PubMed Health⌕ Search

Biomedical subjects

B Maheux

Publications and source records attributed to B Maheux.

At least 19 recordsLinked to original sources
PubMed1992

Effects of residency training in family medicine v. internship training on professional attitudes and practice patterns.

OBJECTIVES: To determine whether the professional attitudes and practice patterns of physicians with residency training in family medicine differ from those of generalists with internship training. DESIGN: Mail survey conducted in 1985-86. SETTING: Province of Quebec. PARTICIPANTS: A stratified random sample of French-speaking family and general practitioners who graduated after 1972 (325 physicians with residency training and 304 with internship training) (response rate 82%). MAIN RESULTS: Physicians with residency training were 3 years younger on average than those with internship training, were more likely to be female (38% v. 18%, p less than 0.001) and were more likely to work on a salaried basis in CLSCs (public community health centres) (36% v. 14%, p less than 0.001). Even after these confounding factors were controlled for, physicians with residency training seemed to be more sensitive to the psychosocial aspects of patient care and tended to attach more importance to informing patients about useful materials and resources concerning their health problems. They were not, however, more likely to value health counselling or integrate it in medical practice. CONCLUSION: Our findings provide some evidence that the new requirement that physicians complete a residency in family medicine to obtain medical licensure in general practice in Quebec may foster a more patient-centred approach to health care.

Adult↗
PubMed1991

Elderly patients' use of hospital-based emergency services.

Past studies have shown in many instances that elderly people are represented in the hospital emergency room in proportion to their distribution in the population. It is possible, though, that elderly patients in the emergency room are using different types of resources than individuals of a younger age. Samples of two hospital emergency room users were selected in 1981 and in 1986. Patients aged 25 years or older were included in the study. The dependent variable was the extent to which patients used resources available at the hospital emergency room only or at alternative emergency medical services in the community. The effect of age on the use of resources in the hospital emergency rooms was estimated separately for those who were transported to the emergency room by ambulance and for those who were not. Age had an effect on use of resources under both conditions, regardless of the patients' gender, time of the visits, availability of alternative sources of emergency care, and diagnostic categories. The role of the hospital emergency room is to address medical care needs of specific segments of the population in special circumstances. Elderly emergency room patients are indeed one of these specific segments with very special needs.

Adult↗
PubMed1991

Measurement of attitudes and behaviors in public health surveys.

We divided 900 general practitioners into two groups: one group received a questionnaire measuring both attitudes and behaviors toward preventive aspects of medical care, while the other received two separate questionnaires--one measuring behaviors, and one measuring attitudes. Response rates of the two groups were similar. Respondents in the first group retrieved their answer to the attitudinal items when responding to behavioral items, increasing the correlations between attitudes and behaviors by an average of .147 as compared to the second group; hence the second procedure was preferable.

Attitude of Health Personnel↗
PubMed1991

Characteristics of physicians practicing in alternative primary care settings: a Quebec study of local community service center physicians.

Since the early 1970s, there have been two primary care networks in Quebec: the traditional one characterized by private practice remunerated on a fee-for-service basis, and the public one comprising 15 percent of physicians and characterized by salaried practice within publicly funded local community health service centers (CLSCs). Using data collected on 616 Quebec generalists, 333 in private practice and 283 in CLSCs, we compared physicians' profiles in both networks. In contrast to their colleagues in private practice, CLSC physicians are younger, more often women, and more often graduates of innovative primary care training programs. They are more sensitive to the biopsychosocial nature of health problems and to giving patients an active role in their care. Significant differences were also observed in physicians' self-reported clinical practices, more so for women than for men. The study suggests that alternative primary care settings attract physicians that are more preventive and socially oriented. As a result, they may contribute to the emergence of a more comprehensive type of medical practice in health care delivery systems.

Adult↗
PubMed1991

[Parental knowledge about their asthmatic children].

A questionnaire was administered to parents of 171 asthmatic children, and their knowledge of asthma was evaluated using a quantitative score. The mean age of children was 5 yr and the mean duration of their asthma was 3 yr. Each sign of the classical triad "noisy breathing, cough, indrawing" was mentioned by two-thirds of parents. Inhaled agents perceived as triggers of asthma were: animal hair (73.7%), dust (69.6%), pollen (60.2%), tobacco (44.4%), molds (14.6%). Other triggering agents mentioned were: stress (51.5%), infections (38%), exercise (13.5%). Mothers with college or university education knew more clinical signs of an attack (P less than 0.01) and more triggering factors (P less than 0.005). Parents satisfied with previous teaching knew more threatening signs of an attack (P less than 0.01). About 80% of those that used theophylline and 49.4% of those that used inhaled beta-2-agonists knew the correct mode of administration. Parents satisfied with previous teaching had better knowledge of the side-effects of theophylline (P less than 0.005) and beta-2-agonists (P less than 0.02). 58.5% of those that used cromolyn sodium did not know the mean duration of a therapeutic trial and 15% did not use it as prophylaxis. 57.1% of those that used oral corticosteroids did not know any side-effects of the drug. About half of the parents indicated that they would like to receive more information about the causes and the appropriate treatment of asthma. It was concluded that parental teaching should focus more on environmental and therapeutic issues.

Asthma↗
PubMed1991

Television and the 3- to 10-year-old child.

A questionnaire on the use of television was administered to the parents of 387 children aged between 3 and 10 years. All families owned at least one television set and 57.6% of families owned two or more sets, with one in the child's bedroom in 10.6% of cases. Television was turned on all day in 16% of cases, mostly in families with low level of parental education (P less than .01). Television was on at mealtime in 54.5% of cases; 45.2% of children were watching television for between 7 to 16 hours per week, and the heavy viewers belonged to families with low levels of maternal education (P less than .05). About one third of children watched television without any interdiction set by their parents. According to age, from 28% to 40% of children watched violence on television. Parents believed that television facilitates learning (65.3%) but were concerned about violence (22.7%) and commercials (7.4%). Finally, 63.3% of parents reported that they would like to obtain more information about television use. According to this survey, many children are watching television without any limits being set by their parents and are witnessing violent scenes at an impressionable and vulnerable age. The pediatrician should include at routine office visits parental guidance on the mediation of television effects through coviewing, content discussion with children, and program selection.

Analysis of Variance↗
PubMed1990

Socio-spatial perspectives on the utilization of emergency hospital services in two urban territories in Quebec.

Hospital emergency services located in urban areas have been severely congested for several years in the province of Quebec. This problem is not caused by ambulatory patients who are using emergency services as a regular source of care, but by patients in need of emergency services. To study the factors affecting the utilization rates of emergency services in two urban areas, the city of Laval and the Quebec metropolitan area, two samples of more than 30,000 patients each were drawn from the 1981 file of the Régie de l'assurance-maladie du Quebec. The utilization rates of emergency services for emergent and urgent causes in these two samples were computed on the basis of the census tract location of these patients. The socio-economic characteristics of these census tracts were taken from the 1981 Canadian census, the distance travelled from each census tract to the location of hospital emergency services was computed and included as a predictor of the utilization rates. Also, the prevalence of chronic and psychiatric diagnoses were obtained for each census tract. The result of the analysis showed that distance affected the utilization rates only in the Quebec metropolitan area where the hospitals are mostly located in the downtown area near deprived and working class neighbourhoods, while the socio-economic characteristics affected the utilization rates in both Quebec and Laval.

Age Factors↗
PubMed1990

Humanism in medical education: a study of educational needs perceived by trainees of three Canadian schools.

The authors examined how medical trainees and recent graduates of three Quebec medical schools value 16 dimensions of medical competence classified in four broad categories: clinical, technological, humanistic, and social and preventive. To assess perceived educational needs, the trainees' perceptions of the importance that medical faculties attribute to these same dimensions in the education of physicians were also examined. The survey was conducted in 1986-87 via a questionnaire mailed to 2,030 individuals, including freshmen, juniors, interns, residents, and newly practicing generalists; 80.3% responded. Compared with the views attributed to the faculty, the medical trainees gave more importance to basic diagnostic and therapeutic skills such as the medical history, the physical examination, and the treatment of common diseases. They also valued to a greater extent non-biological dimensions of clinical competence, such as communication with patients, patient education, the social context of disease, and the multidisciplinary nature of patient care, while they ascribed less importance to medical technology and rare diseases. The study raises the question of the relevance of medical education to medical practice by suggesting that those who are preparing themselves to become doctors may not be receiving the training they wish to receive.

Attitude of Health Personnel↗
PubMed1989

Do conventional and innovative medical schools recruit different students?

A mail questionnaire was used to survey the social and demographic characteristics, educational background, attitudinal profiles and expected career choice of 243 first-year students enrolled in three US medical schools. The aim was to determine whether different types of schools selected different types of students. Two schools were considered as conventional whereas one school was considered as innovative both in its admission policies and in its curriculum which emphasizes a biopsychosocial approach to health care. The survey achieved an 84% response rate. The results showed no difference in students' career expectations. Students recruited in the innovative school, however, differed from students recruited in the conventional schools with regard to their social and demographic characteristics, educational background and attitudinal profiles. This study suggests that as some medical schools are innovating in their curriculum and admission policies, new types of medical students are entering medicine. Implications of these results are discussed.

Adult↗
PubMed1989

Increasing response rates in physicians' mail surveys: an experimental study.

It is becoming increasingly difficult to obtain high response rates in physicians' mail surveys. In 1983-84, we tested the effectiveness of two techniques among 604 Quebec physicians who had not responded to an initial letter. A handwritten thank you note at the bottom of the letter accompanying the questionnaire and a more personalized mailout package increased response rates by 40.7 per cent and 53.1 per cent, respectively, compared to control groups.

Cooperative Behavior↗
PubMed1988

Do female general practitioners have a distinctive type of medical practice?

Using data collected in 1983-84 for a representative sample of 736 general practitioners practising in Quebec, we compared the practice characteristics of the 296 female physicians and the 320 male physicians who agreed to participate. The female doctors were more likely than the male doctors to favour salaried practice in local community health centres, to practise in an urban setting and to have an office-based practice. The female physicians had a less diversified type of practice, being less involved in hospital care, emergency care, home care and administrative work. Sex differences were more marked for physicians in fee-for-service practice than for salaried physicians. Given the increasing numbers of women in the medical profession, these findings are of special interest since they indicate distinctive differences in medical practice between women and men.

Adult↗
PubMed1987

Changes in students' sociopolitical attitudes during medical school: socialization or maturation effect?

This study examined medical students' attitudes toward the issue of universal access to medical care in order to determine whether students become more conservative with increased training and, if this is the case, whether changes in students' sociopolitical attitudes can be mostly attributed to the influence of professional education (socialization effect) or to the fact that students change their way of thinking as a result of getting older (maturation effect). Data were obtained from a survey of 586 freshmen, juniors and recent graduates trained in three differently-oriented schools, one being more socially-oriented in its approach to medical education than the other two. The findings documented a conservative trend in more advanced students, not only in the two traditional schools but in the socially-oriented school as well. However, based on the authors' conceptual model, this conservative trend could not be attributed to a pure socialization effect nor to a pure maturation effect. Rather, both types of effect seemed simultaneously at play. In general, students' sociopolitical attitudes were more related to their personal background characteristics than to the characteristics of their professional medical training. These results suggest that selection more than medical training per se is the crucial determinant in influencing medical graduates' sociopolitical outlook.

Age Factors↗
PubMed1987

The influence of medical school programs on physicians' attitudes toward universal access to medical care.

The extent to which medical education influences physicians' attitudes toward the issue of universal access to medical care was studied. Data were obtained from a survey of graduates from three medical schools with differing orientations. The first school could be described as traditional and highly research-oriented; the second as also traditional but more middle-of-the-road in its curriculum content; and the third as more social and primary care-oriented. Our results indicated that graduates from the more socially-oriented medical school were significantly more positive in their attitudes about the universality of the medical care issue than were graduates of the more traditional medical schools. The medical school effect vanished completely, however, when differences in personal characteristics among the three groups of graduates, namely, sex and interest in social sciences, were taken into account. Such findings support the hypothesis that the medical school effect can be explained to a greater extent by differences in medical student recruitment than by differences in medical school curricula. They also limit the expectations of those who advocate changes in medical curricula as a mean of inducing more favorable attitudes toward progressive medical care approaches in tomorrow's physicians.

Attitude of Health Personnel↗
PubMed1986

Students' perceptions of values emphasized in three medical schools.

The purpose of the study presented here was to assess medical students' perceptions of the weight given to scientific and humanistic values in their learning environment and to determine whether students' perceptions in a given school vary according to their level of medical training and personal characteristics. The study was conducted in 1979 via a mail questionnaire sent to a sample of 713 freshmen, juniors, and graduates from three U.S. medical schools; 82.2 percent responded. The results indicated that the students' perceptions of school values varied little according to the students' personal characteristics, such as sociodemographic and educational background, interests before medical training, and expected specialty choice. However, important differences were observed in students' perceptions of values emphasized to them at different schools. Preclinical and clinical students' perceptions of the importance given to scientific values were similar. As for humanistic values, significantly lower ratings were given by clinical students than preclinical students in two of the schools.

Humanism↗