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The 1996 and 1997 National survey of physician asthma management practices: background and study methodology.

https://arctichealth.org/en/permalink/ahliterature201629
Source
Can Respir J. 1999 May-Jun;6(3):269-72
Publication Type
Article
Author
R L Jin
B C Choi
Author Affiliation
Laboratory Centre for Disease Control, Ottawa, Canada. robert_jin@hc-sc.gc.ca
Source
Can Respir J. 1999 May-Jun;6(3):269-72
Language
English
Publication Type
Article
Keywords
Adolescent
Analysis of Variance
Asthma - therapy
Attitude of Health Personnel
Canada
Child, Preschool
Confidence Intervals
Female
Health Care Surveys
Humans
Male
Physician's Practice Patterns - statistics & numerical data
Practice Guidelines as Topic - standards
Questionnaires
Abstract
To collect national baseline information on asthma management practices by physicians, and to compare these practices with the recommendations of the Canadian Asthma Consensus Conference ('the guidelines').
Cross-sectional survey of representative samples of physicians in Canada in late 1996 and early 1997.
Five specialty types of physicians who manage asthma patients: respirology, pediatrics, internal medicine, allergy and clinical immunology, and general practice and family medicine. Stratified sampling by province and specialty was used to select physicians for the study. Weighting was used in the analysis to generalize the results to the national level for the five specialty groups of physicians.
Mailed questionnaire, self-administered by the respondent; three mailings of the questionnaires were used to increase the response rate.
The frequency with which each of the five specialty types chose specific asthma management choices was determined, using weighted percentages representative of the specialty groups on a national basis. ANOVA determined the statistically significant differences among the five specialties in choosing particular asthma management actions. Then, logistic regression was used to calculate the odds ratios showing an association between the characteristics of the physician respondents and specific asthma management choices that they made in the survey.
The data analysis demonstrated significant variations among physicians in asthma management practices, according to specialty type and other characteristics. The initial report was released in April 1998, and manuscripts for journal submissions are being prepared.
PubMed ID
10393288 View in PubMed
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Academic family physicians' perception of genetic testing and integration into practice: a CERA study.

https://arctichealth.org/en/permalink/ahliterature115009
Source
Fam Med. 2013 Apr;45(4):257-62
Publication Type
Article
Date
Apr-2013
Author
Arch G Mainous
Sharleen P Johnson
Svetlana Chirina
Richard Baker
Author Affiliation
Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA. mainouag@musc.edu
Source
Fam Med. 2013 Apr;45(4):257-62
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Canada
Clinical Competence
Curriculum
Education, Medical, Undergraduate
Faculty, Medical
Family Practice - education - methods
Female
Genetic Testing - methods
Health Care Surveys
Humans
Internship and Residency
Male
Middle Aged
Self Report
United States
Abstract
Genetic testing for a variety of diseases is becoming more available to primary care physicians, but it is unclear how useful physicians perceive these tests to be. We examined academic family physicians' perception of and experiences with clinical genetic testing and direct-to-consumer genetic testing.
This study is an analysis of a survey conducted as part of the Council of Academic Family Medicine Educational Research Alliance (CERA). Academic family physicians in the United States and Canada were queried about their perception of genetic testing's utility, how frequently patients ask about genetic testing, and the importance of genetic testing in future practice and education of students and residents.
The overall survey had a response rate of 45.1% (1,404/3,112). A majority (54.4%) of respondents felt that they were not knowledgeable about available genetic tests. Respondents perceived greater utility of genetic tests for breast cancer (94.9%) and hemochromatosis (74.9%) than for Alzheimer's disease (30.3%), heart disease (25.4%), or diabetes (25.2%). Individuals with greater self-perceived knowledge of genetic tests were more likely to feel that genetic testing would have a significant impact on their future practice (23.1%) than those with less knowledge (13.4%). Respondents had little exposure to direct-to-consumer genetic tests, but a majority felt that they were more likely to cause harm than benefit.
Academic family physicians acknowledge their lack of knowledge about genetic tests. Educational initiatives may be useful in helping them incorporate genetic testing into practice and in teaching these skills to medical students and residents.
PubMed ID
23553089 View in PubMed
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Access and perceived need for physical and occupational therapy in chronic arthritis.

https://arctichealth.org/en/permalink/ahliterature144640
Source
Disabil Rehabil. 2010;32(22):1827-32
Publication Type
Article
Date
2010
Author
Debbie Ehrmann Feldman
Sasha Bernatsky
Jean Frédéric Lévesque
My Tram Van
Michelle Houde
Karine Toupin April
Author Affiliation
Université de Montréal, Ecole de Réadaptation, C.P. 6128, Succ. Centre-Ville, Pavillon 7077 du Parc, Montreal, Quebec, Canada H3C3J7. debbie.feldman@umontreal.ca
Source
Disabil Rehabil. 2010;32(22):1827-32
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Arthritis, Rheumatoid - rehabilitation
Attitude of Health Personnel
Chronic Disease - rehabilitation
Health Care Surveys
Health Services Accessibility
Health services needs and demand
Humans
Interviews as Topic
Male
Middle Aged
Occupational therapy
Odds Ratio
Physical Therapy Modalities
Physicians, Family
Quebec
Referral and Consultation
Rheumatology
Abstract
Physical and occupational therapy are beneficial for persons with chronic arthritis; however, access is problematic. The goal was to examine issues related to access to these services for patients with chronic arthritis.
We used two data sources: 1) questionnaires sent to a random sample of 600 family physicians and to all 85 rheumatologists in the province of Quebec; and 2) interviews of 211 patients with physician-confirmed chronic arthritis recruited from 34 primary care settings in Quebec.
Only 11.5% of family physicians and 31.7% of rheumatologists referred patients with rheumatoid arthritis (RA) to rehabilitation, whereas 60.4% of family doctors referred patients with osteoarthritis. Only 26.1% of patients felt that they required rehabilitation and this was associated with lower self-efficacy (OR: 0.84, 95% CI: 0.72, 0.99) and higher educational level (OR: 2.10, 95% CI: 1.01, 4.36).
Family physicians are less likely to refer patients with RA to therapy. Only about a quarter of patients with chronic arthritis treated in primary care perceived the need for these services. Efforts to improve arthritis care should address education of physicians and patients regarding the benefits of rehabilitation and there should be efforts to increase therapy resources in order to enhance access.
PubMed ID
20345251 View in PubMed
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Access to care for rheumatology patients may be compromised: results of a survey to members of the Canadian Rheumatology Association.

https://arctichealth.org/en/permalink/ahliterature173517
Source
J Rheumatol. 2005 Aug;32(8):1418-21
Publication Type
Article
Date
Aug-2005

Access to health care for undocumented migrant children and pregnant women: the paradox between values and attitudes of health care professionals.

https://arctichealth.org/en/permalink/ahliterature126329
Source
Matern Child Health J. 2013 Feb;17(2):292-8
Publication Type
Article
Date
Feb-2013
Author
Mónica Ruiz-Casares
Cécile Rousseau
Audrey Laurin-Lamothe
Joanna Anneke Rummens
Phyllis Zelkowitz
François Crépeau
Nicolas Steinmetz
Author Affiliation
Department of Psychiatry, McGill University, Montreal, Canada. monica.ruizcasares@mcgill.ca
Source
Matern Child Health J. 2013 Feb;17(2):292-8
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Attitude of Health Personnel
Canada
Child
Female
Health Care Surveys
Health Policy
Health Services - utilization
Health Services Accessibility - statistics & numerical data
Healthcare Disparities
Human Rights
Humans
Middle Aged
Pregnancy
Pregnant Women
Questionnaires
Socioeconomic Factors
Transients and Migrants - statistics & numerical data
Young Adult
Abstract
Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children's rights are needed to promote equitable practices and advocacy against regulations limiting services.
PubMed ID
22399247 View in PubMed
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Access to multiple sclerosis diagnosis for Canadian neurologists.

https://arctichealth.org/en/permalink/ahliterature201931
Source
Can J Neurol Sci. 1999 May;26(2):115-8
Publication Type
Article
Date
May-1999
Author
P. O'Connor
L. Lee
Author Affiliation
Division of Neurology, St. Michael's Hospital, University of Toronto, Ontario, Canada.
Source
Can J Neurol Sci. 1999 May;26(2):115-8
Date
May-1999
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
Canada
Female
Health Care Surveys
Humans
Magnetic Resonance Imaging - utilization
Male
Middle Aged
Multiple Sclerosis - diagnosis
Neurology - statistics & numerical data
Time Factors
Abstract
Access to multiple sclerosis (MS) diagnosis in Canada has never been assessed. This study was designed to examine the pattern of MS diagnosis in Canada, including neurologists' diagnostic approach and waiting times for investigations.
A mail survey was forwarded to every registered neurologist in Canada (n = 479) in late 1996. Questions included their diagnostic approach to MS including perceived waiting times for various investigations including MRI. Actual MRI waiting periods were separately obtained from booking clerks or neuroradiologists from every MRI unit in Canada.
153 responses were received. Neurological assessment is obtained, on average, 1 month after referral. MRI is routinely ordered by 92% of neurologists for suspected MS followed by evoked potentials (EP) (36%) and lumbar puncture (LP) (17%). The perceived waiting period for EP and LP is less than one month but 3 months for MRI. This is very similar to the actual waiting periods obtained from the MRI units surveyed (mean of 101 days). There is a trend for longer waiting periods as one moved east to west (Eastern provinces--mean of 62 days, Ontario--95 days, Quebec--102 days and 122 days in the Western provinces). Private MRI units have appeared in the Western provinces and have the shortest waiting periods (2 weeks maximum). The current MRI/million population ratio in Canada is 1.8, far below the ratios of other developed nations.
Canadian neurologists prefer MRI of the brain to confirm an MS diagnosis and desire greater access to it. Access to neurological assessment, EP and LP is probably adequate but the average wait for MRI of 3 months is relatively long. The perceived average waiting period for MRI is similar to the actual waiting times of 3 months, with the Western provinces of Canada having the longest waits. Canada continues to have one of the lowest MRI/population ratios in the developed world.
PubMed ID
10352870 View in PubMed
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The accuracy of nurses' estimates of their absenteeism.

https://arctichealth.org/en/permalink/ahliterature142102
Source
J Nurs Manag. 2010 Jul;18(5):599-605
Publication Type
Article
Date
Jul-2010
Author
Alice Gaudine
Connie Gregory
Author Affiliation
School of Nursing, Memorial University of Newfoundland, St John's, Newfoundland, Canada A1B 3V6. agaudine@mun.ca
Source
J Nurs Manag. 2010 Jul;18(5):599-605
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Attitude of Health Personnel
Canada
Health Care Surveys
Humans
Job Satisfaction
Nurse Administrators
Nurses - psychology
Nursing Staff, Hospital - organization & administration - statistics & numerical data
Questionnaires
Statistics, nonparametric
Abstract
The purpose of the present study was to determine the accuracy of nurses' self-reports of absence by examining: (1) the correlation, intra-class correlation, and Cronbach's alpha for self-reported absence and absence as reported in organizational records, (2) difference in central tendency for the two measures of absence and (3) the percentage of nurses who underestimate their absence.
Research on nurses' absenteeism has often relied on self-reports of absence. However, nurses may not be aware of their actual absenteeism, or they may underestimate it.
Self-reported absence from questionnaires completed by 215 Canadian nurses was compared with their absence from organizational records.
There is a strong positive correlation, a strong intra-class correlation and Cronbach's alpha for the two measures of absence. However, there is a difference in central tendency that is related to the majority of nurses in this study (51.1%) underestimating their days absent from work.
Research examining the predictors of absence may consider measuring absence with self-reports. Nevertheless, nurses demonstrated a bias to underestimate their absence.
Feedback interventions to reduce absenteeism can be developed to include providing nurses with accurate information about their absence.
PubMed ID
20636509 View in PubMed
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Acute and postoperative pain in children: a Swedish nationwide survey.

https://arctichealth.org/en/permalink/ahliterature31436
Source
Acta Paediatr. 2002;91(6):660-6
Publication Type
Article
Date
2002
Author
M. Karling
M. Renström
G. Ljungman
Author Affiliation
Department of Anaesthesia and Intensive Care, University Hospital of Northern Sweden, Umeå. mats.karling@vll.se
Source
Acta Paediatr. 2002;91(6):660-6
Date
2002
Language
English
Publication Type
Article
Keywords
Acute Disease
Analgesia - utilization
Analgesics - administration & dosage
Analgesics, Non-Narcotic - administration & dosage
Analgesics, Opioid - administration & dosage
Attitude of Health Personnel
Child
Child, Preschool
Comparative Study
Drug Utilization
Female
Health Care Surveys
Hospitals, Pediatric
Humans
Male
Needs Assessment
Pain - diagnosis - drug therapy
Pain Measurement
Pain, Postoperative - diagnosis - drug therapy
Physician's Practice Patterns
Severity of Illness Index
Sweden
Treatment Outcome
Abstract
Many studies demonstrate inadequate pain treatment in children. The aim of this nationwide survey was to evaluate the prevalence of acute and postoperative pain in children; extent of, and reasons for, inadequate pain therapy; therapy methods; pain-management structure; and the need for education of healthcare professionals. Questionnaires concerning these points were sent to all departments in Sweden involved in the treatment of children. The response rate was 75% (299/ 395). Answers from physicians and nurses showed that, despite treatment, moderate to severe pain occurred in 23% of patients with postoperative pain and 31% of patients with pain of other origin. Postoperative pain seemed to be a greater problem in units where children were treated along with adults and in departments where fewer children were treated. According to 45% of physicians and nurses, treatment of pain could often or always be managed more efficiently. Pain assessments were performed regularly in 43% of all departments, but pain measurement was less frequent; 3% of the departments had no formal organization for pain management; and 15% never or infrequently used potent opioids. Educational needs were high. Insufficient pain treatment seemed to be mostly related to organizational aspects, such as inadequate prescriptions. Anxiety in children or parents also contributed to ineffective pain treatment. Swedish treatment practices for the management of pain in children roughly follow the published guidelines, but many improvements are still necessary. CONCLUSION: Acute pain in children is still undertreated in Swedish hospitals. This seems to be related mainly to organizational aspects.
PubMed ID
12162598 View in PubMed
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Acute care hospital strategic priorities: perceptions of challenges, control, competition and collaboration in Ontario's evolving healthcare system.

https://arctichealth.org/en/permalink/ahliterature173511
Source
Healthc Q. 2005;8(3):36-47
Publication Type
Article
Date
2005
Author
Adalsteinn D Brown
L Miin Alikhan
Guillermo A Sandoval
Neil Seeman
G Ross Baker
George H Pink
Author Affiliation
Institute for Clinical Evaluative Sciences, Toronto.
Source
Healthc Q. 2005;8(3):36-47
Date
2005
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Chief Executive Officers, Hospital - psychology
Cooperative Behavior
Economic Competition
Health Care Surveys
Health Priorities
Hospital Planning - economics - trends
Humans
National Health Programs - trends
Ontario
Organizational Innovation
Abstract
To explore the current and pending strategic agenda of Ontario hospitals (the largest consumers of the provincial healthcare budget), a survey of Ontario acute care hospital CEOs was conducted in January 2004. The survey, with an 82% response rate, identifies 29 strategic priorities under seven key strategic themes consistent across different hospital types. These themes include (1) human resources cultivation, (2) service integration and partnerships, (3) consumer engagement, (4) corporate governance and management, (5) organizational efficiency and redesign, (6) improved information use for decision-making, (7) patient care management. The extent to which an individual hospital's control over strategic resolutions is perceived may affect multilevel strategic priority-setting and action-planning. In addition to supporting ongoing development of meaningful performance measures and information critical to strategic decision-making, this study's findings may facilitate a better understanding of hospitals' key resource commitments, the extent of competition and collaboration for key resources, the perceived degree of individual control over strategic issue resolution and where systemic resolutions may be required.
PubMed ID
16078398 View in PubMed
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Adherence to guidelines when positioning the defibrillation electrodes.

https://arctichealth.org/en/permalink/ahliterature180186
Source
Resuscitation. 2004 May;61(2):143-7
Publication Type
Article
Date
May-2004
Author
Jouni Nurmi
Per Rosenberg
Maaret Castrén
Author Affiliation
Uusimaa EMS, Helsinki University Hospital, Eteläinen Hesperiankatu, 22A 26, Helsinki 00100, Finland. jouni.nurmi@helsinki.fi
Source
Resuscitation. 2004 May;61(2):143-7
Date
May-2004
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Cardiopulmonary Resuscitation - instrumentation - standards
Clinical Competence
Confidence Intervals
Electric Countershock - instrumentation - standards
Electrodes
Emergency medical services
Female
Finland
Guideline Adherence
Health Care Surveys
Humans
Male
Practice Guidelines as Topic
Probability
Total Quality Management
Abstract
Placement of the defibrillation electrodes affects the transmyocardial current and thus the success of a defibrillation attempt. In the international guidelines 2000, the placement of the apical electrode was changed more laterally to the mid-axillary line. Finnish national guidelines, based on the international guidelines, were published in 2002.
The purpose of this study was to determine to what extent health care professionals adhere to the new guidelines when positioning the electrodes.
Professionals were recruited from emergency medical services, university hospitals and primary care. Not revealing the purpose of the test, participants were asked to place self-adhesive electrodes on a manikin as they would do in the resuscitation situation and to answer a questionnaire about resuscitation training and familiarity with the guidelines. The distance of electrodes from the recommended position was measured in horizontal and vertical planes.
One-hundred and thirty six professionals participated in the study, and only 25.4% (95% CI 18.5-32.9) of them placed both electrodes within 5 cm from the recommended position. The majority of the participants placed the apical electrode too anteriorly. Of the participants, 36.0% were not aware of the new guidelines. Awareness of the guidelines did not increase the accuracy in electrode placement.
The publication of the national evidence based resuscitation guidelines did not seem to have influenced the practice of placement of the defibrillation electrodes to any major extent. The correct placement of the electrodes needs be emphasized more in the resuscitation training.
PubMed ID
15135190 View in PubMed
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312 records – page 1 of 32.