ABSTRACT
We investigated health anxiety and attitudes to doctors and medicine as determinants of use of 'alternative' practitioners and treatments in a sample of 200 general practice attenders. The Health Anxiety Questionnaire and the Attitudes to Doctors and Medicine Scale were used, as well as a schedule of non-medical practitioners and treatments. Half those interviewed had ever used diet supplements, and about a quarter had ever used other nonmedical treatments such as herbal remedies and mega vitamins. 20% has been to a massage therapist, roughly 10% to a faith healer, acupuncturist or chiropractor. Health anxiety scores were unrelated to consultations except that those who had visited a faith healer or had taken dietary supplements were significantly more anxious. On the other hand, positive attitudes to doctors and medicine were positively correlated with almost all measures of use of alternative treatments. Rather than being a rejection of scientific medicine, it suggests that 'alternative' medicine is not distinguished from scientific medicine by Dublin GP attenders.
ABSTRACT
Health anxiety has been hypothesized to lead to a cycle of repeated medical consultations. We investigated the relationship of health anxiety to patients' frequency of general practitioner visits, and to their expectations about the index visit in 200 general practice attenders. Health anxiety scores declined modestly with age, and were similar in men and women. Frequency of visits rose from 2.6 per year in the lowest decile of health anxiety to 4.2 in the highest (p=0.033). Across the same range, the odds of seeking advice prior to visiting the doctor rose from 0.25 to 0.56 (p=0.034), and the odds of believing that a specialist referral would be needed rose from 0.22 to 0.48 (p =0.008). There was no association between health anxiety and previous referral for investigation of symptoms that had not resulted in a medical diagnosis, nor with attitudes to prescriptions, possibly because there was little variation in either. In this population, absolute levels of health anxiety were low. Nevertheless, within this "normal" range, there was an association between level of health anxiety and frequency of visiting, and with expectations for the index visit. The findings support the health anxiety model as predicting use of services by psychologically normal persons.
Subject(s)
Anxiety/psychology , Patient Acceptance of Health Care , Primary Health Care , Referral and Consultation , Adult , Anxiety/diagnosis , Female , Humans , Male , Physician-Patient Relations , Surveys and QuestionnairesABSTRACT
Two siblings manifested a neuro-haematologic syndrome characterised by low birth weight, failure to thrive, chronic persistent tongue ulceration, severe truncal ataxia and pancytopenia without either telangiectasia or chromosomal instability. One sibling died from sepsis and the cerebellum demonstrated reduced cellularity of the molecular and granular layers with relative preservation of Purkinje cells and minimal gliosis. A surviving sibling has shown haematologic progression to a myelodysplastic disorder. There was no evidence of any chromosomal instability following exposure of fibroblasts and lymphocytes to irradiation. Monosomy-7 was not present in the surviving sibling. We suspect that these two patients represent another example of the rare Hoyeraal-Hreidarsson syndrome and we are currently engaged in very close monitoring of the surviving sibling for evidence of any karyotypic abnormality.
Subject(s)
Chromosome Aberrations , Failure to Thrive , Nervous System Malformations , Pancytopenia , Ataxia/genetics , Ataxia/physiopathology , Cerebellum/abnormalities , Cerebellum/pathology , Child, Preschool , Developmental Disabilities/genetics , Developmental Disabilities/physiopathology , Disease Progression , Failure to Thrive/genetics , Failure to Thrive/pathology , Fatal Outcome , Female , Humans , Infant , Karyotyping , Myelodysplastic Syndromes/genetics , Nervous System Malformations/genetics , Nervous System Malformations/pathology , Nuclear Family , Oral Ulcer/genetics , Pancytopenia/genetics , Pedigree , Syndrome , Tongue Diseases/geneticsABSTRACT
Recommendations exist that fasting plasma glucose (FPG) levels can be substituted for glycosylated haemoglobin A1 (HbA1) in Type II diabetic subjects (DM II), which have potential important financial implications. The present study was designed to expand this examination and to include Type I DM (DMI) patients and random blood glucose (RBG) values. Data were obtained from 234 DM II and 104 DM I patients, over 3 years. Correlation of HbA1 with FPG levels in DM II yielded an r value of 0.61. Correlation of HbA1 with RBG and 2 h post prandial glucose measurements yielded r values of 0.59 and 0.51 respectively, p < 0.001. In DM I, similar correlations gave r values ranging between 0.27 and 0.38, p < 0.01-0.001. Thus while significant correlations exist between HbA1 and FPG and RBG measurements in both DM I and DM II, clinically applicable information on long-term diabetic control can only be achieved from glucose measurements in DM II but the correlation is not sufficiently tight to recommend substitution of plasma glucose for HbA1 determinations, despite the cost advantages.
