Thesis (M.A.)--Kent State University, 2008. / Title from PDF t.p. (viewed Nov. 10, 2009). Advisor: Timothy Gallagher. Keywords: sociology, gender, doctor-patient interactions, doing gender. Includes bibliographical references (p. 78-88).

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2009. / Title from title screen (site viewed October 15, 2009). PDF text: iv, 261 p. ; 1 Mb. UMI publication number: AAT 3360084. Includes bibliographical references. Also available in microfilm and microfiche formats.

Disputats, Universitetet i Oslo, 2005. / Sammendrag på engelsk. Delvis opptrykk av artikler.

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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Objective: Effective physician‐patient communication is critical to the clinical decision making process. The informed consent process for any intervention can be one of the most important moments for effective physician‐patient communication in regards to outcome and liability. We studied parental recall of information provided during an informed consent discussion process prior to performance of emergency medical procedures in a pediatric emergency department of an inner city hospital with a large bi‐lingual population. Methods: Parent/child dyads undergoing emergency medical procedures were surveyed prospectively in English/Spanish, post‐procedure for recall of informed consent information. Logistic regression analysis was used; outcome variables were the ability to name a risk, a benefit, and an alternative to the procedure and predictors were language, education, and acculturation. Results: Fifty‐five parent/child dyads completed the survey. Logistic regression analysis showed that respondents with less than high school education were approximately 80% less likely to be able to name a risk or a benefit, while respondents with a high school education were approximately 24 times more likely to be able to name an alternative procedure. Conclusion: A gap in communication exists between physicians and patients during the consent taking; it is significantly impacted by socio‐demographic factors like education level, language and acculturation.

The physician’s crisis in Cameroon has reached an alarming stage and has the potential to worsen existing health problems including the attainment of millennium development goals. This report emphasized the challenges faced by Cameroonian physicians, and recommended alternative solutions to the current government health workers policies. The report was done through a review of articles and documents covering the topic. At the center of the physician’s crises in Cameroon is the discrepancy between financial, social and professional expectations and what the government offers. The analysis showed that, there is a general dissatisfaction, despite some corrective measures implemented by the government. This suggests that the government needs to aggressively adopt and implement aggressive retention policies, such as improving the remuneration and working conditions of health workers. Beside, there is also need for innovation by adopting and implementing solutions that have been successful in others countries. As in many other countries, establishing powerful unions and lobbying groups by Cameroon physicians may help in negotiating acceptable working conditions that could help in alleviating the challenges of Cameroonian physicians. Despite some limitations, this report can be useful for policy-makers in the formulation of effective human resources for health policies but also to draw attention to the need to publish more on human resources for health issues in Cameroon.

With new medical advances in technology, there has been a push from the legal, medical and political communities to re-examine the policies of end-of-life-care. End-of-life-care (EOLC) is a term that refers to not only a patient’s final hours of life, but also the medical care of individuals with terminal illnesses or conditions that have become advanced and incurable. For the purpose of this paper, I will be referring to physician-assisted death and active euthanasia as forms of end-of-care. The Politics of End-of –Life-Care: Active Euthanasia and Physician-assisted Death examines the political disjuncture between the evidence presented in favour of active euthanasia (AE), physician-assisted death (PAD) and the current practice of refusing to grant AE and PAD legal status in Canada. It will examine the political dynamics underlying the disjuncture using political pressure groups, constructivism, rational choice, institutionalism and structuralism. There is empirical evidence that demonstrates support for the legalization of AE and PAD. Sixty-seven percent of Canadians support AE /PAD and 80 percent support allowing physicians to assist in AE and PAD (Angus Reid 2012) however, Parliament has not legalized AE/PAD and the CMA has not sanctioned AE /PAD. The two sides of the debate have clearly communicated their arguments. The arguments on each side are strong and have merit. Conversely, the arguments against AE and PAD appear to hold more weight with institutions than with the public. This thesis examines a number of different reasons for why AE/PAD remains illegal in Canada despite society’s widespread support for AE/PAD. The results of the research found no one method explains the disjuncture between the evidence presented in favour of active euthanasia and the current practice of refusing to grant it legal status. However, discursive institutionalism does help elites to generate and communicate the discourse of AE and PAD. It also explains how discourse can also occur from the bottom which results in a new discourse. For example, physicians, politicians, and the public who have deviated from the accepted discourse on AE and PAD can help to create a new discourse regarding AE and PAD policies.

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Professionals whose job it is to counsel patients must be cognizant of the role played by communication in the establishment of a trusting working relationship. This is no less true for those within the medical community who must obtain informed consent for surgical interventions than it is for those working within the area of mental health. In order to determine what role communication plays in the obtaining of informed consent within a pediatrics setting, a qualitative study was conducted of 20 surrogates (those individuals giving consent on behalf of legally incompetent children) and of 5 surgeons performing surgical interventions on those children. Two sets of questionnaires were administered in order to elicit information pertaining to how surgeons communicate information to surrogates and to investigate how that information is received and processed by the surrogate. Results showed that while the obtaining of signed informed consent itself may not be a major problem, there are some difficulties in the communication between surgeons and surrogates in this domain. Based on the findings, recommendations for improved communication between surgeons and surrogates are proposed.

The purpose of this study was to validate a set of predictor variables which identify perspective orthognathic surgical patients who may be poor surgical risks. The predictive qualities of four MMPI scales, two Bloom Sentence Completion scales, and seven Dental Inventory scales were used to identify presurgical, orthognathic patients who were likely to express postsurgical dissatisfaction.All variables were considered jointly to assess their significance in predicting surgical satisfaction versus dissatisfaction. Subsequently, a minimal set of predictors, which accounted for a significant proportion of the criterion variance, were derived by using factor analysis.A nonrandomized, pretest-posttest design with a one-way, multivariate analysis of variance yielding a Hotelling T square statistic was used. A discriminate analysis of variance was used as a follow-up to the Hotelling T square to note those variables which caused the differences between the means.This study was conducted at a large military teaching and research hospital in Southwest Texas. Patients used in this study were identified during routine dental examinations or were referred by their dentists. Eighty-nine subjects participated in the research project. All subjects were between the ages of 15 and 50 with a mean age of 23.7. They were all volunteers and received their surgery in the same hospital by the current staff of oral surgeons. All subjects were informed that the psychological evaluation was an integral part of the oral surgery evaluation.Upon admission to the hospital the patient received the scheduled surgery and underwent 8 weeks of routine postoperative care. Prior to being discharged from the hospital the patient was readministered the MMPI, Bloom Sentence Completion, and the Dental Inventory. The 8-week period was chosen for postoperative testing because patients were medically cleared to resume normal functioning at that time.A statistically significant difference between the four MMPI scores on the results of the orthognathic surgery variable was evident when comparing satisfied versus dissatisfied patients (F = 3.020, P 0.028). Additionally, there was a multilinear relationship among the presurgical test and the level of postsurgical satisfaction.Factor analysis rendered a minimal set of predictor variables which proved practical in identifying satisfied from dissatisfied patients.Considering the limitations of the study and the above-mentioned results, it can be concluded that a minimal set of predictor variables could be effective in helping surgeons screen out those patients who have the potential of being poor surgery risks.