RESUMEN

The incidence of hypertension was determined among 10,173 patients of general practices in southwestern Ontario studied from 1978 to 1982. For both sexes the incidence of hypertension rose with increasing age. The incidence was higher among men than among women until age 50, after which it was similar for the two sexes. Obesity was positively associated with incidence for both sexes. In men this association diminished significantly with increasing age. The similar trend in women fell just short of statistical significance. In men but not women heavy alcohol consumption was positively related to the incidence of hypertension. However, the broad definition of this variable may have obscured a relation in women. Among men the effect of obesity on the incidence of hypertension was less for heavy drinkers than for light drinkers. Smoking was not related to the incidence of hypertension in either sex.

Asunto(s)

RESUMEN

Life events were elicited during an average recall period of 8.5 months among 235 hypertensive patients whose blood pressure was under control just prior to the beginning of the recall period. At the end of the recall period, the 41 patients no longer under control reported a significantly higher proportion both of unfavourable and unexpected life changes compared with the 194 patients whose blood pressure was still under control. The differences persisted after allowing for potentially confounding variables. The patients were not aware of their blood pressure status at the time of the life events interview.

Asunto(s)

RESUMEN

Data on 13 baseline characteristics of 618 patients who had previously had a myocardial infarction and who had entered the Ontario Exercise-Heart Collaborative Study were analysed for their ability to predict recurrence of infarction within 3 years. These characteristics were age, serum levels of cholesterol and triglycerides, systolic and diastolic blood pressure, number of hours of competitive sports per week, number of hours of jogging per week, angina, type of occupation, smoking, cough and phlegm production, personality type and the number of previous infarctions. The characteristics showing independent statistical significance (p less than 0.05) were smoking and blue-collar occupation, with estimated adjusted relative odds of 2.3 and 2.1 respectively.

Asunto(s)

Asunto(s)

RESUMEN

The Ontario Exercise-Heart Collaborative Study was a multicenter randomized clinical trial of high intensity exercise for the prevention of recurrent myocardial infarction in 733 men. Of the 678 subjects who could have participated for at least 3 years, 315 (46.5%) dropped out. Stepwise multiple linear logistic regression analysis was carried out to examine the relation between subject characteristics and the probability of dropping out during the study. Analysis was performed on the entry group as a whole by considering those subjects who had reinfarction while complying with the program and also by excluding all subjects with reinfarctions. The consistent and statistically significant predictors of dropout in both analyses were smoking and a blue collar occupation. Angina was significantly associated with dropout only when reinfarctions were excluded. It may be important to consider these factors when investigating the potential for compliance-improving strategies in reducing dropout from exercise rehabilitation programs.

Asunto(s)

RESUMEN

This study compared the subsequent development of children in breech presentation according to the method of their delivery - vaginal or cesarean section. No differences were found between children born vaginally and those born by cesarean section after some labour, except for a larger variability in the outcomes of the latter group. Only 4% of the deliveries were by cesarean section without labour, and when analysed separately the data for this group frequently showed the poorest outcome. Reasons for the observations are suggested, and proposed further research is outlined.

Asunto(s)

RESUMEN

The study of 299 chronically ill patients examined the doctor/patient relationship by asking two questions: first, what factors affect the quality of the relationship and secondly, does the doctor/patient relationship affect outcome for the patient? The doctor/patient relationship was measured by indicators of the doctor's awareness of the patient's problems.The following factors were found to be positively associated with the doctor's awareness: a small number of patient problems, a large number of recent visits, and the patient, rather than the doctor, initiating the consultation. The patient's age and education, the completeness of family care, and duration of care were not found to influence awareness. After eliminating the effect of confounding variables, the relationship between the doctor's awareness and the patient's recovery was maintained for some groups of patients. Awareness did not significantly affect the patient's satisfaction. We list some practical recommendations to aid doctors in increasing their knowledge of their patients.

Asunto(s)

RESUMEN

The purposes of the study were: 1) to describe the extent of the physician's knowledge and his response; 2) to measure the degree of correlation among four indicators of knowledge and among four indicators of response; and 3) to measure the association between physician's knowledge and his response. There were five physicians and 299 patients in the study. All the patients had at least one chronic condition and one current complaint. The four indicators referred to the four kinds of problems considered: discomfort, worry, disturbance of daily living, and social problems. The physicians had high percentages of perfect scores on knowledge of discomfort, worry, and disturbance of daily living, but a low percentage on knowledge of social problems. Scores on response to discomfort were high but were low on response to other aspects. The correlations between knowledge and response, although statistically significant, were low for all four types of problems. It is possible that these correlations were underestimated because the physician's responses were recorded only for the three-month period of the study.

Asunto(s)

RESUMEN

In 1972 McWhinney presented a classification of patient behavior which provided the physician with a framework in which to describe his assessment of the reason for the patient's visit. The present paper assesses the reliability of this classification schema involving seven categories of patient behavior comparing the assessments of the investigators with those of the cooperating physicians. There was agreement in 75 percent of the cases. For a random sample of women, 389 visits over a six-month period were classified. Signal behavior was noted in 14 percent of all visits and psychosocial problems were presented frankly in another 22 percent. The distribution of patient behaviors differed for patient and doctor-initiated visits and differed among the five participating physicians. Characteristics of the doctor, rather than those of the patient, had the greater influence on the degree to which patients used frank presentation rather than signal behavior to provoke discussion of psychosocial problems.

Asunto(s)

Asunto(s)