Archives of family medicine
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We wished to determine whether patient satisfaction was related to physicians' confidence in their abilities to effectively manage low back pain, and to examine their attitudes about patients with back pain. The confidence and attitudes of primary care providers were determined using self-administered questionnaires. Patient satisfaction with care was assessed during telephone interviews conducted 3 weeks after a clinic visit for low back pain. ⋯ However, patients of more confident providers were significantly more satisfied with the information they received than were patients of less confident providers. These differences could not be explained by years in practice, length of visit, patient demographics, or the severity and duration of low back pain. These findings suggest that providers who have more confidence in their abilities to effectively manage low back pain may in fact be more effective patient educators.
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To determine the value of the cerebrospinal fluid examination in the evaluation of hospitalized; elderly patients with delirium and fever. ⋯ Most hospitalized, older patients with fever and delirium have primary causes of the confusion outside the central nervous system and may not require a routine evaluation of their cerebrospinal fluid.
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Medical jargon is commonly used by health-care professionals. The use of such jargon is sometimes criticized as insensitive or callous. Rather than generalize, we identify four basic types of medical jargon and discuss their relevant moral distinctions. ⋯ Physicians should be aware of the ways in which they use medical slang. Jargon can serve useful purposes but its moral status is often dependent on the function it serves and the context in which it is used. Jargon that is clearly derogatory can reflect negatively on the moral character of the medical profession and should be avoided when possible.
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In this review, we condense and summarize the results of studies on the therapeutic use of human albumin to promote the more efficient use of this costly resource. Reports of major controlled and uncontrolled therapeutic trials, reviews, and summary articles published in English between 1972 and 1991 were identified through library and MEDLINE searches. Case series, prospective studies, and blinded therapeutic trials were identified from the bibliographies of these sources. ⋯ Therapeutic albumin has well-defined value in several special circumstances: large-volume paracentesis in cirrhotic patients, acute nephrotic syndromes with diuretic resistance, organ transplantation, and plasmapheresis. Additional studies are needed to compare the efficacy of albumin with other volume expanders. For most purposes, balanced crystalloid solutions are satisfactory substitutes for colloid volume expanders and can be obtained at a fraction of the cost of colloid volume expanders.
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Physical and sexual violence against women is a public health problem that has reached epidemic proportions. An estimated 8 to 12 million women in the United States are at risk of being abused by their current or former intimate partners. This violence causes serious physical, psychological, and social sequelae for these women and their families.