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Biomedical subjects

K Malterud

Publications and source records attributed to K Malterud.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Cervical cytological tests among female general practitioners. A study of health habits of physicians].

The authors present results from a study which focused on physicians' own routines for health controls, using pap-smear screening as example. The study was designed as a survey where a questionnaire was mailed to all Norwegian female general practitioners (720). The response rate was 95%. Half of the informants had a pap-smear taken according to the official recommendations. Of the remainder, just as many had a routine pap-smear taken more often than recommended as less often than recommended. The reported routines are closer to the official recommendations than they are for other women. Half of the informants reported that, as physicians, they found it more difficult for them than for other women to have a routine pap-smear taken. The authors discuss aspects which could motivate female general practitioners to comply themselves with the recommended screening program. The results are also relevant for the planning of a special health service for physicians.

Adult↗
PubMed1994

Key questions--a strategy for modifying clinical communication. Transforming tacit skills into a clinical method.

BACKGROUND: A clinical communicative method designed to promote the doctor's understanding of women's "undefined" disorders is presented and discussed. The method is composed of key questions, which are problem-oriented speech acts, inviting the patient to share with the doctor her conception of illness. The questions are directed towards specific clinical problems, and are not meant as global devices for better doctor-patient communication in general. PROCEDURE: The clinical method is the outcome of a procedure where key questions are systematically developed. The procedure starts with individual successful communicative experiences and moves towards questions that are applicable towards various patients presenting the actual clinical problem. The procedure is described qualitatively, and delivers cues from which the modes of asking can be adjusted and employed by other doctors. OUTCOMES: The procedure consists of these steps: 1) declaring the clinical problem for investigation, 2) specifying a relevant communicative intention, 3) assigning fertile themes of knowledge, 4) identifying an efficacious utterance for further refinement, and 5) expanding the validity of the utterance. CONCLUSION: By making visible, systematizing and refining the doctor's tacit conversational skills, the clinical method represents a model for transforming individual clinical experiences into medical knowledge. Premises for generalization of the method towards clinical problems beyond women's "undefined" disorders are discussed.

Algorithms↗
PubMed1993

[Clinical knowledge--facts or something more? Some theoretical views].

Origins, contents and validation procedures of medical knowledge are rarely discussed in medicine. Clinical knowledge is the core of medicine. Analysis of the procedures and strategies for seeking clinical knowledge, and the content of this knowledge, may enlighten the development of medical theory as well as constitute a basis for quality assurance of medical practice. The article presents epistemological challenges related to analysis of clinical knowledge, and delivers some theoretical frames of reference (postmodernism, pragmatism, practice theory and feminism) with a potential to provide a broader understanding of the medical field--acknowledged as living knowledge produced through human interaction.

Clinical Competence↗
PubMed1993

Shared understanding of the qualitative research process. Guidelines for the medical researcher.

The qualitative research process is presented and discussed as a model, emphasizing matters frequently experienced as unfamiliar by the medical researcher. This model represents a prescriptive methodology, implying underlying values on construction of scientific knowledge where shared understanding--intersubjectivity--is considered as essential. Various stages of the research process are demonstrated, drawing attention to matters that influence analysis and the paths to knowledge, especially preconceptions and theoretical frames of reference. Principles and procedures related to analysis of qualitative data, as decontextualizing and recontextualizing, are explained. The structure of this model, accentuating the researcher's responsibility to give access to all levels of the research process, underlies all kinds of scientific inquiry. Such principles should probably more often be explicitly questioned and accounted for in all sorts of medical research.

Data Collection↗
PubMed1993

Iron supplementation in pregnancy. General practitioners' compliance with official recommendations.

UNLABELLED: OBJECTIVE--To compare general practitioners' routines regarding iron supplementation in pregnancy with national recommendations. DESIGN: Mailed questionnaire to general practitioners. SETTING: A county in western Norway. SUBJECTS: 184 general practitioners. MAIN OUTCOME MEASURES: Descriptive registration of reported routines regarding assessment and supplementation of iron. RESULTS: 11% of general practitioners reported complete adherence to the national programme recommending iron supplements for everyone in the second half of pregnancy and use of s-ferritin estimation if Hb falls below 11 g/dl. 36% of the doctors prescribed iron supplements routinely irrespective of iron status. 87% reported use of s-ferritin estimation in antenatal care; usually on indication of low Hb, almost 20% as a routine screening in all pregnancies. CONCLUSION: General practitioners' compliance with national recommendations for iron supplementation in pregnancy is very low and probably reveals a need both for a review of the national recommendations and for an approach to increase compliance with given standards.

Anemia, Hypochromic↗
PubMed1992

[Lower respiratory tract infections among the elderly in Finnøy municipality. A retrospective study of the incidence, treatment and outcome].

Based on a retrospective study of the case records of the primary health care services in a small Norwegian coastal community (Finnøy), we found an incidence of 13% for lower respiratory infections in persons aged 70 years or more. Most often the initial medication was penicillin. In 23% of recorded episodes, medication was changed, owing to unsatisfactory response. Overall mortality in the group was 9%. Three out of five deaths occurred in patients terminally ill from other diseases at the time the respiratory infection started. Problems related to diagnosis, management and prevention are discussed.

Aged↗
PubMed1992

[What is a scientific publication? On science and cultural hierarchies in medical research].

Discussions have taken place about relevant criteria for "scientific publications". That such criteria exist is apparent when faculties of medicine issue guidelines for classification and quantification of scientific publications. In this article the authors focus on lack of clarity and consistency in the prevailing classifications; for example, that the language in which it is published appears to be essential as such. Different disciplines must of necessity have a variety of forms of publication, depending on the target groups for the different publications. It is argued that classification and evaluation of scientific publications should be based on a more nauanced academic standpoint.

Classification↗
PubMed1992

Women's undefined disorders--a challenge for clinical communication.

Patients presenting illness without disease are common in general practice. A clinical communicative method was developed in order to clarify women's 'undefined' disorders. Outcomes from this approach registered from 122 audiotaped consultations were qualitatively analysed, in order to explore potential conditions and premises constituting the phenomena labelled as undefined. Knowledge produced by female patients was applied for transformation of the undefined nature of the problem into various levels of medical understanding. Gender-specific illness-promotive mechanisms were identified, as well as certain communicative dilemmas distorting symptom presentation into undefinedness. Relevant medical management was also suggested.

Adult↗
PubMed1992

Antenatal care in general practice. 1: A questionnaire as a clinical tool for collection of information on psychosocial conditions.

In pregnancy the woman's emotional sensitivity and also her receptiveness of emotional support increase. Antenatal care that is exclusively focused on somatic conditions may lead to ignorance of pregnant women's psychosocial problems, thus missing a chance of intervention. A psychosocial questionnaire, used as a clinical tool in history taking during the first two antenatal consultations, is described and evaluated. The purpose of the questionnaire was to elucidate the pregnant woman's psychosocial assets as well as problems. The information collected by means of this questionnaire is compared with the information on psychosocial conditions collected by means of the traditional antenatal care form. Screening for psychosocial conditions in pregnant women may reveal information about important life aspects that are not detected in the antenatal care form.

Adult↗
PubMed1992

Antenatal care in general practice. 2: Components of clinical knowledge which indicate need for intervention in pregnancy.

In clinical work in general practice decisions are based on biomedical data as well as on clinical knowledge rarely analysed in research. In this study all accessible clinical knowledge was used by the doctor in an assessment of pregnant women's psychosocial conditions and needs for intervention during antenatal care. Components of clinical knowledge (verbal and non-verbal communication, background knowledge about the woman and her network, and the clinician's own feelings during consultation) are described and discussed. The analysis of the material showed that, when there was a discrepancy between the GP's assessment (clinical observations and background information) and the woman's own verbal description of her psychosocial situation, the GP gave precedence to the former. Different information sources seem to be closely linked. The doctor's own feelings and evaluations will influence the atmosphere in the consultation, and through this the quality of information collected.

Adult↗
PubMed1991

[Attitudes of women to estrogen use seen from the medical point of view].

Hormone replacement therapy is a personal not a theoretical question for women. This article reviews the literature on the use of oestrogen assessed from the personal female perspective which emerges when the hormones are to be taken by myself. I should probably choose oestrogens for myself if I suffered very troublesome oestrogen-related climacteric vasomotor or atrophic symptoms. The increased risk of breast cancer would make me delay such treatment as long as possible. -Until reliable and valid methods for individual risk assessment are available I should prefer physiological and less risky ways of preventing my own osteoporosis than years of hormone treatment. If, in old age, I may need oestriols to prevent urogenital troubles I am glad to know that they are efficient and involve little risk. Nevertheless, I should not want to take hormones "to be on the safe side".

Attitude to Health↗