This article explores the challenges of mandated collaboration among public health care organizations. in-depth longitudinal multiple case study examines interests and values various organizational actors in three collaborative initiatives, focusing on mobilization power within governance frameworks available to them. The authors elaborate alternate readings processes examined: managerialist views poor interorganizational as a failure adequately manage process; symbolic focuses value...

Objectives To describe researchers’ experiences with involving health system managers and public policy-makers (i.e. decision-makers) in the research process, decision-makers’ including their assessments of benefits costs involvement, recommendations for facilitating it. Methods We conducted semi-structured interviews principal investigators staff seven programmes funded by Canadian Health Services Research Foundation 1999 2000 competition years, decision-makers they involved programmes....

Primary health care practitioners routinely search for information within electronic knowledge resources. We proposed four levels of outcomes information‐seeking: situational relevance, cognitive impact, use, and patient outcomes. Our objective was to produce clinical vignettes describing testing these levels. conducted a mixed methods study combining quantitative longitudinal qualitative multiple case study. Participants were 10 nurses, medical residents, pharmacists. They had access an...

Background: There has been an exponential increase in the general population's usage of internet and information accessibility; current demand for online consumer health (OCHI) is unprecedented. are multiple studies on access usage, quality information, needs. However, few explored negative outcomes OCHI detail or from different perspectives, none examined how these could be reduced. Objective: The aim this study was to describe associated with use primary care identify potential preventive...

The participation of patients in making decisions about their care is especially important towards the end life because palliative involve extensive uncertainty and are heavily influenced by personal values. Yet, there a scarcity studies directly observing clinical interactions between health providers. In this study, we aimed to understand how patient constructed through discourse community hospital-based team. This qualitative study combined ethnographic observations team with analysis....

Background: Given the significant benefits of living donor kidney transplantation, nephrology and transplant communities are augmenting efforts to increase donation. However, prior donors (LKDs) report suboptimal experiences unmet care needs. The LKDs healthy, vast majority have good outcomes post-donation. Thus, in clinical practice, their is primarily assumed by practitioners, such as family physicians (FPs). Objective: This study aimed better understand integration primary LKDs’ donation...

Aim To establish international expert recommendations on clinical features to prompt referral for diagnostic assessment of cerebral palsy ( CP ). Method An online Delphi survey was conducted with experts in early identification and intervention children , validate the results obtained two previous consensus groups Canadian content knowledge users. We sent rounds questionnaires by e‐mail. Participants rated their agreement using a 4‐point Likert scale, along optional open‐ended questions...

BACKGROUND: Pain is one of the most common reasons for individuals to seek medical advice, yet it remains poorly managed. One main that poor pain management persists lack adequate knowledge and skills practicing clinicians, which stems from a perceived education during training undergraduate students. OBJECTIVE: To identify gaps in with respect as by students, patients educators. METHODS: A qualitative descriptive study was conducted. Data were generated through six focus groups second‐...

Conversations about end-of-life care remain challenging for health providers. The tendency to delay conversations options represents a barrier that impedes the ability of terminally-ill patients participate in decision-making. Family physicians with palliative practice are often responsible discussing preferences patients, yet there is paucity research directly observing these interactions. In this study, we sought explore how and family initiated decision-making context community...

To understand the influence of academic discourses about family medicine on medical students' professional identity construction during undergraduate training.The authors used a multiple case study research design involving international schools, one each from Canada, France, Spain, and United Kingdom (UK). The completed fieldwork between 2007 2009 by conducting 18 focus groups (with 132 students) 67 semistructured interviews with educators gathering pertinent institutional documents. They...

The increasing prevalence of Alzheimer's disease and other forms dementia raises new challenges to ensure that healthcare decisions are informed by research evidence reflect what is important for seniors their caregivers. Therefore, we aim evaluate a tailored intervention help providers empower caregivers in making health-related decisions. In two phases, will: (1) design tailor the intervention; (2) implement it. We will use theory user-centered an comprising distance professional training...

Background and Objectives: Medical educators researchers have increasingly sought to embed online educational modalities into graduate medical education, albeit with limited empirical evidence of how trainees perceive the value experience learning in this context. The purpose study was explore experiences hybrid a research methods course family medicine primary care program. Methods: This qualitative description recruited 28 students during fall 2016 academic term. Data sources included...

Headings purpose: Fibromyalgia (FM) is a chronic, nondegenerative disease with important limitations in patients. Its average global prevalence 1.78%, and women are more affected than men (3:1). Due to the lack of objective diagnostic tools, it complex medical condition that frequently unseen by patients' relatives doctors, which might nonetheless have noticeable impact on patient's entourage.

The purpose of this paper was to help answer two persistent calls in the literature: first asks strengthen understanding medical collaboration across levels healthcare delivery; second one requests paying more attention individual experience different forms professional work. Accordingly, study guided by following research question: How do family physicians and specialists working at delivery enact their identity when interacting situated clinical contexts?This a multiple interpretive case...

Case management programs (CMP) for frequent users of healthcare services presenting complex needs constitute an effective strategy to improve patient experience integrated care and decrease overuse cost. This study sought identify characteristics these programs, their implementation contexts, that help self-management, care, use.

Since 2002 the Health Ministry of Québec (Canada) has been implementing a primary care organizational innovation called 'family medicine groups'. This is occurring in political context which reorganization considered necessary to improve health system performance. More specifically, purpose this reform overcome systemic deficiencies terms accessibility and continuity care. paper examines first years implementation family group program, with focus on emergence identity one pilot groups...

The Diagnostic and Statistical Manual of Mental Disorders the American Psychiatric Association (DSM-IV-TR) includes an Outline for Cultural Formulation (CF) that identifies cultural information can be used to modify diagnosis, clinical assessment treatment plan. This study examined use CF by a Consultation Service in psychiatric patients referred primary care providers. uses conversation analysis 12 case conferences explore ways which influenced interaction multidisciplinary group mental...

We aim to shed light on medical students' professional identification with family medicine by means of a qualitative case study examining the reputation of, and processes with, among students enrolled in Canadian school, where consistently low number choose as first choice for postgraduate training. Six focus groups, three second year fourth students, were conducted 2007 2008. Transcripts from group discussions submitted thematic analysis, while documentary sources supported...