Journal of general internal medicine
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To determine initial patient acceptance of a cardiopulmonary resuscitation/do-not-resuscitate orders (CPR/DNR) information sheet intended to facilitate early discussion of CPR preferences. ⋯ Written information about CPR options was perceived as helpful and acceptable to most patients surveyed. Since a few patients initially reported feeling worse after reading the CPR/DNR information sheet, written information should not be used alone but may facilitate initial communication and discussion.
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Comparative Study
Home blood glucose monitoring: effectiveness in a general population of patients who have non-insulin-dependent diabetes mellitus.
To determine whether home blood glucose monitoring as used by non-insulin-dependent diabetes mellitus patients followed in primary care nonresearch clinics improves glycemic control or reduces utilization of the outpatient laboratory. ⋯ For non-insulin-dependent diabetic patients followed in a nonresearch clinic setting, the benefits of home blood glucose monitoring remain to be proven.
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To identify patient, institutional, and physician characteristics that predict failure to attend scheduled mammography appointments. ⋯ Interventions to improve completion of breast cancer screening should include additional efforts targeted at groups with high rates of appointment failure, such as women under the age of 60, the uninsured, and Native Americans. Long waiting intervals to obtain mammography appointments may decrease compliance.
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To assess the attitudes of internal medicine housestaff and their attending physicians regarding the impact of the reduction in on-call working hours and increased supervision mandated in New York by a revision of the State Health Code (Section 405). ⋯ Housestaff had more positive attitudes about the impact of the mandated changes in working conditions for residents than did attending physicians in the same institutions. The major benefits seen by residents were less fatigue and more spare time. There was no consensus about whether these changes had a positive impact on internal medicine practice and clinical supervision. There was some concern that a shift-work mentality is developing among residents and that continuity of patient care has suffered. Thus, despite some substantial benefits, Section 405 may not be achieving its goals of improving resident supervision and the quality of patient care by houseofficers.