How much is residents' distress detection performance during a clinical round related to their characteristics?

in Patient Education & Counseling (2011)

Adjusting insulin doses : from knowledge to decision

in Patient Education & Counseling (2005), 56

The aim of this study was to analyze the absence of adjustment of insulin doses in type 1 diabetic patients with poorly controlled diabetes. Twenty-eight patients (HbA1c higher than 8.5% during the last 6 ... [more ▼]

The aim of this study was to analyze the absence of adjustment of insulin doses in type 1 diabetic patients with poorly controlled diabetes. Twenty-eight patients (HbA1c higher than 8.5% during the last 6 months, performing at least three capillary blood glucose determinations per day), completed a questionnaire on the degree of confidence in their own knowledge, the nature of their health beliefs, their fear of hypoglycemia, their own appreciation on how they adjust their insulin doses (subjective score). An analysis of their diabetes logbook provided an objective score of the adjustment of doses actually performed. The results show that the subjective and objective scores of adjustment were not significantly correlated. Further there was a significant negative correlation between the score of uncertainty on knowledge and the subjective score of adjustment of the insulin doses, but not with the objective score. There was a significant correlationbetween the score of positive health beliefs and the subjective score of adjustment of the insulin doses, but not with the objective score. No correlation was found between the score of fear of hypoglycemia and the subjective score of adjustment of the insulin doses. Correlation with the objective score was higher, but not significant. Actually, the fear of hypoglycemia was the most frequently given reason for not adjusting the insulin doses, when the question was asked to the patients with an open answer. This study illustrates the difference between thinking and doing. It also shows that the degree of confidence in one’s own knowledge, the health beliefs, and the fear of hypoglycemia differently influence the perception that the patients have of their behavior, and what they really do. © 2004 Elsevier Ireland Ltd. All rights reserved. [less ▲]

Characteristics of adolescent attempts to manage overweight

in Patient Education & Counseling (2003), 51(2), 183-189

This study evaluates the actions taken by obese adolescents in an attempt to lose weight in relation to changes in weight. Particular emphasis is put on the context surrounding the management process ... [more ▼]

This study evaluates the actions taken by obese adolescents in an attempt to lose weight in relation to changes in weight. Particular emphasis is put on the context surrounding the management process. Thirty one obese adolescents aged 14-18 participated in this study. The adolescents answered a written questionnaire, took a body-size dissatisfaction test and were interviewed. Their family physicians were interviewed by telephone. Quantitative data concerned changes in weight and body-size dissatisfaction scores. Qualitative analysis included cases analyses and building up of synthesis variables. Loss of weight is linked with continuity of management attempts as well as with medical follow-up. The most frequent management attempt is diet. Self-image is correlated with weight. The exclusive emphasis put on diet is discussed in relation to the importance of more psychosocial factors such as self-image, denial and attraction to discontinuity. Some recommendations for the management of overweight adolescents are then outlined. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved. [less ▲]

The use of degrees of certainty to evaluate knowledge

in Patient Education & Counseling (2003), 51(1), 29-37

In patients with chronic diseases education should improve knowledge about the disease and increase certainty in knowledge. We present here a technique to measure changes in certainty after an educational ... [more ▼]

In patients with chronic diseases education should improve knowledge about the disease and increase certainty in knowledge. We present here a technique to measure changes in certainty after an educational intervention. For this purpose, before and after a course, patients answer a questionnaire in which answers are accompanied by an estimate of the degree of certainty. Answers are then assigned to areas of knowledge defined a priori: mastered (certainty >=90%, correctness >=90%), hazardous (certainty >=90%, correctness =<50%), uncertain (certainty =<50%, correctness >=90%) and residual. Finally differences in the distribution of answers among different areas are analysed statistically. Using this technique in a group of patients with type I diabetes who followed a course on insulin use, we found significant changes in the distribution of answers among different areas of knowledge. Thus changes in certainty can be analysed quantitatively and used to evaluate better the effect of therapeutic education. [less ▲]