ABSTRACT
Individual with so-called mild bleeding disorders (MBD) are being investigated with increasing frequency on an outpatient basis at the Central Hematology Laboratory of the Inselspital, Berne. Following diagnosis of a given disorder the patients are informed orally, and sometimes also in writing, concerning the nature of the disorder, prophylactic and therapeutic measures prior to elective surgery, and the role of certain drugs in promoting hemorrhage. In the present study we attempt to evaluate the quality of these specialized medical services catamnestically. As a first step 67 patients with well defined bleeding disorders, and who had had no further contact with this institution since the investigation, were invited for interview. The interviewer was unknown to the patients and the patients participating in the study remained anonymous. A total of 47 patients came for interview. The goal of the enquiry was to find out how far the advice given by the physicians of our laboratory had been actually taken, or what were the possible grounds for ignoring it. Since MBD causes few symptoms in everyday life and complications may arise only as a consequence of surgery, there were particular problems in properly informing patients and thereby motivating them to act on medical advice. On the basis of the criteria selected, two thirds of patients showed adequate, and one third inadequate, compliance. Compliant patients correlated significantly with understanding of diagnosis, carrying brief written information with them for emergencies, coping with disease in general, poor perception of their own body, a "positive memory for medical advice", and their position within the family.(ABSTRACT TRUNCATED AT 250 WORDS)
