Physician Communication Skills: Results of a Survey of General/Family Practitioners in Newfoundland

Purpose: To describe the attitudes related to communication skills, confidence in using commnication skills, and use of communication skills during the physician-patient encounter among a population-based sample of family physicians. Procedures: A mailed survey, distributed to all family physicians and general practitioners currently practicing in Newfoundland. The questionnaire was designed to collect data in five general areas participant demographics, physician confidence in using specific communication strategies, perceived adequacy of time spent by physicians with their patients, physician use of specific communication strategies with the adult patients they saw in the prior week, and physician use of specific communication strategies during the closing minutes of the encounters they had with adult patients in the prior week. Main Findings: A total of 160 completed surveys was received from practicing family physicians/general practitioners in Newfoundland, yielding an adjusted response rate of 43.1%. Most of the respondents (83.8%) indicated their communication skills are as important as technical skills in terms of achieving positive patient outcomes. Between one-third and one-half of the respondents, depending on the educational level queried, rated their communications skills training as being inadequate. Fewer than 20% of the respondents rated the communications skills training they received as being excellent. Physicians indicated a need to improve their use of 8 of 13 specific communication strategies during patient encounters, and reported using few communication strategies during the closing minutes of the encounter. Interactions that occurred during a typical encounter tended to focus on biomedical versus psychosocial issues. Conclusions: Family physicians/general practitioners recognize a need to improve their commnications skills. Well-designed communications skills training programs should be implemented at multi-levels of physician training in order to improve patient satisfaction with their encounters with family/general practitioners, and to increase the likelihood of positive patient outcomes

Depression and quality of life in cancer survivors: is there a relationship with physical activity?

<p>Abstract</p> <p>Background</p> <p>Evidence is growing on the benefit of physical activity to improve well-being following a cancer diagnosis. This study examined changes in physical activity from pre to post diagnosis and explored this relationship with quality of life and depression.</p> <p>Methods</p> <p>Participants were recruited by posters and by letter of invitation. The questionnaire was completed by 59 prostate and 32 breast cancer survivors.</p> <p>Results</p> <p>Physical activity decreased by 72 minutes per week from pre to post diagnosis, although 20.9% reported having increased activity post diagnosis. Over 30% were considered depressed. Breast cancer participants who increased physical activity post diagnosis reported higher scores for Physical Wellbeing subscale (26 versus 21; F[1,29] = 5.19, p < .03), Emotional Wellbeing subscale (22 versus 19; F[1,30] = 4.57, p < .04) and Functional Wellbeing subscale (26 versus 19; F[1,30] = 9.03, p < .001). A greater proportion of participants taking part in no physical activity were depressed (55.6%; χ²= 6.83, p < .04).</p> <p>Conclusion</p> <p>Over 25% of participants identified with emotional and/or well being problems, and more than half reported insufficient physical activity to yield benefits. Future research needs to gain a better understanding of why cancer survivors decrease their physical activity following a cancer diagnosis and what is necessary for them in order to retain or increase their physical activity.</p

System for determining position of normal shock in supersonic flow

Light from a plurality of light emitting diodes is transmitted through optical cables (12) to a lens system. The lenses (56, 58) expand and collimate the light and project it in a sheet (16) across the supersonic inlet of an aircraft power plant perpendicular to incoming airflow. A normal shock bends a portion of the sheet of light (16). A linear array of a multiplicity of optical fiber ends collects discrete samples of light. The samples are processed and compared to a predetermined profile to determine the shock location

Toddler milk advertising in Australia: the infant formula ads we have when we don’t have infant formula ads

The Marketing in Australia of Infant Formula: Manufacturers’ and Importers’ Agreement (MAIF) prevents manufacturers and importers from advertising infant formula. However, toddler milks, which share brand identities with infant formula, are advertised freely; and recent research suggests consumers fail to distinguish between advertising for infant formula and for toddler milk. This study examined whether Australian parents recalled having seen advertisements for ‘formula’. Most respondents (66.8%) reported seeing an advertisement for infant formula, with those who had only seen non-retail advertising more than twice as likely to believe that they had seen such an advertisement as those who had only seen retail advertising. This suggests that toddler milk advertisements are functioning as defacto infant formula advertisements in Australia. Thus the MAIF is failing to achieve its stated purpose

The impact of self-efficacy on asthma management amongst older Australian adults

Rationale: Australian asthma rates are high by international standards causing greatest mortality amongst older adults. This paper looks at the relationships between perceived self-efficacy (belief in oneself) to manage the physical discomfort or pain caused by asthma and also the emotional distress caused by asthma and: reported health status; asthma quality of life for both mood and breathlessness; asthma management practices; and emergency health care use for asthma in adults aged 55 years and over. Methods: A 20 page survey exploring the health beliefs, behaviours and attitudes of older Australians, was mailed to 9,000 people, (response rate = 46.8%). Participants were recruited through a random sample obtained from the Australian Electoral Roll Office. Results: Correlations show that people who reported high physical or emotional self-efficacy were more likely to report better health and quality of life. They were less likely to report that asthma had interfered with their day-to-day activities or that they had utilised emergency health care for asthma. Regular asthma reviews with their general practitioner, owning an asthma action plan, having received asthma education and regularly monitoring asthma control did not appear to be related to self-efficacy. Summary: These results indicate that neither physical nor emotional self-efficacy are significantly correlated with popular asthma self-management strategies. However, both physical and emotional self-efficacy were significantly correlated with health rating, quality of life for breathlessness and mood and the impact of asthma on their day-to-day activities. Factors that increase older adults\u27 asthma self-efficacy need to be further investigated

Do Australian adolescent female fake tan (sunless tan) users practice better sun-protection behaviors than non-users?

Objective: To determine differences in sun-protection behaviours, and incidence of sunburn, between Australian adolescent female fake tan users and non-users. Design: Cross sectional survey. Method: 398 adolescent females aged 12 to 18 years participated in a survey at public venues, schools, and online. The main outcome measures were self-reported fake tan usage in the past 12 months, frequency of sunburns and habitual sun-protection behaviours. Setting: Surveys were completed in New South Wales, Australia. Results: The prevalence of self-reported use of fake tanning products in the past 12 months among Australian adolescent females was 34.5%. Female fake tan users were significantly less likely to report wearing a hat, wearing a shirt with sleeves or wearing pants covering to the knees. There was no difference between fake tan users and non-users in use of sunscreen, seeking shade, wearing sunglasses or avoidance of peak ultraviolet (UV) hours. Logistic regression modelling, when accounting for age, desire for a tan and skin type, revealed fake tan users were more likely to experience frequent sunburns and less likely to wear protective clothing. Conclusions: Our findings show that fake tan use among Australian female adolescents is associated with decreased sun protection, specifically reduced use of both upper and lower body protective clothing. Fake tan users were significantly more likely to experience repeated sunburns, after controlling for skin type. These findings provide impetus for the development of health education programmes targeting a new sub-group of adolescents with distinct tanning behaviours

Driving, dementia and Australian physicians: primum non nocere?

Older Australians are increasingly reliant on automobiles as their sole form of transport. As our population is ageing and the prevalence of dementia is increasing, it is anticipated that the number of drivers with dementia will rise over time. Much of the literature relating to driving and dementia focuses on safety rather than mobility. The objective of this paper is to highlight several topical ethical issues that pertain to Australian drivers with dementia. It is recommended that future research, policy and practice should centre on the crucial mobility and transport needs of our senior citizens

Combining the health belief model and social marketing to develop a community-level campaign about asthma for older adults

This conceptual paper provides a rationale for combining health behaviour theory with a social marketing framework in order to develop a community-level asthma campaign for adults aged 55 years and older. The prevalence of asthma in older adults in Australia is approximately 10%, higher than in many other countries, and asthma mortality increases with age. In addition, older adults\u27 perceptions of asthma causes and treatments are often inaccurate. Many older adults believe that asthma is a childhood disease and that the effects of the condition are relatively minor and would not impact on daily life. In order to address these misperceptions, it is useful to utilise the constructs of the Health Belief Model in conjunction with a framework for the development and implementation of a health promotion effort. The social marketing framework is directly aligned with the most successful methods of promoting health to older adults; tailoring health messages (promotion) to individuals and the community that they are living in, actively involving the older adults themselves to understand their health beliefs and behaviours, empowering individuals by reducing barriers to action (price), enabling individuals to take control of their health (product) through increased knowledge, and ensuring ease of access (place) to health messages and promotional activities. The segment of the population aged 55 years and over not only has a demonstrated need for asthma awareness but also has been largely ignored by past asthma awareness activities. To extend the efforts of previous health promotion efforts, a campaign must be developed, implemented and evaluated to specifically target older adults about asthma to address their low perceived susceptibility to, and severity of, the condition. This paper presents a conceptual framework for the application of the Health Belief Model and social marketing theory to influence the asthma perceptions of older adults

Understanding the behaviour of the target market: what do adolescents think about when asked questions about their behaviour in the sun?

We undertook a project to develop a psychometrically sound instrument measuring adolescent sun-related behavior for use in the evaluation of a social marketing program. During the preliminary stages, we conducted a pilot study to test the face validity of the instrument with adolescents. Think-aloud sessions were completed with 24 adolescents. Results identified gaps in our understanding of adolescent sun-related behavior. Adolescents interpreted 'tanning' as specifically lying at the beach in the sun, however also reported behaviours to 'get a bit of sun', suggesting adolescents and researchers have different interpretations of key terms. The study highlights that use of the think-aloud technique can improve understanding behaviours of the target market and improve the validity of measures of adolescent sunrelated behaviour

Older patients\u27 attitudes to general practice registrars: a qualitative study

Background Research suggests that older patients may be reluctant to engage general practice registrars (GPRs) in their care. The authors undertook a qualitative study of the attitudes of older patients to GPRs to investigate this issue. Method Thirty-eight patients aged 60 years and over from three training practices participated in semistructured telephone interviews, which explored patients responses to GPRs. The interviews were recorded, transcribed and analysed using a template analysis approach. Results Analysis of the interviews produced five major themes concerning patient attitudes to GPRs: desire for continuity, desire for access, openness, trust and a desire for meaningful communication. Discussion Older patients attitudes to GPRs cannot be viewed in isolation from their relationship with their usual general practitioner, and this needs to be taken into account when engaging GPRs in the care of older patients. Systems need to be developed to maintain relational and informational continuity with older patients\u27 regular GPs