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Biomedical subjects

T Marteau

Publications and source records attributed to T Marteau.

25 records · Page 2Linked to original sources

General practice based diabetes surveillance: the views of patients.

Forty three patients with non-insulin dependent diabetes registered at two suburban practices were interviewed at least one year after the introduction of an organized general practice based system of diabetic surveillance and the results compared with data gathered from interviews administered before the introduction of the system. Structured data from the two interviews were compared in relation to the importance which patients attached to diabetes and its medical review, patients' preference for place of future review and the health professionals from whom they wished to receive diabetes care. Patients' ratings of the performance of health professionals on various aspects of care were compared with the ratings given before the introduction of the new service. At the follow-up interviews the reasons behind patients' responses to the structured questions were explored using a qualitative method. The introduction of a general practice based diabetes service was marked by an improvement in attendance for diabetes monitoring (56% before introduction, 98% in the year following introduction). This was associated with an increase in the importance which patients attached to diabetes and its medical review. After experience of diabetes care in general practice, patients remained enthusiastic about general practice involvement and confident in their general practitioners' knowledge about diabetes management. In spite of an improvement in the patients' ratings of hospital doctors' communication skills, they continued to rate general practitioners significantly more highly in these skills (P < 0.01) and in terms of convenience and accessibility (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Instructors--a weak link in resuscitation training.

One explanation for the well documented poor basic resuscitation skills of health-care professionals is that these skills are not acquired during initial training. The first aim of our study was to assess the basic life-support skills of trainers teaching basic resuscitation. The second aim was to examine the relationship between the trainers' confidence and actual skill. We found that practical basic life-support skills prior to the two-day training course were poor. They were still inadequate after training. Assessments before and after the course showed significant positive correlation between confidence at performing basic life-support and actual skill. There is an urgent need for formal instructor training in the UK. The training programme should be evaluated, as should the performance of both trainers and trainees, to ensure that all have acquired the requisite skills.

Certification↗

An advanced resuscitation training course for preregistration house officers.

Preregistration house officers need to be able to manage the first 5-10 minutes of a cardiac arrest. A course has been designed based on the recommendations of the Resuscitation Council UK 1984 and the format of the American Heart Association advanced cardiac life support course. Fifty-nine newly qualified doctors from the same medical school class were studied in two consecutive groups: Group 1 (n = 31) were commencing their first post and Group 2 (n = 28), whose first preregistration post had been at other hospitals without practical resuscitation training, were commencing their second post. They were pretested and taught in three 2-hour sessions. Five months later they were tested to measure retention of knowledge and skills. Before training there was no difference in knowledge between the two groups but Group 1 were more skilled. The knowledge and skills of both groups immediately after training were significantly improved and at 5 months skills were subject to modest decay only. Experience of managing cardiac arrests was not a substitute for formal practical training.

Educational Measurement↗

Diabetes and its care--what do patients expect?

A sample of 77% of the non-insulin dependent diabetics aged 30-70 years from two urban practices offering no structured diabetic care were interviewed. The 55 patients (mean age 60 years) were asked about their experiences and expectations of diabetes and the health professionals involved in their care. Twenty-six patients attended the hospital diabetic clinic regularly but 13 patients received no review at all; 46 patients wanted their general practitioner to be involved in future care and only six wanted to continue with hospital review alone. Patients gave hospital doctors and general practitioners similar high ratings for knowledge of diabetes and its management but general practitioners and practice nurses were rated more highly for communication and accessibility. The aspect of care valued most was being given clear information about diabetic management. Twenty two patients thought that diabetes would have a significant impact on their future health and 35 rated regular diabetic review as extremely important in keeping themselves healthy. Most patients felt it likely that they would have a high blood glucose level most of the time and develop diabetic complications. Little difference was found between the views of clinic attenders and non-attenders, and there was no evidence that non-attenders had actively rejected review. These non-insulin dependent diabetics considered diabetes to be a serious disorder warranting regular care and expressed confidence in the primary care team's ability to provide such care.

Adult↗

Race against time.

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Heart Arrest↗