Integration of the recommendations of the Canadian Task Force on Preventive Health Care: Obstacles perceived by a group of family physicians
Notice bibliographique
Résumé
BACKGROUND: Surveys conducted in North America and in several European countries show that the preventive activities recommended by some groups of experts are difficult to integrate into medical practice. Interventions to correct this problem have produced mitigated results. OBJECTIVES: Our aim was to gain a better understanding of the obstacles perceived by a group of family physicians concerning the integration of prevention into their routine practices. METHODS: A qualitative design was selected to facilitate the exploration of that topic. Seven focus groups with 35 physicians practising in the Montreal area were conducted. Questions regarding their perception of, and obstacles to, the integration of prevention in their daily work were explored. The text of these interviews was analysed following the content analysis method. Codification of the important themes that were identified was done by two of the researchers. RESULTS: We met with 35 family physicians in two regions in Montreal, Quebec. The lack of motivation on the part of users and the lack of value placed on continuity of care appear to be the main obstacles in the eyes of the physicians, followed by a lack of financial incentives, work overload, and contradictions among the recommendations. In addition, other obstacles were observed by the researchers: limited intervention strategies on the part of physicians to support behaviour modification among patients, non-recognition of the importance of the organization of practice and inability to acknowledge the obstacles that can be ascribed to their own beliefs. CONCLUSION: The family physicians we met identified several barriers to the integration of prevention in their practices. The interventions proposed to date do not address the barriers perceived by the physicians in our study. Continuing medical education activities focus on knowledge, while the difficulties expressed relate more to communication skills coupled with a feeling of powerlessness. The physicians we met with do not seem to consider recall systems and looking at their organization of practice as possible solutions. The physicians seem to 'cave in' under the weight of the responsibilities that have been assigned to them in terms of health promotion. There may be room for proposing a more realistic menu. This study identifies a need for much more specific and concrete training on communication and counselling skills.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,039 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,010 | 0,003 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».