William J. Rudman

Psychological distress, stressful life events, and religiosity in younger African American adults

Prior research has found that stressful life events relate to increased psychological distress as well as mental and physical morbidity, particularly in minority groups. However, there is limited understanding of factors that may influence this relationship. This paper examines psychological distress, stressful life events, and religiosity among younger African American adults between the ages of 18 and 43 (n = 215). Stressful life events and religiosity levels did not differ by gender, though females reported greater levels of each distress category. Female gender and stressful events were predictive of increased levels of distress. Dimensions of religiosity related in unique ways to individual categories of distress. This would suggest that the role of religion in reduced distress differs according to the type of religious experience. Intrinsic religiosity was found inversely related to both total distress and depression; organizational religiosity inversely related to somatization and obsessive-compulsiveness; finally, non-organizational religiosity was inversely related to interpersonal sensitivity. Further research is needed across additional sociodemographic and economic categories to further clarify the relationship of religiosity, stressful events, and distress in younger African American adults.

The Pharmacist-Physician Relationship in the Detection of Ambulatory Medication Errors

Background:Expenditures on outpatient prescription drugs have increased enormously in the last decade. Despite this growth in expenditures, prescription medication safety in the ambulatory setting is lacking. Prior research in outpatient care has centered around the physician-patient encounter. What remains unexamined in the ambulatory care literature is the pharmacist’s role as interceptor, detector, and reporter of medication errors to the physician. Methods:Data about the role, responsibilities, and expectations to inform physicians about this subject were collected from pharmacist (N = 30) and patient (N = 31) focus groups conducted between July 2002 and July 2003. Pharmacists in outpatient practices and patients were randomly selected from the state licensure database and the Jackson Metropolitan phonebook, respectively. Analysis:Grounded theory provided the perspective on which data were interpreted. Data patterns were linked using key words and phrases for theme analysis. Arbitration between coders resulted in an inter-rater reliability of 0.85. Results:Three complementary patterns were identified from the data: 1) patients likely see multiple physicians and only one pharmacist; 2) patients are more likely to report medication errors to the pharmacist than to the physician; and 3) pharmacists are the final interceptors, detecting medication errors before they reach patients. Conclusions:Ambulatory pharmacists are in a privileged position to gather data regarding adverse responses to prescribed medication or incidents of medication mishaps. The failure of pharmacists to report information back to physicians is a missed opportunity to improve patient safety.

Identifying Domestic Violence Within Inpatient Hospital Admissions Using Medical Records

ABSTRACT This paper examines incidences of domestic violence among hospitalized patients identified as being victims of domestic violence. Specifically, we focus on defining the type and cost of domestic violence and identifying demographic characteristics of individuals at risk for domestic violence. Data for this paper were abstracted from the 1994 HCUP-3 data set. Findings from these data suggest that identifying incidences of domestic violence is very complex and difficult. The primary diagnosis of those who are victims of domestic violence range from broken bones and bruises to chronic and acute illness to mental illness. Finally, non-white populations are approximately two times more likely to be identified as victims of physical violence than whites and as age increases the likelihood of being identified as a victim of physical violence decreases.