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Biomedical subjects

C P Vojir

Publications and source records attributed to C P Vojir.

12 recordsLinked to original sources
PubMed2001

Hispanic versus white, non-Hispanic physician medical practices in Colorado.

The purpose of the study was to extend the scope of earlier research on minority physicians attending to the needs of the poor and their own ethnicity by contrasting practice characteristics of Hispanic doctors in Colorado with those of their white, non-Hispanic counterparts. It was found that Hispanic physicians spent more hours per week in direct patient care, were more likely to have a primary care specialty, and were less often specialty board certified than white, non-Hispanic doctors. Hispanic generalists established practices in areas in which the percentages of the population that were (1) below poverty level, (2) Hispanic, (3) Hispanic and below poverty level, and (4) white, non-Hispanic, and below poverty level were greater than in areas in which white, non-Hispanic primary care physicians practiced. These findings argue for special provision to admit ethnic minorities to undergraduate and graduate medical education programs.

Adult↗
PubMed2000

Predicting hospice appropriateness for patients with dementia of the Alzheimer's type.

The appropriateness of admitting individuals to hospice services is determined by assessing the individual's 6-month survival prognosis. Clinical parameters that guide clinicians in assessing prognosis, however, are not well defined in cases of dementia of the Alzheimer's type (DAT) when compared to other illnesses. The Alzheimer's-Hospice Placement Evaluation Scale (AHOPE) was developed to assess the 6-month prognosis of individuals with late-stage DAT. The purposes of this study were to estimate the reliability and predictive validity of AHOPE and to test additional demographic and clinical indicators to determine their added contribution to predicting 6-month survival and hospice appropriateness. Data were collected on 112 long-term care residents with DAT at enrollment and 6 months following enrollment. Initial reliability and predictive validity of AHOPE were supported. Other demographic and clinical indicators were not predictors of 6-month survival. Although additional research is indicated, nurses can use AHOPE to enhance clinical observation and decision making for implementing appropriate care strategies for patients with end-stage DAT and their families.

Aged↗
PubMed1999

Multi-method assessment of access to primary medical care in rural Colorado.

The objectives of this study include conducting an analysis of access to primary medical care in rural Colorado through simultaneous consideration of primary care physician-to-population and distance-to-nearest provider indices. Analyses examined the potential development and implications of excessively large, perhaps unmanageable patient caseloads that might result from every rural Coloradoan's exclusive use of the nearest generalist physician as a regular source of care. Using American Medical Association Physician Masterfile data for 1995 and coordinates for latitude and longitude from U.S. Census files (Census of Population and Housing, 1990), the authors calculated distance to the nearest primary care physician for residents of each of the 1,317 block groups in Colorado's 52 rural counties. Caseloads for each generalist physician were computed assuming the population used the nearest provider for care. Straight-line mileage to primary medical care was modest for rural Coloradoans--a median distance of 2.5 miles. Almost two-thirds (65 percent) of the population resided within 5 miles, and virtually all residents (99 percent) were within 30 miles of a generalist physician. However, had everyone traveled the shortest possible distance to care, demand for service from many of the 343 primary care doctors in rural regions of the state would have been overwhelming. The results of simultaneous application of distance-to-care and provider-to-population techniques unrestricted by geographic boundaries depict access to primary medical care and corresponding consumer difficulty more fully than in previous studies. Further combination of methods of needs assessment such as those used in this analysis may better inform the future efforts of organizations mandated to address health care underservice in rural areas.

Colorado↗
PubMed1999

Testing a model of the nursing assessment of infant pain.

The purpose of this study was to test whether elements of an infant pain assessment model interacted as postulated by the model. The elements are the infant's response to comfort measures and the principle of consolability. Four different scenarios for each of 16 videotaped infants were prepared. Each scenario represented one of four different combinations of likelihood of pain and consolability and consisted of a videotape plus written clinical information. Forty-eight volunteer pediatric nurses assessed infant pain of 16 scenarios, each depicting one of the 16 infants. Mean level of assessed pain was highest for the "high likelihood of pain and difficult to console" group, second highest for the "high likelihood of pain and easily consoled" group, third highest for the "low likelihood of pain and difficult to console" group and least for the "low likelihood of pain and easily consoled" group. Findings supported the infant pain assessment model.

Female↗
PubMed1997

Symptom management outcomes. Do they reflect variations in care delivery systems?

OBJECTIVES: Symptom management is increasingly recognized as a critical element of patient care, particularly in managing chronic illness. However, research on outcomes related to symptom management is in its infancy, except for the symptom of pain. This symptom was therefore chosen as a prototype to review the state of the science regarding relations between organizational variables and symptom management outcomes and to illustrate the issues regardless of the symptom managed. This article discusses pain outcome measures appropriate for acute and cancer pain, proposes attributes of the care delivery system that may affect outcome measures, and identifies challenges associated with this type of research. METHODS: Review of quality assurance studies raises issues concerning the adequacy of currently used outcomes for pain and satisfaction with pain management. Although considerable effort has been expended in developing pain measurement in adults and children, critical issues for examining pain management outcomes include deciding what perspectives should be used as the most valid indicator of the pain outcome and when the measures should be obtained. RESULTS: Critical concerns are raised about the measure of satisfaction with pain management and its appropriateness as the end-result outcome. A key issue is whether respondents actually disentangle satisfaction with pain management from satisfaction with other aspects of care, including caring dispositions of health-care providers. Finally, the question is raised: Are pain outcomes affected by organizational context? CONCLUSIONS: Although the answer to this question is unknown, a few research studies suggest that organizational context is likely to influence pain outcomes. It is clear, however, from ongoing work that until several conceptual, methodological, and analytic challenges are resolved, research is unlikely to capture the influence of variations in care delivery systems on symptom management outcomes.

Adult↗
PubMed1996

Evaluating a pediatric pain management research utilization program.

Research-based pain assessment and management innovations are not fully utilized in clinical nursing practice. Thus children continue to suffer despite strategies that could eliminate or significantly reduce their pain. An educational program was developed and implemented to integrate state-of-the-art pain assessment and management strategies into the clinical practice of pediatric nurses. This article reports on evaluation of the research utilization process during development and implementation of the program. The program included formal classes, development of instruments for pain assessment and documentation, ongoing consultation on pain management strategies, and designation of a unit-based staff nurse liaison. Findings illuminated the process through which nursing staff on one unit came to learn about new ideas, try those ideas in their clinical practice, re-invent certain strategies to better meet their needs, and, ultimately, to adopt innovations deemed helpful in their work.

Adult↗
PubMed1993

Identification of HIV/AIDS-associated oral lesions.

PURPOSE: The purpose of this study was to assess the degree to which dentists, dental hygienists, and dental assistants could recognize possible HIV/AIDS-related intraoral lesions. Recognition of such lesions is important since they are often early manifestations of this disease. METHODS: Following a regional pilot study (n = 234), a national convenience sample of 486 dentists, 124 dental hygienists, and 25 dental assistants was examined and their abilities to recognize HIV/AIDS-associated intraoral lesions were compared. Subjects attending a national dental meeting in November 1989 were shown six color photographs (2.5" x 3.5") and asked to determine which conditions could be depicted from a provided choice list. RESULTS: Statistical analysis using ANOVA revealed no significant differences in recognition scores among the three groups. However, results suggest that individuals in all groups may not be adequately recognizing the oral clinical manifestations of HIV infection. CONCLUSIONS: Although study limitations such as non-random sampling and methodology constraints must be considered, one can conclude that HIV/AIDS pathology should receive greater educational emphasis in dental, dental hygiene, and dental assisting curricula and continuing education programs.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Applicant selection procedures: a more objective approach to the interview process.

The applicant interview process is a valued component of the selection of students into the University of Colorado Medical Technology Program. However, problems related to the inherent subjectivity of the interview caused the faculty to investigate a more objective approach. A behaviorally anchored measurement instrument was developed and faculty rater training techniques were instituted to enhance objectivity and reliability. The new interview system performed measurably better than did its predecessor as demonstrated by higher reliability coefficients and a significant canonical correlation with a set of four student success variables. These outcomes are to be expected from the procedure used and demonstrate that careful design and implementation of an interview process will yield objective results that are reliable enough to predict student success.

Colorado↗
PubMed1976

Medical technology education II: Evaluation of a classroom-laboratory program.

Data gathered on the graduates of the first three classes of the University of Colorado medical technology program student classroom-laboratory approach indicate that these graduates are successful medical technologists, although the program is nontraditional. The program includes lecture-laboratory sessions in a student laboratory setting with a shortened clinical education component. Questionnaires to evaluate 11 aspects of work performance were submitted to each graduate's immediate supervisor. Seventy-seven per cent of the evaluations were returned. Ninety per cent of those evaluated were rated as successful technologists (average performance or better). Following 7 to 12 months of job experience, graduates showed no significant change in work performance ratings. Therefore, using a classroom-laboratory setting prior to the clinical component appears to be an effective means of educating medical technologists.

Colorado↗
PubMedDate not supplied

Multisite clinical research: a challenge for nursing leaders.

The need for the application of research-based data to diversified healthcare systems has led to more attempts by nurse researchers to investigate phenomena across clinical sites. Nurse executives increasingly are asked to justify resource allocation among organizations, and must compare patient-care practices within complex systems that are often geographically distant. This article describes the pitfalls encountered and the progress made by researchers during a 4-year multisite, multimethod clinical investigation collecting clinical outcome and organizational context data from seven hospitals.

Child↗
PubMedDate not supplied

A comparison of parent and adolescent responses from independent health histories.

This study compared agreement of written responses between parent and adolescent concerning medical and psychosocial information from independent health histories during an initial medical visit. Records with two health histories completed separately by 268 parent/adolescent pairs were studied. The following medical questions were coded and compared: chief complaint, infectious diseases, review of systems, hospitalizations, accidents, allergies, and medications. Psychosocial questions included recreational drug use, sexual behavior, body image, home life, and mental health. Using three-factor repeated measures ANOVA, significant differences (P less than or equal to 0.05) were obtained for gender and age when comparing the mean scores for medical and psychosocial questions. These differences were found primarily in the psychosocial category and chief complaint question. Findings suggest that many adolescents are reliable informants about their medical histories, but private interviewing of the teenager may be necessary to determine high-risk behaviors.

Adolescent↗