[Identification of non-compliant hypertensive patients]. / Identificering af nonkompliante patienter med hypertension.

INTRODUCTION: The purpose was to contribute to the development of a validated instrument for identification of patients with poor compliance in the use of hypertension medicine in primary health care. MATERIAL AND METHODS: The analysis included questionnaire data from 1,421 hypertensive patients, data from the Danish register "Patient Medical Profile" (PEM, n = 182) and electronic medicine containers (MEMS, n = 33). The analysis included preliminary scale validation resulting in five scales. The scales were used in a subsequent multivariate regression analysis which involved a total of 29 variables. The key variables were established via the correlations between variables in the graphic model and included in the instrument. RESULTS: The scale "Unintentional non-compliance" (concerning the patient's self-assessed tendency to forget to take the medicine) is central in the graphic network in terms of its relation to the scales "Intentional non-compliance" (when patients opt not to follow the prescriptions) and "Medical concern" (concerns related to medicine intake). "Unintentional non-compliance", moreover, correlates with PEM. The item concerning the patient's systolic blood pressure proved to be crucial because of its correlation with both PEM and MEMS. The scales "Medical concern" and "Intentional non-compliance" are, moreover, assessed to measure different dimensions of compliance. CONCLUSION: A group of items has been developed and validated. Collectively they can identify hypertensive patients with poor compliance in primary health care.

[Is it time to reevaluate the entrance requirements for medical studies?]. / Tid for revurdering af adgangskravene til laegestudiet?

INTRODUCTION: Since 1960, the number of female medical students has risen and now amounts to about 60% of the total. During this period, the entrance requirements for medical studies have been changed, meaning that it is average A-level marks that qualify students for studying medicine (Quota 1 students). Some students whose A-level marks are unsatisfactory can be admitted anyhow, if they have had occupational experience (Quota 2 students). The aim of this article is to present some of the conditions that are of importance to the students' rate of finishing their medical studies. MATERIALS AND METHODS: From 1992 to 2002, four questionnaires were given to a cohort of medical students admitted to the university in summer 1992. The first questionnaire, the data from which are used in this article, was answered by 252 students (79%). Information about the graduation status of this group was extracted from the university database. RESULTS: The results showed that 49% of the 252 students were Quota 2 students and that these were on average somewhat older at time of admittance (22.3 years) than were Quota 1 students (20.3 years). More women (53%) than men were Quota 1 students. There was no difference between Quota 1 and 2 students as regarded the time spent on their studies and the percentage who graduated. Male students were significantly more successful in finishing their studies (75%) than were female students (61%). Furthermore, there was a majority of upper-class students, and these students, like the students with a background in natural science and those whose father had a university degree, had a high completion rate. CONCLUSION: The study does not show that there is a basis for abolishing the Quota 2 arrangement. Even if the differences are minor, it might lead to a reduction in the number of male students. Seen from the point of view of gender equality, that would not be desirable. The fact that so many students, particularly the female students, do not finish their studies should be further examined.

[The newly graduated doctor.Is he or she sufficiently prepared to fulfill a doctor's responsibilities?]. / Den nyuddannede laege. Er denne tilstraekkelig godt "klaedt på" til laegegerningen?

INTRODUCTION: The goal of this study was to illuminate how a group of newly graduated medical doctors experienced their knowledge and resources in their work shortly after they had graduated. MATERIALS AND METHODS: We performed a prospective study of the students who started medical school in 1992. 252 students (79%) answered questionnaire 1, which was sent to them at the beginning of medical school in 1992. Questionnaire 4 was sent to the students at their graduation in 2002, and 57% answered. 80% (n = 143) of those who had graduated answered questionnaire 4. 111 of those who had graduated had been practising medicine for more than 1 year and were included in the study. RESULTS: 72% of the medical doctors stated that the theoretical part of medical school had given them a solid foundation for clinical work but too little direction toward clinical work. They did not feel that they had developed a good foundation for collaborating with other professionals, did not have good role models or had not received good enough support for personal development. Only 55% felt that it was easy to talk about professional issues. At the start of medical school, many of the students reported having had psychological problems; this percentage fell during the course of medical school but was again high at graduation. 60% of the medical doctors stated that the clinical work had strengthened their self-esteem, but 41% felt that the clinical work had caused them personal problems. The study showed that conditions in the students' private life as well as at the university were important to the results. Women doctors had the most serious problems. CONCLUSION: The medical doctors did not feel that they were well enough equipped for their clinical work. The study points out that it is important to make clinical education better and to give more personal support to the students during their time in medical school. Furthermore, focus is directed at the pattern of the gender roles, where women in particular are having problems.