Purpose of the Study: Stanford's Chronic Disease Self-Management Program (CDSMP) has been proven to increase patients' ability to manage distress. We describe how we replicated CDSMP in Asian and Pacific Islander (API) communities. Design and Methods: We used the "track changes" tool to deconstruct CDSMP into its various components…

Discusses literature on the physician-elderly patient-companion triad and proposes conceptual framework and methodological approach for understanding the companion's presence during the geriatric visit. Suggests agenda for both clinical and social science research. (Author)

Explored post-visit recall of medication regimens and lifestyle recommendations among 83 elderly clinic patients. Found recall problematic: average patient failed to recall 46 percent of medications. Of 42 patients receiving lifestyle recommendations, 52 percent failed to recall them. Patterns of communication during visits were more strongly…

Examined agreements between physicians and patients on major goals and topics discussed during outpatient medical visit. Found concordance to be significantly greater for younger patients and their physicians than for older patients and their physicians on major goals and major medical topics discussed during primary care interview. (Author/NB)

Administered Beisecker Locus of Authority in Decision Making: Breast Cancer survey to 67 oncologists, 94 oncology nurses, and 288 patients from women's clinic. All groups believed that physicians should have dominant role in decision making. Nurses felt that patients should have more input than patients or physicians felt they should. Physicians…

Purpose: The purpose of this study is to expand knowledge regarding end-of-life care received in nursing homes through the use of narrative interviews with family members close to the decedents. Design and Methods: We conducted follow-up qualitative interviews with 54 respondents who had participated in an earlier national survey of 1,578…

Purpose: This study examined attitudes of caregivers and physicians toward assessing and diagnosing dementia, with an emphasis on how a diagnosis is disclosed. Design and Methods: Seventeen focus group interviews were conducted with caregivers or physicians from three sites; 52 caregivers participated in nine interviews (three each at the three…

While attitudes of 106 rehabilitation medicine patients interacting with doctors indicated that all wanted medical information, older patients gave more decision-making authority to doctors and more often brought companions who questioned doctors on their behalf. Found no age differences in patient consumerist communication behaviors. Age was…

Discusses the need for members of several different professions to work closely together to achieve an integrated resolution in the best interests of an older person. Proposes that the physician's legal and ethical responsibilities toward an older patient would include a duty to interact and cooperate with other relevant health or human service…

Using a newly developed coding method, the Geriatric Interaction Analysis system, the interactions of doctors with a matched sample of older and younger patients were audiotaped and scored. Patients and doctors raised fewer psychosocial issues in interviews with older patients than with younger patients. Doctors also responded less well to these…

Evaluated physicians' responses to Alabama state elder abuse reporting statutes in Alabama Protective Services Act of 1976. Survey responses from over 100 Alabama physicians suggest that they have reservations about their ability to diagnose abuse, operation of the law, and their willingness to report abuse. (Author/NB)

Found that experience-based educational intervention in which medical students interview volunteer nursing home residents significantly changed medical students' responses to two geriatric patient vignettes. Concluded that use of elderly volunteers in practice interviews helped to sensitize students to problems of aging and taught them empathic…

Using retrospective, self-report data collected from women recently diagnosed with breast cancer (N=179), examines the influence of age differences in the treatment decision-making process. Findings indicate that older women were less likely than their younger counterparts to have desired participation in therapy selection or sought out medical…

Describes the development and implementation of a new standardized patient program in a required geriatrics clinical clerkship for fourth-year medical students. A student survey was also conducted. The standardized patient program provided students with direct feedback on their clinical skills--76% of the students favored the program. (RJM)

Explores nature of physician decision making in the case of elderly who reside in the community. Interviews with 40 physicians revealed 3 dilemma sources: (1) how much to intervene in patients' lives to reduce risk; (2) structural, moral, and medical limits to patient advocacy; and (3) assessing vulnerability and quality of life when pondering…