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Biomedical subjects

K C Stange

Publications and source records attributed to K C Stange.

81 records · Page 5Linked to original sources
PubMedDate not supplied

Family history-taking in community family practice: implications for genetic screening.

PURPOSE: To identify characteristics of physicians, patients, and visits associated with obtaining family history information in community family practice. METHODS: Research nurses directly observed 4,454 patient visits to 138 family physicians and reviewed office medical records. RESULTS: Family history was discussed during 51% of visits by new patients and 22% of visits by established patients. Physicians' rates of family history-taking varied from 0% to 81% of visits. Family history was more often discussed at well care rather than illness visits. The average duration of family history discussions was <2.5 minutes. CONCLUSIONS: These data can form the basis for realistic interventions to increase the use of family history in primary care.

Adolescent↗
PubMedDate not supplied

Mentoring needs and family medicine faculty.

Mentor relationships have long been advocated as an important mechanism for facilitating the personal and professional development of junior members of a profession. The relative youth of the discipline of family medicine and the bimodal age distribution of its members limit the availability of mentors for junior faculty. Junior faculty members seeking mentor relationships can benefit from taking a proactive approach to identifying needs likely to be met by a mentor. These needs include: professional socialization, role modeling, nurturing, teaching, and advocacy. Multiple mentors may be required to meet these needs. Family medicine departments can foster mentor relationships by providing formal and informal mechanisms for interaction between junior faculty members and the senior faculty within and outside the department. Future research which characterizes successful components of mentor relationships and examines creative ways of meeting mentoring needs would benefit the discipline of family medicine.

Clinical Competence↗
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Integrating qualitative and quantitative research methods.

Researchers have traditionally worked within either a quantitative or a qualitative paradigm. The quantitative paradigm is dominant in biomedical research. This paper describes the differences between quantitative and qualitative methods and discusses the limitations of research which involves one approach to the exclusion of the other. The possible advantages of the combined use of both types of methods are outlined and highlighted with examples from the medical literature.

Bias↗
PubMedDate not supplied

Family physicians and current inpatient practice.

BACKGROUND: Increasing demand for primary care physicians has led some to recommend that family physicians focus on ambulatory care, leaving inpatient care to hospital-based physicians only. This study examines the current level of family physician involvement in the care of hospitalized patients and the factors which determine that involvement. METHODS: A questionnaire was sent to a random sample of 415 practicing family physician members of the American Academy of Family Physicians. An inpatient involvement score was generated based on responses to a series of hypothetical clinical scenarios involving hospitalized patients. Physician and practice characteristics were tested for associations with the involvement score. RESULTS: The typical responding physician (n = 228) was male, married, and board certified, with an average age of 45 years and in community-based practice. The median number of annual admissions was 60. Independent predictors of inpatient involvement were younger physician age, greater enjoyment of inpatient and outpatient medicine, fewer extrahospital obligations, and less-complex disease in the hospitalized patient. CONCLUSIONS: Inpatient medicine continues to figure prominently in the work of family physicians. The strongest predictors for inpatient involvement are those controlled by the physician's individual choices and characteristics rather than external and bureaucratic factors.

Adult↗
PubMedDate not supplied

Using practice genograms to understand and describe practice configurations.

BACKGROUND: Demands for change in medical practices are coming from multiple sources. Since interventions to change clinical practice continue to have limited success, understanding the functional structure of primary care practices and the dynamics of providing care have become increasingly important. METHODS: To portray and understand the primary care office system, we developed "practice genograms" that describe practice participants and their relationships with each other. Formal organizational structure is evaluated using family systems theory and family of origin genogram techniques. RESULTS: Practice genograms provided a more dynamic, relational model than the organizational chart and promoted identification of relationship strengths and weaknesses within a practice the same way that family genograms identify these characteristics in a family system. CONCLUSIONS: Research implications for the use of the practice genogram include enhanced data gathering, increased understanding of the complexity of practices as adaptive systems, and increased understanding of current and potential approaches to changing practices.

Family Practice↗