Abstract:
PURPOSE:We wanted develop a reliable and valid objective measure of patient-physician collaborative decision making, the Rochester Participatory Decision-Making Scale (RPAD). METHODS:Based on an informed decision-making model, the RPAD assesses physician behavior that encourages patient participation in decision making. Data were from a study of physician-patient communication of 100 primary care physicians. Physician encounters with 2 standardized patients each were audio recorded, resulting in 193 useable recordings. Transcribed recordings were coded both with RPAD and the Measure of Patient-Centered Communication (MPCC), which includes a related construct, Finding Common Ground. Two sets of dependent variables were derived from (1) surveys of the standardized patients and (2) surveys of 50 patients of each physician, who assessed their perceptions of the physician-patient relationship. RESULTS:The RPAD was coded reliably (intraclass correlation coefficient [ICC] = 0.72). RPAD correlated with Finding Common Ground (r = 0.19, P < .01) and with the survey measures of standardized patient's perceptions of the physician-patient relationship (r = 0.32 - 0.36 [P < .005]) but less with the patient survey measures (r = 0.06 to 0.07 [P < .005]). Multivariate, hierarchical analyses suggested that the RPAD made a more robust contribution to explaining variance in standardized patient perceptions than did the MPCC Finding Common Ground. CONCLUSIONS:The RPAD shows promise as a reliable, valid, and easy-to-code objective measure of participatory decision making.
journal_name
Ann Fam Medjournal_title
Annals of family medicineauthors
Shields CG,Franks P,Fiscella K,Meldrum S,Epstein RMdoi
10.1370/afm.305keywords:
subject
Has Abstractpub_date
2005-09-01 00:00:00pages
436-42issue
5eissn
1544-1709issn
1544-1717pii
3/5/436journal_volume
3pub_type
杂志文章abstract:PURPOSE:Hot tea and coffee have been found to have antimicrobial properties. The purpose of this study was to determine whether the consumption of tea, coffee, or both is associated with less frequent nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA). METHODS:We performed a secondary analysis of dat...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1262
更新日期:2011-07-01 00:00:00
abstract:PURPOSE:Potentially inappropriate prescribing (PIP) is a common yet preventable medical error among older persons in primary care. It is uncertain whether PIP produces adverse outcomes in this population, however. We conducted a systematic review with meta-analysis to pool the adverse outcomes of PIP specific to primar...
journal_title:Annals of family medicine
pub_type: 杂志文章,meta分析
doi:10.1370/afm.2373
更新日期:2019-05-01 00:00:00
abstract:PURPOSE:We wanted to evaluate novel decision aids designed to help patients trust and accept the controversial, evidence-based, US Preventive Services Task Force recommendations about prostate cancer screening (from 2012) and mammography screening for women aged 40 to 49 years (from 2009). METHODS:We created recorded ...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1996
更新日期:2017-01-01 00:00:00
abstract:PURPOSE:We undertook a study to evaluate the effectiveness of corticosteroid injections in primary care patients with greater trochanteric pain syndrome (GTPS). METHODS:We evaluated the effect of corticosteroid injections compared with expectant treatment (usual care) in a pragmatic, multicenter, open-label, randomize...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1232
更新日期:2011-05-01 00:00:00
abstract:PURPOSE:The distinction between physiologic (innocent) and pathologic (organic) heart murmurs is not always easy in routine practice, leading too often to unnecessary cardiology referrals and expensive investigations. We aimed to test the hypothesis that the complete disappearance of murmur on standing can exclude card...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.2105
更新日期:2017-11-01 00:00:00
abstract:PURPOSE:Despite the benefits of well-child care visits, up to one-half of these visits are missed. Little is known about why children miss them, so we undertook a qualitative study to elucidate these factors. METHODS:We interviewed 17 caregivers whose children had missed well-child visits and 6 clinicians, focusing on...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2466
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:Persons with multiple chronic diseases must integrate self-management tasks for potentially interacting conditions to attain desired clinical outcomes. Our goal was to identify barriers to self-management that were associated with lower perceived health status and, secondarily, with lower reported physical func...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.722
更新日期:2007-09-01 00:00:00
abstract::In the United States, stable health insurance coverage is associated with improved health outcomes. A lack of insurance is associated with premature death from preventable causes. Although primary care clinicians are often in a position to see firsthand the impact that being uninsured has on patients, most ambulatory ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1541
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:To address doubts regarding National Lung Screening Trial (NLST) generalizability, we analyzed over 6,000 lung cancer screenings (LCSs) within a community health system. METHODS:Our LCS program included 10 sites, 7 hospitals (2 non-university tertiary care, 5 community) and 3 free-standing imaging centers. Pri...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2519
更新日期:2020-05-01 00:00:00
abstract:PURPOSE:In this study, we aimed to assess (1) the agreement between patient self-reports and general practitioner (GP) reports of the chronic conditions affecting the patients and (2) the agreement between patients and GPs on health priorities in a primary care setting. METHOD:Patients were recruited in the Parisian a...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2444
更新日期:2019-09-01 00:00:00
abstract:PURPOSE:Automated office blood pressure monitoring during 30 minutes (OBP30) may reduce overtreatment of patients with white-coat hypertension in primary health care. OBP30 results approximate those of ambulatory blood pressure monitoring, but OBP30 is much more convenient. In this study, we compared OBP30 with routine...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2041
更新日期:2017-03-01 00:00:00
abstract::POEMs (patient-oriented evidence that matters) are studies that address a relevant clinical question, demonstrate improved patient-oriented outcomes, and have the potential to change practice. For 20 years the authors of this article have reviewed more than 100 English language clinical journals monthly to identify PO...
journal_title:Annals of family medicine
pub_type: 历史文章,杂志文章,评审
doi:10.1370/afm.2288
更新日期:2018-09-01 00:00:00
abstract:PURPOSE:Avoidable hospitalizations due to adverse drug events and high-risk prescribing are common in older people. Primary care physicians prescribe most on-going medicines. Deprescribing has long been essential to best prescribing practice. We sought to explore the views of primary care physicians on the barriers and...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2094
更新日期:2017-07-01 00:00:00
abstract::The exposure to unethical and unprofessional behavior is thought to play a major role in the declining empathy experienced by medical students during their training. We reflect on the reasons why medical schools are tolerant of unethical behavior of faculty. First, there are barriers to reporting unprofessional behavi...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1763
更新日期:2015-03-01 00:00:00
abstract:PURPOSE:Patient ratings of physician's patient-centered communication are used by various specialty credentialing organizations and managed care organizations as a measure of physician communication skills. We wanted to compare ratings by real patients with ratings by standardized patients of physician communication. ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.643
更新日期:2007-03-01 00:00:00
abstract:PURPOSE:Our goal was to describe an approach to patient-centered medical home (PCMH) measurement based on delineating the desired properties of the measurement relative to assumptions about the PCMH and the uses of the measure by Blue Cross Blue Shield of Michigan (BCBSM) and health services researchers. METHODS:We de...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1472
更新日期:2013-05-01 00:00:00
abstract:PURPOSE:Conducting studies in national practice-based research networks presents logistic and methodologic challenges. Pediatric Research in Office Settings (PROS) has learned valuable lessons in implementing new strategies and adapting to challenges. We describe practical challenges and results of novel applied strate...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1370/afm.1809
更新日期:2015-09-01 00:00:00
abstract::As a family physician, I have become increasingly uncomfortable being associated with the US health care system. While shiny, new buildings go up each day, there is still little movement toward a model that will shore up the crumbling foundation. The current delivery system and financing structures are unsustainable. ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.837
更新日期:2008-05-01 00:00:00
abstract:PURPOSE:Hearing loss, the second most common disability in the United States, is under-diagnosed and under-treated. Identifying it in early stages could prevent its known substantial adverse outcomes. METHODS:A multiple baseline design was implemented to assess a screening paradigm for identifying and referring patien...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2590
更新日期:2020-11-01 00:00:00
abstract::We propose a new set of priorities for quality management in primary care, acknowledging that payers and regulators likely will continue to insist on reporting numerical quality metrics. Primary care practices have been described as complex adaptive systems. Traditional quality improvement processes applied to linear ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2014
更新日期:2017-03-01 00:00:00
abstract::William Osler is quoted as saying, "Nothing will sustain you more potently than the power to recognize in your humdrum routine, as perhaps it may be thought, the true poetry of life-the poetry of the commonplace, of the plain, toil-worn woman, with their loves and their joys, their sorrows and their griefs."(1) A fami...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1622
更新日期:2014-05-01 00:00:00
abstract:PURPOSE:Practice transformation in primary care is a movement toward data-driven redesign of care, patient-centered care delivery, and practitioner activation. A critical requirement for achieving practice transformation is availability of tools to engage practices. METHODS:A total of 48 practices with 109 practice si...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2382
更新日期:2019-08-12 00:00:00
abstract:PURPOSE:Previous studies suggest that the highest-risk patients value accessible, coordinated primary care that they perceive to be of high technical quality. We have limited understanding, however, of how low-income, chronically ill patients and the staff who care for them experience each individual step in the primar...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.1808
更新日期:2015-07-01 00:00:00
abstract:PURPOSE:Peer health coaches offer a potential model for extending the capacity of primary care practices to provide self-management support for patients with diabetes. We conducted a randomized controlled trial to test whether clinic-based peer health coaching, compared with usual care, improves glycemic control for lo...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1443
更新日期:2013-03-01 00:00:00
abstract::Translational research seeks to improve health care by promoting action and change in real-world health care settings. Although translational research advocates a break from the traditional researcher-initiated approach to science, strategies to successfully engage clinicians and leaders of health care delivery organi...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1117
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:We wanted to identify differences between diabetic patients who smoke and those who do not smoke to design more effective strategies to improve their diabetes care and encourage smoking cessation. METHODS:A random sample of adult health plan members with diabetes were mailed a survey questionnaire, with tel...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.36
更新日期:2004-01-01 00:00:00
abstract:PURPOSE:Various models of care delivery have been investigated to meet the increasing demands in primary care. One proposed model is comanagement of patients by more than 1 primary care clinician. Comanagement has been investigated in acute care with surgical teams and in outpatient settings with primary care physician...
journal_title:Annals of family medicine
pub_type: 杂志文章,评审
doi:10.1370/afm.2230
更新日期:2018-05-01 00:00:00
abstract:PURPOSE:In 2004, we undertook a consultation with Canadian primary health care experts to define the attributes that should be evaluated in predominant and proposed models of primary health care in the Canadian context. METHOD:Twenty persons considered to be experts in primary health care or recommended by at least 2 ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.682
更新日期:2007-07-01 00:00:00
abstract:PURPOSE:This report describes outcomes of an ongoing quality-improvement project (VitalSign6) in a large US metropolitan area to improve recognition, treatment, and outcomes of depressed patients in 16 primary care clinics (6 charity clinics, 6 federally qualified health care centers, 2 private clinics serving low-inco...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.2418
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS:This cohort study includes participants from 4 waves (1994-2000) of the He...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.54
更新日期:2003-11-01 00:00:00