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R Pineault

Publications and source records attributed to R Pineault.

64 records · Page 4Linked to original sources
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[Primary care in Québec: a comparison between private practitioners and physicians working in public community health centers].

Since the early 1970s, there have been two primary care networks in Quebec: the traditional one characterized by fee-for-service; and the public one regrouping 10% of physicians and characterized by a salaried practice within publicly funded local institutions known as CLSCs. Using 1984 data collected on 616 Quebec generalists, 333 in private practice and 283 in CLSCs, we compared the physicians' profile in both networks. In contrast to their colleagues in private practice, CLSC physicians were younger, more often female and more involved in rural practice as well as in community health. They also differed in their attitudes and to some extent in their clinical practices. Overall, the study suggests that the introduction of a public primary care network has served to facilitate the emergence of a more comprehensive type of medical practice in the Quebec health care system.

Adult↗
PubMedDate not supplied

Health promotion activities in Quebec hospitals: a comparison of DSC and non-DSC hospitals.

In the early 1970s, public health units were introduced to 32 Quebec hospitals. One of the reasons for introducing public health to hospitals was the beneficial influence this new structure, called "Département de santé communautaire" (DSC), was expected to have on the development of health promotion and prevention activities in the hospital. This study compared 19 DSC hospitals with 19 non-DSC hospitals that were matched for mission, size and location. The data came from a larger survey which had been conducted by the Canadian Hospital Association in Canadian hospitals in 1985. According to our results, DSC hospitals differed from their non-DSC counterparts mainly on dimensions related to their public health mandate (e.g. community programs, advocacy). They did not differ greatly on dimensions related to other health promotion and prevention activities within the hospital (e.g. inpatient and outpatient care, employees). These results suggest that while hospitals have not created organizational obstacles to the achievement of public health activities by DSCs, DSCs did not have the expected impact on hospitals.

Canada↗
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Referral continuity between private and public health care for the patient under 18 in the Montreal metropolitan region.

One of the objectives of the health and social services reform launched in Quebec in the early 70s was to achieve continuity between the public and the private sector. This study focuses on specific aspects of continuity, namely referral continuity as measured by the degree to which physicians refer to public health resources in the care they provide to patients under 18, as well as their perception of these resources. A telephone survey conducted in February, 1984 gathered information on the way Montreal general practitioners and pediatricians use other medical, paramedical and public health resources. The findings indicate that the objective of continuity has not been fully achieved. Among the factors which explain such results are the lack of communication between the two sectors and the perception by physicians that these other resources, especially CLSCs, offer competitive rather than complementary services. Such a view constitutes a major constraint to the effective and efficient coexistence of the private and public sectors in a medical care system.

Adolescent↗
PubMedDate not supplied

Factors influencing physicians' preventive practices.

We used data on a stratified random sample of 809 Quebec physicians to determine the extent to which the integration of prevention into medical practice was related to physicians' sociodemographic background, area of specialization, medical practice characteristics, and professional attitudes. Among factors positively associated with physicians' preventive practices were favorable attitudes toward prevention, patient education and patient-oriented activities, being in primary care medicine or in a medical specialty such as cardiology, gastroenterology, or pneumology, practicing in a public community health center on a salary basis, working in a group practice, having an office-based practice, devoting time to research activities, being older, and being a woman. Specialization in neurology, hematology, dermatology, nephrology, obstetrics-gynecology, and most notably surgery was negatively associated with preventive practices, as was working in an emergency room. Overall, the study variables explained 33% of the variance in physicians' preventive practices. The study underlines the prevailing role of attitudes in predicting physicians' preventive practices.

Attitude of Health Personnel↗
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Determinants of health counseling practices in hospitals: the patient's perspective.

We conducted a survey of 518 patients who had been admitted to three hospitals for selected medical, surgical, and obstetrical conditions. All patients came from the same city. One of the hospitals had put forward health promotion and disease prevention as a formal goal. Almost 40% of the respondents reported that they received health counseling during their hospital stay. Logistic regression analyses revealed that medical care processes and organizational factors were more important than patient characteristics in determining health counseling. The only patient characteristic that was positively related to health counseling was "perceived poor health status." Favorable conditions for the development of health counseling included having an attending physician different from the one who treated the patient before entering the hospital, an adequate number of physician visits, and a longer length of stay. Being admitted to a medical ward rather than a surgical or an obstetrical ward also was associated with more frequent health counseling. No significant differences were found among hospitals. Finally, having a general practitioner rather than a specialist as attending physician did not make a difference. These findings support the view that although hospitals have an important and legitimate role to play in health promotion, organizational and institutional obstacles to implementing such practices must not be ignored.

Adult↗
PubMedDate not supplied

Factors influencing physicians' orientation toward prevention.

We examined the influence of various background characteristics as well as other variables such as personal health practices, specialty choice, and political orientation, on the attitudes of medical graduates toward the physician's role in prevention. The study was part of a 1979 survey conducted in three U.S. medical schools. The results revealed that graduates who believed more strongly in the physician's role in prevention tended to be in primary care training, had a more liberal political orientation, and came more often from physician families. These graduates also believed more strongly that physicians ought to be role models for their patients in health habits. However, they did not manifest better personal health practices than physicians less oriented toward prevention. There was also a medical school effect, although it could not be determined whether this represented the influence of the curriculum or of the selection process into medical school.

Adult↗
PubMedDate not supplied

A supermarket cardiovascular screening program: analysis of participants' solicitation of follow-up care.

We conducted a cardiovascular screening program in 54 supermarkets in the province of Québec, Canada to determine cardiovascular risk factors, including total cholesterol, blood pressure, tobacco use, height, weight, and physical activity levels. A 10-minute debriefing counseling session followed. Of the 3,432 screening participants 18-74 years of age, 2,420 participated in a nutrition study, consisting of answering a brief questionnaire before the screening. Three months after the screening, 1,293 individuals returned the posttest nutrition questionnaire sent to them by mail. We report follow-up care activity for low-risk and high-risk individuals for respondents of the posttest nutrition questionnaire. Overall, 53% of respondents reported seeing a physician within three months after the screening to discuss their blood cholesterol or blood pressure results, and the percentage ranged from 25% for individuals with normal cholesterol (< or = 199 mg/dL) and normal blood pressure (< 140/90 mm Hg) to 83% for individuals with high cholesterol (> or = 240 mg/dL) and high blood pressure (> or = 140/90 mm Hg). Respondents who saw a physician following the screening were more likely to be (1) those on medication at the time of the screening for high blood cholesterol and high blood pressure, (2) older individuals, (3) those found to have high blood cholesterol and high blood pressure values during the screening, (4) women, and (5) individuals with a lower level of education. Seventy-nine percent identified as having high blood cholesterol during the screening reported that their blood cholesterol was remeasured. The majority of high-risk participants and their physicians took appropriate follow-up action.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
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Changes in knowledge and food behaviour following a screening program held in a supermarket.

We examined the relationship between knowledge, health beliefs and dietary behaviours of participants in a supermarket cardiovascular screening program, the conceptual framework for which was the Health Belief Model. 3,432 individuals aged 18-74 participated in the screening program conducted in 54 supermarkets in Montreal and Quebec. This program identified participants' risk for cardiovascular disease by measuring total serum cholesterol, blood pressure, height, weight, level of physical activity, and tobacco use. A ten-minute debriefing counselling session interpreted risk factors and recommended follow-up. 70% (n = 2,420) also completed a nutrition questionnaire on knowledge, health beliefs, and frequency of consumption of high fat foods. Respondents increased their knowledge and reduced the frequency of consumption of high-fat foods following the screening program (p < or = 0.05), particularly individuals with higher blood cholesterol levels, high blood pressure, and women.

Adolescent↗
PubMedDate not supplied

[Innovation in the Quebec's community health departments].

Following the reform of the health care system in Quebec at the beginning of the 1970s, 32 Community Health Departments (départements de santé communautaire or DSC) were created; these new organizations were administratively and physically integrated into 32 acute care hospitals throughout the province. Our study investigates to what extent variations in the implementation of DSCs and in the way they have fulfilled their mandate influence the degree of innovation of their practices. The results show that DSCs devoting greater efforts to research activities and to their relationships with other health care establishments and agencies achieve a higher level of innovation in their practices.

Community Health Services↗