Abstract:
OBJECTIVE:The purpose of this study is to assess the effect of a geriatrics-focused acute medicine inpatient rotation and the presence or absence of a geriatrician as attending physician on knowledge about and attitudes toward older patients and the field of geriatrics. DESIGN:Randomized trial. INTERVENTION:A 4-week acute care inpatient internal medicine rotation at a university-affiliated Veterans Affairs Medical Center; experiences included caring for acutely ill, older medical patients, interdisciplinary team meetings, geriatrics-based noon conferences, interaction with geriatrics-trained nurse practitioners, and a syllabus of readings on geriatric medicine. PARTICIPANTS:Postgraduate year 1, 2, and 3 internal medicine residents were randomly assigned to one of three groups: (1) the intervention with a geriatrics-trained internist attending (n = 44); (2) the intervention with a non-geriatrics-trained internist attending (n = 25); or (3) no exposure to the intervention (n = 24). INSTRUMENTS:Knowledge was assessed using a 35-item test. Attitudes were evaluated using a 24-item questionnaire. RESULTS:There were no differences among the three groups of residents in pretest knowledge (p = .971, analysis of variance). There was a significant difference in the changes in scores from the pretest baseline among the three groups (group 1 = .030, group 2 = .051, group 3 = -.009; p = .039). Both groups assigned to the intervention showed significant improvement in knowledge (p = .011); the presence or absence of a geriatrics-trained attending physician did not alter the results. Resident attitude scores were generally positive and did not change after the intervention. CONCLUSIONS:An intensive integrated acute medicine rotation in geriatrics improved residents' knowledge of geriatric medicine. The presence of a geriatrics-trained attending physician was not necessary for this improvement. Residents' attitudes toward geriatric medicine and their geriatrics education were generally positive and were not influenced by this experience.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Lindberg MC,Sullivan GMdoi
10.1007/BF02600185subject
Has Abstractpub_date
1996-07-01 00:00:00pages
397-400issue
7eissn
0884-8734issn
1525-1497journal_volume
11pub_type
临床试验,杂志文章,随机对照试验abstract:BACKGROUND:Language barriers present a substantial communication challenge in the hospital setting. OBJECTIVE:To describe how clinicians with various levels of Spanish language proficiency work with interpreters or their own Spanish skills in common clinical scenarios. DESIGN & PARTICIPANTS:Survey of physicians and n...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-011-1779-5
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Lack of regular physical activity is highly prevalent in U.S. adults and significantly increases mortality risk. OBJECTIVE:To examine the clinical impact of a newly implemented program ("Exercise as a Vital Sign" [EVS]) designed to systematically ascertain patient-reported exercise levels at the beginning o...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-013-2693-9
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Limitations in instrumental activities of daily living (IADL) hinder a person's ability to live independently in the community and self-manage their conditions, but its impact on hospital readmission has not been firmly established. OBJECTIVE:To test the importance of IADL dependency as a predictor of 30-da...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05982-0
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Treatment decisions about menopause are predicated on a transient duration of vasomotor symptoms. However, evidence supporting a specific duration is weak. OBJECTIVE:To estimate the natural progression of vasomotor symptoms during the menopause transition by systematically compiling available evidence using...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,meta分析
doi:10.1007/s11606-008-0655-4
更新日期:2008-09-01 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::Mycophenolate mofetil (MM) is commonly used in patients with autoimmune diseases or who have undergone transplantation. Common side effects of MM include anemia, leukopenia, mucositis and opportunistic infections. We report an unusual case of pulmonary alveolar proteinosis (PAP) in a 67-year-old woman on MM for Wegene...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1433-7
更新日期:2010-10-01 00:00:00
abstract:INTRODUCTION:US adults with serious mental illness (SMI), compared to those without SMI, have a higher prevalence of smoking, which contributes to a shorter life expectancy. This study compared current smoking and quitting-related characteristics of low-income US adults with and without SMI who received healthcare at f...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-04857-3
更新日期:2019-06-01 00:00:00
abstract::Hospital discharges against medical advice (AMA) are common, costly, stigmatizing to patients, and are associated with excess morbidity and mortality. Achieving better quality care for patients discharged AMA has been limited both by the sparse research illuminating how best to care for this challenging patient popula...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-013-2540-z
更新日期:2013-12-01 00:00:00
abstract::This study is a cross-sectional descriptive survey of randomly selected primary care patients and physicians regarding patient, physician, and family roles in end-of-life decision making. The subjects included 329 adult outpatients and 272 practicing physicians. Physicians were more likely than patients to believe the...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00008.x
更新日期:1998-01-01 00:00:00
abstract::Polypharmacy occurs when a medical regimen includes at least one unnecessary medication. Factors that contribute to this problem include: patient characteristics of increasing age, multiple medical problems, therapy expectations, and decisions to self-treat; physician factors such as excessive prescribing; and system ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02600099
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Concern about the link between clinical supervision and safe, quality health care has led to widespread increases in the supervision of medical trainees. The effects of increased supervision on patient care and trainee education are not known, primarily because the current multifacted and poorly operationali...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0179-3
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Despite high rates of post-deployment psychosocial problems in Iraq and Afghanistan veterans, mental health and social services are under-utilized. OBJECTIVE:To evaluate whether a Department of Veterans Affairs (VA) integrated care (IC) clinic (established in April 2007), offering an initial three-part prim...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-011-1746-1
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Little information exists regarding the impact of Medicare Part D on generic drug use. OBJECTIVE:To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries. DESIGN, PARTICIPANTS, AND MEASUREMENTS:Difference-in-difference analysis of pharmacy claim...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0742-6
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Many employers offer worksite wellness programs, including financial incentives to achieve goals. Evidence supporting such programs is sparse. OBJECTIVE:To assess whether diabetes and cardiovascular risk factor control in employees improved with financial incentives for participation in disease management a...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3686-2
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:The Department of Veterans Affairs (VA) mandates disclosure of large-scale adverse events to patients, even if risk of harm is not clearly present. Concerns about past disclosures warranted further examination of the impact of this policy. OBJECTIVE:Through a collaborative partnership between VA leaders, po...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-3034-3
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:Online learning has changed medical education, but many "educational" websites do not employ principles of effective learning. This article will assist readers in developing effective educational websites by integrating principles of active learning with the unique features of the Web. DESIGN:Narrative revie...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1111/j.1525-1497.2004.30029.x
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:African Americans suffer more than non-Hispanic whites from type 2 diabetes, but diabetes self-management education (DSME) has been less effective at improving glycemic control for African Americans. Our objective was to determine whether a novel, culturally tailored DSME intervention would result in sustain...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11606-019-04894-y
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:To examine the knowledge of, counseling about, and use of prior directives among patients with HIV-related disease. DESIGN:Cross-sectional survey with personal interviews that was part of the evaluation of a multi-site AIDS Health Services Program. SETTING:Outpatient clinics and AIDS community-based organiz...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600877
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:To examine how Asian race/ethnicity affects patients' health care experiences and satisfaction with care. DESIGN:Telephone interview using random-digit dialing, stratified to over-sample adults living in areas with disproportionately large numbers of minorities. PARTICIPANTS AND SETTING:White (N = 3,205) an...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2004.30143.x
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:The patient-centered medical home (PCMH) has clinical benefits for chronic disease care, but the association with patient-reported outcomes such as health-related quality of life (HRQoL) is unexplored in patients with multimorbidity (two or more chronic diseases). OBJECTIVE:To examine if greater clinic-leve...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05429-1
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Small Changes (SC) is a weight management approach that demonstrated superior 12-month outcomes compared to the existing MOVE!® Weight Management Program at two Veterans Affairs (VA) sites. However, approaches are needed to help graduates of treatment continue to lose or maintain their weight over the longer...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11606-017-3987-0
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:To compare physicians' and their patients' attitudes toward pharmaceutical gifts. DESIGN:Survey of physicians and their patients. SETTING:Two tertiary-care medical centers, one military and one civilian. PARTICIPANTS:Two hundred sixty-eight of 392 consecutively surveyed physicians, 100 of 103 randomly sele...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00048.x
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:To assess whether newer antipsychotic medications are associated with weight gain and development of diabetes. DESIGN:Retrospective cohort study. SETTING:Data from a comprehensive electronic medical record serving an urban public hospital and a citywide network of mental health clinics. PATIENTS/PARTICIPAN...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2004.40126.x
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:The quality of the continuity clinic experience for internal medicine (IM) residents may influence their choice to enter general internal medicine (GIM), yet few data exist to support this hypothesis. OBJECTIVE:To assess the relationship between IM residents' satisfaction with continuity clinic and interest...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-012-2280-5
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVES:To develop and evaluate a web-based curriculum to introduce first year medical students to the knowledge and attitudes necessary for working with limited English proficient (LEP) patients through interpreters. METHOD:Six hundred and forty first year medical students over 4 consecutive years took this curric...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.0193.x
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVES:Shared medical appointments (SMAs) are an increasingly used system-redesign strategy for improving access to and quality of chronic illness care. We conducted a systematic review of the existing literature on SMA interventions for patients with diabetes in order to understand their impact on outcomes. DATA ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-014-2978-7
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Little is known regarding the prevalence or risk factors for non-comprehension and non-compliance with discharge instructions among older adults. OBJECTIVE:To quantify the prevalence of non-comprehension and non-compliance with discharge instructions and to identify associated patient characteristics. RESE...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-2956-0
更新日期:2014-11-01 00:00:00
abstract::Initial reports on HemoQuant, a new quantitative test for occult gastrointestinal bleeding, suggest it is more sensitive than Hemoccult. Increased detection of upper gastrointestinal tract bleeding and dietary hemoglobin may reduce HemoQuant's specificity in the screening setting. The authors performed a cost effectiv...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596117
更新日期:1988-03-01 00:00:00
abstract:BACKGROUND:Guidelines recommend administration of antibiotics with activity against methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa for treatment of healthcare-associated pneumonia (HCAP). It is unclear if this therapy improves outcomes for patients with HCAP. OBJECTIVE:To determine if ad...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-012-2011-y
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To describe adult primary care physicians' and psychiatrists' approach to alcohol screening and treatment, and to identify correlates of more optimal practices. DESIGN:Cross-sectional mailed survey. PARTICIPANTS:A national systematic sample of 2,000 physicians practicing general internal medicine, family me...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2000.03379.x
更新日期:2000-02-01 00:00:00