ABSTRACT
BACKGROUND: Establishing effective communication between doctor and patient help doctors treat their patients easily and influence patient's compliance with medical regimen and treatment outcome. The objective of this study was to evaluate common characteristic of third-year medical student's behavior in their patient interview and apply these results to medical education of communication. METHODS: Ninety-one third-year medical students in Hanyang University College of Medicine through their clerkship in family medicine had been instructed to perform medical interviews of patients who visited the Department of Family Medicine of Hanyang University Hospital. Video-taped records of the interviews using CCTV were done. The evaluation was done with a rating scale table consisting of 20 items. The rating scale was categorized in to 5 areas: beginning the interviews, collection of information, doctor-patient relationship, structure of interview and ending the interview. RESULTS: Among the 62 students who were enrolled in the study, 55 students were males(84%). In the process of collecting information 33 students(53%) applied open-ended question at least once. Eighteen students(29%) used leading question. In the doctor-patient relationship, 3 students gave empathic verbal response among 58 records which were applicable. In the structure of interview, 25 students(40%) appropriately avoided to shift abruptly the focus of discussion. When ending their interviews, 6 students(10%) clarified the interview in whole. CONCLUSIONS: We conclude that there are several deficiencies in medical students' communication skills during their process of interviews that might influence information gathering and doctor-patient relation ship.
Subject(s)
Humans , Compliance , Education, Medical , Physician-Patient Relations , Ships , Students, Medical , Treatment OutcomeABSTRACT
BACKGROUND: It is important for the health care provider, particularly primary care physicians as gatekeepers of health care, to understand the social interests and needs toward health care. This study was done to find ways to deal with public opinion by analyzing the contributions of health care in the newspapers. METHODS: Two hundred twenty four contributions about health care were sorted out in the three national newspapers during one calendar year from January to December, 1996. These contributions were coded by themes and subjects according the content analysis and qualitative text interpretation. RESULTS: The contributions were classified into three categories, medical insurance, and hospital services, and health care policies. Forty four contributions of medical insurance category were coded into 5 themes and 18 subject. Fifty eight contributions of hospital services category were coded into 3 themes and 31 subjects. One hundred twenty two contributions of medical insurance category were coded into 8 themes and 32 subjects. The themes and subjects were listed and findings were described qualitatively. The characteristics of public opinions about health care were diversity, conflicting interests, plentifulness of complaints and discontent, and finally, infrequency of alternative proposals for problem solving. How to deal with public opinions were discussed. CONCLUSIONS: We can recognize the public attitude of health care and complaints of patients and consumers of health care by analyzing the contributions in the newspapers. These data can be used to develop ways of primary care physicians to deal with patients' needs.
Subject(s)
Humans , Delivery of Health Care , Health Personnel , Insurance , Periodical , Patient Education as Topic , Physicians, Primary Care , Problem Solving , Public OpinionABSTRACT
In order to evaluate the clinical usefulness of maternal serum C-reactive protein measurement in early detection of infectious morbidity at term laboring women, serum C-reactive protein levels were measured in 521 healthy pregnant women : 64 who were not in labor before term, 55 who were in labor before term, 71 who were not in labor at term and 331 who were in labor at term. The frequencies of elevated serum C-reactive protein level were compared in relation to the gestational weeks, the presence or absence of labor, the status of amniotic membranes and the degree of cervical dilation. The obtained results were as follows. 1. The frequencies of women with elevated serum C-reactive protein, 0.8 mg/dl or higher and 2.9 mg/dl or higher, in 521 health pregnant women were, 12 % and 4 %, respectively. 2. C-reactive pretein levels of 0.8 mg/dl or higher were more frequent in the group of women in labor than those not in labor(5. 93 %, vs, 13.73 %, p<0.05), but the frequencies of C-reactive protein level of 2.0 mg/dl or higher were not statistically different between both groups. The frequencies of C-reactive protein level of 0.8 mg/dl or higher and 2.0 mg/dl or higher were not statistically different between the groups before term and at term, intact and ruptured membranes, latent phase and active phase of labor, respectively. 3. Before term, C-reactive protein levels of 0.8 mg/dl or higher and 2.0 mg/dl or higher were more frequent in the group of women in labor than those not in labor(23.64 vs. 4.69, p<0.001 and 12.73% vs. 3.13%, p<0.05, respectively), but those statistical differences were not seen between both group at term. Above results and review of literature suggest that serum C-reactive protein level of 2.0 mg/dl or higher may be reliable in early detection of infectious morbidity at term laboring women as well as laboring women before term, and the presence of subclinical infection should be suspected in the laboring women before term with serum C-reactive protein level of 0.8 mg/dl or higher.