Ending a nurse practitioner-patient relationship: uncovering patients' perceptions.

DATA SOURCES: Seventy-nine patients assigned to the care of a nurse practitioner (NP) were interviewed to explore reactions to ending a yearlong therapeutic relationship at the conclusion of a clinical trial. Three researchers identified, reviewed and CONCLUSIONS: Of the total 79 patients, 22 (28%) spontaneously discussed perceptions and feelings about the termination of their relationship with the NP, Qualitative analysis of their statements identified future concerns about continuity of care and emotional themes ranging from gratitude, regret, and anxiety to grief. IMPLICATIONS FOR PRACTICE: Changes in health care coverage often result in abrupt termination of patient-provider relationships. The involuntary termination of a patient-provider relationship may have significant negative consequences on patients with substantial influence on physical and emotional health. Awareness and anticipatory counseling may be useful in stemming these effects.

Targeting lead screening: The Ohio Lead Risk Score.

OBJECTIVE: Annual blood lead (BPb) screening is recommended for children /=12% of BPb test results >/=10 microg/dL. RESULTS: Data from 897 census tracts were available. Higher risk for lead toxicity existed in areas where: 1) >/=55% of houses were built before 1950 (adjusted odds ratio [AOR]: 10.9 [6.1,19.6]); 2) >/=35% of residents were black (AOR: 3.5 [2.0,6. 3]); 3) >/=35% of residents had less than a high school education (AOR: 6.1 [3.6,10.4]); and 4) >/=50% of housing units were renter-occupied (AOR: 3.6 [2.1,6.2]). Receiver operator characteristic (ROC) curves demonstrated no significant differences after applying the model in a second dataset. CONCLUSIONS: Several community characteristics predict risk for lead toxicity in children and may provide a useful approach to focus lead screening, especially in communities where public health resources are limited. The approach described here may also prove helpful in identifying factors within a community associated with other environmental public health hazards for children.

Impact of headache education program in the workplace.

We evaluated the impact of a headache education program in a workplace setting. A 45-minute standardized educational program was delivered to 492 participants at eight companies. Participants completed questionnaires regarding their headaches and headache management techniques, the Short Form (SF)-36, and the Headache Disability Inventory (HDI) before and 1 month after the presentation. The intervention significantly improved health-related quality of life, decreased headache-related disability, and promoted the use of self-management techniques.