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Biomedical subjects

C Vallbona

Publications and source records attributed to C Vallbona.

At least 37 records · Page 2Linked to original sources
PubMed1995

Measuring social desirability among senior medical students.

The purpose of the study was to assess the role of medical students' social desirability scores on influencing their attitudes toward either a geriatric or hypochondriac patient. To carry out this investigation, we developed a social desirability scale that was domain-specific for medicine. Students' medical social desirability scores predicted negative attitudes and beliefs toward the geriatric but not the hypochondriac patient. This difference suggests that medical students find it acceptable to dislike the hypochondriac as a patient but not the elderly person. Social desirability scores were inversely related to Machiavellan scores, suggesting that medical students with a Machivellian response pattern tended to view their role as a physician in a less idealized way. Students who scored highest on social desirability tended to choose obstetrics-gynecology for their future career and those with the lowest scores either pathology or surgical subspecialties. Research with this scale should help access social desirability's role in medical students' in managing the impression they leave with patients.

Adult↗
PubMed1995

Is obstetrics-gynecology a primary care specialty?

Suddenly everyone wants more primary care physicians. For several years, we collected data from senior medical students to relate their attitudes and beliefs about several clinical problems common to primary care to their choices of residencies. Because the Texas Medical Association's Special Committee on Primary Care included obstetrics-gynecology as a primary care specialty, we reviewed our data to see if the personal traits and professional role characteristics of seniors choosing obstetrics-gynecology differed materially from those of seniors choosing family medicine, internal medicine, or pediatrics. Results of this analysis put obstetrics-gynecology about as firmly in the primary care group as if the experimental design had planned it that way.

Family Practice↗
PubMed1994

Uncertainties and ambiguities: measuring how medical students cope.

To develop psychometric measures specific to the ambiguities encountered in medicine and determine their value in predicting medical students' attitudes towards patients and their choice of residency, we administered to senior and first-year medical students a 25-item Likert-type questionnaire to assess their intolerance of ambiguity (ITA). Factor analysis yielded two dimensions that were converted to scales: 'Aversion to uncertainties in clinical medicine' (ITA1) and 'Preference for highly structured training environs' (ITA2). First-year students scored higher on ITA1 and lower on ITA2 than seniors. An excessive reliance on high-technology medicine, a negative orientation toward psychological problems, and Machiavellianism predicted ITA1. ITA1 was the best predictor of senior medical students' negative attributional style toward hypochondriac, geriatric and chronic pain patients. The following rank order of seniors' career choice was predicted by ITA1 scores: internal medicine, psychiatry and family medicine (lowest); radiology, surgery and anaesthesiology (highest). And by ITA2 scores: surgery, obstetrics and gynaecology, and surgical subspecialties (lowest); radiology, psychiatry and anaesthesiology (highest). We concluded that personality traits and role characteristics which predict 'Aversion to uncertainties in clinical medicine' are maladaptive to managing many primary care patients, and this mismatch is reflected in seniors' residency choice.

Adaptation, Psychological↗
PubMed1993

Machiavellianism in medical students.

To be more responsive to the nation's health needs, medical educators should identify those personal qualities associated with effective primary medical care. For this research Machiavellianism was chosen as a tracer character trait opposed to the characteristics embodied in an ideal family physician. A survey was conducted of 167 freshmen from one medical school and 823 seniors from four medical schools, with Machiavellianism scores used to predict their professional role characteristics, attributional style toward patients, and choice of a career specialty. Results showed that 15% of all students scored positively on the Machiavellianism scale. Mean Machiavellianism scores for seniors did not differ from those for freshmen. Men had higher Machiavellianism scores than women. Those students with high Machiavellianism scores relied excessively on high-tech medicine and were externally controlled, intolerant of ambiguity, and authoritarian. Seniors' high Machiavellianism scores predicted a negative attributional style toward geriatric and hypochondriac patients, thereby validating the use of Machiavellianism to measure medical students' indifference to patients and their problems.

Career Choice↗
PubMed1992

Advances in the community control of hypertension: from epidemiology to primary care practice.

PURPOSE: To review the progress in hypertension control in the United States since 1972, to examine the factors that contributed to that progress and to consider areas in which further improvement is required. METHODS: A review of epidemiological, clinical and health services research related to hypertension control was conducted. We report our experience in evaluating hypertension control in a multi-ethnic community clinic population as an illustration of the challenges of hypertension management in primary care practice. SUMMARY OF FINDINGS: Hypertension prevalence in the United States population has remained relatively stable, whereas actual blood pressure levels in the population have declined slightly. Most Americans (approximately 80%) have had a blood pressure check within the past year, but the rate of blood pressure control in treated hypertensives has been disappointing. The current diagnostic and therapeutic criterion of blood pressure < or = 140/90 mmHg, regardless of individual patient characteristics (e.g. age, race), should be re-evaluated.

Ambulatory Care↗
PubMed1991

Factors related to medical school application and acceptance in minority summer enrichment program students.

Baylor College of Medicine has conducted a summer enrichment program for minority/disadvantaged premedical students since 1969. Follow-up data on medical school application and acceptance for participants from 1980 through 1984 were analyzed in relation to selected preprogram variables--cumulative college grade point average, total Scholastic Aptitude Test score, competitiveness of undergraduate college, sex, and ethnicity. Results of univariate and multivariate analyses indicated that: 1) females were significantly less likely to apply to medical school than males, 2) females had significantly lower mean MCAT scores (5.9 vs 7.2) even though their preprogram academic performance was comparable to that of the males, and 3) after controlling for MCAT scores, none of the preprogram variables were significant in predicting medical school acceptance. These findings suggest the need for research to explain the discrepancy between male and female MCAT performance and frequency of medical school application in summer program participants. The findings also have implications for the type of counseling provided to female participants in summer enrichment programs.

College Admission Test↗
PubMed1990

AIDS, minority patients, and doctors: what's the risk? Who's talking?

We asked 39 physicians providing primary care for a mostly minority patient population to respond to a questionnaire concerning their attitudes and behavior toward AIDS risk assessment and preventive counseling and to indicate their beliefs concerning patients' knowledge and behavior. Most of the 36 physicians who responded (92%) agreed that physicians must educate their patients about AIDS. They also reported that patients who engage in risk-taking behavior may not know much about AIDS transmission and prevention. Despite these beliefs, these doctors reported that they gave advice to only 11% of their male patients and 14% of their female patients. More than one third of physicians reported feeling uncomfortable talking about patients' sexual preferences and practices. To identify patients at risk and to help prevent AIDS, methods must be found to make physicians more comfortable discussing sexual issues with their patients, especially their minority patients.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Patient exposition and provider explanation in routine interviews and hypertensive patients' blood pressure control.

Hypertensive patients' expressing themselves in their own words (Exposition) and providers' giving information (Explanation) during medical interviews were hypothesized to be associated with subsequent blood pressure control. Transcripts of routine return visits to clinics in low-income areas of Houston, TX, were coded using the Verbal Response Modes (VRM) system. VRM indexes of Patient Exposition and Provider Explanation were tested in relation to systolic and diastolic blood pressure obtained during home interviews 2 weeks after the clinic visits. Patient Exposition was significantly correlated with reductions in systolic and diastolic blood pressure from clinic visit to home interview, and Provider Explanation was significantly correlated with lower diastolic blood pressure at home interview. The results suggest that patients' and providers' verbal behavior in medical interviews should be included in predictive models of blood pressure control.

Adult↗
PubMed1987

Adult onset diabetes mellitus: glycemic control and family function.

To test the hypothesis that family function differs in patients according to their level of diabetes control, family function was assessed using the Family APGAR questionnaire in low-income patients with adult-onset diabetes who were under comprehensive care in five community health centers. From 3,000 active patients, a group of 385 with the following characteristics were randomly selected: mean age, 59.1 (range 25-93); M:F ratio, 1:4; and ethnic distribution (blacks: Hispanics: whites, 48%:31%:21%). Categorizing patients by their extent of diabetes control, good family function was found in 92% of patients in good control of their diabetes mellitus, in 66% of those in fair control, and only in 50% of those in poor control (p less than 0.005, chi 2 = 44.1, df = 2). Since these data point to the association between levels of family functioning and control of diabetes, further studies are needed to ascertain if an improvement in family functioning will lead to better diabetic control.

Adult↗