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Biomedical subjects

J E Ware

Publications and source records attributed to J E Ware.

170 records · Page 10Linked to original sources
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Patients' participation in medical care: effects on blood sugar control and quality of life in diabetes.

To maximize disease control, patients must participate effectively in their medical care. The authors developed an intervention designed to increase the involvement of patients in medical decision making. In a 20-minute session just before the regular visit to a physician, a clinic assistant reviewed the medical record of each experimental patient with him/her, guided by a diabetes algorithm. Using systematic prompts, the assistant encouraged patients to use the information gained to negotiate medical decisions with the doctor. A randomized trial was conducted in two university hospital clinics to compare this intervention with standard educational materials in sessions of equal length. The mean pre-intervention glycosylated hemoglobin (HbA1) values were 10.6 +/- 2.1% for 33 experimental patients and 10.3 +/- 2.0% for 26 controls. After the intervention the mean levels were 9.1 +/- 1.9% in the experimental group (p less than 0.01) and 10.6 +/- 2.22% for controls. Analysis of audiotapes of the visits to the physician showed the experimental patients were twice as effective as controls in eliciting information from the physician. Experimental patients reported significantly fewer function limitations. The authors conclude that the intervention is feasible and that it changes patient behavior, improves blood sugar control, and decreases functional limitations.

Clinical Trials as Topic↗
PubMedDate not supplied

John E. Ware Jr. on health status and quality of life assessment and the next generation of outcomes measurement. Interview by Marcia Stevic and Katie Berry.

John E. Ware Jr. PhD, is a founder of QualityMetric. Inc., as well as its president and chief scientific officer. He also is executive director of the Health Assessment Lab at the Health Institute, New England Medical Center, and holds professorships at Harward University and at Tufts University School of Medicine. For 14 years, he was senior research psychologist at RAND, where he developed health status and patient satisfaction measures used in the Health Insurance Experiment. He also was principal investigator for the Medical Outcomes Study (MOS), which developed the SF-36 Health Survey and other tools widely used in monitoring patient outcomes. A coauthor of papers from the MOS that received the Association for Health Services Research (AHSR) Article of the Year Award in 1993, Dr. Ware has received numerous awards for work in the field of outcomes research. He now is principal investigator of the International Quality of Life Assessment Project, which is translating and validating the SF-36 Health Survey for use in 45 countries. Dr. Ware also is developing the next generation of patient-based assessments that use advances in computer technology to provide very brief measures, yet meet the standard of precision necessary for use on an individual patient basis.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

Impact of changes in asthma severity on health-related quality of life in pediatric and adult asthma patients: results from the asthma outcomes monitoring system.

The goals of asthma treatment have broadened beyond managing traditional clinical markers of disease severity, and now include a focus on benefits of treatment in terms that are most meaningful to patients. Measurement of both generic and disease-specific health-related quality of life (HQL) is advocated because each provides complementary information about how the condition affects everyday functioning and well-being and whether treatments have their intended effects. The purpose of this study was to determine the impact of changes in asthma severity (defined using NHLBI/NAEPP severity staging) on patient-assessed HQL. Two hundred and thirty-three pediatric asthma patients and 269 adult asthma patients were evaluated in a one-year observational study. Analyses were performed to compare the generic and asthma-specific scores for patients whose asthma severity improved, stayed the same, or worsened over one year. The asthma-specific scales are sensitive to changes in disease severity. Of the generic scales, those tapping areas of physical health are more affected than the mental/emotional scales. This confirms that HQL measures are responsive to changes in asthma severity. They complement traditional clinical markers used to evaluate changes in a patient's disease state and thus give the physician another useful tool in following the clinical progress of the child with asthma.

Adult↗
PubMedDate not supplied

Adherence to health care regimens among elderly women.

This study examined selected components of nurse practitioners' care to determine which contributed most to the intent to adhere to the care plan. High and low levels of components of care (technical quality, psychosocial, and patient participation) were depicted by videotapes of a patient visit to a nurse practitioner. The videotapes were randomly selected and shown in 26 senior citizen nutrition centers in a metropolitan area. Elderly women indicated how likely they would be to adhere if they had been the patient in the tape. High psychosocial care was the only component significantly related to intent to adhere; however, the significance did not hold in an analysis of covariance when individual characteristics were controlled. Individual characteristics related to high intent to adhere were widowed marital status, religion, perceived importance of the examination, social network, and preexisting satisfaction with health care.

Aged↗
PubMedDate not supplied

Do physicians preach what they practice? A study of physicians' health habits and counseling practices.

We examined the relation of physicians' clinical specialty, personal health habits, and health-related beliefs to their practices in counseling about smoking, weight, exercise, and alcohol. We surveyed a random sample of members of a county medical society in selected specialties. Physicians with better personal health habits and more positive attitudes toward counseling counsel a broader range of patients and counsel more aggressively. Surgeons counsel less than nonsurgeons, even after controlling for differences in health-related attitudes and personal habits.

Alcohol Drinking↗