Laparoscopy and the internet. A surgeon survey.

BACKGROUND: The Internet has become an important new tool for the delivery and acquisition of medical information. METHODS: A 13-item questionnaire designed to collect information on the attitudes and practices of surgeons regarding the use of the Internet as a medical resource was posted on the World Wide Web and also sent via e-mail. RESULTS: Over a 2-month period, 459 surgeons were enrolled in this study. Most of the respondents were identified as male surgeons (96%) between the ages of 31 and 50 years (79.25%). They accessed the Internet mainly from their homes (67.10%) and offices (17%) using 56 Kbps (34.86%) and 33.6 Kbps (21.79%) modems. These participants indicated that they use the Internet to expand their knowledge of general surgery (78.87%), learn more about technologies related to the practice of surgery (74.51%), access the Medline medical database (73.20%), and locate other resources for academic purposes (68%). Approximately half of them said that they favored the use of robotic assist devices in the operating room (53%), and most supported the use of technology for telementoring purposes (78%). Almost 80% professed an interest in video streaming technology applied to surgical education. CONCLUSIONS: This study showed that the Internet is a useful and powerful real-time survey tool that can help us to assess the impact of the World Wide Web and related technologies on surgical education and practice. However, the respondents in this study belong to a biased group that is already familiar with the Internet and computer technology and thus may not be representative of the surgical community as a whole.

Stage of illness, level of HIV symptoms, sense of coherence and psychological functioning in clients of community-based AIDS counseling centers.

The psychological functioning of HIV-infected individuals in community populations has taken on new meaning and urgency for healthcare policymakers responding to the special challenges of the AIDS epidemic. The authors' objective is to test several hypotheses that predict depression and anxiety in adults infected with HIV. Data were obtained from 156 HIV-infected adults (age > or = 18) who sought support, counseling, and maintenance services from one of three HIV care and referral centers in the Mid-South. The results of the study emphasize the relative importance of perceived physical symptoms over stage of illness for psychological functioning among adults with HIV.

Collaborative problem solving with a total quality model.

A collaborative problem-solving system committed to the interests of those involved complies with the teachings of the total quality management movement in health care. Deming espoused that any quality system must become an integral part of routine activities. A process that is used consistently in dealing with problems, issues, or conflicts provides a mechanism for accomplishing total quality improvement. The collaborative problem-solving process described here results in quality decision-making. This model incorporates Ishikawa's cause-and-effect (fishbone) diagram, Moore's key causes of conflict, and the steps of the University of North Dakota Conflict Resolution Center's collaborative problem solving model.

Professional territoriality: a study of the expanded role of the nurse.

This study examines the expanded role of the nurse as a specific example of the extension of professional boundaries. Three characteristics of professional territoriality--autonomy, accountability, and identity--were selected as variables in the study. The specific objectives were to examine attitudes of members of the nursing and medical profession toward the expanded role of the nurse, and to test the usefulness of the concept of professional territoriality in understanding the expanded role of the nurse. Attitudes toward nurses functioning in an expanded role were examined for two aspects: beliefs as to what nurse practitioners are now doing and what they should be able to do. Data was obtained through questionnaries mailed to a random sample of nurses and physicians in Minnesota. As predicted, the researcher found that nurses held more positive attitudes toward nurse practitioners working in an expanded role than do physicians.