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Biomedical subjects

J De Maeseneer

Publications and source records attributed to J De Maeseneer.

15 recordsLinked to original sources
PubMed2002

Is GP-patient communication related to their perceptions of illness severity, coping and social support?

The aim of the study was to explore the relationship between the communicative behaviour of general practitioner and patient on the one hand and the perception of the coping behaviour of the patient, the severity of the complaint and the presence of social support on the other hand. From 20 general practitioners (GP), 15 consultations per GP were videotaped and analysed using the Roter Interaction Analysis System. Doctors and patients rated their perceptions on questionnaires. The finding was that doctors and patients used predominantly task-oriented (instrumental) behaviour, with some exceptions. With older patients and patients with low social support the GPs used more affective communication, mainly consisting of social talk and mutual agreement. In the case of complex problems, the GP paid special attention to the relationship with the patient. Within the domain of instrumental communication, some differences between doctor and patient were observed. Although doctors and patients exchanged a lot of information about medical issues, patients gave information about their lifestyle and emotions, which the doctors did not verbally explore. In consultations where the patient perceived the complaint as severe, he or she was more focussed on the medical content. When the GP considered psychosocial issues important, doctor and patient communicated about lifestyle, emotions and social relations. This doctor-patient correlation was not found when patients perceived their problem as psychosocial.

Adaptation, Psychological↗
PubMed2002

Wet combing for head lice: feasibility in mass screening, treatment preference and outcome.

There is no scientific consensus on the best way to control head louse infestation in schoolchildren. A study was conducted to test the feasibility and acceptability of a screening campaign by wet combing and a community approach to head-louse control with home visits, and to explore parents' treatment preferences and treatment outcomes. A non-controlled intervention (advice on treatment options offered to all positive children) was nested within an epidemiological prevalence study. All children in three primary schools in Ghent, Belgium, were invited to take part in screening by wet combing (n=677, 3-11 years). Positive children were offered structural treatment advice, a home visit on day 7, and a check by wet combing on day 14. 83% of the children were screened. The prevalence of active infestation (living moving lice) was 13.0% in school 1 and 19.5% in school 3. In school 2, prevalence of signs of active and past infestation was 40.7%. A home visit was made to 58% of the positive children. 85% of the positive children were screened again on day 14. Wet combing was the most widely used treatment, followed by chemical treatment and a combination of the two. In school 1 and 3 51% were cured, and in school 2 24% became nit-free. A wet combing screening campaign and a community-oriented approach to head-louse control is feasible though resource-intensive. The prevalence of head lice was high and the cure rate was low, with either topical treatments or wet combing.

Animals↗
PubMed2001

Intensive and prolonged health promotion strategy may increase awareness of osteoporosis among postmenopausal women.

The aim of the study was to measure the results of a 15-year health promotion strategy towards osteoporosis, in an urban community of subjects over 45 years old, in terms of osteoporosis awareness and handling. To this end an ancillary study to a large survey of the Belgian population's self-perceived health status was carried out. A rectangular sample of 4800 individuals over 45 years old was randomly selected in two Belgian cities, among the affiliates of the two main health insurance providers. One of the cities (Liège) had been, since the early 1980s, the target of a constant health promotion strategy, directed to both the medical community and the general population, aimed at increasing osteoporosis awareness in women after the menopause. During the same period, no particular steps were taken in the other city (Aalst) to increase osteoporosis awareness in the community. In our study, the participants were asked to spontaneously report any chronic, serious and/or severe disorders that they had been suffering from, for at least 6 months, during the previous 12 months. They also provided a list of drugs they were taking at the time of the survey. Osteoporosis was reported to be a disease affecting 1.5% of men in Aalst and 1.3% of men in Liege (p = 0.61). For women, osteoporosis was reported to be present in 4.8% in Aalst and 10.8% in Liege (p<0.001). Self-reporting of osteoporosis prevalence in Liege was statistically significantly higher in women aged 45-64 years, 65-74 years or over 75 years (p<0.001). Obesity, alcohol consumption or physical activity were equally distributed between women from Liège and Aalst. Prescription drugs used for osteoporosis had been delivered to a similar proportion of men in Aalst and Liège. In women, a statistically significant difference in these prescription drugs was observed between Liège and Aalst, both for the overall population (p<0.001) and in each of the age classes (p<0.001 for 45-64 years and 65-74 years; p<0.009 for over 75 years). A continuous long-term health promotion strategy, directed toward both physicians and the general population, thus appears to increase awareness about osteoporosis in women over 45 years and/or in the medical community. This is reflected by an increase in self-reported prevalence of osteoporosis and in the prescription of drugs aimed at prevention and treatment of this disorder. Whether these observations reflect an appropriate diagnosis and a proper handling of the disease remains to be evaluated by objective diagnostic tools such as bone densitometry and by an evaluation of the effectiveness of prescription practices in postmenopausal women.

Aged↗
PubMed1998

Which bacteria are found in Belgian women with uncomplicated urinary tract infections in primary health care, and what is their susceptibility pattern anno 95-96?

Dysuria is a frequent reason for encounter in general practice and also gynaecologists and urologists will be frequently confronted with it. In female patients 1/2 to 2/3 of dysuric episodes are due to urinary tract infections. In nearly all cases therapy is started before the results of a culture is available. Therefore it is very important to know which bacteria are most prevalent in the treated population, and what their susceptibility pattern is . Because most available information is based on retrospective data issued from very mixed populations, we performed a prospective study including the most frequently involved population: symptomatic adult women without any symptom of complicated UTI. Among 279 urine specimens collected in general practices, 164 were positive (59%). The most frequent micro-organism found was E. coli (78%), followed by S. saprophyticus (9%) and Proteus spp. (4%). In the 15 remaining specimens, 8 different bacterial species were found. Overall resistance to ampicillin was 30%, to cotrimoxazole 14%, to nitrofurantoin 7%, to fluoroquinolones 1%. The E.coli resistance to ampicillin was 27%, to co-trimoxazole 17%, to nitrofurantoin 1% and to fluoroquinolones 1%. In this population the same bacteria, in the same proportion, are found as in earlier studies in other countries. The susceptibility pattern confirms a substantial resistance level to ampicillin and co-trimoxazole. On the contrary, resistance to nitrofurantoin and fluoroquinolones is negligible. Resistance data from Belgian regional laboratories in their outpatient population were significantly different from ours.

Adolescent↗
PubMed1995

Improved methods for assessing information technology in primary health care and an example from telemedicine.

A change in evaluation methodology, from a strictly technical approach to a more comprehensive one, would result in better and less biased decision making in connection with the introduction of information technology in health care. To reach this goal, guidelines are required for building and refining contextual frames, taking qualitative considerations into account. We used primary health care as an example. A literature search produced over 200 relevant articles, from which 76 were selected which explicitly referred to evaluation in connection with health-care information systems. Text analysis allowed us to classify them into three groups. This allowed the development of a contextual frame and emphasized the human dimension as a possible problem area when using medical information systems.

Belgium↗
PubMed1995

Use of blood tests in general practice: a collaborative study in eight European countries. Eurosentinel Study Group.

BACKGROUND: Laboratory tests are routine examinations in general practice and are associated with increasing costs in industrialized countries. AIM: The objective of this collaborative study was to determine the differences in general practitioners' use of blood tests in different European countries and to evaluate the relationship between these differences and organizational aspects of the health care system and also characteristics of the participating general practices. METHOD: A descriptive study was conducted by eight European sentinel networks. Voluntary participating general practitioners registered all blood tests requested for four weeks, specifying the type of test, and age group and sex of patients. Details of all face-to-face encounters with patients by age group and sex were collected for the same period. Information on the participating practices and general practitioners was collected by questionnaire. RESULTS: The request rate for blood tests varied considerably between countries. The characteristics of general practitioners and practice were only slightly or were not associated with the use of blood tests while dummy 'country' variables were strongly associated. The number of general practitioners per 1000 inhabitants was the most positively associated variable partly explaining the intercountry variation. CONCLUSION: This European study suggests that some national characteristics of the health system could determine the use of blood tests in general practice and underlines the need for further investigation in order to develop successful strategies for promoting the optimal use of diagnostic technology.

Adult↗
PubMed1994

Telematics in primary health care: a concerted action (AIM-PRIMACARE A2105).

The AIM Concerted Action 'Telematics in Primary Care' tries to identify how the applications of telematics to general practice, in the framework of primary health care, can be further developed to improve the quality of health care in Europe. The concerted action started in January 1993 with a broad survey of the 'state of the art' in the different EC-countries. Three working groups will look at the following aspects: communication and data-flows, GP-systems for medical records and contextual aspects of telematics. Preliminary results will be available at the end of 1994. The concerted action hopes to contribute to enhance the importance of primary health care within the AIM-programme.

Computer Communication Networks↗
PubMed1990

Attitudes to risk taking in medical decision making among British, Dutch and Belgian general practitioners.

The attitudes of groups of general practitioners in Belgium, the UK and the Netherlands to risk taking in medical decision making have been determined. The results indicate that many doctors seek to minimize the risks that they take when treating patients. Doctors in Belgium had the highest levels of 'no risk-taking' attitudes with 60% preferring not to take risks; Dutch doctors had the lowest levels with only 24% preferring not to take risks. Possible explanations for this difference include the differences in doctor-patient relationship and the systems of medical education in these two countries.

Attitude of Health Personnel↗
PubMed1989

[Utilization of the International Classification of Primary Care, a new family practice classification].

It is difficult to find an appropriate classification to describe first-line epidemiology adequately. The general practitioner cannot always use the existing classification such as ICD-9-CM: as he is dealing with illness in an early stage, he often uses "hypotheses" and not "diagnoses". The "International Classification of Primary Care", (I.C.P.C.), which has been developed by the World Organisation of National Colleges, Academies and Academic Associations of general practitioners/Family Physicians is one primary health care classification. This classification has two axes with 17 chapters and 7 components. It classifies the reason for encounter, the diagnosis as well as the interventions of the general practitioner. The author reports on a first-trial using I.C.P.C. in Belgium. By means of participating observation by student-trainees, 5.478 encounters between general practitioner and patient of 94 general practitioners have been registered and centrally encoded. The possibilities to analyse the data are illustrated. At the same time, the author developed a nomenclature of medicine (6-figure code) which has been integrated in the I.C.P.C. Finally, the importance of this kind of epidemiologic first-line research has been pointed out.

Belgium↗