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J W Pichert

Publications and source records attributed to J W Pichert.

At least 19 recordsLinked to original sources
PubMed1992

Registered dietitians' teaching and adherence promotion skills during routine patient education.

Even following education sessions, dietary adherence among medical patients is generally poor. One contributor to this problem may be the quality of teaching and adherence promotion skills employed by Registered Dietitians, whose behavior during routine patient interactions was evaluated in this observational study. Thirty dietitians were videotaped with one of their patients. Twenty operationally defined skills were rated on a scale from 0 (skill absent) to 3 (excellent). Dietitians' interpersonal skills were good (mean = 2.1, S.D. = 0.35), but all other skills were performed significantly less well (mean scores less than 1.0). Adherence promotion skills were rarely observed. Dietitians need supplemental training to improve teaching and adherence promotion skills.

Adult↗
PubMed1992

Improving dietitians' teaching skills.

Many health professionals lack important teaching skills, perhaps adding to patient difficulties in understanding and adopting therapeutic diets. Research suggests that teaching skills improved after dietitians took a continuing education course entitled "Effective Patient Teaching." Our study tested whether dietitians' new skills would persist in the field and whether selected patient outcomes would differ as a result. Thirty staff dietitians from six urban hospitals were videotaped teaching patients, then randomly assigned to take the Effective Patient Teaching course or not (control group). Follow-up videotapes were made after 1 week, 1 month, and 3 months. After each teaching session, patient satisfaction and recall were assessed. Two judges rated 20 teaching skills, which were divided into four subsets for analysis. Repeated measures analyses of variance showed overall gains only for the group that took the Effective Patient Teaching course, which scored higher than the control group at 1 week and 1 month, but not at baseline or 3 months. Gains occurred in presentation skills and essential teaching functions. Throughout the study, interpersonal skills were high and adherence promotion skills were low for dietitians in both groups. Groups did not differ on patient satisfaction or recall. Improvements in dietitians' teaching skills translated to the field immediately after they completed the continuing education program, but not all gains were sustained after 3 months. We recommend that dietitians assess their teaching and adherence promotion skills, obtain training where warranted, and periodically reassess the application of those skills during patient teaching sessions.

Adult↗
PubMed1986

Perceived stress and diabetes control in adolescents.

Studies of diabetes control have traditionally focused on patients' regulation of insulin, diet, and exercise. Although psychosocial stress may also influence blood glucose, researchers have infrequently accounted for the three primary physiological factors when estimating the effects of stress. In addition, few investigators have considered the influence of everyday minor stressors on health outcome. The Tennessee Camp for Diabetic Children provided an opportunity to monitor insulin administration, dietary intake, and exercise levels and to obtain measures of blood glucose and perceived minor stressors. The best index of stress was one in which number and magnitude of negative stressors were combined into a cumulative stress measure. Negative cumulative stress significantly correlated with blood glucose levels after controlling for the effects of insulin, diet, and exercise. In addition, diabetes control tended to be better when adolescents, particularly boys, adjusted well to negative stress. These findings suggest that minor stressors can influence health outcome, but positive and negative stress need to be assessed independently.

Adolescent↗
PubMed1986

Impact of interprofessional training on medical students' willingness to accept clinical responsibility.

Interprofessional training has been suggested as a means of preparing medical students for team health care, but the effects of such training have not been carefully studied. A multidisciplinary training programme in ambulatory diabetes care was developed to promote positive attitudes towards team care. Programme effects were assessed by a questionnaire which asked medical students to indicate their willingness to delegate or share 25 specific clinical tasks with a nurse. Following programme participation, students' willingness to share responsibility increased significantly for seven of the 25 tasks. To test the hypothesis that this effect resulted from the assignment of a teaching role to nurses, selected seminar content was taught by doctors or nurses on a random basis. No differences in willingness to share responsibility were related to which professional taught the seminar content. However, students were more willing to share responsibility with a nurse when they thought they had learned that topic from a nurse, suggesting that their experience in observing nurses at work may have been important in influencing attitudes towards team care.

Ambulatory Care↗
PubMed1986

Organ donation.

Explore the source record for details and available documents.

Death↗
PubMed1985

Diet-related knowledge, skill, and adherence among children with insulin-dependent diabetes mellitus.

The dietary adherence of a sample of 97 patients with insulin-dependent diabetes mellitus has been quantitatively described. Now, in an effort to understand the poor dietary adherence found, diet-related knowledge and skill and their relationship to dietary adherence among 90 diabetic children have been studied. Diet-related competencies assessed were the ability to: (1) recall the personal diet plan, (2) correctly fill one's plate from a buffet, with the diet plan in hand, and (3) choose an appropriate meal from a restaurant menu. Adherence to the diet was assessed by unobtrusive observations at meals. Error rates on the three tests of knowledge and skill were .21, .28, and .51, respectively. The mean error rate at mealtime was .35, only slightly higher than the error rate for filling a plate when the children knew they were being tested. In a multiple regression analysis, age (r = .37) and sex (R = .48) were associated with adherence to the diet plan. Ability to choose correctly from a menu, duration of diabetes, and ability to correctly fill a plate from a buffet also entered the regression equation (R = .54). The data suggest that many children did not possess the knowledge and skill required for good dietary adherence, regardless of motivation. Health educators may underestimate the complexity of the behaviors expected of chronically ill patients.

Adolescent↗