Knowledge of cervical cancer screening among women attending a university health center

One hundred fifty-four female students completed a questionnaire regarding the Pap test and cervical cancer screening during routine yearly examination at a university health center. Ninety percent knew that a Pap test screened for precancerous and cancerous lesions of the cervix. More than half of the students, however, thought that the test also screened for other forms of gynecologic cancer and for a variety of sexually transmitted diseases. Approximately half of the respondents were unfamiliar with proper preparation for the test (e.g., avoiding sexual intercourse and intravaginal contraceptive application) and the majority did not know about specific risk factors for cervical cancer. These findings indicate a need for improved health education efforts regarding the risk factors for cervical disease and the role and importance of Pap smears.     

Implementation of an intimate partner violence screening program in a university health care clinic

Abstract

Objectives: To examine whether an intimate partner violence (IPV) screening program is related to a positive change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening. Participants: Eleven health care providers at a university health care clinic participated in the IPV screening program. Methods: A one-group pretest-posttest design was used to examine whether an IPV screening program was related to a change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening. Results: Findings indicated that there was a significant difference (p?<?000) between the posttest scores and the pretest scores on the Domestic Violence Healthcare Provider Survey Scale. Domain analysis of the scale revealed a significant difference in perceived self-efficacy (p?=?.001), system support (p?=?<.002), victim provider safety (p?=?.015), and beliefs of blaming victims (p?=?<.004). No statistical difference was found in professional role resistance/fear of offending (p?=?.158). Conclusions: A university health care clinic IPV screening program was related to a positive change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening.     

Quality improvement in patient distribution at a major university student health center

Healthcare in a major university setting poses unusual challenges and great opportunities. Two traditionally challenging areas in patient distribution are the initial intake of allergy/immunization patients and the triage of outpatients in the general medical clinic. The authors describe the use of the FOCUS-PDCA quality improvement (QI) problem-solving process for each situation. After identifying major problems, the health center established cross-functional teams of experts representing the allergy/immunization and general medical clinics. The teams analyzed the problems with a flow chart and undertook studies to further elucidate causes and potential solutions. They listed potential solutions in order of priority and submitted them to the student health center director for review and initiation. Each team then used the PDCA (plan-do-check-act) cycle to put approved solutions into effect. Permanent improvements made in each area resulted in a more effective and efficient patient distribution system, favorable staff comment, and greater patient satisfaction.     

Relationship of interpersonal behaviors and health-related control appraisals to patient satisfaction and compliance in a university health center

OBJECTIVE: The authors' aim was to evaluate patient-provider relationships in a college health center. PARTICIPANTS: Eighty student patients and their health-care providers. METHODS: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before and after the consultation. They evaluated their satisfaction with care and compliance after the consultation and again 2 weeks later. Providers completed measures of their participatory behavior and patients' interpersonal behavior after the consultation. RESULTS: Patients preferred to be well informed and to have their preferences taken into account, and generally felt competent at managing their own health affairs. They indicated they obtained the high level of participation they desired. Patients desired and actually experienced friendly and submissive providers. Degree of match between patients' desired and actual level of involvement in their care was associated with greater satisfaction. A greater match between the extent to which they desired the provider to be affiliative and the provider's actual affiliative behavior was associated with more satisfaction. No variables were predictive of patient compliance. CONCLUSION: The authors discuss results in terms of the influence of situational factors characteristic of a college health center.     

Patient satisfaction in primary health care: a literature review and analysis.

This paper reviews the literature on patient satisfaction in primary health care settings. Definitions and models of satisfaction are considered first. Attention is given to the conceptualization of satisfaction by investigators concerned about consumers in general as well as by researchers focusing on consumers of medical services. Research findings are discussed and used to develop a model of patient satisfaction. The measurement of patient satisfaction and the findings of empirical studies are then reviewed, including summaries of effect sizes. It is concluded that patient satisfaction information can provide a dependent measure of service quality and serves as a predictor of health-related behavior. Issues deserving further investigation and recommendations regarding research strategies are presented.     

Primary health care in the context of rapid urbanization

A review of demographic trends and health and social problems in the fast growing urban areas of the world indicates that, in the future, increasing numbers of people will be living in precarious socioeconomic conditions which impede the achievement of health. It is estimated that from 4.4 billion in 1980 the world's population will increase to 6.2 billion by the year 2000. The urban population will increase from 1.8 to 3.2 billion during the same period, over 2 billion of which will be in developing countries. The rapid and often uncontrollable demographic growth of cities, especially in the developing world, stimulates the demand for resources, intensifies their utilization and creates an intolerable pressure on the urban infrastructure and physical environment. A number of action oriented projects to combat disease and contamination have been successful. Projects in Addis Ababa, Ethiopia, Colombo, Sri Lanka, Hyderabad, India, Guayaquil, Ecuador, Lima, Peru, and Rio de Janeiro have been implemented under a partnership among WHO, UNICEF, the Netherlands Aid Agency, the World Bank, and other international organizationals and governments. These projects all emphasize the fundamental role of community organizations, especially that of women; low-cost technology and the need to mobilize and efficiently use locally available resources; an ecological multisectoral concept of health whereby action concerning the environment, education, income generation and the availability of food, all with a powerful disease preventive potential, carry equal if not greater weight than the efforts to provide the population with health centers or implement curative practices. All these projects are focused on marginal groups; many were initiated by imaginative individuals or groups with a considerable amount of social orientation and motivation, and often, at least in the beginning, without the support of governments, nongovernmental or international organizations. It is important to study these projects in their accomplishments and failures; to help describe them and disseminate related information when appropriate; and to promote political and technical support for those which are successful so that they can rapidly come out of the experimental/demonstration phase and be expanded to become part of routine programs.     

The process and results of an evaluation of a nurse-managed, family-oriented health care center

This paper discusses an example of action research, the evaluation of a nurse-managed, family-oriented health care center serving a low-income, black population in an isolated section of a highly industrialized suburban community. The evaluation was the result of many necessary compromises, yet other than lack of cost effectiveness, it brought substantial evidence of the success of the agency. Patients had positive health attitudes, were knowledgeable, and practiced health-inducing behaviors. As compared to other community health centers, the quality of care was found to range from average to excellent. Notable gains in quality of care occurred from pre- to posttest, partially as a result of formative evaluation procedures. Despite the positive nature of the product evaluation, the Center was closed, raising questions as to the utility of evaluation in the decision-making process.     

Trauma screening in students attending a medical university

Clinicians seldom assess trauma history in patients who seek treatment for psychological problems, yet trauma exposure is often related to psychological distress. Assessing trauma history can provide valuable information for treatment conceptualization and provision, although patients may not spontaneously share their histories because of embarrassment, avoidance, or other concerns. The authors compared 73 students at a southeastern US medical university who sought counseling and psychological services and completed intake paperwork without a trauma screen with 130 students whose intake procedures included trauma screening. They found that (a) patients who were specifically asked about trauma history were more likely to report such events, (b) previous physical assaults with a weapon were related to current psychological distress, and (c) physical assaults with or without a weapon were related to clinically significant psychological distress. These findings suggest that screening for lifetime trauma history should be a standard part of mental health screenings in similar medical university counseling centers.     

A five year retrospective analysis of occupational injuries and incidence reported at a research intensive Canadian university

Limited information of occupational injury statistics within academic settings exists. Universities and colleges are an important and insightful work environment due to the varied nature of the work performed by employee groups. The objective of this study was to describe occupational injuries for all work groups in a large research intensive university. A retrospective database analysis was conducted on 2029 employee incident reports over a five year period (2000-2004) to determine general and departmental prevalence of injury types, locations, and mechanisms. Demographic analysis revealed an average age of 42 years and 9 years of work experience. Overall, the most frequent injuries were to the hand (40%), were musculoskeletal in nature (42%), and resulted from being "struck or contacted by" (33%). The greatest number of incidents occurred in food services, followed by physical plant and staff services. Closer examination of incidents reported by food services indicated 53% of injuries occurred to the hand and 72% required first aid. Notable too was that 19% of physical plant injuries occurred to the back, but these reports accounted for 40% of total back injuries and 50% of all lost time claims in the total database. Further epidemiological research in academic institutions is needed to better understand the inherent injury risk in this work sector.