Search PubMed⌕ Search

Biomedical subjects

P Fugelli

Publications and source records attributed to P Fugelli.

At least 37 records · Page 2Linked to original sources
PubMed1998

Work disability and health-affecting psychosocial problems among patients in general practice.

Psychosocial problems are often ignored among patients in general practice. By identifying high risk groups this situation could possibly be altered. This study aimed to explore if patients in general practice perceiving themselves as work-disabled by at least 50% more often have health-affecting psychosocial problems than those not work-disabled. In a geographically defined population, 1,058 consecutive adult patients consulting 89 general practitioners were approached during one regular working day in March 1995. They completed a questionnaire at home, returning it directly to the department of general practice. Male patients considered themselves work-disabled more often than female patients. All psychosocial problems except having a demanding caregiving task were more common among the work-disabled. The doctors should bear in mind that work-disabled patients more often than other patients have concomitant health-affecting psychosocial problems. Granting long-term sick leave or a disability pension may not be the only management needed.

Adolescent↗
PubMed1997

[Norwegian physicians and alternative medicine. Knowledge, attitudes and experiences].

1272 members of the Norwegian Medical Association took part in a survey on knowledge about, attitudes towards and experience of acupuncture, reflexology, healing, homoeopathy and herbalism. The response rate was 91%. Knowledge about these five complementary methods of treatment was poor, particularly in regard to reflexology, healing and herbalism. Four out of five physicians, on the other hand, felt that they needed such knowledge to put them in a position to inform their patients. Furthermore, the physicians' attitudes were also fairly negative, except towards acupuncture. Only 4-11% regarded homoeopathy, reflexology or healing as valuable supplements to scientific medicine. 9% of the physicians had undergone acupuncture, and 4% practised this method. 65% referred their patients to acupuncture. Experience of the other four methods was less common. Poor knowledge and limited experience put Norwegian physicians in a weak position in the debate about complementary methods of treatment.

Attitude of Health Personnel↗
PubMed1997

General practitioners' knowledge of their patients' psychosocial problems: multipractice questionnaire survey.

OBJECTIVES: To evaluate general practitioners' knowledge of a range of psychosocial problems among their patients and to explore whether doctors' recognition of psychosocial problems depends on previous general knowledge about the patient or the type of problem or on certain characteristics of the doctor or the patient. DESIGN: Multipractice survey of consecutive adult patients consulting general practitioners. Doctors and patients answered written questions. SETTING: Buskerud county, Norway. SUBJECTS: 1401 adults attending 89 general practitioners during one regular working day in March 1995. MAIN OUTCOME MEASURES: Doctors' knowledge of nine predefined psychosocial problems in patients; these problems were assessed by the patients as affecting their health on the day of consultation; odds ratios for the doctor's recognition of each problem, adjusted for characteristics of patients, doctors, and practices; and the doctor's assessment of previous general knowledge about the patient. RESULTS: Doctors' knowledge of the problems ranged from 53% (108/203) of "stressful working conditions" to 19% (12/63) of a history of "violence or threats." Good previous knowledge of the patient increased the odds for the doctor's recognition of "sorrow," "violence or threats," "substance misuse in close friend or relative," and "difficult conflict with close friend or relative." Age and sex of doctor and patient, patient's educational level and living situation, and location of practice influenced the doctor's awareness. CONCLUSIONS: Variation in the patients' communication abilities, the need for confidence in the doctor-patient relationship before revealing intimate problems, and a tendency for the doctors to be entrapped by their expectations may explain these findings.

Adolescent↗
PubMed1997

General practitioners' drug prescribing practice and diagnoses for prescribing: the Møre & Romsdal Prescription Study.

We have examined the prescribing patterns among general practitioners (GPs) in a Norwegian county in relation to the patients' age and sex and the diagnosis for prescribing. Altogether 69,843 contacts with patients were recorded during which 56,758 items were prescribed. The average number of items prescribed per patient contact was 0.81 (male 0.76, female 0.83). Diazepam, the compound analgesic of paracetamol (i.e. acetaminophen) and codeine, and triazolam were the three most frequently prescribed drugs for females as compared to phenoxymethylpenicillin, paracetamol/codeine and diazepam for males. Insomnia was the most frequently recorded diagnosis for prescribing. Listed second were upper respiratory tract infections (males) and anxiety (females). Hypertension was the number three diagnosis. The twenty most frequently prescribed items accounted for 48.5% of all drugs prescribed and the twenty most frequently recorded diagnoses for prescribing accounted for 61.7% of all diagnoses. This makes it possible to analyze a substantial part of the GPs' total prescribing by focusing on a few drugs or diagnoses.

Adult↗
PubMed1996

[Dangerous health].

Explore the source record for details and available documents.

Attitude to Health↗
PubMed1995

[With Rudolf Ludwig Karl Virchow as a guide into the new community medicine].

Internationally there is an urge to vitalize the theory and practice of public health. A new public health emerges, characterized by: Knowledge base on anthropology and ecology, not on epidemiology Export of health expertise and commitment to other sectors: agriculture, urban planning, media, etc. Mobilizing and qualifying the individual as well as the local community to invest in personal and environmental health Focus on public health threats deriving from political and economic power structures. The new public health needs the old virtues of the pioneers of social medicine, in this article represented by Virchow (1821-1902): One half of the brain in biomedicine, one in social medicine Courage to confront the Establishment Respect for the people and a dedication to democratize medicine A basic instinct for social justice.

Community Medicine↗
PubMed1995

Can drug treatment be improved by feedback on prescribing profiles combined with therapeutic recommendations? A prospective, controlled trial in general practice.

We have carried out a prospective, controlled trial to ascertain whether mailed feedback on general practitioners' (GPs) own prescribing combined with relevant recommendations on drug treatment, can improve the prescribing. The GPs in the Norwegian county of Møre and Romsdal recorded all their contacts with patients and prescriptions during two periods. After the first period the GPs in Romsdal only (intervention group) received a mailed report giving their prescribing profiles as well as treatment recommendations for insomnia and acute cystitis. The total number of contacts with patients was 68,625 in which 55,747 items were prescribed. The GPs in the intervention group changed their prescribing in accordance with the intervention: they prescribed significantly less sleeping-pills for each patient, preferred short- to long-acting benzodiazepine hypnotics and tranquilizers, and they chose trimethoprim as a first line treatment for acute cystitis. We conclude that it is possible to improve the GPs' prescribing through mailed feedback.

Acute Disease↗
PubMed1994

Is smoking intervention in general practice more successful among pregnant than non-pregnant women?

The objective of this study was to evaluate the effect of a simple smoking intervention programme, carried out by a large number of general practitioners (GPs) among pregnant and non-pregnant women. Four groups of women were defined by the dichotomies pregnant versus non-pregnant and intervention versus control. The intervention was semistructured, using a flip-over and a booklet, and it was implemented in an ordinary sequence of consultations. The study involved 187 GPs in western Norway. The subjects were 350 daily smoking pregnant women and 274 daily smoking non-pregnant women, 18-34 years of age. The point prevalence abstinence rate at 18 months was 15 and 20% for pregnant and non-pregnant women, respectively, in the intervention groups, and 7% in the control groups (Ppregnant = 0.06, Pnon-pregnant = 0.006). Twenty-five per cent of the pregnant women and 34% of the non-pregnant women reported that they had reduced their cigarette consumption, but had not stopped smoking entirely. If we include all drop-outs as smokers, the continuous abstinence rate during 15 months was 6%/0% among pregnant women (intervention/control) and 5%/1% among non-pregnant women. Stopping smoking was associated with having a non-smoking partner (P = 0.001), and being encouraged to do so by their partner (P = 0.004). The prevalence of both pregnant and non-pregnant women who stopped smoking was higher in the intervention than in the control groups. Pregnant women stopped smoking as frequently as non-pregnant individuals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

The erythrocyte sedimentation rate in general practice: clinical assessment based on case histories.

Thirteen case histories were mailed to 273 general practitioners to study the clinical assessment of the ESR. Participants were asked to state their reference limits for the ESR, as well as action values for the ESR in several clinical situations typical of primary care. The action value should represent the minimal ESR change from a given value necessary to initiate some kind of action towards the patient. The response rate was 76%. In most case histories, half the general practitioners reacted on an ESR change of 10 mm h-1 or less, which is usually due to analytical and biological variation, thus underlining the need for good analytical quality. In general the response was of the same magnitude irrespective of type of case history, i.e. whether the ESR was used in case finding, in diagnosis, or in follow-up. Estimation of the reference limit displayed considerable variation, and knowledge of a previous 'normal' ESR was of minor clinical importance. Furthermore, we found substantial variation regarding the change in ESR necessary to take action in different clinical situations. In principle, for many general practitioners the action value increased as the given ESR increased whereas others reacted on a constant change in ESR, or the change necessary to take action depended on the clinical situation. We conclude that both the different assessments as to the clinical significance of the ESR, and the unawareness of the significance of analytical and biological variation indicate that guidelines for rational use are needed.

Adult↗