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Biomedical subjects

Jane Ogden

Publications and source records attributed to Jane Ogden.

29 records · Page 2Linked to original sources
PubMed2004

Expectant or surgical management of miscarriage: a qualitative study.

OBJECTIVE: To explore women's reasons for selecting either expectant or surgical management of first trimester miscarriage and to examine the impact of treatment upon them. DESIGN: A qualitative study using interviews. SETTING: The Early Pregnancy and Gynaecology Assessment Unit at a London hospital. SAMPLE: Thirteen women diagnosed as having a first trimester miscarriage who had opted for either expectant management (n= 5), surgical management (n= 5) or who had undergone both (n= 3). METHODS: Qualitative in depth interviews. MAIN OUTCOME MEASURES: The experience of management. RESULTS: The choice of expectant management was motivated by desire for a natural solution and a fear of operation. Women described how pain and bleeding had made them anxious, that something was wrong and how they felt unprepared for how gruelling the experience would be. Some also described how their support had dwindled as the miscarriage progressed. In contrast, women who chose surgery valued a quick resolution and focussed on the support from hospital staff, although some commented that their emotional needs had not always been met. CONCLUSION: If expectant management is to be more widely offered, women should be told not only of the likely clinical effect of letting a miscarriage run its course but also how women experience this.

Abortion, Spontaneous↗
PubMed2004

The effectiveness of an acupuncturist working in general practice--an audit.

This audit was based in general practice and examined 49 consecutive referrals to a UK trained traditional Chinese acupuncturist. It aimed to assess the type of patients referred to an acupuncturist, subsequent changes in health status, whether the effectiveness of acupuncture was related to the type of presenting problem and to examine which factors were predictive of the success of acupuncture. The referred patients had a wide variety of conditions which were categorised as to whether or not there was empirical evidence from trials of responsiveness to acupuncture (evidence based vs non evidence based). Patients completed measures of their health status prior to treatment and at two and six month follow ups. In addition, the referring GP's beliefs about the prognosis of the problem and the therapist's and patient's expectations of success were measured at baseline. The results showed that referred patients reported poorer health status than a historical sample of general practice patients and that they showed significant improvements in all aspects of health status following acupuncture. In particular, patients showed improved energy, pain, emotional reactions, sleep and reduced social isolation at two months which were maintained at six months. Physical mobility was improved at six months. In addition, the results indicated that the best predictors of effectiveness were the therapist's and patient's expectations of success at baseline. Effectiveness was not related to the category of condition (evidence based or not) nor to the GP's expectations about the prognosis of the condition. The results are discussed in terms of implications for the role of acupuncture in General Practice and selectively targeting patients who would be responsive to such an approach.

Acupuncture Therapy↗
PubMed2004

Contraceptive risk and compensatory behaviour in young people in education post-16 years: a cross-sectional study.

OBJECTIVES: To describe contraceptive risk and compensatory behaviour, using condoms or emergency contraception (EC), in young people in education aged 16-24 years. DESIGN: Cross-sectional study. SUBJECTS: A total of 1135 students aged 16-24 years. SETTING: Educational establishments in and around London, UK. RESULTS: Seventy-six percent of women and 55% of men reported having experienced sex either without contraception or when a condom split or came off. Most participants (or their sexual partners) who reported such risks had compensated by using EC at least once (72% women, 55% men) but only a minority had compensated on each occasion of risk (37% women and 22% men). Of the oral contraceptives users the majority (83%) had experienced a pill 'problem' and the majority of these participants had compensated for such problems by using condoms (79%). Fewer than half of the women who experienced pill problems (45%) compensated by using condoms on each occasion. Less than a quarter (23%) of those who experienced pill problems but did not compensate by using condoms ever compensated by using EC. CONCLUSIONS: This study demonstrates high levels of primary contraceptive risk and low levels of consistent compensatory condom or EC use. The findings suggest that there would be large increases in EC use and repeated use if all primary contraceptive risks were followed by compensatory action. Interventions to increase contraceptive use should focus not only on initiation of contraception use but acknowledge that risks do happen and promote both continuing use and compensatory behaviour.

Adolescent↗
PubMed2004

Predicting uptake of MMR vaccination: a prospective questionnaire study.

BACKGROUND: Recent years have seen a decline in the uptake of the measles, mumps, and rubella (MMR) vaccination. AIM: To describe parents' beliefs about the MMR vaccination and to explore the best predictors of uptake by the age of 2 years. DESIGN OF STUDY: Prospective questionnaire study. SETTING: Brighton and Hove area of East Sussex. METHOD: Five hundred and eleven parents (response rate = 56.9%) completed a baseline questionnaire regarding their profile characteristics, beliefs about MMR and previous vaccination history prior to receiving a letter to attend for their child's vaccination. Attendance data was collected at follow-up by the age of 2 years. RESULTS: The majority of parents believed that measles, mumps and rubella were serious illnesses and stated that they would feel guilty about any adverse consequences of their decision about vaccination. Many responders were ambivalent about the benefit of vaccinations and were unsure whether to trust either the medical profession or the media. Uptake of MMR vaccination at follow-up was related to previous uptake for vaccination, increased faith in the medical profession, increased faith in the media, and a lower belief that vaccination is unhealthy and can harm the immune system. CONCLUSION: Many parents hold mixed beliefs about the MMR vaccination and the doctors who administer it. Uptake relates to past vaccination and more positive beliefs.

Adult↗
PubMed2003

Some problems with social cognition models: a pragmatic and conceptual analysis.

Empirical articles published between 1997 and 2001 from 4 health psychology journals that tested or applied 1 or more social cognition models (theory of reasoned action, theory of planned behavior, health belief model, and protection motivation theory; N = 47) were scrutinized for their pragmatic and conceptual basis. In terms of their pragmatic basis, these 4 models were useful for guiding research. The analysis of their conceptual basis was less positive. First, these models do not enable the generation of hypotheses because their constructs are unspecific; they therefore cannot be tested. Second, they focus on analytic truths rather than synthetic ones, and the conclusions resulting from their application are often true by definition rather than by observation. Finally, they may create and change both cognitions and behavior rather than describe them.

Attitude to Health↗
PubMed2003

What's in a name? An experimental study of patients' views of the impact and function of a diagnosis.

OBJECTIVE: The aim of the present study was to examine patients' views about the relative impact and function of lay and medical diagnoses for stomach and throat problems. METHODS: A questionnaire survey was carried out among 900 consecutive patients attending nine general practices across England. A total of 740 questionnaires were completed (response rate: 82.2%). Each participant rated a series of statements describing the impact upon the patient and the function for the doctor following both a stomach and a throat problem case scenario involving either a lay (stomach upset/sore throat) or medical (gastroenteritis/tonsillitis) label. RESULTS: The results showed consistent differences between the lay and medical labels for both stomach and throat problems in terms of their impact upon the patient and their function for the doctor. In particular, the medical labels were rated as beneficial for the patient in terms of validating the sick role and improving their confidence in the doctor. In contrast, the lay labels resulted in a greater sense of ownership of the problem which could be associated with unwanted responsibility and blame. In addition, the medical labels were seen to provide the doctor with a greater sense of professionalism, as giving them a clearer role in the consultation and to imply less blame on the part of the patient. 'Stomach upset' was also seen as a more pragmatic label than 'gastroenteritis'. CONCLUSION: Although much current prescriptive literature in general practice advocates the use of lay language in the consultation as a means to promote better doctor-patient partnerships, the issue of diagnosis is more complex than this. Patients attribute greater benefits to the use of medical labels for themselves and state that such medical labels are of greater benefit to the doctor.

Attitude of Health Personnel↗
PubMed2002

Young women's accounts of factors influencing their use and non-use of emergency contraception: in-depth interview study.

OBJECTIVES: To explore young women's accounts of their use and non-use of emergency contraception. DESIGN: Qualitative study using in-depth interviews. PARTICIPANTS: 30 women aged 16-25; participants from socially deprived inner city areas were specifically included. SETTING: Community, service, and educational settings in England. RESULTS: Young women's accounts of their non-use of emergency contraception principally concerned evaluations of the risk conferred by different contraceptive behaviours, their evaluations of themselves in needing emergency contraception, and personal difficulties in asking for emergency contraception. CONCLUSIONS: The attitudes and concerns of young women, especially those from disadvantaged backgrounds, may make them less able or willing than others to take advantage of recent increases in access to emergency contraception. Interventions that aim to increase the use of emergency contraception need to address the factors that influence young women's non-use of emergency contraception.

Adolescent↗
PubMed2002

A questionnaire study of GPs' and patients' beliefs about the different components of patient centredness.

Much research has explored the interaction between doctor and patient in the consultation and patient centredness has generally emerged as the preferred mode of consultation style. The present study aimed to examine and compare general practitioners' (GPs) and patients' beliefs about the importance of the different aspects of patient centred behaviour in a consultation. Matched questionnaires were completed by 410 patients (response rate=76.5%) and 64 GPs (response rate=85.3%) from practices around London concerning aspects of patient centredness operationalized in terms of doctor receptiveness, patient involvement, the affective content of the relationship and information giving. The results showed that GPs and patients showed similar beliefs about involving the patient in decision making, aspects of doctor receptiveness and the importance of the patient's own feelings in the consultation. However, GPs believed that it was less important to focus only on the patient's main problem, and more important to acknowledge their own feelings and avoid medical language. Further, GPs rated doctor receptiveness and the affective content of the relationship overall as more important for a good consultation than the patients. The patients also consistently rated information giving as more important than the GPs. To conclude, GPs rated the doctor receptiveness and affective components of patient centredness as more important than patients whereas patients showed greater endorsement of information indicating that although patient centredness may currently be the preferred style of consultation, doctors and patients prefer different aspects of this behaviour.

Adult↗
PubMedDate not supplied

Doctors expressions of uncertainty and patient confidence.

Although recent work has encouraged doctors to express their uncertainty to patients as a means to improve communication the potential impact of this on patients remains unclear. The present study first explored the impact of the way in which uncertainty was expressed (behaviourally versus verbally) on doctor's and patient's beliefs about patient confidence. Second the study examined the role of the patient's personal characteristics and knowledge of their doctor as a means to address the broader context. Matched questionnaires were completed by GPs (n=66, response rate=92%) and patients (n=550, response rate=88%) from practices in the south-east of England. The results showed that the majority of GPs and patients viewed verbal expressions of uncertainty such as 'Let's see what happens' as the most potentially damaging to patient confidence and both GPs and patients believed that asking a nurse for advice would have a detrimental effect. In contrast, behaviours such as using a book or computer were seen as benign or even beneficial activities. When compared directly, GPs and patients agreed about behavioural expressions of uncertainty, but the patients rated the verbal expressions as more detrimental to their confidence than anticipated by the doctors. In terms of the context, patients who indicated that both verbal and behavioural expressions of uncertainty would have the most detrimental impact upon their confidence were younger, lower class and had known their GP for less time. To conclude, patients' reactions to uncertainty occur within the context of the patient's own background and experience, however, some consistent responses can be found. In particular, whilst behavioural expressions of uncertainty may have a positive impact upon patient confidence, verbal expressions have a consistently detrimental effect which is underestimated by GPs.

Adult↗