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Biomedical subjects

J Sobal

Publications and source records attributed to J Sobal.

At least 73 records · Page 4Linked to original sources
PubMed1988

A family medicine research library.

A family medicine research library can be a useful tool for conducting and teaching research methodology and data analysis. This paper lists 100 research books for family medicine collected from a questionnaire given to participants at the North American Primary Care Research Group (NAPCRG) annual meeting and a panel of experts in epidemiology and biostatistics. The areas (and number of books) include: general epidemiology (12), case control studies (3), clinical trials (3), experimental design (6), surveys (6), sampling and subject recruitment (5), measurement, scales and indices (10), family assessment and measurement (3), writing, publishing and presenting research (5), reading and reviewing the literature (5), statistics (19), coding and classification (5), and other books (18). Acquisition of a research library can facilitate family medicine research.

Bibliographies as Topic↗
PubMed1988

Family practice patients' experiences and beliefs in faith healing.

Faith healers have become more visible as an alternative to traditional medicine because of the growth of television evangelism. The extent to which patients engage in alternative therapies such as faith healing, however, is not fully known. To further explore patients' involvement in faith healing, a cross-sectional survey was administered to 207 patients in one rural family practice. Most respondents (58 percent) reported that faith healers are "quacks," but 29 percent believed that faith healers can help some people who physicians cannot help. Twenty-one percent had attended a faith-healing service. Six percent stated they had actually been healed by faith healers, and 15 percent reported they personally knew someone who had been healed. Participation in faith-healing services was significantly higher among blacks (P less than .01) and those with less than a high school education (P less than .01). The finding that many patients embrace faith healing has implications for traditional family practice and may explain why patients sometimes reject medical treatment. Physicians need to be sensitive to patients' beliefs about "faith," and must determine the extent to which patients reject the scientific approach before physicians can become effective "healers."

Adolescent↗
PubMed1988

Health concerns of high school students and teachers' beliefs about student health concerns.

Information about health concerns of adolescents can assist in assessment and treatment of their particular medical problems. Because teachers are important figures in the lives of young people, their beliefs about student health concerns are often solicited. A survey to assess adolescent health concerns and teachers' beliefs about student health concerns was conducted in two urban high schools on a sample of 831 students and 146 teachers. An assessment of 22 health concerns among the students revealed that a moderate level of concern existed on virtually every issue (the mean percentage "very concerned" was 55%), with black students and girls reporting more concern about many topics. In contrast, teachers significantly underestimated the level of concern of the students by an average of 13%, consistently having inaccurate beliefs about the types and level of student concerns. Students are concerned about health issues and are in need of health education and counseling in these areas. Teachers are not always aware of the level and types of student health concerns and may not be good sources of information about adolescent health.

Adolescent↗
PubMed1988

Family medicine residency training--three or four years?

Opinions about a four-year family practice residency were elicited from a nationally representative sample of three groups of family physicians. Questionnaires were mailed to a random sample of 308 residency graduates aged 30 to 35 years, all 383 residency directors, and a random sample of 319 third-year residents. Two mailings produced an 82 percent response rate. A four-year residency was favored by 32 percent of recent graduates, 20 percent of program directors, and 34 percent of third-year residents. Over 60 percent of residents and recent graduates would have entered a family practice program had the residency been of four years' duration. Perceived barriers to a four-year residency included lack of resources, loss of appeal, and the additional time commitment. Respondents were most willing to complete a fourth year of residency to receive additional training in orthopedics, obstetrics, gynecology, and pediatrics. Many respondents believed that the additional year would be helpful in obtaining hospital privileges in obstetrics and in coronary care and intensive care units. This study provides information useful in discussions regarding extending residency training.

Adult↗
PubMed1988

Hospital privileges for family physicians. Patterns of recent residency graduates, residency director perceptions, and resident expectations.

A national mail survey was performed that examined reports of recent residency graduates about hospital privileges for family physicians, perceptions of residency program directors about the percentage of their graduates who obtain privileges, and plans of third-year residents for seeking privileges. Privileges in medicine, pediatrics, surgery, obstetrics, and coronary care/intensive care units (CCU/ICU) were examined. Questionnaires were mailed to a random sample of 308 residency graduates aged 30 to 35 years, all 383 family practice residency directors, and a random sample of 319 third-year residents. Two mailings produced an 82 percent response rate. Most recent graduates had privileges in medicine (97 percent), pediatrics (95 percent), and CCU/ICU (87 percent). A majority (64 percent) had obstetric privileges, and a minority (36 percent) had surgical privileges. Directors were accurate in their perceptions of privileges attained by graduates in medicine, pediatrics, and CCU/ICU, but underestimated the percentage who had privileges in surgery and overestimated the percentage who had privileges in obstetrics. Residents planned on seeking privileges in medicine, pediatrics, and obstetrics at a rate similar to recent graduates, with lower percentages planning on seeking them in surgery and CCU/ICU. Privileges in surgery and obstetrics were more prevalent in the Midwest and West.

Adult↗
PubMed1987

A practical method of estimating stature of bedridden female nursing home patients.

Accurate measurement of stature is important for the determination of several nutritional indices as well as body surface area (BSA) for the normalization of creatinine clearances. Direct standing measurement of stature of bedridden elderly nursing home patients is impossible, and stature as recorded in the chart may not be valid. An accurate stature obtained by summing five segmental measurements was compared to the stature recorded in the patient's chart and calculated estimates of stature from measurement of a long bone (humerus, tibia, knee height). Estimation of stature from measurement of knee height was highly correlated (r = 0.93) to the segmental measurement of stature while estimates from other long-bone measurements were less highly correlated (r = 0.71 to 0.81). Recorded chart stature was poorly correlated (r = 0.37). Measurement of knee height provides a simple, quick, and accurate means of estimating stature for bedridden females in nursing homes.

Aged↗
PubMed1987

Health concerns of young adolescents.

Assessment of health concerns independent of health knowledge, beliefs, and behaviors is important for understanding health among adolescents, who are being socialized into adult health roles yet have their own particular concerns. The health concerns of 278 young adolescents were examined with respect to 30 topics in a survey of all seventh- and eighth-grade students attending an urban school. Their highest levels of concerns pertained to dental health, friendships, nutrition, and sex; their lowest levels pertained to smoking, birth control, pregnancy, and homosexuality. Younger, female, and less healthy students expressed greater health concerns. Most desired class health presentations (particularly about sex), while relatively few requested private counseling on specific health topics. Health concerns need to be emphasized as a component of theoretical models, and also applied in the development of health education and school health programs.

Adolescent↗
PubMed1987

The vitamin-mineral supplement history.

The prolonged use of vitamin or mineral supplements in amounts greater than their recommended dietary allowance (RDA) can lead to medical complications or interfere with the treatment of some diseases. A vitamin-mineral supplement history is necessary to determine whether patients may be contributing to a medical problem and for physicians to counsel patients about the appropriate use of vitamins and minerals. This article provides a three-phased guide for obtaining a comprehensive history of vitamin-mineral supplement use. Phase 1 determines current and past behaviors with respect to kind, dosage, frequency, duration, and constancy of supplement intake. Phase 2 considers patient beliefs about taking supplements and outcomes of supplement usage. Phase 3 outlines considerations important for patient guidance. A vitamin-mineral supplement history should be a routine component of every complete medical history.

Attitude to Health↗
PubMed1986

Informed consent by proxy. An issue in research with elderly patients.

The need for clinical study of patients in nursing homes is growing as this population grows; yet many of these patients are mentally incompetent to give informed consent for such research, and the decision must therefore be left to family members or other proxies. We studied the decisions by the proxies for 168 patients in nursing homes about whether to permit the patients' participation in a study involving minimal risk. The proxies were family members in all but one case, and 78 of 168 (46 percent) refused consent. Refusal was significantly associated (P less than 0.001) with the views that research should not be done in nursing homes, that the study would disturb the patient, that the patient, if able, would refuse to participate in the study, and that the proxy would refuse to participate in such a study if asked. Of the 55 proxies who believed that the patient would refuse consent, however, 17 (31 percent) gave consent, in apparent opposition to the patient's wishes. We conclude that refusal by family members to allow incompetent elderly patients to participate in studies may be an important obstacle to research among the elderly. Both the selection of proxies and the bases for their decisions require further study and definition.

Aged↗
PubMed1986

Health protective behaviors in first year medical students.

Individual health behaviors are an important aspect of preventive care. A survey of 164 entering medical students examined their health protective behaviors, including the three things they most frequently did to protect their health and thirty specific health behaviors studied in a previous analysis of the general population. The first semester results show similarities between the students and the general population. Diet and sleep were among the most important health protective behaviors in students and the population, but exercise and relaxation/stress control were more prevalent in students than in the public. Medical students were much more likely to be nonsmokers and wear seat belts than the public, but less likely to get regular checkups or see doctors when they felt healthy. Students also reported fewer personal safety and accident prevention behaviors. A resurvey at the beginning of the second semester showed a very high consistency with original behaviors. Among the students there were few health behavior differences by sex and martial status. These findings suggest students in medical school practice common but not extensive health protective behaviors which do not decline severely upon entry to medical school.

Attitude to Health↗
PubMed1986

Nutritional supplement use by patients in a rural family practice.

The use of nutritional supplements (vitamins, minerals) has been reported to be as high as 66% for individuals and 54% for households. Among medical patients in metropolitan areas, 66% of suburban private patients and 31% of urban clinic patients use supplements. Reported here are results of a survey to assess the use of nutritional supplements by rural family medicine patients. A sample of patients (N = 199) in one practice completed a standardized questionnaire, and 54% reported that they had taken supplements (primarily multivitamins) during the previous 6 months. The desire to assure good nutrition and less fatigue were the major reasons cited for supplement use; 50% were daily users, and 42% had used supplements for longer than 3 years.

Adolescent↗
PubMed1986

Prescribing postpartum iron supplementation: a survey of practicing obstetricians.

Supplemental iron (excluding the amount in prenatal vitamins) is routinely recommended post partum by standard obstetric textbooks. We surveyed practicing obstetricians in Maryland to examine their indications for and prescription of postpartum iron supplements. The survey was returned by 201 physicians (33% response rate). Iron was prescribed by 25% of the physicians always, 12% never, and 63% depending upon the patient. An average of 37% of postpartum patients were given iron. The most frequently cited indication for prescribing iron was the postpartum hematocrit level (used by 90% of the physicians), followed by high blood loss (41%), operative delivery (15%), mean corpuscular volume (12%), and toxemia (9%). The postpartum iron dosage (325 mg) was prescribed as a single daily dose by 22%, twice daily by 37%, and three times daily by 32%. These practices do not correspond to the current recommendation that postpartum iron should always be prescribed.

Decision Making↗
PubMed1986

Nutrient intake and obesity in a multidisciplinary assessment of osteoarthritis.

The nutritional composition of diets and prevalence of obesity in 77 osteoarthritis patients were assessed biweekly for 12 weeks as part of a multidisciplinary approach to the management of osteoarthritis. Height was measured at the first visit, and weight was measured at each of the seven biweekly follow-up visits. A body mass index was calculated, based on height and weight, to determine obesity. Nutrient information was obtained by use of a 24-hour dietary recall and a food frequency questionnaire. Seventy-nine percent of the patients were obese. Obesity was positively related to pain from osteoarthritis and was more prevalent among these osteoarthritis patients than it is among the general geriatric population. Dietary intakes of vitamin D, folacin, vitamin B6, zinc, and pantothenic acid were below 80% of the recommended dietary allowance. Osteoarthritis patients may benefit from weight loss if they are obese and from eating more foods that supply the nutrients in which they are deficient. In addition to providing nutritional recommendations to avoid dietary deficiencies, a registered dietitian can assist in the multidisciplinary treatment of osteoarthritis by providing weight-control counseling and follow-up.

Adult↗
PubMed1986

Psychosocial aspects of the multidisciplinary assessment of osteoarthritis.

The social network, family functioning, and health-protective behaviors of 77 osteoarthritis patients treated for 12 weeks by a multidisciplinary team were assessed. Measures included assessments of social network using components of the OARS, family satisfaction using the APGAR, family cohesion and adaptability using the FACES II, alcohol abuse using the CAGE, and indicators of health-protective behaviors. Participants were generally socially active, socially integrated, and satisfied with family relationships. Reported health-protective behaviors were low, indicating the need for assistance in improving preventive health practices. Few of the patients appeared to be at risk for alcoholism. Improvements in pain and activities of daily living were not correlated with changes in social functioning. Social functioning appeared to be relatively stable and not altered by short-term improvements in osteoarthritis. Social workers can play an important role in facilitating individual and family adjustment to the limitations imposed by osteoarthritis and in the rehabilitation process for osteoarthritis patients.

Adult↗
PubMed1986

Psychological evaluation of well-being in the multidisciplinary assessment of osteoarthritis.

Relationships among psychological well-being, pain, and disability were investigated in 77 osteoarthritis patients who were followed up for 12 weeks by a multidisciplinary assessment and management team. The General Well-Being Schedule and six subscales were used to measure overall psychological well-being in this group of elderly patients (mean age, 69 years). Individuals with high levels of pain and disability at the initial and final visits had less psychological well-being, less control over emotions and behaviors, more concern about their health, and more depressive symptoms. Patients who were more disabled reported lower energy levels and more anxiety. Overall, the subset of osteoarthritis patients aged 65 to 74 years was similar in psychological well-being to the same age group in the general population.

Activities of Daily Living↗
PubMed1985

Physicians' beliefs about the importance of 25 health promoting behaviors.

A mail survey of 1,040 primary care physicians in Maryland examined their beliefs about the importance of 25 behaviors for promoting the health of the average person. Physician consensus existed across specialties in rating most health behaviors as very important and few as very unimportant. Eliminating smoking was most important and taking vitamin supplements least important.

Attitude of Health Personnel↗