A qualitative study of physicians' own wellness-promotion practices.

OBJECTIVE: To delineate the specific practices that physicians use to promote their own well-being. DESIGN, SETTING, AND PARTICIPANTS: 304 members of a primary care practice-based research group responded by mail to a survey on physician well-being. From the original survey, 130 subjects responded to an open-ended survey item regarding their own wellness-promotion practices. METHODS: Qualitative content analysis was used to identify the common themes in the physicians' responses to the open-ended question. A validated 18-item instrument, the Scales of Psychological Well-Being (SPWB), was used for measurement. MAIN OUTCOME MEASURES: Similarities and differences between the various wellness-promotion practices that respondents reported using and associations between the use of these practices and SPWB scores. RESULTS: The 5 primary wellness-promotion practices that evolved from thematic analysis of the survey responses included "relationships," "religion or spirituality," "self-care," "work," and "approaches to life." The use of the last type of practice was significantly associated with increased psychological well-being (SPWB) scores compared with the use of any of the other wellness-promotion practice categories (P<0.01), and there was a trend toward increased well-being among users of any category of wellness-promotion practices. Comments by our respondents provide specific descriptions of how physicians attend to their emotional, spiritual, and psychological well-being. CONCLUSION: Physicians use a variety of approaches to promote their own well-being, which sort themselves into 5 main categories and appear to correlate with improved levels of psychological well-being among users.

Evaluation of the abbott LCx assay for detection of Neisseria gonorrhoeae in endocervical swab specimens from females.

The Abbott LCx Neisseria gonorrhoeae assay (Abbott Laboratories, Abbott Park, Ill.) uses a ligase chain reaction (LCR) amplification in the LCx probe system for detection of a specific nucleotide sequence in the Opa-encoding gene of N. gonorrhoeae. We evaluated the LCx assay in a comparison with conventional culture employing modified Thayer-Martin media for the detection of N. gonorrhoeae from female endocervical specimens obtained from patients attending a sexually transmitted disease clinic. Discordantly LCR-positive and culture-negative specimens were further evaluated by testing with another LCR assay which used an N. gonorrhoeae-specific pilin probe. Specimens positive by both LCR assays were considered confirmed LCx-positive specimens. A specimen was considered to contain N. gonorrhoeae when it was either culture positive or culture negative and confirmed LCx positive. A total of 403 female endocervical specimens were evaluated. The prevalence of N. gonorrhoeae in this population was 8.7%. The sensitivity and specificity of the LCx assay were 94.3 and 99.4%, and those of culture were 77.1 and 100%, respectively. The Abbott LCx assay is a rapid, sensitive method for detection of N. gonorrhoeae in female endocervical specimens.

Smoking cessation intervention: the practices of maternity care providers.

BACKGROUND: Little is known about the actual smoking intervention practices of maternity care providers. This study examines smoking intervention practices of maternity care providers in a large Midwestern city. METHODS: A telephone survey was used to collect information on the care of pregnant patients who smoke (n = 73). RESULTS: After brief counseling during the first prenatal care visit (98 percent), 84 percent of providers readdressed smoking at follow-up visits. Family physicians were significantly more likely than obstetricians to provide further counseling (97 versus 72 percent, P < 0.005). Common cessation interventions included provider counseling (99 percent) and recommending smoking cessation classes (26 percent). Reasons cited by providers for patients' inability to stop smoking during pregnancy included addiction, habit, and environment or family. Methods used to encourage smoking cessation did not correlate with those known to be effective for treating addiction, modifying behavior, or responding to family or social system problems. CONCLUSION: Maternity care providers underutilize effective methods of smoking cessation for their patients who smoke and rely on less effective methods.

An interdisciplinary educational model for health professions students in a family practice center.

Health professions students have little or no opportunity to practice together during their formative stages of development. Therefore, can we realistically expect them to practice together as professionals? This is an important area for educators to address, given the current emphasis on interdisciplinary collaboration. The authors describe an interdisciplinary education program model for nursing, medicine, and social work students in a family practice center.