Disclosing the diagnosis of dementia: the performance of Flemish general practitioners

2004 ◽  
Vol 16 (4) ◽  
pp. 421-428 ◽  
Author(s):  
J. De Lepeleire ◽  
F. Buntinx ◽  
B. Aertgeerts
Keyword(s):  
Differential Diagnosis ◽  
Detailed Analysis ◽  
General Practitioners ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Patient Relationship ◽  
Good Doctor ◽  
Diagnosis Of Dementia ◽  
Set Up

Background: This issue of whether or not, how and when patients should be told of the diagnosis of dementia remains a matter for discussion. Recent data confirm that the patient is told of the diagnosis in only 40 to 55% of cases. We therefore studied the performance of Flemish general practitioners (GPs) in this area.Method: A postal questionnaire, based on that prepared by Johnson et al., was sent to a random sample of 1000 Flemish GPs, out of a total of 7000.Results: A total of 647 answers were returned, of which 521 were eligible for analysis (response rate 60%). Thirty-six percent of these 521 GPs always or usually disclose the diagnosis, while 37% provide information about the prognosis. Most doctors (75%) see benefits in disclosure, particularly as regards planning care, providing treatment and encouraging a good doctor-patient relationship. Only 61% of respondents present an appropriate differential diagnosis.Discussion: The results obtained from the Flemish GPs are similar to those of other known studies. A detailed analysis of the reasons for and the benefits of disclosing the diagnosis reveal a less reluctant attitude than could be inferred from the rough data. GPs pay a great deal of attention to the patient's feelings, experiences and ability to cope and to the proper timing of their information. However, intensive educational projects have to be set up in order to stimulate a more etiologically-oriented diagnosis and to improve the quality of the process of disclosing the diagnosis of dementia.

General Practitioners' Knowledge and Use of a Disabled Living Centre

1996 ◽  
Vol 59 (2) ◽  
pp. 79-83
Author(s):  
Anna V Phillips
Keyword(s):  
Monitoring System ◽  
General Practitioners ◽  
Telephone Interview ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Professional Group ◽  
Second Stage ◽  
Set Up ◽  
Two Stages ◽  
To Receive

In March 1994, 141 Aberdeen general practitioners (GPs) were surveyed to clarify why Hillylands Disabled Living Centre (DLC) appeared to receive few direct referrals from this professional group. This was carried out in two stages. The first consisted of a postal questionnaire which received a 77% response rate. This identified that 90% of the 108 respondents knew of Hillylands' existence but only 24% were fully aware of the services it offered. Forty-six per cent had advised someone to visit Hillylands DLC, although only 17% of GPs had visited the centre themselves. The second stage, a telephone interview of 46 volunteer GPs, indicated that some GPs recognised a need to increase their awareness. Some felt that it was not appropriate that they visit Hillylands DLC, although those who had done so had found their visit useful. Recommendations are made to extend the mailing list at Hillylands and to set up a monitoring system to ensure regular liaison and supply of publicity material. It is also suggested that the feasibility of developing a comprehensive publicity initiative be investigated.

scholarly journals Flexible higher training in psychiatry

1999 ◽  
Vol 23 (10) ◽  
pp. 613-615 ◽  
Author(s):  
Anne Dean ◽  
Samaa El Abd ◽  
Ann York
Keyword(s):  
Response Rate ◽  
Postal Questionnaire ◽  
Psychiatric Training ◽  
Department Of Health ◽  
Part Time ◽  
Training Opportunities

Aims and methodThis survey was commissioned and funded by the Department of Health to examine perceptions of training by flexible trainees in higher psychiatric training. A total of 214 trainees were surveyed using a postal questionnaire.ResultsOne hundred and thirty-five questionnaires were returned (response rate 63%). In general, flexible trainees valued the opportunity to train part-time and perceived the quality of their training to be high. However, there were drawbacks such as: perceived lack of status, restricted training opportunities and a lack of part-time consultant posts at the end of training.ImplicationsFlexible training plays a major role in maintaining doctors in the workforce. However, there is a need for part-time opportunities to extend beyond the training grades and into consultant posts.

scholarly journals The Pilot Survey of the Perception on the Practice Pattern, Diagnosis, and Treatment on Korean Medicine Insomnia: Focusing on the Difference between Korean Medical Neuropsychiatry Specialists and Korean Medical General Practitioners

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Jung-Hwa Lim ◽  
Jin-Hyung Jeong ◽  
Sang-Ho Kim ◽  
Kyeong-Ok Kim ◽  
Seung-Yeon Lee ◽  
...  
Keyword(s):  
Clinical Practice ◽  
General Practitioners ◽  
Medical Diagnosis ◽  
Response Rate ◽  
Diagnosis And Treatment ◽  
Pilot Survey ◽  
Pattern Diagnosis ◽  
The Difference ◽  
Guipi Decoction

Introduction. This study aims to investigate the clinical practice states on the diagnosis and treatment for insomnia between Korean medical general practitioners (KMGPs) and Korean medical neuropsychiatry specialists (KMNPSs). Methods. We distributed questionnaires via email or in person to 1,017 KMGPs and via email to 165 KMNPSs. We collected and analyzed responses from 305 (30.00%) KMGPs and 53 (32.12%) KMNPSs. Results. Most KMGPs and KMNPSs responded that the number of new patients visiting the clinic for treatment of insomnia was less than 10 per month (78.2%). Frequently utilized therapies for insomnia are acupuncture and herbal decoctions. Particularly acupoint GV20 and Guipi decoction were chosen with the highest response rate. There was no difference between KMNPSs and KMGPs in the traditional Korean medical diagnosis methods. However, KMNPSs utilized more various methods to diagnose, treat, and evaluate insomnia and educated more actively sleep hygiene compared to KMGPs. Conclusions. This survey showed how insomnia is currently diagnosed and treated in Korean medical care settings. Moreover, we identified some differences between KMNPSs and KMGPs. Further research is required to explore the underlying reasons for these discrepancies among KMDs and to improve the quality of Korean medical clinical practice in treating insomnia.

scholarly journals Evaluation of quality of life in prostate cancer patients

2015 ◽  
Vol 62 (3) ◽  
pp. 272-275
Author(s):  
Justin Aurelian ◽  
◽  
Daniel Badescu ◽  
Ileana Ionel ◽  
Valentin Ambert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Emotional State ◽  
Patient Relationship ◽  
Significant Treatment ◽  
Good Doctor ◽  
Patient’S Perception ◽  
The Impact ◽  
Over Time

Quality of life is not a new concept but one whose understanding and terminology evolved over time. The impact of prostate cancer on quality of life is significant, treatment outcomes being influenced by the patient’s perception about his illness. Emotional state and concerns induced by the disease progression and treatment are important elements for a good doctor-patient relationship.

Usage of clozapine and the new neuroleptics

1999 ◽  
Vol 23 (8) ◽  
pp. 478-480
Author(s):  
M. F. Bristow
Keyword(s):  
General Practitioner ◽  
General Practitioners ◽  
Atypical Antipsychotic ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
England And Wales

Aims and methodTo explore clozapine and atypical antipsychotic usage in England and Wales, particularly availability, restrictions on use and shifting of prescribing to general practitioners. To examine the hypothesis that respondents in acute trusts would encounter more restrictions. Method used – postal questionnaire sent to general psychiatrists derived from the 1996 Medical Directory.ResultsThere was an 80% response rate and over 90% of respondents used clozapine, with only 9% reporting any difficulty in obtaining it. Difficulty was not associated with any particular type of trust. Only about 4% of respondents suggested that general practitioners regularly took over the prescribing costs of the drug.Clinical implicationsOptimistic, with widespread usage and few difficulties in obtaining clozapine. General practitioner prescribing is still very low and needs to increase.

scholarly journals Difficulties with use of the Mental Health (Scotland) Act 1984 by general practitioners in rural Scotland

2004 ◽  
Vol 28 (7) ◽  
pp. 248-250 ◽  
Author(s):  
Millia Begum ◽  
Rebecca Helliwell ◽  
Angus Mackay
Keyword(s):  
Mental Health ◽  
General Practitioners ◽  
Rural Areas ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Questionnaire Response ◽  
Populated Area ◽  
Local Conditions ◽  
Psychiatric Staff ◽  
Agency Action

Aims and MethodAnecdotal evidence suggests that considerable difficulties are experienced in rural areas by isolated general practitioners, when detaining patients under the Mental Health (Scotland) Act1984. The aim of this study was to identify the range and extent of these difficulties in a structured way, and to identify ways of responding to them. A postal questionnaire was sent to 85 general practitioners in a sparsely populated area of Scotland to assess their experience of emergency detention.ResultsThe questionnaire response rate was 62%. Considerable difficulties were recorded from those who responded, notably their lack of support with clinical management during the delay between the patient's detention and the arrival of psychiatric staff, the lack of satisfactory places of safety for the patient during this period, and the difficult logistics of safe and satisfactory transport to hospital.Clinical ImplicationsRural general practitioners and their patients appear to be disadvantaged through lack of coordinated help in the management of inherently difficult and risky clinical situations. Even without additional resources, the process could be improved through coordinated, multi-agency action plans which take account of local conditions.

scholarly journals Correspondence from substance misuse services – what do general practitioners really want?

2006 ◽  
Vol 30 (8) ◽  
pp. 292-294
Author(s):  
Devatha Radhae Shyam ◽  
Hugh Williams
Keyword(s):  
General Practitioners ◽  
Questionnaire Survey ◽  
Substance Misuse ◽  
Quality Standards ◽  
Management Plan ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Medication Prescribing

Aims and MethodTo improve the quality of correspondence by identifying what general practitioners (GPs) regarded as the important attributes in patient letters from a substance misuse service. A postal questionnaire survey was carried out to determine the views of general practitioners in Brighton and Hove City.ResultsResponses were obtained from 32 out of 45 GP surgeries (71%) and indicated that correspondence should be prompt, concise and regular. An assessment summary, management plan and clear medication prescribing arrangements between primary and secondary services were considered particularly important.Clinical ImplicationsNew quality standards for correspondence to GPs have been implemented by the Brighton Substance Misuse Service. These might be of interest to other such services.

Acceptable outcomes after fundoplication—different views are held by patients, GPs, and surgeons

2019 ◽  
Vol 32 (8) ◽  
Author(s):  
Andrew C Currie ◽  
Tim Bright ◽  
Sarah K Thompson ◽  
Lorelle Smith ◽  
Peter G Devitt ◽  
...  
Keyword(s):  
General Practitioners ◽  
Antireflux Surgery ◽  
Laparoscopic Fundoplication ◽  
Response Rate ◽  
Multivariate Statistical ◽  
Female Patients ◽  
Clinical Scenarios ◽  
Male Patients ◽  
Acceptable Outcome

SUMMARY Antireflux surgery aims to improve quality of life. However, whether patients and clinicians agree on what this means, and what is an acceptable outcome following fundoplication, is unknown. This study used clinical scenarios pertinent to laparoscopic fundoplication for gastroesophageal reflux to define acceptable outcomes from the perspective of patients, surgeons, and general practitioners (GPs). Patients who had previously undergone a laparoscopic fundoplication, general practitioners, and esophagogastric surgeons were invited to rank 11 clinical scenarios of outcomes following laparoscopic fundoplication for acceptability. Clinicopathological and practice variables were collated for patients and clinicians, respectively. GPs and esophagogastric surgeons additionally were asked to estimate postfundoplication outcome probabilities. Descriptive and multivariate statistical analyses were undertaken to examine for associations with acceptability. Reponses were received from 331 patients (36.4% response rate), 93 GPs (13.4% response), and 60 surgeons (36.4% response). Bloating and inability to belch was less acceptable and dysphagia requiring intervention more acceptable to patients compared to clinicians. On regression analysis, female patients found bloating to be less acceptable (OR: 0.51 [95%CI: 0.29–0.91]; P = 0.022), but dysphagia more acceptable (OR: 1.93 [95%CI: 1.17–3.21]; P = 0.011). Postfundoplication estimation of reflux resolution was higher and that of bloating was lower for GPs compared to esophagogastric surgeons. Patients and clinicians have different appreciations of an acceptable outcome following antireflux surgery. Female patients are more concerned about wind-related side effects than male patients. The opposite holds true for dysphagia. Surgeons and GPs differ in their estimation of event probability for patient recovery following antireflux surgery, and this might explain their differing considerations of acceptable outcomes.

Ego Psychoanalytic Rorschach Interpretation

2017 ◽  
Vol 38 (1) ◽  
pp. 22-32 ◽  
Author(s):  
Irving B. Weiner
Keyword(s):  
Differential Diagnosis ◽  
Sequence Analysis ◽  
Treatment Planning ◽  
Well Being ◽  
Adjustment Difficulties ◽  
Behavioral Features ◽  
Defensive Style ◽  
Cognitive Slippage ◽  
Interpretive Process

Abstract. This article concerns the utility of ego psychoanalytic perspectives in Rorschach interpretation. Psychoanalytic ego psychology focuses on how people cope with events in their lives and how effectively they can meet challenges to their sense of well-being. The way people deal with experienced distress constitutes their defensive style and determines to a large extent what kind of person they are. Adequate defenses against anxiety promote comfortable and productive adjustment, whereas ineffective defenses typically cause adjustment difficulties and susceptibility to psychological disorders. In Rorschach assessment, the nature and effectiveness of a person’s defensive style can often be identified with a sequence analysis that integrates the structural, thematic, and behavioral features in the protocol. In particular, the sequential quality of responses, especially preceding and following instances of cognitive slippage, can help identify causes of upsetting concerns, defensive efforts to alleviating these concerns, and the adequacy of these defensive efforts in restoring equanimity. This interpretive process is illustrated with attention to implications for differential diagnosis and treatment planning in the Rorschach protocol of a 20-year-old suicidal woman.

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