COMPARISON OF PRIMARY-CARE RESIDENTS CONFIDENCE AND CLINICAL BEHAVIORIN TREATING HYPERTENSION VERSUS TREATING ALCOHOLISM

Purpose. To compare the self-reported confidence and clinical behavior s of primary care residents in treating alcoholism versus hypertension . Method. Eighty-five residents, 36 in family medicine and 49 in prima ry care internal medicine, representing all years of the three-year tr aining programs at two hospitals affiliated with the Brown University School of Medicine, were surveyed in 1988. Self-report questionnaires elicited demographic data and several responses (ranged on scales of 1 , not confident or frequent, to 10, very confident or frequent) about the residents' confidence and frequency of use of clinical behaviors w ith both alcoholic and hypertensive patients. Paired t-tests were used to compare the responses about hypertension with those about alcoholi sm. Results. Questionnaires were completed by 54 (63.5%) of the reside nts. No significant difference was found between the residents' respon ses by sex or program, but there was a significant difference (p < .00 01) between the responses with regard to the two disorders. The reside nts had more confidence about their management of hypertension (a mean score of 8.81 versus 7.95 for alcoholism). They also reported greater use of appropriate clinical behaviors with hypertensive patients (mea n scores in the very confident range of 7.5 to 8.2 compared with means in the moderate range of 4.9 to 7.1 for alcoholism). Conclusion. Both the family medicine and the internal medicine residents were signific antly more confident in managing all aspects of hypertension than in m anaging alcoholism, and they reported significantly greater frequency in utilizing appropriate clinical behaviors for hypertension than for alcoholism.