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A sample should be given to improve the intensity of contact-tracing. Therefore three re-interviews were performed in two groups of patients suffering on gonorrhoea (Group A=1000;Group B=110 persons) with the aim to find out, how many persons could be traced more by re-interviews and could be found infected with gonorrhoea too. By re-interviews 12.0% more contacts could be traced, of whom 55.5% were infected.
Two methods of supervision of the initial evaluation of outpatients by psychiatric residents were compared. In condition 1, residents evaluated patients and then presented the case material to a supervisor in the traditional manner. In condition 2, the supervisor observed the interview directly. Supervisor and residents then independently completed ratings of psychopathology, motivation, insight, and prognosis of the patients. Significant differences in several variables between the two conditions were noted. Resident and supervisor ratings of patients were in clear agreement when both observed the interview.
A screening interview for Briquet syndrome consisting of 14 symptom questions was administered to a group of 50 medically ill women. No patient was found eligible for a diagnosis of Briquet syndrome, a frequency less than the estimated general population prevalence of 1% to 2%. When symptoms explainable by known organic disorder were considered positive, 14% of patients became eligible for the diagnosis. We consider this a low enough rate to allow screening by lay interviewers. A frequency distribution of symptoms comparing the medically ill women and a group of psychiatric clinic women with Briquet syndrome shows that the Briquet group had both more symptoms and distinctive patterns of symptoms.
Demographic and treatment variables were, for a second time, found associated with number of treatment interviews completed by lower socioeconomic patients of a barrio area neighborhood mental health service. Of the eight variables that originally differentiated patients with respect to number of interviews, six remained significant on cross-validation. The longer staying patients were characterized by: young adult age range; disrupted marital status; self-referral; using psychotropic medication; major and secondary problems of anxiety and depression.
The clinical Alcoholism Interview Schedule (CAIS) is being developed as a standardized instrument for initial assessment of alcoholic patients and as a research tool. Fifty questions cover key areas of clinical concern, and accompanying guidelines describe the method of administration. An initial study of inter-rater reliability has been conducted with five raters independently rating taped interviews with each of ten patients. Agreement was assessed both by percentage agreement and by weighted Kappa. Detailed results, which are presented, in general show a fairly satisfactory level of reliability except for certain identified items which include the Jellinek classification of type of alcoholism.
In two apparently disoriented patients, the emergency physician's use of amobarbital quickly eliminated diagnoses of an organic etiology. Although thousands of amobarbital interviews have had no complications, the use of amobarbital should follow a thorough evaluation. The amobarbital interview is a safe and simple technique to discriminate functional from organic illness, thus avoiding unnecessary medical and surgical treatment, neglected illness, and inappropriate disposition.
The relative specificity of the structure of psychological traits has presented the clinical psychologist with a very difficult problem; it means that generalized test procedures are of limited use. This paper suggests: (1) that the interview presents one way of beginning to solve this problem, and (2) that the findings of psychological research may provide the means of arriving at a distinctive style of valid interviewing for assessment purposes. This style has two main features: (1) it facilitates self-exploration and self-disclosure and (2) it maximizes the accuracy of the information obtained. An outline of some of the research findings is presented; some of the methodological problems are discussed; and a brief example is given.
In a sample of 89 patients referred from a psychiatric service emergency room, the author investigated variables related to completion and noncompletion of the physician's recommendation. The completers (58%) tended to be older and more educated, to be diagnosed as depressed, and to demonstrate congruence in terms of their request and their perception of the physician's goal. Implications for referral include ensuring that the interview with the patient includes a communication, empathy, and mutual influence. Using the negotiated approach and criteria derived during the clinical interview, certain patients can be identified as being "at risk" for noncompletion and as requiring special efforts.
Immediately following receipt of their 1-year follow-up mailed questionnaire, 55 former patients from an addiction treatment program were interviewed personally, and a urine sample was collected. Results indicate a high degree of correspondence of self-reported drug use with the urinalysis reports, and moderately high correspondence between the information on employment, school attendance, legal status,and length of heroin run given in the mailed questionnaire with that provided in the personal interview.
In observing more than 300 clinical interviews, we have seen a high frequency of physician-engendered defects. Most of the defective examples can be classified as one or a combination of five syndromes: the therapeutic lack; inattention to primary data (symptoms); a high control style; an incomplete data base usually omitting patient-centered data and active problems other than the present illness; and a thoughtless interview in which the physician fails to formulate needed working hypotheses. Proper diagnosis of these defects allows for better prescription of educational correction.
BACKGROUND: The endpoint Time to Subsequent Therapy (TTST) is an intermediate endpoint used in research and regulatory assessments. TTST denotes initiation of subsequent therapy and is a clearly definable, clinically relevant event for healthcare professionals. However, it has not been systematically established to which extent TTST is subjectively meaningful to patients. The objective of this study was to define TTST as a patient-relevant intermediate endpoint. METHODS: The study examined five oncological indications (breast cancer, prostate cancer, melanoma, multiple myeloma, and non-small cell lung cancer) using a systematic literature review, analysis of case report forms used in international randomized controlled trials, review of German Federal Joint Committee (G-BA) documents, semi-structured interviews and a two-stage Delphi survey with healthcare professionals, patients, and relatives. RESULTS: A total of 35 individuals participated in qualitative interviews. Most of them rated TTST as particularly significant. The Delphi Survey included 264 interviewees in round one, and 117 in round two. Patient-relevance of TTST was confirmed by 81% of respondents (95% confidence interval 76%, 85%). Nine treatment scenarios that justify TTST were identified. To capture patient-relevance, prospective collection of reasons for and consequences of therapy change are required. A checklist with standardized response formats plus free-text fields was developed: a comprehensive master checklist for flexible, complete documentation and a short version focused on therapy change-specific items. CONCLUSIONS: TTST is an intermediate endpoint whose systematic documentation of characteristics demonstrating patient-relevance can be standardized in research and clinical practice using the developed checklists.
This paper describes a structured course for teaching interviewing which focuses on the interaction between the patient and the practitioner. Three main areas of learning were selected because of their universal application: relationship, communication, and feelings. Theoretical material is related to positive and negative interactions with patients, and these are described behaviorally in a checklist form. The development of good interviewing techniques consists of increasing the positive interactions and learning to use them as diagnostic and therapeutic tools. Different methods are utilized to help students apply these skills in clinical situations. Although this course was developed for a specific group of pediatric practitioners, it can be utilized by all types of health care professionals.
A press interview provides a unique opportunity to promote a positive public image of your institution. A good interview takes preparation, some understanding of what interests the press, and often follow-up. Covering all three areas, this article tells the nurse administrator how to deal effectively with journalists.
An immunization interview survey was carried out in the urban and rural areas of Mongolia. The population sample interrogated comprised 1359 households with 6994 household members, 3634 of them younger than 15 years. The data collection unit was a private household, where information on administrative, demographic and socio-economic items was obtained in addition to detailed information on vaccination histories. A fair number of individuals with a positive history was found among children aged 1 to 5 years; the highest rates were determined among preschool and school-children aged 5 to 9. Significant differences in vaccination rates were found between urban and rural dwellers, urban areas displaying a higher proportion of vaccinated children in the younger age groups and rural areas among school-age children. A significantly higher proportion of vaccinated individuals was found among children living in somons than those living in aimac centres. No significant differences were found between children attending child collective institutions and those educated solely at home. The immunization interview survey was specially directed toward obtaining an estimate of the vaccinated population segment with reference to age in demarcated areas and thus detecting "weak spots" requiring remedial action.
A representative, nationwide sample comprising 50 dentists in Norway was surveyed through personal interviews concerning their opinions on and need for postgraduate education. The reports clearly indicated that the professional challenges are changing rapidly as a result of improved treatment habits and dental health among most patients and that continuing dental education should adjust to the new situation. Most interviewers were satisfied with the courses presently offered, but they nevertheless wanted more of them, particularly in oral medicine and surgery, prosthetics, prevention and community dentistry. Scientific papers abounding with statistics and histology were suggested to be reduced in the Norwegian Dental Journal, and should be replaced by practical review papers. Social motives for attending professional meetings were common, the dentists said they learned much of practical value and picked up news in conversations with colleagues. Improved contacts with the dental schools was desired. Concerning undergraduate education, a prevailing view was that too much time was devoted to basic sciences as opposed to clinical- and community dentistry. The attitude towards compulsary continuing education was ambiguous, conceivably a reflection of the two different professional ideals: high standards and autonomy.
For a pilot study, a random sample of 181 office personnel in steel companies were interviewed about their knowledge and feelings on X-rays and other forms of ionizing radiation. The general knowledge about the beneficial and detrimental aspects of X-rays was good, with education at school and news media reports being the main sources of information (70%). In general, the news media are considered to give objective and correct reports on this matter. 85% of the interviewed held ionizing radiation to be at least somewhat dangerous. Those with higher education (college/university) were significantly more vocal on the dangerous aspects. Concerning personal fear of X-rays, 30% were at least somewhat fearful. A significant correlation was found between statements on the dangerous aspects and subjective feelings of fear (anxiety). Interestingly, there was no correlation between general fearfulness (manifest anxiety) and fear of X-rays.
A simple, inexpensive video-recording system was designed to provide raw data for the evaluation of therapist interview behaviors in the out-patient clinic. The system uses a combination of commercially available cameras, lenses, and recording equipment which do not require technical audio-video expertise to operate. Video-cassette recordings are produced that contain full-face, head-and-shoulders images of both the therapist and the patient. An automatic search control terminal rapidly locates any point on the video-cassette for review. Using normal clinic lighting and little space, the system is easily installed in any existing clinic examination room. A description of the system's use in examining the counseling and interviewing skills of a medical clinic staff is presented.
Suggestions for pharmacists interviewing technician applicants are given. An outline of methods to make interviews more productive and suggested questions to be discussed is presented.