An evaluation of the effects of Tai Chi exercise on physical function among older persons: a randomized contolled trial.

This study was designed to determine whether a 6-month Tai Chi exercise program can improve self-reported physical functioning limitations among healthy, physically inactive older individuals. Ninety-four community residents ages 65 to 96 (Mage = 72.8 years, SD = 5.1) volunteered to participate in the study. Participants were randomly assigned to either a 6-month experimental (Tai Chi) group (n = 49), which exercised twice per week for 60 min, or a wait-list control group (n = 45). A 6-item self-report physical functioning scale, assessing the extent of behavioral dysfunction caused by health problems, was used to evaluate change in physical functioning limitations as a result of Tai Chi intervention. Results indicated that compared to the control group, participants in the Tai Chi group experienced significant improvements in all aspects of physical functioning over the course of the 6-month intervention. Overall, the experimental group had 65% improvement across all 6 functional status measures ranging from daily activities such as walking and lifting to moderate-vigorous activities such as running. It was concluded that the 6-month Tai Chi exercise program was effective for improving functional status in healthy, physically inactive older adults. A self-paced and self-controlled activity such as Tai Chi has thepotential to be an effective, low-cost means of improving functional status in older persons.

Communication between surgeons and patients in routine office visits.

BACKGROUND: Research conducted in primary care settings has demonstrated that effective communication enhances patient recall of information, compliance, satisfaction, psychologic well-being, and biomedical outcomes. However, surgeons face communication challenges that are unique to the surgical situation. This study provides the first description of routine communication between community-practicing surgeons and their patients. METHODS: Audiotapes of 676 routine office visits with 29 general surgeons and 37 orthopedic surgeons were coded for structure and content. Descriptive analysis of quantitative data is supplemented by illustrative examples of dialog selected to represent typical patterns of communication. RESULTS: The mean visit length was 13 minutes. Surgeons talked more than patients, with typical surgical consultations containing relatively high amounts of patient education and counseling. Consultations had a narrow biomedical focus with little discussion of the psychologic aspects of patient problems. The affective tone of visits was generally positive, with few instances of overt criticism or disagreement by either party. However, surgeons infrequently expressed empathy toward patients, and social conversation was brief. CONCLUSIONS: The study underscores the differences in both the content and process of routine surgical visits compared with primary care visits. On the basis of this work, it seems particularly important for surgeons to develop skills that enhance patient education and counseling. Further research is needed to understand the influences of surgeons' communication on patient behavioral, psychologic, and biomedical outcomes.

Recruiting physicians for office-based research.

OBJECTIVES: Research conducted in community outpatient offices can provide insight into the common experiences of patients and physicians. However, recruiting physicians to participate in office-based research is challenging and few descriptions of methods that have been used to successfully recruit random samples of physicians are available. This article describes recruitment strategies utilized in a project that achieved high rates of participation from community-based primary care physicians and surgeons. METHODS: Recruitment methods included the use of advisory boards to identify potential barriers to participation, use of respected members of the medical community as recruiters, and obtaining endorsements from physician organizations and prominent members of the medical community. RESULTS: Overall, 81% of physicians contacted from a sample frame agreed to participate in the project. Participating physicians most frequently reported that they participated because the project could provide them with feedback about their interviewing style. CONCLUSIONS: The recruitment methods described here can be generalized to other types of investigations.