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Biomedical subjects

M J Verhoef

Publications and source records attributed to M J Verhoef.

At least 55 records · Page 3Linked to original sources
PubMed1995

The relationship between chinook conditions and women's illness-related behaviours.

The objective of this study was to (1) to describe the relationship between chinook conditions and illness related behaviour in women, aged 20-49 years, and (2) to examine the possibility of the existence of subgroups of chinook-sensitive women. At present no empirical evidence is available regarding a relationship between chinook conditions and illness related behaviours. This study comprises the secondary analysis of a large survey of various health and health-related factors of urban women aged 20-49 years, carried out in 1985-1986 in Calgary. The interview date was used to link behaviours to chinook conditions. We found no evidence of a significant relationship between the behaviours investigated and chinook conditions in the general population. However, the data strongly supported the concept of chinook sensitivity. Women with a history of chronic health problems were more likely to visit a health care professional on chinook days than healthy women and women in the subgroup aged less than 35 years cut down their usual daily activities during chinook conditions. Women with a history of recurring migraine headaches were less likely to take prescription medication on chinook days, and women with a history of emotional disorders were more likely to have higher scores on the accident scale and to report bursts of energy or excitement during chinook days. More research is needed to identify subgroups of susceptible persons, as well as to determine whether chinook sensitive persons are equally susceptible to weather changer of other types.

Adult↗
PubMed1995

General practitioners' assessment of and interest in alternative medicine in Canada.

Canadian physicians' opinions about alternative medicine have, as yet, not been assessed. The objectives of this pilot study were to assess general practitioners': (1) desired involvement in alternative medicine; (2) perceived demand for alternative medicine; and (3) beliefs about the efficacy of different alternative approaches. The study design was a cross-sectional survey of 400 randomly selected Alberta and Ontario general practitioners. Of the 384 eligible physicians, 200 (52%) completed the questionnaire. Seventy-three percent of physicians felt that they should have some knowledge about the most important alternative treatments. However, with respect to other issues, physicians desired less involvement with alternative medicine. Sixty-five percent perceived a demand for alternative medicine from their patients, in particular chiropractic. Alternative medicine was perceived to be needed most for musculoskeletal problems and chronic pain or illness. Chiropractic, hypnosis and acupuncture (for chronic pain) were believed to be most efficacious, while homeopathy and reflexology were considered to be least efficacious. Undergraduate, graduate clinical and continuing medical education will need to address alternative treatments in order to provide physicians with up-to-date and relevant information.

Attitude of Health Personnel↗
PubMed1995

Quality of life, bypass surgery and the elderly.

OBJECTIVE: To examine changes in health-related quality of life (HQOL) following coronary artery bypass surgery (CABS) in elderly patients and to compare patient ratings with proxy ratings. DESIGN: Descriptive, nonrandomized, prospective study. SETTING: Patients from a single primary care facility in a major urban centre within a one-year period. PATIENTS: All eligible patients undergoing CABS at the site within a one-year period were approached for study participation. The study sample consisted of 18 patients 65 years of age or older and 18 proxies at baseline. Fourteen patients and 13 proxies completed follow-up assessments. INTERVENTIONS: All patients underwent CABS. HQOL was studied using the Sickness Impact Profile (SIP) and the Psychological Well-Being Schedule (PGWB). MAIN RESULTS: Significant improvements were noted in physical, social and psychological functioning (P < 0.05). Proxies' reports provided good indications of patient functioning for these dimensions with significant differences found only for certain preoperative measures including the total SIP score and the Anxiety and Depression subscales of the PGWB (P < 0.05). CONCLUSIONS: Patients 65 years of age and older accrue improvements in HQOL following CABS. Such findings may influence the allocation and justification of various medical procedures. Proxy ratings closely reflected the patients' own ratings and may therefore be considered a reliable, alternate source of information.

Age Factors↗
PubMed1995

Alternative medicine and general practitioners. Opinions and behaviour.

OBJECTIVE: To describe general practitioners' opinions and behaviour regarding alternative medicine. DESIGN: Cross-sectional survey of a random sample of Ontario and Alberta general practitioners. SETTING: General practices in Ontario and Alberta. PARTICIPANTS: A questionnaire was mailed to 400 general practitioners. Of the 384 eligible physicians, 200 completed the questionnaire. MAIN OUTCOME MEASURES: Reported beliefs and practices concerning alternative medicine. RESULTS: Acupuncture, chiropractic, and hypnosis were considered most useful and reflexology, naturopathy, and homeopathy least useful. Results showed 56% of general practitioners believed that alternative medicine has ideas and methods from which conventional medicine could benefit, 54% referred to alternative practitioners, and 16% practised some form of alternative medicine. Province of practice, place of graduation, training in alternative approaches, number of alternative approaches perceived useful, and attitude toward alternative medicine were clearly related to referring to alternative practitioners. Sex, age, type of practice, training in alternative medicine, referring to alternative practitioners, number of alternative approaches perceived useful, and attitude toward alternative medicine were related to practicing alternative medicine. CONCLUSION: Although acceptance and integration of alternative medicine extend only to certain approaches, alternative medicine cannot be discounted in general practice. A study encompassing all Canadian provinces could help in planning medical education and developing policies to guide physician behaviour.

Adult↗
PubMed1995

Assisted suicide: opinions of Alberta physicians.

The legal status of assisted suicide and active euthanasia are receiving increasing attention among physicians, legislators, the judiciary, and public lobby groups. Many seem to assume that these forms of assisted dying reside naturally within the practice of medicine but, surprisingly, comprehensive data about the opinions of Canadian physicians are not available. We report the results of a survey of the opinions of Alberta physicians about assisted suicide, compare their opinions to those about active euthanasia, and determine their relationships with various demographic and bioethical matters. A stratified random sample (n = 2,002) was drawn from all Alberta physicians. The response rate was 69% (1,391) and was representative of the reference population for age, sex, and type of practice. Fifty-five percent believed assisted suicide should remain a criminal offence, whereas 18% did not, and 27% were uncertain. Strong relationships were found between opinions about assisted suicide, and age and religious activity. These data demonstrate no ground swell of support by Alberta physicians for the decriminalization of assisted suicide. Our data confirm the need for a national study of the opinions of Canadian physicians about physician-assisted dying, and caution against precipitate changes in relevant legislation and health policy.

Alberta↗
PubMed1994

Why do patients seek a second opinion or alternative medicine?

The objectives of the study were (a) to determine psychosocial determinants of two measures of health care use: seeking a second opinion and alternative medicine use, and (b) to assess whether changes in these two measures of health care use had taken place during the past 4 to 5 years. All patients attending a university-based gastroenterology clinic were asked to complete a self-administered questionnaire. The response rate was 83% (N = 341). Health locus of control, scepticism toward medicine, satisfaction with health care, and perceived health status were included as potential determinants. Sixteen percent (21) of the new patients (95% confidence interval, 10.0-22.8) sought a second opinion compared to 7.5% (95% confidence interval, 4.3-10.7) 5 years ago. Seeking a second opinion was negatively related to internal locus of control, perceived health status, and demanding to know all details of treatment. Eight percent (28) of all patients (95% confidence interval, 5.3-11.1) saw an alternative practitioner for the same problem for which they saw the gastroenterologist compared to 9% (95% confidence interval, 6.2-12.8) 4 years ago. Using alternative medical care was positively related to scepticism toward conventional medicine and negatively related to perceived health status and satisfaction with clinic physicians. Knowledge about the incidence and determinants of these behaviors provides valuable information for clinicians in communicating with their patients and may eventually result in cost containment.

Adolescent↗
PubMed1993

Alberta euthanasia survey: 1. Physicians' opinions about the morality and legalization of active euthanasia.

OBJECTIVE: To ascertain the opinions of a sample of Alberta physicians about the morality and legalization of active euthanasia, the determinants of these opinions and the frequency and sources of requests for assistance in active euthanasia. DESIGN: Cross-sectional survey of a random sample of Alberta physicians, grouped by site and type of practice. SETTING: Alberta. PARTICIPANTS: A total of 2002 (46%) of the licensed physicians in Alberta were mailed a 38-item questionnaire in May through July 1991; usable responses were returned by 1391 (69%). RESULTS: Of the respondents 44% did believe that it is sometimes right to practice active euthanasia; 46% did not. Moral acceptance of active euthanasia correlated with type of practice and religious affiliation and activity. In all, 28% of the physicians stated that they would practice active euthanasia if it were legalized, and 51% indicated that they would not. These opinions were significantly related to sex, religious affiliation and activity, and country of graduation. Just over half (51%) of the respondents stated that the law should be changed to permit patients to request active euthanasia. Requests (usually from patients) were reportedly received by 19% of the physicians, 78% of whom received fewer than five. CONCLUSIONS: This survey revealed severely disparate opinions among Alberta physicians about the morality of active euthanasia. In particular, religious affiliation and activity were associated with the polarized opinions. The desire for active euthanasia, as inferred from requests by patients, was not frequent. Overall, there was no strong support expressed by the physicians for the personal practice of legalized active euthanasia. These data will be vital to those involved in health education and public policy formation about active euthanasia in Alberta and the rest of Canada.

Alberta↗
PubMed1993

Alberta euthanasia survey: 2. Physicians' opinions about the acceptance of active euthanasia as a medical act and the reporting of such practice.

OBJECTIVE: To ascertain the opinions of Alberta physicians about the acceptance of active euthanasia as a medical act (the "medicalization" of active euthanasia) and the reporting of colleagues practising active euthanasia, as well as the sociodemographic correlates. DESIGN: Cross-sectional survey of a random sample of Alberta physicians, grouped by site and type of practice. SETTING: Alberta. PARTICIPANTS: A total of 2002 (46%) of the licensed physicians in Alberta were mailed a 38-item questionnaire in May through July 1991; usable responses were returned by 1391 (69%). RESULTS: Although only 44% of the respondents considered active euthanasia morally "right" at least 70% opted to medicalize the practice if it were legal by restricting it to be performed by physicians and to be taught at medical sites. Even though active euthanasia is criminal homicide in Canada, 33% of the physicians stated that they would not report a colleague participating in the act of anyone, and 40% and 60% stated that they would not report a colleague to medical or legal authorities respectively. Acceptance or rejection of active euthanasia as a medical act was strongly related to religious affiliation and activity (p < 0.01). CONCLUSIONS: This survey about active euthanasia revealed profound incongruities in the opinions of the sample of Alberta physicians concerning their ethical and social duties in the practice of medicine. These data highlight the need for relevant modifications of health education policies concerning biomedical ethics and physicians' obligations to society.

Alberta↗
PubMed1993

Exercising at work: barriers to women's participation.

Only a minority of women in an urban random sample have the opportunity to exercise at work, and even fewer women use these opportunities. Lack of time and inconvenient times are the major reasons for not participating in exercise programs at work. Exercise programs at work are used by women who are already physically active, suggesting that workplace exercise programs do not serve the needs of women who may need exercise programs most. Multivariate analysis shows that age, having children, lack of energy, and lack of support are significant barriers to women's exercise participation at work. The results of this study suggest a leadership opportunity for on site occupational health nurses in addressing these barriers to workplace exercise.

Adult↗
PubMed1992

Women's social roles and their exercise participation.

How women's social roles such as parenthood, marital status and employment status affect their exercise participation, is important for the rational planning of suitable and effective exercise programs for women in different social contexts. A secondary analysis of a large data-base of urban women aged 20-49 (n = 5939) was carried out to determine if social roles, their characteristics and their combinations were related to women's exercise participation. Parenthood and marital status were significantly related to whether women exercise, and among those exercising, all three roles were significantly related to the amount of exercise. Statistical modelling, including all three roles and their interactions, controlling for age and education, showed that with respect to whether women exercise, parenthood affected exercise participation most and that its effect was dependent on age. Of the role characteristics only the number of children and overall satisfaction with daily activities improved the prediction of exercising. With respect to how much women exercise, the effect of parenthood interacted with marital status. Married parents were least likely to exercise very much. Of the role characteristics only overall satisfaction with daily activities improved the prediction of the amount of exercise.

Activities of Daily Living↗
PubMed1990

Use of alternative medicine by patients attending a gastroenterology clinic.

We carried out a study to determine the proportion of patients attending a university-based gastroenterology outpatient clinic who sought alternative medical care for the same health problem that had prompted them to see a gastroenterologist. After the patients completed a self-administered questionnaire, the gastroenterologist gave a diagnosis and assigned a functional rating. Of the 395 patients 287 (73%) had not used alternative medicine, and 36 (9%) had sought alternative medical care for the problem that had prompted them to see a gastroenterologist. There were no significant differences between alternative medicine users and nonusers in sociodemographic characteristics, use of health care services or general health status. Patients with a functional disease were more likely to seek alternative medical care than those with organic disease (33% v. 7%) (p less than 0.0001). Fewer alternative medicine users (54%) than nonusers (85%) were satisfied with conventional medicine (p less than 0.001), and more alternative medicine users (49%) than nonusers (13%) were very sceptical of conventional medicine (p less than 0.0001).

Adolescent↗
PubMed1990

Outpatient health care utilization of patients with inflammatory bowel disease.

On the basis of the normal life expectancy of inflammatory bowel disease patients, the early onset of their disease, and the variety of symptoms, inflammatory bowel disease patients were anticipated to be frequent users of outpatients services. This study assesses (1) the characteristics, (2) outpatient health care utilization, and (3) the degree of satisfaction with health care of inflammatory bowel disease patients compared to patients with other gastrointestinal disease. The study method was a secondary analysis of data collected on 395 patients attending the University of Calgary Gastroenterology Outpatient Clinic in 1988. Inflammatory bowel disease patients were significantly younger (P less than 0.001) and better educated (P less than 0.05) than other patients. During the past year inflammatory bowel disease patients consulted significantly more often with their gastroenterologist (P less than 0.001) and spent more time in hospital (P less than 0.05) than other patients. Inflammatory bowel disease patients also consulted more frequently with herbalists and naturopaths. Lastly, inflammatory bowel disease patients were as satisfied with the health care they received as other patients. These results provide information useful for health care planners as well as for those dealing directly with inflammatory bowel disease patients.

Adolescent↗
PubMed1989

Patients who seek a second opinion: are they different from the typical referral?

Little is known about what factors determine when a patient decides to seek a second opinion from an internist. The Canadian health care system, which places no responsibility for payment on the patient, allows a unique opportunity to assess such factors when financial influences are minimized. We hypothesized that in such a milieu patients with functional diseases might be more apt to seek a second opinion. In a university-based gastrointestinal unit we investigated how many of the patients, referred for the first time, were seeking a second opinion--i.e., a second consultation within 2 years of seeing a gastroenterologist. We compared the characteristics of 20 patients with 246 patients referred for the first time to a university-based gastrointestinal unit. All patients were interviewed at clinic registration, prior to seeing the gastroenterologist. Variables assessed included demographic characteristics, health care utilization within the last year, and perceived health status. A second questionnaire was offered to second opinion patients to determine (1) reasons for seeking a second opinion, and (2) whose decision it was to seek the second opinion. Following the interview, the patient's referring physician was contacted and asked identical questions. Both referring physician and gastroenterologist assessed every patient on a functional rating (FR) scale of 1 to 5 (with 1 being definitely organic and 5 being definitely functional).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Women and exercise participation: the mixed blessings of motherhood.

Exercise participation, perceived barriers to exercise, and perceived benefits of exercise were analyzed in a large random sample of urban women ages 20-49 (N = 1,113). Although mothers and women without children perceived similar benefits of exercising, mothers were much less active than women without children. The differences were greatest for women under the age of 40. After age 40, the differences were smaller as a result of the decrease in exercise in women without children. The study also indicated that motherhood itself, rather than the number and ages of children, was a barrier to exercise participation. In general, mothers perceived more barriers to exercising than did women without children. These findings illustrate the differences in opportunities for mothers and women without children due to sociocultural circumstances and have implications for the planning of exercise promotion for mothers.

Adult↗
PubMedDate not supplied

Women's exercise participation: the relevance of social roles compared to non-role-related determinants.

The objectives of this study were 1) to determine the relationship between women's exercise participation and their social roles as well as characteristics of these roles, and 2) to determine the relative importance of social roles compared to non-role-related determinants (including social support, perceived barriers, interest in exercise, and perceived importance of exercise). A cross-sectional survey was done among 1,113 randomly selected urban women aged 20-49. Social roles did not emerge as a major risk factor for exercise participation. Statistical modelling indicated that whether women exercise was only related to role overload in the presence of the non-role-related determinants. For women exercising, parenthood as well as role overload were related to the amount of exercise in the presence of the non-role-related determinants. These findings have important implications for exercise promotion for women.

Adult↗