An employee-counseling program: first year's experience.
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Biomedical subjects
Publications and source records attributed to E Hoffman.
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Some of the major aspects of the relationship between young adult grandchildren and their grandparents were examined. A sample of 269 undergraduate females, each with at least one living grandparent, responded to a survey instrument that assessed their current frequency of interaction and perceived emotional closeness with respect to each living grandparent. Results suggested that the grandparent's kin position relative to the grandchild was a critical variable, more so than the grandparent's sex, in influencing the intensity of the bond, Adult grandchildren tended to be significantly closer to maternal than paternal grandparents, and were significantly closer emotionally to the maternal grandmother than to each of the other grandparents. Also found was a wide variability among young adult grandchildren in their current involvement and emotional attachment to grandparents.
OBJECTIVE: To assess female primary care patients' knowledge about breast cancer genetics and attitudes toward genetic testing. DESIGN: Self-administered survey. PARTICIPANTS: A convenience sample of 91 female patients awaiting appointments at a large primary care clinic of Group Health Cooperative in Seattle, Washington. RESULTS: Forty-seven percent of women had read or heard almost nothing about genetic susceptibility testing, and most did not know the answers to questions that assessed knowledge about breast cancer genetics. Eighty-one percent "somewhat" or "strongly" agreed that testing should be offered to everyone; women who had heard or read about genetic testing for breast cancer were more likely to agree that genetic testing should be offered only to people who have a reason to think that they have an altered gene. When asked whether they planned to have genetic testing for breast cancer, many women said "probably or definitely yes" (71% would do so if insurance covered the cost; 44% would do so even if they had to pay out-of-pocket). CONCLUSIONS: Although most women knew little about genetic testing, many expressed interest in being tested and believed that it should be offered to everyone. Primary care providers may be asked to educate women about cancer genetics and appropriate use of susceptibility testing.
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The purpose of this study was to assess the perceptions of patients with elevated cholesterol who participated in a physicians' office-based cholesterol management program and to compare patient reports with clinic counseling records. We conducted telephone interviews with 94 patients from five family practice clinics participating in the Physician-Based Nutrition Program (PBNP) between January and March 1988. Within two weeks after a cholesterol counseling visit, interviewers asked patients what happened during the cholesterol management process, queried their understanding of their health risk and recommended dietary changes, and assessed their attitudes toward the educational process and recommended nutrition behavior changes. Results indicate that a large majority of patients understood the problem of high cholesterol and the needed behavior changes and were highly satisfied with the cholesterol management process. However, patients' memory of specific facts, such as their cholesterol levels and behavioral goals, was often incorrect. We discuss the implications of these findings for developing and providing patient cholesterol education.
The growth of managed care is changing the practice of medicine; it has a direct impact on the quality of care offered to women and may erode gains made in the field of women's health. Graduate medical education must be transformed if women's health is to be effectively represented in the evolving health care system. An interdisciplinary primary care specialty in women's health is the best strategy for preparing physicians to deliver cost-effective comprehensive care to women in a changing health care marketplace.
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