Kentuckians' attitudes toward children with epilepsy.

We explored Kentuckians' attitudes toward children with epilepsy. Questions compared respondents' attitudes about children with epilepsy, asthma, hyperactivity, and AIDS. Random digit dialing led to 617 completed interviews. The key questions asked concerned (a) how a pupil with each illness would alter the classroom environment, and (b) how the condition would affect the child's quality of life (QOL) at age 21 years. Respondents used a 0-10 rating scale (0 = worst, 5 = normal, 10 = best). A dichotomous variable divided respondents into those who rated below and those who rated at or above the norm: 24% predicted a deterioration of the classroom environment with the addition of a pupil with epilepsy (similar to AIDS at 26%); 41% predicted a lessened QOL at age 21 years (a worse rating than either asthma or hyperactivity). We created summary indexes, using difference scores between epilepsy ratings and ratings for the other conditions: Relative Educational Distance (RED) and Relative Quality of Life Distance (RQLD) measures. On the RED index, rural and Appalachian respondents showed the greatest prejudice toward pupils with epilepsy. Conversely, we noted the greatest prejudice in RQLD among urban residents (the best educated group). Our data do not support contentions that prejudices against persons with epilepsy are disappearing.

Biogenic, psychogenic, and sociogenic models of adjustment to chronic pain: an exploratory study.

OBJECTIVE: Based upon three models of etiology and adjustment in CLBP, predictions were made about the variables that were expected to differentiate organic and nonorganic patients, including: psychological distress (anxiety, depression, stress, alienation), pain condition and treatment, and general health. METHOD: Patients from a medical school orthopedic clinic with an organic (N = 58) or a nonorganic (N = 33) diagnosis for chronic low back pain (CLBP) were compared on medical, psychological and sociodemographic variables. RESULTS: Nonorganic patients exhibited greater emotional distress, contrary to the biogenic model, and nonorganic patients did not exhibit more somatic complaints, contrary to the psychogenic model. Both patterns were consistent with the sociogenic model; nonorganic patients were more distressed, but not because of a greater tendency to somatize. Moreover, modeling was not supported as an explanation of the pain and distress among these patients. CONCLUSIONS: Social anomie may explain why patients without a medically diagnosable cause for their pain are more psychologically distressed.

Obesity stigma reduction in medical students.

The purpose of this study was to develop and evaluate an educational intervention designed to modify the stigma held by first-year medical students towards obese patients. The intervention, composed of video, audio and written components, was based on Petty and Cacioppo's elaboration likelihood model. Prior to the course, the medical students held largely accurate beliefs about the causes of obesity, but they still maintained negative stereotypes of the obese as lazy and lacking in self-control. Analysis of students' attitudes toward obese patients five weeks and one year after the course indicates that the intervention was effective. At the five-week assessment, students in the intervention group differed from students in the control group on six of eight measures of attitudes toward the obese. One year after the course, the intervention group was significantly more likely to rate genetic factors as important in obesity and less likely to blame the obese for their condition.

On the perceived meaning of symptoms.

The importance of understanding the manner in which symptoms are interpreted is generally recognized, but has received relatively little direct research attention. In an attempt to obtain some evidence on the meaning attached to each of a set of 45 symptoms, subjects were asked to rate the symptoms on eight semantic properties. The symptom ratings on the various properties were then correlated and the correlation matrix subjected to a principal components factor analysis. Three factors of perceived meaning emerged. The first factor is defined by the extent to which symptoms are perceived as threatening, disruptive and painful. The second factor consists of the familiarity of symptoms and the perceived personal responsibility for their occurrence. The third factor reflects how embarrassing the symptoms are. This structure of perceived meaning of symptoms is discussed with reference to the literature on delay in seeking medical care.

Teaching interviewing skills to pharmacy residents.

An instructional program for first-year pharmacy residents in the use of interviewing techniques when assessing the drug therapy of patients is described. The objectives of this project were to (1) teach the appropriate use of interviewing skills and (2) observe the performance of pharmacy residents in assessing the drug therapy of ambulatory patients. Instructional methods included a written self-instructional packet, videotaped lecture and demonstration skits, group discussion, and role playing. Following these, during a four-week period, the residents interviewed patients in the outpatient pharmacy and reviewed their performance on videotape with the instructor. Two simulated patient case situations using a resident posing as a patient who provided predetermined information were used to measure student performance in interviewing patients. An improvement in the ability of the residents to employ the interview techniques and to assess the therapy of patients was noted.

Satisfaction with care and the utilization of dental services at a neighborhood health center.

The purpose of this research was to develop further information relevant to the problem of utilization of dental services at neighborhood health centers. The research objectives were: (1) A descriptive assessment of the utilization trends of the population served by a neighborhood health center; (2) Some determination of any possible correlation between failed appointments and patients' satisfaction with dental care; and, (3) Some exploration of possible reasons for non-utilization of scheduled dental appointments by a sample of patients from the neighborhood health center who report a history of previous dental treatment. From dental clinic daily appointment sheets, an assessment of utilization trends of a neighborhood health center population for a seven-month period (jon trends of a neighborhood health center population for a seven-month period (June 1, 1973 to December 31,1973) was obtained. In addition, analyses of patient treatment records and information obtained from personal interviews with 40 individuals from the health center population facilitated the completion of the second and third research objectives. The results indicated: (1) Compared to the findings of earlier research,-3 the reported ratio of broken to total appointments scheduled for this study population was substantially lower; (2) There is a rather strong relation between satisfaction with care and the utilization of dental services at the neighborhood health center studied; (3) Satisfaction with care is dependent upon a number of factors; and (4) Reasons given for nonutilization of scheduled dental services are practical ones, of which some are also reflected in the reasons given ofr dissatisfaction with dental care.