Biomedical subjects

R C Westbury

Publications and source records attributed to R C Westbury.

5 recordsLinked to original sources

PubMed1997

A multinational study of the factorial structure and other characteristics of the Dartmouth COOP Functional Health Assessment Charts/WONCA.

BACKGROUND: The 'Dartmouth COOP Functional Health Assessment Charts/WONCA' constitute a relatively new derived instrument for assessing health status that is specifically intended for use in primary care on a world-wide basis. It needs further validation in its special area of use. OBJECTIVES: Over a range of countries, social backgrounds and case mixes, our aim was (i) to examine the factorial structure of the instrument; (ii) to explore how well it was understood; (iii) to check its acceptability; and (iv) to assess the value of the pictures on the charts. METHODS: The charts themselves, accompanied by a short questionnaire about the charts, were administered to 1719 patients at eight varied types of treatment centre in Canada, Japan, Nepal and Spain. The responses to the instrument were subjected to standard factor analysis and a special Q-type principal components analysis. The responses to direct questions about the charts were compared with the answers to open-ended questions. RESULTS: Factor analysis suggested a shared factorial pattern for all sites, with the first two factors accounting for 88.5% of the variability in correlations between the charts across the sites. The individual questions were understood by most patients, but a substantial minority did not appear to grasp the underlying purpose of the instrument. The instrument was well accepted. The pictures were considered to be helpful by most respondents, especially those at the Nepal sites. The variability in the scores for the individual charts across sites was less than expected and not always in the expected direction. CONCLUSIONS: The COOP/WONCA system continues to show promise, but needs more validation.

Canada↗

PubMed1993

Why do patients continue to see the same physician?

In this study we examined the meaning that patients attach to continuity of care, an important construct of family practice and primary care. Structured oral interviews were conducted with 60 patients who were 35 years of age or older and who had sought health care from a single family physician for at least 15 years. The data included 10 domains that characterize patients' perceptions regarding long-term continuous care. The interview data were analyzed using ethnographic techniques. The main factors contributing to the maintenance of a continuous care relationship seemed to be patient familiarity with the physician, physician knowledge of the patient, patient satisfaction with care received, and patient confidence in the physician. Other factors were personal attributes of the physician, friendship with the physician, ease of communication with the physician, and professional growth of the physician. The availability of the physician and the location of the practice appeared to be reasons to start consulting a physician rather than to continue the relationship with a physician.

Continuity of Patient Care↗

PubMed1989

The epidemiology of mumps in southern Alberta 1980-1982.

The full spectrum of mumps in Southern Alberta was studied over the years 1980-1982. In the community, a random sample of 3,497 children was tested for prevalence of immunity to mumps. The 1,816 who were not immune were retested after one year. The incidence of new immunity was 16.5%. Most seroconverters had no illness suggestive of mumps. History of previous mumps or immunization were found to be unreliable predictors of serologic immune status. In the family study, information was obtained on 342 cases diagnosed as mumps by family physician recorders. The overall complication rate was 10.8% and the secondary attack rate within families was 11.7%. Hospital records of all 25 patients admitted in Calgary with mumps during the same period were analyzed. Estimated costs of unopposed mumps over 20 years compared with the estimated costs of vaccination showed that a vaccination program could give a benefit-cost ratio between 6.4 and 247. These studies show that mumps is a mild disease with relatively few serious complications or sequelae. Even so, there would be definite medical and economic benefit with immunization. A low-cost addition of mumps vaccine to the immunization program would be justified.

Adolescent↗

PubMed1977

The analysis of family practice workloads by seriousness.

There is a need for a measure of the overall seriousness of a given family practice workload. In the past, such measurements have been attempted in various ways. In this work, the rubrics of the Canuck Book Classification (a classification of health problems in family practice) were rated for seriousness. There was sufficient agreement on 96 rubrics for them to be used as indicators of the seriousness of workloads in general. Some examples of the uses of the system are shown. Several difficulties were encountered; these are not insuperable, and the method deserves to be developed further.

Adolescent↗

PubMed1969

Classification of disease in general practice: a comparative study.

A comparison is made between the International Classification of Diseases (Eighth Revision) and the classification of the British College of General Practitioners (1963 Revision), with particular reference to their application to the diagnostic data from a family practice in Canada over a period of one year. The International Classification proves superior but would require modification to be ideal for use in recording morbidity from general practice. A plan for such a modification is outlined.

Canada↗