The Journal of the American Board of Family Practice / American Board of Family Practice
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J Am Board Fam Pract · Jan 2000
Comparative StudyAdolescent preventive health visits: a comparison of two invitation protocols.
Adolescent health care in family practice at times creates conflicting responsibilities for parents and their teenagers. In the context of a new adolescent preventive health program in a family practice setting, we compared attendance rates using two invitation protocols, the protocols differing in their emphasis on adolescent autonomy vs parental responsibility. ⋯ Nearly one half of this population of adolescents attended preventive health visits at the family nurse's and physician's initiative. A follow-up telephone call after the initial written invitation resulted in increased participation, while approaching the teenager or parent initially did not make a difference in attendance. This pilot study shows the potential for initiating an adolescent health program in the family practice setting.
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Approximately 10% of the US population has some degree of hearing loss, and 2 million Americans are deaf. Most medical school curricula and major textbooks characterize deafness as pathologic condition only, which is at odds with the movement to understand the Deaf population as a minority group with a unique language and cultural tradition. Physicians might therefore be unprepared to meet the needs of deaf patients effectively and sensitively. This study seeks to understand the health care experiences of elderly Deaf adults in Richmond, Va. ⋯ The authors suggest a possible explanation for this perspective, and make specific recommendations for three levels of competency in caring for deaf patients. When the provider and the office staff provide methods to communicate with deaf patients using telephone-assisted communication, qualified interpreters, and some basic knowledge of lipreading or sign language, the care of deaf patients is greatly enhanced and the physician-patient relationship improved.
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J Am Board Fam Pract · Sep 1999
Family practice patients' attitudes toward firearm safety as a preventive medicine issue: a HARNET Study. Harrisburg Area Research Network.
Firearm-related deaths are expected to outnumber motor-vehicle-related deaths within the next 5 years. The goal of this project was to document gun ownership and safety habits among patients of family physicians and to determine patients' attitudes toward physician counseling about firearm safety. ⋯ With regard to firearm safety, family physicians lack credibility in the eyes of their patients. These patients do not appear to be receptive to information about firearm safety, and efforts to decrease firearm-related injury might be more effective if focused elsewhere.
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J Am Board Fam Pract · Jul 1999
Using opioid analgesics to manage chronic noncancer pain in primary care.
Opioid analgesics have been considered the drugs of choice for the treatment of moderate to severe cancer and postoperative pain. Cultural attitudes and concerns about abuse have inhibited their use for a larger population of patients who have chronic noncancer pain. ⋯ The World Health Organization has published a "three-step ladder" guide to treatment of cancer pain graded from mild to severe; this guide can be readily applied to the treatment of pain from all sources. Opioid analgesics are the mainstay of treatment for moderate to severe pain. Chronic pain patients offer some difficult challenges for busy primary care physicians. The unique pharmacologic characteristics of opioid medications are important in outpatient management. A four-sheet office management protocol helps to focus efficiently on important clinical issues related to pain control, to monitor for opiate abuse, and to incorporate pain management more effectively in the overall primary care plan of the patient.