RESUMEN

The aim of this study was to evaluate the reliability of a French Canadian version of the "Psychological Consequences Questionnaire" (PCQ) among 306 Quebec women between the ages of 50 and 69. The internal consistencies of the emotional, physical and social dimensions are respectively 0.91, 0.86 and 0.72 (Cronbach's alpha). The temporal stability was greater than 68% for each question. Meanwhile, analysis showed that 4 of the 12 questions were highly predictive of the results of the whole questionnaire (R2 = 0.91). In addition, these 4 questions are in concordance with the diagnostic criteria for adaptive disorder, anxiety disorder and general anxiety. The French Canadian version of PCQ was found to be easy to use and reliable. We would suggest a shorter version of the questionnaire, including only four questions. This version would be even easier to use and more effective to control the emotional, physical and social consequences over the different stages of breast cancer screening.

Asunto(s)

RESUMEN

Combined pharyngeal and nasal swab specimens were collected from 100 subjects who presented with a flu-like illness (fever >37.8 degrees C plus 2 of 4 symptoms: cough, myalgia, sore throat, and headache) of <72 hours' duration at 3 different clinics in the province of Quebec, Canada, during the 1998-1999 flu season. The rate of laboratory-confirmed influenza infection was 72% according to cell culture findings and 79% according to the results of multiplex reverse-transcription polymerase chain reaction (RT-PCR) analysis (85%, influenza AH3; 15%, influenza B). All subjects for whom these results were discordant (negative culture and positive PCR) presented with a temperature > or =38.2 degrees C as well as 3 or 4 of the symptoms in the clinical case definition. Stepwise logistic regression showed that cough (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.4-34.1; P=.02) and fever (OR, 3.1; 95% CI, 1.4-8.0; P=.01) were the only factors significantly associated with a positive PCR test for influenza. The positive predictive value, negative predictive value, sensitivity, and the specificity of a case definition including fever (temperature of >38 degrees C) and cough for the diagnosis of influenza infection during this flu season were 86.8%, 39.3%, 77.6%, and 55.0%, respectively.

Asunto(s)

Asunto(s)

RESUMEN

OBJECTIVE: To assess whether knowing blood cholesterol test results influences people's intention to lower their dietary fat intake and to assess changes in diet after 3 months. DESIGN: Randomized clinical study. SETTING: Two hospital-based family medicine centres. PARTICIPANTS: A total of 526 patients aged 18 to 65, without prior knowledge of their blood cholesterol levels, were recruited. Seventy did not appear for their appointments, and 37 did not meet study criteria, leaving 419 participants. From that group, 391 completed the study. INTERVENTIONS: Patients submitted to cholesterol screening were randomly assigned to one of two groups, completing the study questionnaires either before (control group) or after (experimental group) being informed of their screening test results. All participants were called 3 months after transmission of test results to assess their dietary fat intake at that time. MAIN OUTCOME MEASURES: Differences in intention to adopt a low-fat diet reported between the experimental and control groups and differences in dietary fat intake modification after 3 months between patients with normal and abnormal blood cholesterol test results. RESULTS: Knowledge of test results influenced patients' intentions to adopt low-fat diets (F1,417 = 5.4, P = .02). Patients reported lower mean dietary fat intake after 3 months than at baseline (P < .0001). The reduction was greater in patients with abnormal screening results (F2,388 = 3.6, P = .03). CONCLUSIONS: Being informed of personal blood cholesterol levels effects an immediate change in eating habits that translates into reduced dietary fat intake.

Asunto(s)

RESUMEN

This study describes the anti-influenza vaccination coverage of persons aged 65 or over who presented at the family medicine unit (FMU) of the Saint-Sacrement Hospital (Quebec City), between January 1988 and December 1992. All individuals were classified according to their anti-influenza vaccination status for each vaccination period. In general, the proportion of vaccinated persons increased by 14.1% during the five-year vaccination period. The mean increase in the proportion of vaccinated persons is 22.6% for those seen at least once a year at the FMU and 52.6% for those who were vaccinated at the FMU the previous year. The study results indicate that regular medical examination and previous vaccination increase the likelihood of subsequent vaccination in persons aged 65 or over.

Asunto(s)

RESUMEN

OBJECTIVE: To evaluate the effectiveness of a program to improve hypertension control practices in primary care. DESIGN: Retrospective quasi-experimental study. SETTING: Three hospital-based family medicine centres (FMCs) PARTICIPANTS: Two study groups of 100 randomly-selected adult patients each, who visited the study FMC before implementation of the hypertension program (from April 1, 1983 to March 31, 1984) or afterward (from April 1, 1986 to March 31, 1987). These patients were compared to patients from control FMCs A and B seen during the same time frames (100 patients before and after at FMC A and 60 at FMC B). INTERVENTIONS: 1) Educational sessions for physicians to standardize knowledge of the recommendations of the Canadian Hypertension Society on hypertension treatment and 2) specific operational incentives to improve hypertension control, including a reference guide placed in each physician's office, a specific hypertension follow-up form placed with each patient's chart, a recall card file, and hypertension information handouts. MAIN OUTCOME MEASURE: Blood pressure measurements recorded in patient charts. Hypertension control is determined from the Canadian Hypertension Society recommendations. RESULTS: The hypertension control rate was 52% in the study group before program implementation and 34.3% afterward (p = 0.01); the corresponding rates in the two control groups moved from 47.4% to 59.8% (p > 0.05) in Group A and from 40.7% to 39.3% (p > 0.05) in Group B. Patients listed in the recall card file were not controlled more frequently (33.3%) than those not listed (35.3%). CONCLUSION: This intervention did not improve physician practice regarding hypertension control. Clinicians did not follow the protocol as recommended. Physicians must be convinced that a change in their practice is needed before any specific strategies are introduced to support the change. Different suggestions and alternatives related to hypertension management are discussed.

Asunto(s)