RESUMO
The aim of this study was to describe the frequency and content of discussions on lifestyle issues during an annual examination and to identify characteristics of patients, physicians, and visits associated with lifestyle discussions. Audio-recordings of the visits of 35 family physicians with 148 of their patients were analyzed. Bivariate descriptive and multivariate analyses were used. On average, the visits contained discussions of 3.6 different issues for a total time of 2.9 min. Of the 11 topics of interest, weight, diet and nutrition, physical activity, and tobacco use were the most frequently discussed. Consultation with a female physician and perception by the physician of a poorer patient mental health status were associated with the number of themes discussed and the duration of exchanges. Results suggest that although, discussions on lifestyle issues are frequently observed during these visits, they remain limited in scope. Physicians appear to concentrate their energy on targeted patients, and female doctors are more active in this domain.
Assuntos
Medicina de Família e Comunidade/normas , Estilo de Vida , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Educação de Pacientes como Assunto/normas , Relações Médico-Paciente , Adulto , Idoso , Análise de Variância , Comunicação , Feminino , Promoção da Saúde/normas , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Quebeque , Fatores Sexuais , Inquéritos e Questionários , Gravação em FitaRESUMO
OBJECTIVE: To compare the continuing medical education (CME) activities of family physicians in the province of Quebec with more than 25 years in practice with those with less than 25 years in practice. DESIGN: Mailed questionnaire survey. SETTING: Family practices in the province of Quebec. PARTICIPANTS: All physicians (n = 722) with more than 25 years in practice (expressed as older) and a matched sample of 721 physicians with less than 25 years in practice (expressed as younger). MAIN OUTCOME MEASURES: Types of CME activities and time spent on them, participant characteristics. RESULTS: Older physicians spent more time in individual CME activities than younger ones (21 hours vs 18 hours monthly). Younger physicians, however, spent more time in group CME activities than older ones did (100 hours vs 80 hours yearly). Excluding physicians who devoted no time to CME activities, only two activities differentiated between the two groups: older physicians spent more time than their younger colleagues reading and listening to audiocassettes. CONCLUSIONS: Older physicians maintained their clinical competence by participating in different CME activities from younger physicians. They participated in as many CME activities as their younger colleagues.
Assuntos
Educação Médica Continuada , Médicos de Família/educação , Médicos de Família/psicologia , Adulto , Fatores Etários , Competência Clínica , Educação Médica Continuada/métodos , Educação Médica Continuada/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Quebeque , Inquéritos e Questionários , Fatores de Tempo , Carga de TrabalhoRESUMO
OBJECTIVE: To identify the most commonly used biostatistical concepts and tests in three journals read by family physicians. DESIGN: Descriptive study of the biostatistical content of 12 issues of the Canadian Medical Association Journal (CMAJ), Canadian Family Physician (CFP), and the New England Journal of Medicine (NEJM). MAIN OUTCOME MEASURES: Frequency of citations of concepts and tests, and Spearman's correlation coefficients comparing the biostatistical profiles of the three journals. RESULTS: Biostatistical content of NEJM was diverse (on average, 39 concepts and 21 tests per issue). In CFP, we found 10 concepts and four tests per issue. In CMAJ, there were, on average, nine concepts and five tests per issue. CONCLUSIONS: The journals' profiles (order of importance of concepts and tests) were fairly similar.
Assuntos
Medicina de Família e Comunidade/educação , Publicações Periódicas como Assunto , Estatística como Assunto/educação , Estatística como Assunto/métodos , Humanos , América do Norte , Revisão da Pesquisa por ParesRESUMO
OBJECTIVE: To examine the validity and the reliability of three measurement instruments used to evaluate mental health training offered to residents in family medicine. DESIGN: Development and submission of three French-language instruments measuring knowledge, perceived skills, and attitudes of family physicians and residents. SETTING: Weekly psychotherapy workshop. PARTICIPANTS: A group of 90 family medicine residents and practising doctors were recruited by the authors and by teaching facilities. MAIN OUTCOME MEASURE: Reliability index KR20 and an evaluation of error in the instruments were used. RESULTS: The results satisfactory in terms of the measurement of perceived skills (KR20 = 0.86) and the measurement of attitudes (KR20 = 0.96); the measurement of knowledge (KR20 = 0.70) was clearly unsatisfactory and the instrument will require upgrading. The measurement of perceived skills was the only one to reveal a distinction between the groups; practising doctors and those interested in psychotherapy believed their skills to be superior to those of residents in training (P = 0.005). CONCLUSION: Instruments measuring attitudes and perceived skills have excellent psychometric potential; however, it remains to be determined whether the measurement of perceived skills is valid and whether these instruments are useful for monitoring family medicine residents during their training or for assessing the impact of mental health training programs.
Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Medicina de Família e Comunidade/educação , Psicoterapia/educação , Adulto , Transtornos de Ansiedade , Feminino , Humanos , Internato e Residência , Masculino , Transtornos Mentais , Pessoa de Meia-Idade , Transtornos do Humor , Transtornos da Personalidade , Psicometria , Reprodutibilidade dos Testes , Esquizofrenia , Transtornos Somatoformes , Transtornos Relacionados ao Uso de SubstânciasRESUMO
PURPOSE: To evaluate the influence on knowledge, perceived skills, and attitudes of a psychotherapeutic intervention program for family practice residents. METHODS: Between 1991 and 1993, a nonrandomized controlled study, using a pretest-posttest design, was used to compare a treatment group of 38 residents with a control group of 16 residents at two family medicine clinics affiliated with the Université de Montréal and Laval University Faculties of Medicine. The residents participated in a structured series of 12 seminars dedicated to psychotherapeutic interventions by family doctors. Three instruments were used to measure knowledge, perceived skills, and attitudes. Statistical analysis included two-tailed chi-square with Yates' correction and the Mann-Whitney test. RESULTS: Ten residents in the treatment group and one in the control group were excluded from analysis because they did not complete all the evaluations. Greater percentages of residents in the treatment group improved their perceived skills (89% versus 56%, p = .003), and their knowledge (82% versus 50%, p = .06). CONCLUSION: Skills of the "how-to" type improved more than relational skills. No significant effect on attitude was observed.