ABSTRACT
To determine whether patient expectations are fulfilled when they are expressed to physicians, self-administrated questionnaires were given to 360 consecutive ambulatory patients. Information was randomly given or not given to physicians. Diagnosis (94%), information about prognosis (82%) and prevention (76%), and continuing care (80%) were important expectations. There was no agreement between global or individual patient expectation and physician response (kappa < or = 0.3). The physicians prescribed more medications than expected, and almost never discussed prevention or prognosis. Finally, the characteristics of care were not different between the physicians who knew and those who did not know patient expectations. The authors conclude that ambulatory patients visit physicians to receive a diagnosis, continuing care, and information about prognosis and prevention. In this study, physician knowledge of those expectations did not increase their fulfillment.
Subject(s)
Patient Satisfaction , Physician-Patient Relations , Adult , Data Collection , Female , Humans , Male , Middle Aged , Outpatient Clinics, Hospital , Practice Patterns, Physicians' , Surveys and Questionnaires , SwitzerlandABSTRACT
To describe the determinants of patient satisfaction with medical care, self-administered questionnaires were given to a consecutive sample of 237 patients coming to an ambulatory care practice for the treatment of upper respiratory infections (URIs). Patients' most important goal was to obtain a diagnosis (57%). They usually got more reassurance, medication, and personal interest than they had expected (p = 0.0001). In a multivariate model, patients' satisfaction was related to the degrees of personal interest and reassurance they had received and to whether they felt they had received the right medication (r2 = 0.45, p = 0.0001). The authors concluded that patients with URIs generally want a diagnosis but are primarily satisfied by the personal interest, the reassurance, and the medication they receive.
Subject(s)
Ambulatory Care/standards , Patient Satisfaction , Quality of Health Care , Respiratory Tract Infections/therapy , Adolescent , Adult , Aged , Ambulatory Care/psychology , California , Female , Humans , Male , Middle Aged , Physician-Patient Relations , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/psychology , Surveys and QuestionnairesABSTRACT
In order to develop a model of thyroid hormone action, we studied the effect of small doses of T3 and T4 on the development of the hypothyroid neonatal cerebellum of rat pubs. Using granulosa cell death at postnatal d15 (picnotic index) as a criterion of hypothyroidism, it was found that a single injection of 50 ng T3/10g bw or 180 ng T4/10 g bw would reduce the picnotic index to levels found in euthyroid rat cerebelli. We further tested if rT3, known to be an excellent blocker of deiodinase type 2 activity, would be able to block the effects of T4. 20 micrograms rT3/10g bw had to be given to be an effective inhibitor in vivo. This dose did not affect the potency of T4 and control experiments with rT3 alone indicated that rT3 was capable of reducing the picnotic index to euthyroid levels. It is speculated that rT3 might act at the nuclear receptor but also at the cell membrane.
