Search PubMed⌕ Search

Biomedical subjects

M H Becker

Publications and source records attributed to M H Becker.

At least 73 records · Page 4Linked to original sources
PubMed1985

The influence of client-provider relationships on teenage women's subsequent use of contraception.

This paper describes the relationships of selected dimensions of nurse-client interaction in county health department family planning clinics to the subsequent contraceptive use of the clinic's unmarried teenage clients. The subjects for the study are the clients and professional staff of 78 clinics: 2,900 eligible clients making their first contraceptive visit and 338 clinic staff nurses. Results of interviews demonstrate that client and staff expectations and interactions are significant predictors of adherence to a contraceptive regimen; under circumstances where clients anticipate, and staff employ, authoritative guidance in helping the clients to select a contraceptive method, clinic mean levels of contraceptive use are substantially increased. Overall, 40 per cent of clinic variation in contraceptive compliance is explained by the interaction dimensions and other aspects of clinic organization addressed in this paper. Implications of these results for the structuring of family planning clinic programs directed toward teenage women are briefly considered.

Adolescent↗
PubMed1984

Contingency contracting to enhance patient compliance: a review.

Researchers and practitioners have expressed considerable interest in contingency contracting as a promising intervention strategy for enlisting patient cooperation, particularly with regard to long-term treatment regimens. After brief examination of the theoretical background, the authors summarize advantages of contracting, describe elements essential to the development of a contract, and enumerate those ingredients in the contracting process thought to be critical for achieving optimal results. They review relevant research efforts in terms of their designs, methods, target and contracted health-related behaviors, contingencies employed, and initial and follow-up results. On the basis of this review, current issues regarding contingency contracting are raised, and practical considerations for large-scale application are noted along with recommendations for future research.

Diet, Reducing↗
PubMed1984

Dyssegmental dwarfism: a histologic study of osseous and nonosseous cartilage.

Dyssegmental dwarfism is probably an autosomal recessive, lethal, generalized chondrodysplasia; it is characterized by anisospondyly , shortening of long bones, and narrow chest. Maturation of chondrocytes at the epiphyseal plates is disturbed. The pathologic features of osseous and nonosseous cartilage in a stillborn female infant with dyssegmental dwarfism are described. The cartilage matrix of tubular bones, vertebrae, ilia , ribs, nose, larynx, and trachea showed acellular areas with accumulation of acid mucopolysaccharides and no increase in collagen fibers. The findings, although not pathognomonic, suggest that this type of dwarfism may be a generalized connective tissue disorder. The abnormal synthesis, structure, or secretion of the components of the cartilaginous matrix may lead to accumulation of acellular material in both skeletal and respiratory tract cartilage.

Adult↗
PubMed1984

The Health Belief Model: a decade later.

Since the last comprehensive review in 1974, the Health Belief Model (HBM) has continued to be the focus of considerable theoretical and research attention. This article presents a critical review of 29 HBM-related investigations published during the period of 1974-1984, tabulates the findings from 17 studies conducted prior to 1974, and provides a summary of the total 46 HBM studies (18 prospective, 28 retrospective). Twenty-four studies examined preventive-health behaviors (PHB), 19 explored sick-role behaviors (SRB), and three addressed clinic utilization. A "significance ratio" was constructed which divides the number of positive, statistically-significant findings for an HBM dimension by the total number of studies reporting significance levels for that dimension. Summary results provide substantial empirical support for the HBM, with findings from prospective studies at least as favorable as those obtained from retrospective research. "Perceived barriers" proved to be the most powerful of the HBM dimensions across the various study designs and behaviors. While both were important overall, "perceived susceptibility" was a stronger contributor to understanding PHB than SRB, while the reverse was true for "perceived benefits." "Perceived severity" produced the lowest overall significance ratios; however, while only weakly associated with PHB, this dimension was strongly related to SRB. On the basis of the evidence compiled, it is recommended that consideration of HBM dimensions be a part of health education programming. Suggestions are offered for further research.

Adolescent↗
PubMed1984

Understanding and improving patient compliance.

The problem of patient compliance, as well as the ability of the physician to understand, detect, and improve compliance are described in relation to a new model of health decisions and patient behavior. The health decision model combines decision analysis, behavioral decision theory, and health beliefs. This model provides a framework for modifying general health beliefs; treatment recommendations; experience with therapeutic regimens and health care providers; patient knowledge and social interaction patterns. Physicians, guided by certain ethical restraints, are in a unique position of responsibility and opportunity to actively encourage patient compliance with treatment.

Attitude to Health↗
PubMed1984

Construct validity comparisons of three methods for measuring patient compliance.

A multitrait - multimethod design was employed to assess the construct validity of three commonly used methods for assessing patient compliance: physiological assessments (e.g., blood chemistries), ratings by health professionals, and patient self-reports. Subjects were patients receiving ambulatory hemodialysis treatments for end-stage renal disease, whose regimen required them to take medications, to follow dietary restrictions, and to limit fluid intake. Study findings indicated that of the three methods examined, the nurse rating approach was the most valid (although it contained only about 50 percent valid variance). Measures derived from physiological assessments contained a substantial proportion of residual error (over 70 percent), and the patient self-report method contained only about 12 percent valid variance (with about 18 percent method-effects variance, and 68 percent residual-error variance). These results make clear the need for additional research directed at developing valid methods for evaluating patient compliance behaviors.

Adult↗
PubMed1982

Psychosocial factors affecting adherence to medical regiments in a group of hemodialysis patients.

The present research was designed to identify psychosocial correlates of adherence among patients receiving hemodialysis at two outpatient clinics. The 116 participants were interviewed concerning their knowledge of treatment, health beliefs, treatment history, social support, personal characteristics, and adherence to the medication, diet and fluid-intake aspects of the regimen. In addition, medical record data were obtained on serum phosphorus and serum potassium levels, and on between-dialysis weight gains. The magnitude of relationships between predictors and adherence measures varied, depending on the method used to measure adherence. For the self-report measures, beliefs concerning the efficacy of the behavior and barriers to the behavior, along with reported family problems, proved to be consistent predictors. Other beliefs and characteristics did not contribute significantly. For the medical chart information, however, the predictive factors were less consistent. In general, situational factors seem to be the major contributors to patient adherence, and adherence itself is seen as a complex and multidimensional phenomenon.

Adult↗
PubMed1981

Case report 161.

Explore the source record for details and available documents.

Bone Neoplasms↗
PubMed1981

Intervention strategies to improve compliance with medical regimens by ambulatory hemodialysis patients.

This research examined the relative efficacies of three intervention strategies designed to increase compliance to medical regimens in a group of ambulatory hemodialysis patients. The interventions examined included behavioral contracting (with or without the involvement of a family member or friend) and weekly telephone contacts with patients. Compliance was assessed with regard to following dietary restrictions and limiting fluid intake. Data were collected from 116 patients drawn from two outpatient clinics. Within clinics, patients were randomly assigned either to an intervention program or to a control group. The study employed a pretest-posttest control group design. Patients were interviewed before the intervention programs began (T1), after a 6-week intervention period (T2), and 3 months after completion of the intervention period (T3). Results showed that the interventions achieved substantial reductions in patients' serum potassium levels and in weight gains between dialysis treatments between T1 and T2. In general, however, these program effects tapered off to preintervention levels between T2 and T3. The findings thus indicate a need for long-term intervention programs.

Attitude to Health↗
PubMed1981

Giant Meckel's diverticulum. A cause of intestinal obstruction.

Giant Meckel's diverticula are more likely to cause obstruction than bleeding. In neonates, this is commonly due to volvulus; in adults, it is usually due to adhesions and a mass effect. A lateral view of the abdomen following barium studies can be helpful. This entity should be included in the differential diagnosis of intestinal obstruction, especially incomplete, intermittent, and chronic forms.

Colonic Diseases↗
PubMed1980

Bringing the models together: an empirical approach to combining variables used to explain health actions.

Considerable confusion has existed among researchers with regard to the selection of a particular model of health behavior for study, and many investigators have long felt that the actual number of truly distinct concepts relevant to explaining health-related actions is considerably lower than the large number of variables currently employed. This paper explores selected approaches and models which have been advanced to explain health actions, in terms of structural similarities and differences identified by a panel of judges who are the relevant experts in this field. Judges were asked to partition a set of 109 variables, representing 14 different models, into 12-14 groups on the basis of similarity. The structural similarities among the variable groups were evaluated using Smallest Space Analysis. Six interpretable factors emerged from the analyses: (1) accessibility to health care, (2) evaluation of health care, (3) perception of symptoms and threat of disease, (4) social network characteristics, (5) knowledge about disease, and (6) demographic characteristics. The results of the study provide a first step in developing a unified framework for explaining health actions.

Attitude to Health↗
PubMed1980

Strategies for enhancing patient compliance.

Patient noncompliance is a substantial obstacle to the achievement of therapeutic goals. This paper reviews a number of practical interventions with demonstrated efficacy in enhancing patient adherence, including (1) improving patients' levels of information concerning the specifics of their regimens, reinforcing essential points with review, discussion, and written instruction, and emphasizing the importance of the therapeutic plan, (2) taking clinically appropriate steps to reduce the cost, complexity, duration, and amount of behavioral change required by the regimen and increasing the regimen's convenience through "tailoring" and other approaches, (3) obtaining a compliance-oriented history of the patient's prior experiences and present health beliefs and, where necessary, employing strategies to modify those perceptions likely to inhibit compliance, (4) improving levels of patient satisfaction, particularly with the provider-patient relationship, (5) arranging for the continued monitoring of the patient's subsequent compliance to treatment, (6) increasing staff awareness of the magnitude and determinants of the noncompliance phenomenon and attempting to develop an "active influence orientation" in each member of the health care team, (7) using such techniques as patient-provider contracts to involve the patient in therapeutic decisions and in the setting of treatment objectives and creating incentives (through rewards and reinforcements) for achieving these objectives, (8) arranging for as much continuity of provider (and other staff) as possible, (9) establishing methods of supervising the patient, including involvement of the patient's social support network, and (10) involving fully the assistance of all available health care providers, assigning specific roles and responsibilities for activities directed at improving adherence to treatment.

Attitude to Health↗
PubMed1980

Dimensions of children's health beliefs.

Health beliefs interviews were conducted with 250 children aged 6-17 years. A factor analysis of the items resulted in six correlated factors which were interpreted as 1) specific health concerns, 2) general health concerns, 3) perceived parental concern, 4) perceived general susceptibility, 5) perceived susceptibility to specific conditions, and 6) perceived seriousness of and susceptibility to disease. Factor scores were computed and two-way analyses of variance (by age and sex of child) were conducted on six sets of factor scores. No significant sex differences or sex by age interaction effects were noted. Younger children scored significantly higher on "specific health concerns" and "perceived general susceptibility," while older children scored significantly higher on "perceived parental concern." Tests of differences among variances showed a tendency for the variability to be greater among younger children. The results are interpreted as providing partial support for a model of children's health beliefs and as a basis for further operationalization of concepts which are central to an understanding of motivated health behavior. Implications for practice are discussed.

Adolescent↗
PubMed1980

Nodular residua of atypical measles pneumonia.

Atypical measles pneumonia should be considered an explanation for nodular pulmonary lesions in older children and young adults. The disorder can develop in children immunized with inactivated measles virus vaccine who are then exposed to natural measles virus. Individuals given the vaccine when it was used (1961--1968) are now at risk to develop atypical measles pneumonia. This pneumonia may have a lobar or diffuse bronchopneumonia pattern. Three cases of this disorder are described. In one case, radiography showed calcification in the nodules 6 years after the pneumonia. Complicated and possibly hazardous workups can be avoided by awareness of this disease.

Adolescent↗
PubMed1979

Case report 93.

Explore the source record for details and available documents.

Bone Neoplasms↗