Abstract：
BACKGROUND:Many medical schools have incorporated the Stages of Change Model into their curricula with specific application to tobacco cessation. OBJECTIVE:This study examined the extent to which medical students were prepared to provide stage-based interventions to treat nicotine dependence. DESIGN:Using a quasi-experimental design, medical students' counseling interactions were evaluated with a standardized patient portraying a smoker in either the precontemplation or preparation stage of change. PARTICIPANTS:Participants were 147 third-year medical students at the University of California, San Francisco. MEASUREMENTS:Checklists completed by standardized patients evaluated students' clinical performance. Surveys administered before and after the encounters assessed students' knowledge, attitudes, confidence and previous experience with treating smoking. RESULTS:Most students asked about tobacco use (89%), advised patients of the health benefits of quitting (74%), and assessed the patient's readiness to quit (76%). The students were more likely to prescribe medications and offer referrals to patients in the preparation than in the precontemplation stage of change (P < 0.001); however, many students had difficulty identifying patients ready to quit, and few encouraged patients to set a quit date or arranged follow-up to assess progress. Students' tobacco-related knowledge, but not their attitudes, confidence, or previous experience predicted their clinical performance. CONCLUSIONS:The findings indicated evidence of students tailoring their counseling strategies to the patients' stage of change; however, they still could do more to assist their patients in quitting. Additional training and integration of cessation counseling into clinical rotations are needed.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Prochaska JJ,Teherani A,Hauer KEdoi
10.1007/s11606-006-0040-0subject
Has Abstractpub_date
2007-02-01 00:00:00pages
223-7issue
2eissn
0884-8734issn
1525-1497journal_volume
22pub_type
杂志文章abstract：:Comprehensiveness of primary care (the extent to which the clinician, as part of the primary care team, recognizes and meets the majority of each patient's physical and mental health care needs) is an important element of primary care, but seems to be declining in the U.S. This is concerning, because more comprehensiv...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-015-3300-z
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:To measure primary care physicians' familiarity with, attitudes toward, and confidence in preventive care practice guidelines for the elderly and to determine whether their attitudes are associated with implementation of guidelines into clinical practice. DESIGN:A self-administered survey of physicians emplo...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599668
更新日期：1995-03-01 00:00:00
abstract：BACKGROUND:Many national guidelines recommend the use of patient provider agreements (PPAs) when prescribing opioids for chronic pain. There are no standards for PPA content, readability, or administration processes. OBJECTIVE:Conduct a national survey of providers who use PPAs to describe the process of administering...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06364-2
更新日期：2021-01-08 00:00:00
abstract：BACKGROUND:Many physicians and professional leaders agree that community participation is an important professional role for physicians. Volunteerism has also received increasing attention in the national agenda for social change. Yet little is known about physicians' community volunteer activities. OBJECTIVE:To measu...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0811-x
更新日期：2008-12-01 00:00:00
abstract：BACKGROUND:For patients with peripheral arterial disease (PAD), depression is associated with worse patency and recurrent symptoms in the treated leg, but its association with death or cardiovascular events in other vascular beds is unknown. OBJECTIVE:To assess the association between depression and mortality or cardi...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0560-x
更新日期：2008-05-01 00:00:00
abstract：BACKGROUND:Incarceration is associated with poor health and high costs. Given the dramatic growth in the criminal justice system's population and associated expenses, inclusion of questions related to incarceration in national health data sets could provide essential data to researchers, clinicians and policy-makers. ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-011-1858-7
更新日期：2012-02-01 00:00:00
abstract：BACKGROUND:eConsult programs have been instituted to increase access to specialty expertise. Opt-in choice eConsult programs maintain primary care physician (PCP) autonomy to decide whether to utilize eConsults versus traditional specialty referrals, but little is known about how this intervention may impact PCP eConsu...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06101-9
更新日期：2020-11-01 00:00:00
abstract：OBJECTIVES:To examine how practice constraints contribute to barriers in the health care of persons with dementia and their families, particularly with respect to behavioral aspects of care. DESIGN:Cross-sectional qualitative interview study of primary care physicians. SETTING:Physicians' offices. PARTICIPANTS:Forty...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-007-0317-y
更新日期：2007-11-01 00:00:00
abstract：BACKGROUND:As electronic health records (EHRs) become widely adopted, alerts and reminders can improve medication safety, but excessive alerts may irritate or overwhelm clinicians, thereby reducing their effectiveness. We developed a novel "stealth" alert in an EHR to improve anticoagulation monitoring for patients pre...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-012-2137-y
更新日期：2012-12-01 00:00:00
abstract：OBJECTIVE:African-American (black) and white individuals have been shown to differ in their desire for life-sustaining treatments and their use of living wills for end-of-life care, but the reasons for these differences are unclear. This study was designed to test the hypothesis that these ethnic differences exist beca...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02600155
更新日期：1996-11-01 00:00:00
abstract：OBJECTIVE:To describe how medical residents discuss do-not-resuscitate (DNR) orders with patients. DESIGN:Prospective observational study. SETTING:Inpatient medical wards of one university tertiary care center, one urban city public hospital, and one Veterans Affairs medical center. PARTICIPANTS:Thirty-one medical r...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599915
更新日期：1995-08-01 00:00:00
abstract：BACKGROUND:The World Health Organization encourages the development of youth friendly services, yet little is known on how youth currently present in general practice. OBJECTIVE:To describe the perspectives, expectations, and service receipt of young people presenting to family doctors to inform the development of you...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-007-0177-5
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To examine in-depth the lives of women whose partners attempted to kill them, and to identify patterns that may aid in the clinician's ability to predict, prevent, or counsel about femicide or attempted femicide. DESIGN:Qualitative analysis of 30 in-depth interviews. SETTING:Six U.S. cities. PARTICIPANTS:T...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2003.21202.x
更新日期：2003-10-01 00:00:00
abstract：OBJECTIVE:To evaluate the accuracy of a preliminary diagnosis based solely on patient history and physical examination in medical outpatients with abdominal or chest pain. DESIGN:Prospective observational study. SETTING:General medical outpatient clinic in a university teaching hospital. PARTICIPANTS:One hundred nin...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.1997.00083.x
更新日期：1997-08-01 00:00:00
abstract：BACKGROUND:Chronic kidney disease (CKD) is a growing public health concern that overwhelmingly affects older adults. National guidelines have called for earlier referral of CKD patients, but it is unclear how these should apply to older adults. OBJECTIVE:This scholarly review aims to explore the current literature abo...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-007-0492-x
更新日期：2008-03-01 00:00:00
abstract：:Several population health big data projects have been initiated in the USA recently. These include the County Health Rankings & Roadmaps (CHR) initiated in 2010, the 500 Cities Project initiated in 2016, and the City Health Dashboard project initiated in 2017. Such projects provide data on a range of factors that dete...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05869-0
更新日期：2020-11-01 00:00:00
abstract：:The call for value-based medicine has augmented the role of primary care physicians, potentially exacerbating the already-acknowledged shortage of primary care physicians in the current delivery landscape. Lifetime earnings for primary care physicians are millions lower than those for other specialties, and the burden...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05759-5
更新日期：2020-05-01 00:00:00
abstract：OBJECTIVE:Examine patterns of alcohol use disorder (AUD) medication use and identify factors associated with prescription fill among commercially insured individuals with an index AUD visit. DESIGN:Using 2008-2018 claims data from a large national insurer, estimate days to first AUD medication using cause-specific haz...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06073-w
更新日期：2020-11-01 00:00:00
abstract：BACKGROUND:Residents demonstrate scholarly activity by presenting posters at academic meetings. Although recommendations from national organizations are available, evidence identifying which components are most important is not. OBJECTIVE:To develop and test an evaluation tool to measure the quality of case report pos...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0860-1
更新日期：2009-03-01 00:00:00
abstract：BACKGROUND:Understanding the impact of the COVID-19 pandemic on healthcare workers (HCW) is crucial. OBJECTIVE:Utilizing a health system COVID-19 research registry, we assessed HCW risk for COVID-19 infection, hospitalization, and intensive care unit (ICU) admission. DESIGN:Retrospective cohort study with overlap pro...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06171-9
更新日期：2020-11-01 00:00:00
abstract：BACKGROUND:Pain self-management is an effective, evidence-based treatment for chronic pain. Peer support, in which patients serve as coaches for other patients, has been effective in other chronic conditions and is a potentially promising approach to implementing pain self-management programs using fewer clinical resou...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06007-6
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVES:To assess the prevalence and persistence of depression in patients with acute myocardial infarction (AMI) and the relationship between assessment modality and prevalence. DATA SOURCES:MEDLINE, Cochrane, CINAHL, PsycINFO, and EMBASE. REVIEW METHODS:A comprehensive search was conducted in March 2004 to ident...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1111/j.1525-1497.2005.00269.x
更新日期：2006-01-01 00:00:00
abstract：OBJECTIVE:To determine factors predicting adherence to a health care provider's screening mammography recommendation in a general internal medicine practice. DESIGN:Prospective observational study. SETTING:An urban academic general internal medicine practice. PATIENTS:Three hundred forty-nine asymptomatic women, age...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599947
更新日期：1995-06-01 00:00:00
abstract：OBJECTIVE:To assess a new technique for the detection of free pleural fluid. DESIGN:118 consecutive inpatients with radiologic evidence of free pleural fluid and a control group of 175 randomly selected inpatients were examined over a three-year period in a prospective blind study by auscultatory percussion (AP) for e...
journal_title：Journal of general internal medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/BF02600204
更新日期：1994-02-01 00:00:00
abstract：:The fourth-year medicine clerkship was restructured at one of four sites. Teams consisting of one attending physician and three students cared for eight new patients per week. The overall experience of the restructured clerkship was rated significantly more positively than the experiences at all other sites and the te...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02600292
更新日期：1993-01-01 00:00:00
abstract：BACKGROUND:Obesity and diabetes family history are the two strongest risk factors for type 2 diabetes (T2D). Prior work shows that an individual's obesity risk is associated with obesity in social contacts, but whether T2D risk follows similar patterns is unknown. OBJECTIVE:We aimed to estimate the relationship betwee...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-016-3723-1
更新日期：2016-10-01 00:00:00
abstract：:This article highlights the timely situation that resident physicians, faculty, and staff are facing after the recent highly publicized murders of Black Americans and its impact on our healthcare communities. We discuss our experiences of how the hospital can serve as a meeting place for anti-racism, as well as how an...
journal_title：Journal of general internal medicine
pub_type： 社论
doi：10.1007/s11606-020-06291-2
更新日期：2020-10-20 00:00:00
abstract：:Older adults often have multiple chronic conditions that may decrease additional life expectancy. Research evaluating the benefits and harms of screening must include consideration of competing morbidities and patient heterogeneity (beyond age), potentially increased harms of screening, and patient preferences. Other ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-012-2227-x
更新日期：2013-02-01 00:00:00
abstract：BACKGROUND:Studies on forgoing treatment often ignore treatments that are continued until death. OBJECTIVE:To investigate how often specific treatments are withdrawn or withheld before death and to describe the associated patient, physician, and care characteristics. DESIGN:National mortality follow-back study in Swi...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05344-5
更新日期：2020-01-01 00:00:00
abstract：:Although the benefit of population-level public facial masking to protect others during the COVID-19 pandemic has received a great deal of attention, we discuss for one of the first times the hypothesis that universal masking reduces the "inoculum" or dose of the virus for the mask-wearer, leading to more mild and asy...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06067-8
更新日期：2020-10-01 00:00:00
