two percent of the nurses involved in the intervention later reported specific examples of implementing the four habits when working with parents in clinical settings. A one-hour four habits communication-training program is effective in improving newly licensed nurses’ preparation for emotion-focused conversations with parents.