SEARCH · Search PubMed

Results for “CONSULTATIONS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,459 records · Page 81Linked to original sources

PubMed2005

Consultation for and identification of child and adolescent psychological problems in Dutch general practice.

BACKGROUND: Child and adolescent psychological problems are rarely brought to the attention of GPs. Children and adolescents with psychological problems who do visit their GP are seldom identified as such by GPs. OBJECTIVE: To investigate in a general population sample of 2,449 Dutch children and adolescents (4-17 years) GP consultation and GP diagnoses of child psychological problems, and the influence of child and family characteristics upon these variables. METHODS: The degree to which parent, teacher, and adolescent reports of the presence of child psychological problems are in concordance with GP diagnoses of these problems was determined. Logistic regression analyses were used to examine correlates of GP consultation and psychological diagnoses. RESULTS: Approximately 80% of children and adolescents with psychological problems had visited their GP within the preceding year. GP consultation was most strongly associated with child/adolescent chronic physical disorders. Concordance between GP psychological diagnoses and parent, teacher, and adolescent reports of psychological problems was limited. Children and adolescents with psychological problems according to parent or teacher report, children with school problems, young boys, adolescents with negative health perceptions, and adolescents from single parent families were more likely to be diagnosed with psychological problems by GPs. CONCLUSION: Improving GPs' interview techniques, introducing standardised screening measures in general practice, increasing GPs' awareness of the possible presence of psychological problems in children consulting for physical problems, and strengthening collaboration between GPs and mental health professionals may increase GP identification of child psychological problems and enhance access to care for those in need.

Adolescent↗

PubMed1984

Curbside consultation in infectious diseases: a prospective study.

This study prospectively evaluates curbside (unofficial, informal) consultation (CSC) directed to the hospital-based Infectious Disease Consultation Service (IDCS) in a 1,000-bed university-affiliated, general teaching hospital. Official consultation (OC) was neither solicited nor discouraged. During a one-year period, the IDCS was consulted officially about 532 patients (503 inpatients, 29 outpatients) and unofficially about 269 patients. Only 31 (11.5%) of the 269 CSCs subsequently resulted in OCs. Problems discussed during a CSC ranged from simple to complicated and life threatening, with pneumonia, hepatitis, and syphilis being the illnesses most frequently discussed. Forty-two percent of the CSCs were sought by the internal medicine housestaff, whereas approximately 29% were sought by internal medicine staff physicians. It may be concluded that a CSC in infectious diseases is common, that it sometimes involves complicated and/or life-threatening illnesses but usually does not result in a subsequent OC, and that it requires a considerable expenditure of time by the Infectious Disease Service. A CSC may also involve the exchange of inaccurate or insufficient information between inquiring physicians and the Infectious Disease Service.

Humans↗

PubMed1985

Roles and responsibilities: theoretical issues in the definition of consultation liaison psychiatry.

Central to much medical ethical analysis is the concept of the role of the physician. While this concept plays an important role in medical ethics, its function is largely tacit. The present paper attempts to bring the concept of a social role to prominence by focusing on an historically recent and rather richly contextured role, namely, that of consultation liaison psychiatry. Since my intention is primarily theoretical, I largely ignore the empirical studies which purport to develop the detailed functioning of the role. My limited intent is to draw attention to the theoretical complexity of the consultation liaison role as an example of the general relevance of role concepts to medical ethics. For this reason, consultation liaison psychiatry will function as an illustration of fundamental concepts of medical ethics rather than as a subject of analysis in its own right. Similarly, the concept of the social role will be developed only as is necessary to explore the general relationship between the consultation liaison role and ethical analysis.

Authoritarianism↗

PubMed1995

Influence of physical, psychological and behavioural factors on consultations for back pain.

Over 34,000 questionnaires were used to study occurrence and consultations for back pain in the community. The 12-month period prevalence was 24% and 13% of the sample consulted a doctor. Elderly women were at greatest risk of back pain. The consultation rate increased in both sexes throughout middle age, but declined in men over the age of 55 yr. Back pain was associated with the Goldberg General Health Health Questionnaire score suggesting psychiatric morbidity [odds ratio (OR) = 2.05; confidence interval (CI) 1.89-2.23], obesity (OR = 1.59; CI 1.40-1.79), and cigarette smoking (OR = 1.52; CI 1.36-1.70). Vigorous daily activity was positively associated with back pain in men aged 18-39 yr (OR = 1.37; CI 1.02-1.85), and women aged 18-39 yr (OR = 1.50; CI 1.08-2.09), but was negatively associated with back pain in women aged over 65 yr (OR = 0.35; CI 0.16-0.76). Alcohol consumption was also negatively associated with back pain (OR = 0.72; CI 0.62-0.85). The prevalence of arthritis, constipation and respiratory disorders was increased in those who consulted for back pain corrected for the other variables. Thus back pain was substantially more common in women compared to men over 55 yr. Psychiatric morbidity, cigarette smoking and obesity were associated with back pain at all ages, but the effect of physical exercise appeared to change with age. Further studies are required to explain the sex differences and nature of the associations.

Adolescent↗

PubMed2005

Competence-based assessment of specialist registrars: evaluation of a new assessment of out-patient consultations.

OBJECTIVE: To implement and evaluate formal assessment of the performance of West Midlands rheumatology specialist registrars (SpRs) in conducting out-patient consultations. METHODS: SpRs conducted a full out-patient clinic while being observed by one or two consultants who scored each SpR's performance on a structured pro forma. The assessment was conducted within the examining consultant's hospital trust (in which the SpR was not working). The process was evaluated by trainees and trainers by means of a questionnaire. RESULTS: Sixteen SpRs were assessed. No trainee failed to reach the required standard. Six trainees scored 'borderline' for management planning and four had a borderline performance recorded for examination skills. Overall the process was valued by trainers and trainees, although consensus was that it would be more practicable for the trainee to be examined within the hospital in which they were working by a visiting consultant examiner. It was also felt that a broader range of scoring options would be preferable. CONCLUSION: Formal assessment, by direct observation, of the skills of SpRs in conducting an out-patient clinic is practicable and offers information which is useful to trainer and trainee. A culture of direct observation of performance can be achieved within the context of rheumatology higher medical training.

Ambulatory Care↗

PubMed2006

The management of knee pain in primary care: factors associated with consulting the GP and referrals to secondary care.

OBJECTIVES: To investigate the treatment of knee pain in primary care and the factors associated with consulting general practitioners (GPs) and referrals to specialist services. METHODS: Individuals with knee pain were identified through postal questionnaires sent to patients aged 50 and over from two GP practices in southeast London. Patients with knee pain were then invited to the department, where demographic, clinical and service use data were collected. Participants also completed measures of pain, function, handicap and illness beliefs. RESULTS: From the 2940 questionnaires that were sent out, the response rate was 34%. Of these, 49% reported experiencing knee pain in the previous 12 months. Two hundred and thirty-one patients with knee pain attended the department. One hundred and thirty-four (58%) had seen their GP about their knee pain, with 50 (37%) referred on to specialist services. Compared with non-consulters, consulters had more severe disease and higher levels of disability and handicap, and believed the condition was more severe and had major consequences on their lives. Those referred to specialist care had higher levels of handicap and also believed the condition was more severe, with major consequences on their lives, than those not referred. CONCLUSION: In this sample nearly half of those who reported knee pain had not seen their GP and were self-managing their condition. A mixture of physical, social and psychological factors predicted visits to GPs and rates of referral to secondary care. Patient perceptions about knee pain were important predictors of both consultations and referrals, highlighting the need to address both physical and psychosocial factors in relation to help-seeking.

Aged↗

PubMed1991

Psychiatric consultation-liaison nursing interventions with nurses of hospitalized AIDS patients.

Acquired Immune Deficiency Syndrome (AIDS) is a devastating medical illness of epidemic proportions with cases continuing to increase at an alarming rate. Hospital nurses at all levels and in all specialized areas of practice are affected by the challenge of caring for AIDS patients, who have overwhelming physical and psychosocial needs. Psychiatric consultation-liaison nurses (PCLNs) in general hospital settings have had to adapt to the needs of the rising AIDS population in their practice. Yet little information exists in the literature about the nature of consultations received from nurses concerning AIDS patients or the subsequent PCLN interventions. A report of the consultative activities related to AIDS patients of a PCLN in a tertiary care center, specifically interventions with managerial and staff nurses, is discussed. The report is derived from a retrospective review and analysis of the author's consultation records of clinical experiences with nurses and AIDS patients over a 6-year period.

Acquired Immunodeficiency Syndrome↗

PubMed1993

Nurse consultant and professional liability.

The expanded role of nurse consultant brings greater responsibility and risk of professional liability in a litigious society. The nurse consultant needs to be aware of the elements that constitute malpractice and be able to plan for the management of risks involved. When purchasing a liability policy, the nurse consultant must consider the practice setting, types of policies, components of the policy, cost, and means to obtain adequate coverage. Other strategies for protection include proper use of the consultant process, client communication, and individualized client contracts. A well-written contract serves as a legal document to delineate responsibilities and outcomes, provide a professional image, and protect against possible negative developments.

Consultants↗

PubMed1994

The development of CNS consultation forms.

Consultation is an essential part of CNS practice. Communication of information completes the consultation process and allows for quality care to be provided by all members aware of the consultation. Therefore, it is important to document the consultation clearly. How one CNS group addressed this issue is described.

Communication↗

PubMed1995

Nursing consultation to reduce restraints in a nursing home.

Consultation is an important function of advanced practice nurses. Within nursing practice, the process of providing consultation has been studied primarily in acute care settings. A CNS in a 180-bed, nonprofit nursing home implemented the intervention for a controlled clinical trial of nursing interventions to reduce physical restraint use. The consulting process undertaken by the CNS is described, and conclusions are offered regarding the most effective approaches to consultation by advanced practice nurses in nursing homes.

Consultants↗

PubMed1998

Psychiatric consultation-liaison nursing: revisiting the role.

With their special training and assessment skills, psychiatric consultation-liaison nurses have a long history of making important contributions to patient care and staff development. This article reviews how psychiatric consultation-liaison nurses have traditionally approached and implemented the nursing consultation process. Issues facing psychiatric consultation-liaison nurses are discussed. Opportunities such as focusing on subspecialization; expanding practice settings; dealing with organization-based, rather than patient-based mental health issues; and entering intra- and entrepreneurial practice are also explored.

Consultants↗

PubMed1999

The challenges of a home-based nursing consultation business.

The transition from working in a traditional setting to working at home alone can be challenging for new nurse consultants. Home-based consultants can use a variety of strategies to stay focused and connected, such as having a designated work area, limiting distractions, and networking. Nurse consultants can obtain information about business management from community resources, and computer on-line services offer a means of contacting other small-business owners. Ongoing business evaluations, which include professional accomplishments as well as an examination of income and expenses, help in planning. Home-based nurse consultants can increase the likelihood of business success by setting objectives, working diligently, and networking with others in the business community.

Adaptation, Psychological↗

PubMed2000

Mental health consultation in a nursing home.

As the world's population ages, increasing numbers of people can anticipate spending their latter years in long-term care settings. Many of these nursing home residents will also present psychiatric illnesses as primary or secondary diagnoses. The resulting behavioral problems may present challenges to nursing staff that they are ill-prepared to meet. This article illustrates the application of the Blake and Mouton consultation model to a Veterans Administration (VA) nursing home situation by a team of psychiatric mental health nurse specialists. The consultation is described and interpreted in terms of the Blake and Mouton model. The focal conflicts addressed in the consultation included issues of morale/cohesion, power/authority, and norms/standards. Interventions used were acceptant, prescriptive, confrontation, and theories/principles. The model provided a useful structure for conceptualizing and organizing assessment and intervention in the consultation situation.

Absenteeism↗

PubMed1998

Consultation-liaison in child psychiatry: a review of the past 10 years. Part II: Research on treatment approaches and outcomes.

OBJECTIVE: To critically review the research and reports on consultation-liaison psychiatry in the past 10 years. METHOD: Articles contributing to the conceptualization of child psychiatric consultation in medical, epidemiological, and nonmedical domains were reviewed. RESULTS: Information was organized into methodology and treatment outcome categories. Nonmedical consultation articles were briefly reviewed. Articles reporting therapeutic techniques in consultation-liaison work and outcome studies are described. CONCLUSIONS: In spite of constraints imposed by managed care upon referral to specialists, the current epoch finds child psychiatrists both better equipped and more compelled to use their skills in innovative ways to help children in different domains.

Child↗

PubMed2003

Long-term follow-up of overweight children: after training, after a single consultation session, and without treatment.

BACKGROUND: A satisfactory treatment of childhood obesity has not yet been found. An individual consultation session is the usual practice while experts recommend an outpatient training program consisting of a combination of physical exercise, nutrition education, and behavior therapy. METHODS: We analyzed degree of overweight (SDS-BMI) after one and two years in overweight children (aged 6-15 years) who had had a single consultation session (n = 66) and who had finished a one-year, structured outpatient training program consisting of physical exercise, nutrition education, and behavior therapy (n = 81). Furthermore we collected data on changes in weight for a control group of overweight children not receiving any treatment (n = 100) over the same period of time. RESULTS: There was no significant change in the degree of overweight over the period of two years either for the control group or for those having received single consultation. The participants of the training were in mean significantly less overweight than at the beginning of the training (P < 0.001), both after one year (mean change in SDS-BMI -0.38) and after the second year (mean change in SDS-BMI -0.30). CONCLUSIONS: Overweight children not receiving treatment do not reduce in weight. A single consultation session is not sufficient to achieve weight reduction in children. Weight reduction over at least two years can be achieved in part of the participants of a long-term, specialized treatment.

Adolescent↗

PubMed1982

The efficacy of second-opinion consultation programs: a cost-benefit perspective.

This study evaluates a mandatory second-opinion consultation program administered on behalf of a large Taft-Hartley welfare fund providing medical care coverage for 120,000 beneficiaries and covered dependents. During a two-year intake period (1977-1978), 2,284 individuals received second-opinion consultations for an elective surgical procedure recommended by a first-contact physician or surgeon. Of this group, 366 received a nonconfirmation of their need for surgery. Medical claims data were available for 342 individuals in this group, and they constitute the base for the current analysis. A comparable number of individuals who received a positive confirmation were randomly selected and served as a control for estimating program savings. Both groups were followed for a one-year period from the date of their consultations. Total program savings were estimated at $534,791. Of this amount, medical care utilization savings were $361,756 and productivity savings were $173,035. The cost of the program was $203,300, yielding a benefit-cost ratio of 2.63. These findings indicate that mandatory second-opinion consultation programs, which are consumer oriented and intervene before care is rendered, are clearly cost-effective.

Adolescent↗

PubMed1992

The effects of consultation on over-the-counter medication purchasing decisions.

This article examines factors that predict changes in consumer purchasing decisions of nonprescription medications. Variables corresponding to factors in Andersen's behavioral model are measured, in addition to data regarding characteristics of the 17 pharmacy consultants who provided counseling services. One thousand seven hundred and thirteen consumers in five stores in southern California were provided consultation during a 6-month period, resulting in 25.4% of the patients purchasing a different drug than intended when entering the pharmacy, 1.3% being referred to a physician, and 13.4% not purchasing any over-the-counter medication at all. Logistic regression techniques demonstrated that one enabling variable (availability of generic medications), and four need factors (the discussion of clinical issues, short encounters, cough and cold products, and vitamin products) were significant predictors of the consumer's decision to purchase a different product than intended. Consultant characteristics (introversion, external locus of control) were also important predictors, but opposite the expected direction. Consumers who received information from female consultants were more likely to change their purchasing decisions.

Adult↗

PubMed1993

Enhancing professional communication: a formal computerized nurse-to-nurse consultation system.

A formal computerized way for nurses to practice intraprofessional consultation was developed by envisioning the ideal and using the research process. Results of the evaluation were: (1) informal consultation per phone or face-to-face continued as before; (2) formal nurse-to-nurse consultation through the computer was rarely being used; and (3) documentation of nurse-to-nurse consultation continued to be rare.

Communication↗