Primary care outcomes and provider practice styles.

The purpose of this study was to evaluate change in patient outcomes as a function of practice styles of primary care providers. A prospective, repeated-measures, correlational design was used. Data were collected about (1) providers' self-ratings of practice styles, inclusive of practice model, confidence, autonomy, collaboration, information giving, and job satisfaction, and (2) primary care patients' self-ratings of health status, functional status, information seeking, and satisfaction. When severity and comorbidity were controlled, physicians, nurse practitioners, and physician assistants produced equivalent outcomes; neither practice style nor provider type resulted in differences in health outcomes of primary care patients. Practice style did affect patient satisfaction. Patients were least satisfied with providers who scored high on collaboration and most satisfied with providers who scored low on the practice model. Neither provider type nor interpersonal attributes had an effect on health outcomes; sicker patients got better and healthy patients stayed that way.

Provider satisfaction in army primary care clinics.

The job satisfaction of physicians, nurse practitioners, and physician assistants was assessed during the course of a multicenter study of Army primary care clinics. All providers in nine clinics at three medical centers who were engaged in adult or family care were invited to participate in the study. Questionnaires on job satisfaction and other practice style variables were completed by 26 physicians, 19 nurse practitioners, and 13 physician assistants (46, 76, and 41% of eligible providers, respectively). Analysis revealed a broad range of job satisfaction in the sample. However, average levels of job satisfaction were not significantly different across the three groups of primary care providers. Autonomy and collaboration were significant predictors of job satisfaction. It is clear that changes in health care systems that reduce, or appear to reduce, the primary care provider's autonomy in clinical matters are likely to reduce provider satisfaction as well.

Overview of the data collection process.

The data collection plan is a series of well-thought-out strategies to implement the data collection process. The details of the plan are written out on paper. Once the research proposal is approved the data collection plan is implemented. This implementation is the action or doing phase of the study. The aim of this phase is to collect the evidence or data. During implementation, the researcher can experience problems related to people, researcher, institution and events. The data collection process is a time that is very challenging and requires the researcher to use mental and interpersonal skills.

Importance of health and family variables related to quality of life in individuals with uncontrolled seizures.

Approximately 2.5 million Americans are epileptic, and nearly 150,000 new cases are diagnosed in the United States each year. While seizures are the most common physical symptom of epilepsy, treatment must include far more than medical intervention for seizure control. Virtually all aspects of life are affected by the disorder including personal relationships, employment, perception of self and overall quality of life. A literature review indicates that, while progress is being made in identifying variables which impact quality of life, little consensus exists regarding their nature. No two patients are necessarily alike, nor are their methods of dealing with the disorder necessarily the same. Arguments have been posed which state that age of onset is a factor, as is the degree to which seizures can be controlled. This is not to say, however, that effective interventions cannot be developed to assist patients in dealing not only with the physical manifestations of epilepsy but other common related factors as well. The purpose of this study was to identify those variables which impact quality of life for persons with epilepsy, and in light of the findings, to make recommendations for nursing interventions.

Novel antiepileptic drugs: nursing implications.

It has been 14 years since the last AED was placed on the drug market in the United States. This article reviews four novel AEDs that hold promise for treating epilepsy. One drug, felbamate, has recently been released, while the other three are expected to be available within 5 years. Since nurses play a critical role in AED therapy, nursing intervention related to assessment, teaching and emotional support is important in the management of epilepsy.

Impact of epilepsy on quality of life.

Epilepsy is a chronic condition with a profound effect on the quality of life. Health, family life, social, community and civic activities, economics and personal development are the major variables associated with quality of life for the person with epilepsy. In this article, a model describing the relationship between these variables and quality of life is presented. This model organizes a comprehensive nursing approach to the patient with epilepsy. A case study analysis approach is used to help further illustrate interactions among the variables. Nursing interventions based upon analysis of the model are suggested.