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PubMed1997

Managing the doctor-nurse game: a nursing and social science analysis.

In the struggle to achieve professional status and develop a body of knowledge, nursing has embraced a number of 'sciences' and 'disciplines'. These have included sociology and feminist perspectives. This paper explores the difficulties of drawing on these disciplines independently of everyday nursing practice. Using a case study approach, we illustrate the way in which some nurses draw on sociological and feminist 'definitions of the situation' in the 'doctor-nurse game', while others draw directly on nursing practice. The nursing practice in this case is concerned with pain management. We conclude that 'shared care' requires a collaboration with medicine that draws on nursing practice to demonstrate an integrated nursing knowledge in a way that acknowledges, challenges and asserts issues of power and status.

Aged↗
PubMedDate not supplied

Using patient satisfaction as an indicator of the quality of laboratory services. Applying social science methods to evaluate outcomes in laboratory medicine.

The authors discuss methods of outcomes research using patient satisfaction as a quality indicator for evaluating point-of-care (POC) laboratory methods. After commenting on the rationale for using this approach, we focus on specific techniques for developing questionnaires, collecting survey response data, and building a database for analysis. We also address problems that arise in incorporating data from medical records into a research database and the linkage of records from disparate sources. Approaches to cost analysis are discussed, including problems with the use of financial and billing records. Preliminary results thus far show no significant effects from the use of POC prothrombin time testing on hospital inpatient evaluations of their overall care. Using laboratory charges and total reimbursements for treatment as proxies for cost, we found a significant (p < 0.0001) difference in the costs for POC testing over those for testing in the central laboratory.

Alabama↗
PubMed2000

Interventions to prevent HIV risk behaviors. National Institutes of Health Consensus Development Conference Statement February 11-13, 1997.

OBJECTIVE: To provide health care providers, patients, and the general public with a responsible assessment of behavioral intervention methods that may reduce the risk of HIV infection. PARTICIPANTS: A non-Federal, nonadvocate, 12-member panel representing the fields of psychiatry, psychology, behavioral and social science, social work, and epidemiology. In addition, 15 experts in psychiatry, psychology, behavioral and social science, social work, and epidemiology presented data to the panel and a conference audience of 1000. EVIDENCE: The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. CONSENSUS PROCESS: The panel, answering predefined questions, developed its conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. CONCLUSIONS: Behavioral interventions to reduce risk for HIV/AIDS are effective and should be disseminated widely. Legislative restriction on needle exchange programs must be lifted because such legislation constitutes a major barrier to realizing the potential of a powerful approach and exposes millions of people to unnecessary risk. Legislative barriers that discourage effective programs aimed at youth must be eliminated. Although sexual abstinence is a desirable objective, programs must include instruction on safer sex behaviors. The erosion of funding for drug abuse treatment programs must be halted because research data clearly show that such programs reduce risky drug abuse behavior and often eliminate drug abuse itself. Finally, new research must focus on emerging risk groups such as young people, particularly those who are gay and who are members of ethnic minority groups, and women, in whom transmission of HIV virus to their children remains a major public health problem.

Female↗