Prevalence and demographic characteristics of vulvodynia in a population-based sample.

OBJECTIVE: The objective of the study was to determine the prevalence and characteristics of vulvodynia among women in southeast Michigan. STUDY DESIGN: A population-based study of adult women was conducted, using telephone recruitment and completion of a self-administered survey. Weighted estimates of vulvodynia prevalence and characteristics were determined. RESULTS: Over a year, 2542 women were recruited and 2269 (89.3%) completed the self-administered survey. The weighted prevalence of vulvodynia was 8.3% (95% confidence interval, 7.0-9.8) or approximately 101,000 women in the targeted population. Prevalence remained stable through age 70 years and declined thereafter. Among sexually active women, the prevalence was similar at all ages. Of 208 women meeting vulvodynia criteria, 101 (48.6%) had sought treatment, and only 3 (1.4%) had been diagnosed with vulvodynia (unweighted values). Previous vulvodynia symptoms had resolved in 384 women (16.9%) after a mean duration of 12.5 years. CONCLUSION: Vulvodynia is common, although rarely diagnosed. Prevalence remains high among sexually active women of any age.

Nursing students' attitudes toward video games and related new media technologies.

Little is known about Millennial nursing students' attitudes toward computer games and new media in nursing education and whether these attitudes differ between undergraduates and graduates. This study elicited nursing students' experience with computer games and new media, their attitudes toward various instructional styles and methods, and the role of computer games and new media technologies in nursing education. We e-mailed all nursing students enrolled in two universities to invite their participation in an anonymous cross-sectional online survey. The survey collected demographic data and participants' experience with and attitudes toward video gaming and multi-player online health care simulations. We used descriptive statistics and logistic regression to compare the differences between undergraduates and graduates. Two hundred eighteen nursing students participated. Many of the nursing students support using new media technologies in nursing education. Nurse educators should identify areas suitable for new media integration and further evaluate the effectiveness of these technologies.

Deafness among physicians and trainees: a national survey.

PURPOSE: To describe the characteristics of and accommodations used by the deaf and hard-of-hearing (DHoH) physician and trainee population and examine whether these individuals are more likely to care for DHoH patients. METHOD: Multipronged snowball sampling identified 86 potential DHoH physician and trainee participants. In July to September 2010, a Web-based survey investigated accommodations used by survey respondents. The authors analyzed participants' demographics, accommodation and career satisfaction, sense of institutional support, likelihood of recommending medicine as a career, and current/anticipated DHoH patient population size. RESULTS: The response rate was 65% (56 respondents; 31 trainees and 25 practicing physicians). Modified stethoscopes were the most frequently used accommodation (n = 50; 89%); other accommodations included auditory equipment, note-taking, computer-assisted real-time captioning, signed interpretation, and oral interpretation. Most respondents reported that their accommodations met their needs well, although 2 spent up to 10 hours weekly arranging accommodations. Of 25 physicians, 17 reported primary care specialties; 7 of 31 trainees planned to enter primary care specialties. Over 20% of trainees anticipated working with DHoH patients, whereas physicians on average spent 10% of their time with DHoH patients. Physicians' accommodation satisfaction was positively associated with career satisfaction and recommending medicine as a career. CONCLUSIONS: DHoH physicians and trainees seemed satisfied with frequent, multimodal accommodations from employers and educators. These results may assist organizations in planning accommodation provisions. Because DHoH physicians and trainees seem interested in primary care and serving DHoH patients, recruiting and training DHoH physicians has implications for the care of this underserved population.

Prenatal group visit program for a population with limited English proficiency.

INTRODUCTION: The declining number of family physicians providing pregnancy care is of concern because they are an important source of pregnancy care in underserved communities. Innovative approaches might reinforce family physician participation in pregnancy care for the underserved. Since group prenatal visits have been shown to improve patient education, support, and satisfaction, we implemented and evaluated a group prenatal visit program for Japanese women in Michigan, an underserved population because of their limited proficiency with English. METHODS: We conducted a convergent quantitative and qualitative mixed methods evaluation involving repeated survey administration (program evaluations, 4-item Patient Health Questionnaire, pregnancy distress questionnaire) to participants during 5 group visits and in-depth postpartum interviews in the University of Michigan Japanese Family Health Program setting. We conducted independent quantitative and qualitative analytics and then thematically integrated these data. RESULTS: Cultural adaptations to the Centering Pregnancy format involved changes in total visits, educational content, and participation format. Based on 5 groups attending 5 sessions each, 42 women evaluated the program through 158 surveys after the sessions. Participants evaluated multiple parameters positively: being with other pregnant women (98%), improving their understanding about prenatal care (96%), preparation for labor and delivery (96%), organization of visits (94%), and preparation for newborn care (85%). In final evaluations, 96% to 100% of participants rated 7 educational topics as "covered" or "covered well." Qualitative interviews with 20 women revealed positive views of social support from prenatal group visits and group facilitation but mixed enthusiasm for clinical assessments in the prenatal group visit setting and partner and children attendance at the sessions. CONCLUSIONS: This research demonstrates the feasibility and cultural acceptability of prenatal group visits for Japanese women. Prenatal group visits provided education and social support for Japanese women during the perinatal and postpartum periods that were not otherwise accessible in Japanese. This study confirms the feasibility of family physicians providing prenatal group visits and extends the literature of the applicability of prenatal group visits for patients with limited English skills.

Truth or fallacy? Three hour wait for three minutes with the doctor: Findings from a private clinic in rural Japan.

INTRODUCTION: While previous reports examine various aspects of Family Medicine in Japan, there is sparse research on consultation lengths. A common phrase permeates throughout Japan, sanjikan machi, sanpun shinsatsu that means, "Three hour wait, three minute visit." The purpose of this study is to examine consultation length in Japan, and how it is affected by patient variables. CASE DESCRIPTION: We conducted a case study of consultation length and how it varies in relation to the demographics, presenting illness, and diagnoses at a rural clinic in central Japan. Data were coded according to the standards of the International Classification of Primary Care. Descriptive statistics were obtained to identify features of the data. Further, regression analysis was performed to characterize and to quantify the association between length of consultation and various subject level characteristics. DISCUSSION AND EVALUATION: A total of 263 patients aged 0 - 93 years old had consultations during the 8-day study period. The mean consultation duration was 6.12 minutes. Of all consultations, 11.8% lasted 3 minutes or less. The mean (median) consultation time among males was 6.29 (5.2) minutes and among females was 6.03 (5.4) minutes. The duration of visits increased with age. Among different International Classification of Primary Care categories, psychological issues required the most time (mean = 10.75 min, median = 10.9 min) while urological issues required the least (mean = 5.08 min, median = 4.9 min). The majority of cases seen in the clinic were stable, chronic conditions and required shorter consultation times. CONCLUSIONS: While the mean and median consultation length in this study extends beyond the anecdotal three minutes, the average length of consultation is still remarkably short. Trends affecting consultation length were similar to other international studies. These data present only one aspect of primary care delivery in Japan. To better understand the significance of consultation length relative to the delivery of primary care, future research should examine issues such as continuity, frequency of consultations over time and comprehensiveness of care.