Medical care
-
Physician and practice characterisitics were reviewed in relation to the quality of the doctor-patient relationship in primary medical care. This relationship was defined in terms of communication between physicians and patients, patient satisfaction with care, and physician awareness of patient concerns. The study subjects were mothers of infants and pregnant women, identified from the offices of a random sample of primary care physicians is a single community. ⋯ Mothers of infants were more highly satisfied with care provided by residency-trained physicians; pregnant women were more satisfied with non-Board certified physicians. Physician awareness of patient concerns presented a mixed pattern of associations with several physicians and practice characteristics. These findings suggest that physician credentials are not consistently associated with the three identified dimensions of the doctor-patient relationship.
-
Randomized Controlled Trial Clinical Trial
Evaluation of a cardiopulmonary resuscitation course for secondary schools.
The objective of this study was to test the feasibility of teaching secondary school students to perform cardiopulmonary resuscitation (CPR) according to National Research Council (NRC)--American Heart Association (AHA) standards. Criterion levels specified by AHA call for cardiac compression at a rate of 60 times a minute with two ventilations interposed after 15 cardiac compressions. Translated into numerical performance per minute, this standard equates to 36 compressions and six ventilations per minute. ⋯ Retention figures compare favorably with studies in the area of psychomotor learning. The study suggests that it is possible to train secondary school students to perform the ABC's of CPR if they have an opportunity to practice these skills. The study also suggests that the teacher training is an important factor.
-
This study of patient and bystander responses to medical emergencies revealed serious shortcomings in the public's ability to respond appropriately to such situations. Decision delays at least as long as ambulance response delays were found to be the result of confusion regarding the seriousness of the emergency, confusion regarding the appropriate reaction to the emergency, and a reluctance to burden the rescue service unnecessarily. A significant group of high-risk patients were identified who not only reacted slowly but who bypassed the emergency ambulance service entirely. A substantial fraction of these patients have had prior contact with the local medical care system for problems related or identical to the one causing the emergency.