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Biomedical subjects

J L Donovan

Publications and source records attributed to J L Donovan.

61 records · Page 4Linked to original sources
PubMed1994

Urinary symptoms in the community: how bothersome are they?

OBJECTIVES: To measure the level of reported urinary symptoms presumed to be associated with benign prostatic hyperplasia (BPH) among men aged 40 years and over in the community, and to assess how bothersome these symptoms are perceived to be. SUBJECTS AND METHODS: All ambulant men aged 40 years and over who were registered in a general practice (703) were invited to attend the health centre to complete a questionnaire containing the Maine prostatectomy scale and the International Continence Society-BPH questionnaire, and to undergo uroflowmetry. RESULTS: The prevalence of symptomatic BPH (as defined by a numerical score > or = 11 on the Maine score, a urinary peak flow of < 15 ml/s, and failure to void > or = 150 ml on three separate occasions) was 284/1000 for men aged 40 years and over. This prevalence increased from 179/1000 in men aged 40-49 to 500/1000 in men aged 70 years and over. The most commonly reported symptoms were those typically associated with BPH (terminal dribble, hesitancy, intermittency, urgency). The symptoms that caused men the greatest degree of bother were frequency, nocturia and those causing incontinence or social embarrassment. CONCLUSION: The high prevalence of urinary symptoms assumed to be related to BPH in men in the community does not necessarily suggest that these men will require treatment. Common symptoms, typically associated with BPH, were tolerated. Further research is required to investigate the natural history of urinary symptoms, the relationships between symptoms and bladder outflow obstruction secondary to BPH, and to determine the most appropriate management for men in the community, ranging from 'watchful waiting' (monitoring without treatment) to medical or surgical treatment.

Adult↗
PubMed1992

Patient non-compliance: deviance or reasoned decision-making?

A large quantity of research concerning issues of patient compliance with medications has been produced in recent years. The assumption in much of this work is that patients have little option but to comply with the advice and instructions they receive. Studies have shown, however, that between one third and one half of all patients are non-compliant, but different authors cite different reasons for this high level of non-compliance. In this paper, the concept of compliance is questioned. It is shown to be largely irrelevant to patients who carry out a 'cost-benefit' analysis of each treatment, weighing up the costs/risks of each treatment against the benefits as they perceive them. Their perceptions and the personal and social circumstances within which they live are shown to be crucial to their decision-making. Thus an apparently irrational act of non-compliance (from the doctor's point of view) may be a very rational action when seen from the patient's point of view. The solution to the waste of resources inherent in non-compliance lies not in attempting to increase patient compliance per se, but in the development of more open, co-operative doctor-patient relationships.

Adolescent↗
PubMed1984

Ethnicity and health: a research review.

This paper is part of a larger piece of research on the perceptions of health and health services by members of the black population in North and East London, funded by the SSRC. The paper concentrates on published research produced principally by the medical profession and which concerns the health of 'immigrants', 'Asians', 'Afro-Caribbeans', 'members of ethnic minorities' or 'black people' in Britain. In five sections, the paper focuses on the illnesses and diseases which have been most intensively investigated and documented by previous researchers, and attempts to uncover the biases and/or assumptions that have led to this concentration on a few topics and groups at the expense of others. An attempt is also made to consider the influence of some of the findings of 'race relations' research on the health of Britain's black and ethnic minority population.

Adolescent↗