-
[show abstract]
[hide abstract]
ABSTRACT: This research examines the relationship between the characteristics of physicians who routinely provide medical care for postpartum mothers and their treatment preferences for managing postpartum depression (PPD) by means of a self-administered postal survey. A survey was sent to a random sample of 600 obstetricians/gynecologists and 600 family practitioners in North Carolina. The overall response rate was 42%. Forty-six percent of the responding physicians (N = 228) reported that they had seen women for postpartum visits during the past 3 months. Physician age, gender, race, and practice type were significantly associated with differences in their treatment preferences of PPD. Older physicians and non-white physicians were less likely to prefer treatment of PPD with antidepressants. Older physicians and physicians trained in obstetrics/gynecology (OB/GYN) were less likely to treat PPD with referral to a social worker or psychologist for counseling, but physicians trained in family practice and female physicians were more likely to do so.
Community Mental Health Journal 03/2008; 44(1):47-56. · 1.03 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The relation of medical literacy to women-reported barriers to taking medication themselves or giving medication to their children was studied.
Women in 18 homeless shelters in four counties in central North Carolina were recruited. Head-of-household homeless mothers with psychiatric or substance-abuse disorders and dependent children were eligible to participate. Trained interviewers administered a site-specific questionnaire on medication use.
One hundred sixty-four homeless women participated. Forty-two percent of the women were currently taking a medication. Forty-six percent of the women stated that there was a barrier to taking their medications as prescribed. Medical literacy was not significantly related to whether women felt there were barriers to taking a medication. Seventy-five percent of the women reported having one or more children living with them. Thirty-seven percent reported having a child with asthma live with them, and 12% reported having a child with attention-deficit disorder. Forty percent reported a barrier to giving their child a needed medication. Taste was the most commonly reported barrier. Women with lower medical literacy and younger women were significantly more likely to report a barrier to giving their children a needed medication. Over 80% of women listed pharmacists as their first or second choice for receiving drug information orally.
Race and perceived barriers to medication use affected the medication-taking behavior of homeless women, while their age and literacy level affected the reporting rates of the barriers to medication use for their children. Homeless women preferred receiving both written and oral drug information from a physician or a pharmacist.
American Journal of Health-System Pharmacy 03/2006; 63(4):346-51. · 1.96 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of the current study was to examine how African American race was related to the use of antidepressants and counseling among homeless depressed women. Women were recruited in 18 homeless shelters in four counties in central North Carolina. Head of household homeless mothers with psychiatric and/or substance abuse disorders who had dependent children were eligible to participate. One hundred and sixty four women enrolled into the study. Fifty-six percent (N=92) of the homeless women were currently depressed at the time of enrollment into the study. Nineteen of the depressed women reported having received counseling during the past 3 months and there were no racial differences in counseling use. A total of 19 depressed women were currently taking antidepressants. Non-Black depressed women (60%) were significantly more likely than Black depressed women (16%) to be currently using antidepressant medication (OR=0.14, 95% CI=0.02, 0.90). Fourteen of the 92 depressed women reported needing mental health services but not receiving them during the past 3 months and all of these women were Black.
Community Mental Health Journal 03/2006; 42(1):77-85. · 1.03 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Measuring health-related quality of life (HRQOL) is important in arthritis and the SF-36v2 is the current state-of-the-art. It is only emerging how well the Centers for Disease Control and Prevention (CDC) HRQOL measures HRQOL for people with arthritis. This study's purpose is to assess the psychometric properties of the 9-item CDC HRQOL (4-item Healthy Days Core Module and 5-item Healthy Days Symptoms Module) in an arthritis sample using the SF-36v2 as a comparison.
In Fall 2002, a cross-sectional study acquired survey data including the CDC HRQOL and SF-36v2 from 2 North Carolina populations of adult patients reporting osteoarthritis, rheumatoid arthritis, and fibromyalgia; 2182 (52%) responded. The first item of both the CDC HRQOL and the SF-36v2 was general health (GEN). All 8 other CDC HRQOL items ask for the number of days in the past 30 days that respondents experienced various aspects of HRQOL. Exploratory principal components analyses (PCA) were conducted on each sample and the combined samples of the CDC HRQOL. The multitrait-multimethod matrix (MTMM) was used to compute correlations between each trait (physical health and mental health) and between each method of measurement (CDC HRQOL and SF36v2). The relative contribution of the CDC HRQOL in predicting the physical component summary (PCS) and the mental component summary (MCS) was determined by regressing the CDC HRQOL items on the PCS and MCS scales.
All 9 CDC HRQOL items loaded primarily onto 1 factor (explaining 57% of the item variance) representing a reasonable solution for capturing overall HRQOL. After rotation a 2 factor interpretation for the 9 items was clear, with 4 items capturing physical health (physical, activity, pain, and energy days) and 3 items capturing mental health (mental, depression, and anxiety days). All of the loadings for these two factors were greater than 0.70. The CDC HRQOL physical health factor correlated with PCS (r = -.78, p < 0.0001) and the mental health factor correlated with MCS (r = -.71, p < 0.0001). The relative contribution of the CDC HRQOL in predicting PCS was 73% (R2 = .73) when GEN was included in the CDC HRQOL score and 65% (R2 = .65) when GEN was removed. The relative contribution of the CDC HRQOL in predicting MCS was 56% (R2 = .56) when GEN was included and removed.
The CDC HRQOL appears to have strong psychometric properties in individuals with arthritis in both community-based and subspecialty clinical settings. The 9 item CDC HRQOL is a reasonable measure for overall HRQOL and the two subscales, representing physical and mental health, are reasonable when the goal is to examine those aspects.
Health and Quality of Life Outcomes 02/2006; 4:66. · 2.11 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Abstract
Background
Measuring health-related quality of life (HRQOL) is important in arthritis and the SF-36v2 is the current state-of-the-art. It is only emerging how well the Centers for Disease Control and Prevention (CDC) HRQOL measures HRQOL for people with arthritis. This study's purpose is to assess the psychometric properties of the 9-item CDC HRQOL (4-item Healthy Days Core Module and 5-item Healthy Days Symptoms Module) in an arthritis sample using the SF-36v2 as a comparison.
Methods
In Fall 2002, a cross-sectional study acquired survey data including the CDC HRQOL and SF-36v2 from 2 North Carolina populations of adult patients reporting osteoarthritis, rheumatoid arthritis, and fibromyalgia; 2182 (52%) responded. The first item of both the CDC HRQOL and the SF-36v2 was general health (GEN). All 8 other CDC HRQOL items ask for the number of days in the past 30 days that respondents experienced various aspects of HRQOL. Exploratory principal components analyses (PCA) were conducted on each sample and the combined samples of the CDC HRQOL. The multitrait-multimethod matrix (MTMM) was used to compute correlations between each trait (physical health and mental health) and between each method of measurement (CDC HRQOL and SF36v2). The relative contribution of the CDC HRQOL in predicting the physical component summary (PCS) and the mental component summary (MCS) was determined by regressing the CDC HRQOL items on the PCS and MCS scales.
Results
All 9 CDC HRQOL items loaded primarily onto 1 factor (explaining 57% of the item variance) representing a reasonable solution for capturing overall HRQOL. After rotation a 2 factor interpretation for the 9 items was clear, with 4 items capturing physical health (physical, activity, pain, and energy days) and 3 items capturing mental health (mental, depression, and anxiety days). All of the loadings for these two factors were greater than 0.70. The CDC HRQOL physical health factor correlated with PCS (r = -.78, p < 0.0001) and the mental health factor correlated with MCS (r = -.71, p < 0.0001). The relative contribution of the CDC HRQOL in predicting PCS was 73% (R<sup>2 </sup>= .73) when GEN was included in the CDC HRQOL score and 65% (R<sup>2 </sup>= .65) when GEN was removed. The relative contribution of the CDC HRQOL in predicting MCS was 56% (R<sup>2 </sup>= .56) when GEN was included and removed.
Conclusion
The CDC HRQOL appears to have strong psychometric properties in individuals with arthritis in both community-based and subspecialty clinical settings. The 9 item CDC HRQOL is a reasonable measure for overall HRQOL and the two subscales, representing physical and mental health, are reasonable when the goal is to examine those aspects.
Health and Quality of Life Outcomes. 01/2006;
-
[show abstract]
[hide abstract]
ABSTRACT: Postpartum depression occurs in 13% of women after delivery making it one of the most common puerperial complications. The purpose of the study was to examine: (1) the extent to which obstetricians/gynecologists and family physicians report discussing depression and other psychosocial issues during postpartum visits and (2) how physician specialty and gender are related to whether physicians report discussing depression and other psychosocial issues with patients during postpartum visits.
A survey was sent to a random sample of 600 obstetricians/gynecologists and 600 family practitioners in North Carolina.
The overall response rate was 42%. Forty-six percent of the responding physicians (N=228) reported that they had seen women for postpartum visits during the past 3 months. Of physicians conducting postpartum visits within this time period, 43% of physicians were almost certain to ask whether the woman felt down, depressed, or hopeless and 27% were almost certain to ask about the woman's interest in her usual activities. Seventy-nine percent of physicians stated that they were unlikely to use a formal screen for depression. Obstetricians/gynecologists were less likely to ask about a womans social support network (OR=0.33, 95% CI=0.14, 0.75), to ask about her relationship with her partner (OR=0.40, 95% CI=0. 18, 0.87), and to use a formal depression screen (OR= 0. 16, 95% CI=0.04, 0.57) than family practitioners.
The study only examined physician self-report of the extent to which they communicated about different issues with women during postpartum visits.
Communication about depression and related psychosocial issues during postpartum visits is substantially limited, likely contributing to the underdiagnosis of this common disorder.
North Carolina medical journal 68(3):151-5.
