No abstract

Objective A quantitative and qualitative evaluation of the views of patients attending two types of clinics for menstrual disorders. Methods Semi-structured qualitative interview and quantitative questionnaire.Setting Five traditional general gynaecology clinics and a one-stop menstrual clinic, where investigations are performed and results given to patients on the same day.Participants Two hundred and thirty-nine women (126 from the gynaecology clinic and 113 from the menstrual clinic) were recruited into the quantitative study; 18 and 26 patients from the gynaecology and the menstrual clinic, respectively, were interviewed for the qualitative study. Main outcome measures Women's views about their care and progress towards resolution of their problem.Results Following the initial consultation, 106 (84%) of the gynaecology clinic, and 98 (87%) of the menstrual clinic patients completed the ®rst part of the questionnaire. Of those, 75 (71%) and 79 (81%) patients from the two types of clinic, respectively, completed a follow up questionnaire one year later. There were statistically signi®cant differences in all the components of the ®rst part of the questionnaire (information, continuity, waiting, organisation, and limbo) in favour of the one-stop menstrual clinic. After one year, there was a statistically signi®cant difference in one of the components, patient centeredness, but not in overall process co-ordination. The interviews showed that patients attending the menstrual clinic appreciated getting the results of their investigations on the same day. They also found the organisation of the one-stop menstrual clinic more closely suited to their needs and as a result were more likely to feel they were making progress.Conclusion Women were consistently more positive about their experience in the one-stop clinic. One-stop clinics organised to meet the needs of patients might be appropriate for other clinical conditions. The combination of quantitative and qualitative methods is an effective method of assessing patients' views of health services.

No abstract

T h e effectiveness ot in the treatment of vaginal intraepithelial neoplasia was assessed in 14 patients diagnosed with t h e condition between January 1980 a n d December 1982. All patients received a standard dose of 2.5 g 5-fluorouracil cream once weekly f o r at least 10 consecutive weeks: m e a n duration of treatment w a s 12 weeks (range 10-20 weeks). T h e vaginal lesion was associated with a major dysplastic lesion of t h e cervix in all patients. The duration of follow-up ranged f r o m 4 t o 42 m o n t h s ( m e a n 15 months). Thirteen patients h a d complete resolution both colposcopically and cytologically. One patient still h a d colposcopic evidence of intraepithelial neoplasia (aceto-white epithelium) b u t a vaginal s m e a r h a s been negative. This patient has since been lost t o follow-up. We conclude that in t h e regimen described 5-fluorouracil is an effective treatment f o r vaginal intra-

f Objective A quantitative and qualitative evaluation of the views of patients attending two types of clinics for menstrual disorders. Methods Semi-structured qualitative interview and quantitative questionnaire.Setting Five traditional general gynaecology clinics and a one-stop menstrual clinic, where investigations are performed and results given to patients on the same day.Participants Two hundred and thirty-nine women (126 from the gynaecology clinic and 113 from the menstrual clinic) were recruited into the quantitative study; 18 and 26 patients from the gynaecology and the menstrual clinic, respectively, were interviewed for the qualitative study. Main outcome measures Women's views about their care and progress towards resolution of their problem.Results Following the initial consultation, 106 (84%) of the gynaecology clinic, and 98 (87%) of the menstrual clinic patients completed the ®rst part of the questionnaire. Of those, 75 (71%) and 79 (81%) patients from the two types of clinic, respectively, completed a follow up questionnaire one year later. There were statistically signi®cant differences in all the components of the ®rst part of the questionnaire (information, continuity, waiting, organisation, and limbo) in favour of the one-stop menstrual clinic. After one year, there was a statistically signi®cant difference in one of the components, patient centeredness, but not in overall process co-ordination. The interviews showed that patients attending the menstrual clinic appreciated getting the results of their investigations on the same day. They also found the organisation of the one-stop menstrual clinic more closely suited to their needs and as a result were more likely to feel they were making progress.Conclusion Women were consistently more positive about their experience in the one-stop clinic. One-stop clinics organised to meet the needs of patients might be appropriate for other clinical conditions. The combination of quantitative and qualitative methods is an effective method of assessing patients' views of health services.