The Help-Seeking Experiences of Parents of Children with a First-Episode of Psychosis.
*Help-Seeking Behavior; Adolescence; Adolescent; Adolescents and young adults; Adult; Affective Disorders; Child Behavior; Diagnostic Errors; Early Intervention; Families; Female; First episode psychosis; Health Services Accessibility; Help Seeking Behavior – Ohio; Human; Humans; Interviews as Topic; Male; Ohio; Parental Attitudes; Parents; Parents – Psychosocial Factors; Parents/*psychology; Pathways to treatment; Patient Acceptance of Health Care/*psychology; Professional Development; Psychosocial; Psychotic – In Adolescence; Psychotic Disorders/diagnosis/*psychology/therapy; Qualitative Studies; Semi-Structured Interview; Support; Treatment Delay; Young Adult
The objective was to understand the experiences of parents as they sought psychological and specialized medical services for a loved one having a first episode of psychosis. The research method was qualitative and the data gathering was done through semi-structured interviews. Eleven parents of eight adolescent or young adult children consented to be interviewed. Data from these interviews were coded and sorted. Parents reported that many of their encounters resulted in delays in accessing treatment. These encounters were characterized by misattributions of the child's behavior, poor advice, misdiagnosis, disbelief in the seriousness of the child's condition, and an unwillingness to share information. But parents also reported that encounters with other individuals were characterized by helpful advice, emotional support, and suggestions as to how to access early intervention services. Encounters with many professionals were generally not helpful to parents. These encounters served as roadblocks to accessing proper treatment for their child. More publicity, outreach, and education are recommended in the professional community.
Skubby David; Bonfine Natalie; Tracy Hattie; Knepp Kristen; Munetz Mark R
Community mental health journal
2015
2015-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s10597-015-9877-1" target="_blank" rel="noreferrer noopener">10.1007/s10597-015-9877-1</a>
Financial incentives in residency recruiting for primary care: scope, characteristics, and students' perceptions.
*Career Choice; *Financing; *Program Development; *Students; Family Practice/economics; Government; Humans; Internal Medicine/economics; Internship and Residency/*economics; Interviews as Topic; Medical; Medicine; Pediatrics/economics; Perception; Personnel Selection; Primary Health Care/*economics; Specialization
BACKGROUND: One response to the decline in interest among medical students in residency training in primary care has been the offering, by residency programs and hospitals, of financial recruitment incentives to medical students during their residency interviews. Few data on the breadth and effectiveness of this practice have been available. METHOD: To gain insight into how hospitals and/or programs offered incentives, the authors compared 1990 and 1992 survey data on this topic from the members of the Association of American Medical Colleges' Council of Teaching Hospitals (AAMC/COTH) with 1992 data from the members of the Association for Hospital Medical Education (AHME), employing responses to identical questionnaire items. Complementary data on students' experiences with recruitment incentives in 1991 and 1992 were also analyzed. These data have been collected since 1991 in the Medical School Graduation Questionnaire (GQ) of the AAMC's Section for Educational Research, but little or no information had been available on medical students' perceptions of the effectiveness of these incentives. Therefore, one of the authors surveyed members of the classes of 1992 at four Midwestern medical schools about their residency interviewing experiences, including their reactions to financial incentives they encountered. RESULTS: The outcomes from these surveys indicate that, as expected, family practice, internal medicine, and pediatrics were the specialties most likely to offer financial incentives; that a wide variety of recruitment incentives was available to students; that the proportion of programs and hospitals offering such incentives was increasing (e.g., from 37% in the 1990 COTH survey to 54% in the 1992 survey); and that a large majority (79%) of students who encountered these incentives viewed them as at least somewhat effective in persuading them to consider matching with the programs that offered them. CONCLUSION: The prevalence and persuasiveness of financial incentives raise a number of serious questions, including whether competition for residents will divert funds from improving educational quality to recruitment.
Boex J R; Kirson S M; Keyes-Welch M; Evans A
Academic medicine : journal of the Association of American Medical Colleges
1994
1994-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/00001888-199411000-00012" target="_blank" rel="noreferrer noopener">10.1097/00001888-199411000-00012</a>
Making fun of patients: medical students' perceptions and use of derogatory and cynical humor in clinical settings.
*Attitude of Health Personnel; *Attitude to Health; *Physician-Patient Relations; *Social Perception; *Wit and Humor as Topic; Adult; Female; Focus Groups; Humans; Interviews as Topic; Male; Medical; Medical/*psychology; Mentally Ill Persons; Morbid; Obesity; Ohio; Quality of Health Care; Sociology; Stereotyping; Students
PURPOSE: It has long been known that medical students become more cynical as they move through their training, and at times even exhibit "ethical erosion." This study examines one dimension of this phenomenon: how medical students perceive and use derogatory and cynical humor directed at patients. METHOD: The authors conducted five voluntary focus groups over a three-month period with 58 third- and fourth-year medical students at the Northeastern Ohio Universities College of Medicine in 2005. After transcribing the taped interviews, the authors analyzed the data using qualitative methods and identified themes found across groups. RESULTS: The categories that emerged from the data were (1) categories of patients who are objects of humor, including those deemed "fair game" due to obesity or other conditions perceived as preventable or self-inflicted; (2) locations for humor; (3) the "humor game," including student, resident, and faculty interaction and initiation of humor; (4) not-funny humor; and (5) motives for humor, including coping and stress relief. CONCLUSIONS: The authors offer recommendations for addressing the use of derogatory humor directed at patients that include a more critical, open discussion of these attitudes and behaviors with medical students, residents, and attending physicians, and more vigorous attention to faculty development for residents.
Wear Delese; Aultman Julie M; Varley Joseph D; Zarconi Joseph
Academic medicine : journal of the Association of American Medical Colleges
2006
2006-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/01.ACM.0000222277.21200.a1" target="_blank" rel="noreferrer noopener">10.1097/01.ACM.0000222277.21200.a1</a>
Evaluation of a screening interview for restless legs syndrome.
80 and over; ACTION spectrum; Adult; Aged; Brain Diseases/complications; Cardiovascular Diseases/complications; EPIDEMIOLOGICAL research; Female; Humans; INTERVIEWING; Interviews as Topic; Male; Middle Aged; MOVEMENT disorders; Reproducibility of Results; RESTLESS legs syndrome; Restless Legs Syndrome/complications/*diagnosis; Sensitivity and Specificity
OBJECTIVES: We evaluated a fully structured interview for restless legs syndrome (RLS) for potential use in primary care settings and in epidemiological research. METHODS: Seventy-four veterans were recruited at Veterans Affairs outpatient clinics. The interview was administered telephonically by trained non-clinicians (time 1) and readministered face to face (time 2). A physician conducted gold standard examinations. We calculated sensitivity, specificity and reproducibility. RESULTS: Reproducibility was low (kappa = 0.34, P \textless 0.01), but was higher for interviews repeated within 1 year (kappa = 0.55, P \textless 0.01). Including those reporting \textgreater or =3 symptoms as cases, sensitivity ranged from 63% (time 1) to 75% (time 2). Specificity ranged from 88% to 71%. CONCLUSIONS: The sensitivity and specificity reported here are lower than previously reported in specialty care. This interview for RLS might be useful for preliminary screening of patients with related complaints if followed by additional diagnostic maneuvers or might be used in observational epidemiological research.
Bourguet C C; Ober S K; Panzner M P; Baughman K R
Acta neurologica Scandinavica
2009
2009-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/j.1600-0404.2008.01117.x" target="_blank" rel="noreferrer noopener">10.1111/j.1600-0404.2008.01117.x</a>
Emergency department use and barriers to wellness: a survey of emergency department frequent users.
*Emergency department; *Frequent user; *Health Services Accessibility/statistics & numerical data; *Survey; Emergency Service; Emergency Service – Utilization; Female; Health Services Accessibility – Statistics and Numerical Data; Health Services Needs and Demand – Statistics and Numerical Data; Health Services Needs and Demand/statistics & numerical data; Hospital/*statistics & numerical data; Human; Humans; Interviews; Interviews as Topic; Male; Middle Age; Middle Aged; Prospective Studies; Surveys and Questionnaires; Trauma Centers – Utilization; Trauma Centers/statistics & numerical data
BACKGROUND: There is no common understanding of how needs of emergency department (ED) frequent users differ from other patients. This study sought to examine how to best serve this population. Examinations of why ED frequent users present to the ED, what barriers to care exist, and what service offerings may help these patients achieve an optimal level of health were conducted. METHODS: We performed a prospective study of frequent ED users in an adult only, level 1 trauma center with approximately 90,000 visits per year. Frequent ED users were defined as those who make four or more ED visits in a 12 month period. Participants were administered a piloted structured interview by a trained researcher querying demographics, ED usage, perceived barriers to care, and potential aids to maintaining health. RESULTS: Of 1,523 screened patients, 297 were identified as frequent ED users. One hundred frequent ED users were enrolled. The mean age was 48 years (95% CI 45-51). The majority of subjects were female (64%, 64/100, 95% CI 55-73%), white (61%, 60/98, 95% CI 52-71%) and insured by Medicaid (55%, 47/86, 95% CI 44-65%) or Medicare (23%, 20/86, 95% CI 14-32%). Subjects had a median of 6 ED visits, and 2 inpatient admissions in the past 12 months at this hospital. Most frequent ED users (61%, 59/96, 95% CI 52-71%) stated the primary reason for their visit was that they felt that their health problem could only be treated in an ED. Transportation presented as a major barrier to few patients (7%, 7/95, 95% CI 3-14%). Subjects stated that "after-hours options, besides the ED for minor health issues" (63%, 60/95, 95% CI 53-73%) and having "a nurse to work with you one-on-one to help manage health care needs" (53%, 50/95, 95% CI
Birmingham Lauren E; Cochran Thaddeus; Frey Jennifer A; Stiffler Kirk A; Wilber Scott T
BMC emergency medicine
2017
2017-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1186/s12873-017-0126-5" target="_blank" rel="noreferrer noopener">10.1186/s12873-017-0126-5</a>
Medical students' experience of academic review and promotions committees.
*Attitude; Adult; Anecdotes as Topic; Education; Humans; Interprofessional Relations; Interviews as Topic; Medical; Medical/*organization & administration; Medical/*psychology; Ohio; Peer Review/*methods; Professional Staff Committees/*standards; Qualitative Research; Schools; Students; Surveys and Questionnaires; Undergraduate/*standards
BACKGROUND: Like all medical schools, Northeastern Ohio Universities College of Medicine (NEOUCOM) has an elaborate committee system for academic review and promotions (ARP). Little research exists locally or nationally on this system. PURPOSE: E-mail invitations to all 420 NEOUCOM currently enrolled students were sent seeking their participation in a qualitative study that involved interviewing students who had appeared before an ARP committee at any time for any reason to understand how they experienced the process. METHOD: NUD*IST software was used to analyze the data generated by the interviews. RESULTS: The invitation drew 19 volunteers from the pool of 84 students who, at the time of the messages, had appeared before an ARP committee at least once. Themes were discovered surrounding students' perceptions of the committee's purpose, their experience of it, their beliefs about students' honesty when appearing before the committee, how they felt about themselves after a committee appearance, and how they would improve the process of academic review.
Wear Delese; Keck-McNulty Cynthia; Jones Bonnie; Penn Mark; Moss Polly
Teaching and learning in medicine
2004
2004
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1207/s15328015tlm1603_1" target="_blank" rel="noreferrer noopener">10.1207/s15328015tlm1603_1</a>
From pragmatism to politics: a qualitative study of abortion providers.
Female; Humans; United States; *Attitude of Health Personnel; Quality of Life; Motivation; Interviews as Topic; Physicians/*psychology; Health Services Accessibility; *Politics; Legal; *Abortion
Twenty-eight years after the United State Supreme Court issued its landmark Roe v. Wade, the struggle continues to ensure that all women have the full range of reproductive choices, including abortion. While the struggle can be addressed through its political, religious, and medical dimensions, it also can be examined through the perspectives of those who actually provide abortions. This paper examines the perspectives of physician abortion providers to understand more fully their motivations, the quality of their personal and professional lives, their views on the future of abortion services, and their recommendations for undergraduate and residency medical education. Such questions are often best answered through qualitative inquiry, particularly when the subject at hand has had little interpretive scrutiny, lacks theoretical understandings, and remains in general an under-investigated phenomenon. Because abortion providers and the work they do fit those criteria, a qualitative study of physician providers in Ohio was undertaken. This paper is divided into the following sections: a literature review of abortion services in the United States, methods, interview data and discussion, and last, recommendations and conclusions.
Wear Delese
Women & health
2002
2002
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1300/J013v36n04_08" target="_blank" rel="noreferrer noopener">10.1300/J013v36n04_08</a>
The medically underserved: who is likely to exercise and why?
Adult; Female; Humans; Male; Middle Aged; Ohio; Adolescent; Aged; Interviews as Topic; *Medically Underserved Area; *Motivation; *Exercise; Counseling; *Health Behavior/ethnology; Medically Uninsured/ethnology/*psychology; Vulnerable Populations/ethnology/*psychology
Adults who exercise regularly have better health, but only 15% of U.S. adults engage in regular exercise, with some social groups, such as people with lower incomes and women, having even lower rates. This study investigates the rate at which medically underserved patients receive exercise counseling from health care providers, characteristics of those who exercise, and barriers and motivations to exercise. The convenience sample was predominantly female and White and exclusively low-income and uninsured or underinsured. On average, participants were obese, by Federal Obesity Guidelines; 43% smoked. Although 60% of 126 patients reported that providers discussed exercise with them, the discussions had no relationship with patients' engagement in exercise. Women and those with lung problems, diabetes, or children in the home were less likely than others surveyed to exercise. The highest rated motivations included body image and health issues. The most important barriers were time, cost, and access to exercise facilities and equipment. In order for exercise counseling to be more effective, health care providers' interventions must consider patients' personal characteristics, health status, readiness to engage in an exercise program, and motivations and barriers to exercise.
Schrop Susan Labuda; Pendleton Brian F; McCord Gary; Gil Karen M; Stockton LuAnne; McNatt Joshua; Gilchrist Valerie J
Journal of health care for the poor and underserved
2006
2006-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1353/hpu.2006.0069" target="_blank" rel="noreferrer noopener">10.1353/hpu.2006.0069</a>