Family Medicine Commons^™

About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski

Electronic Thesis and Dissertation Repository

This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …

The Attainment Of Obstetrical Competency In Postgraduate Family Medicine Training: A Qualitative Study, Nisha Arora

Electronic Thesis and Dissertation Repository

Aims: This study explored the Family Medicine resident experience in working towards their obstetrical competencies from the perspectives of residents and educators.

Methods: Using a qualitative descriptive design, semi-structured interviews were conducted with second-year Family Medicine residents and obstetrical supervisors from one Family Medicine program in Ontario, as well as key informants of Canadian Family Medicine maternity education. Interviews were audio-taped and professionally transcribed. Transcripts were coded and interpreted for common themes.

Findings: There was a disconnect between the intent of the College of Family Physicians of Canada Key Features document, and how it is applied at …

The Experiences Of Family Medicine Teachers And Family Medicine Residents In Multimorbidity Care And Education, Julie A. Copeland

Electronic Thesis and Dissertation Repository

Aim: This thesis explored the experiences of family medicine preceptors and family medicine residents regarding multimorbidity care and education.

Methods: Two qualitative descriptive studies were conducted using semi structured interviews with family medicine preceptors and focus groups with family medicine residents. Interviews and focus groups were audio-taped and transcribed verbatim. Data analysis was iterative and interpretive in nature and done both independently and as a team.

Findings: Multimorbidity care is predominantly provided by family physicians yet there is little focus on multimorbidity education in the medical education curriculum. Multimorbidity education is informal and experiential in nature. There are both facilitators …

The Health Experiences Of Long-Haul Truck Drivers And Their Relationship With Their Primary Care Provider, Jennifer K. Johnson

Electronic Thesis and Dissertation Repository

Long-haul truck drivers in North America experience greater health risks than people employed in other occupations. The magnitude of their health risks is directly associated with crash risk which has implications for public road safety. The health experiences of long-haul truck drivers residing in Ontario, Canada and their relationship with their primary care provider were explored using a phenomenological approach. Themes of perseverance, isolation, dehumanization and living in a hidden, separate world emerged from the analysis. Focus groups were held where family physicians and nurse practitioners were asked for their responses to these findings and for their experiences caring for …

Japanese Patients' Preference For Patient-Centered Medicine And Its Association With The Satisfaction Of Patients With Their Family Physicians, Tesshu Kusaba

Electronic Thesis and Dissertation Repository

Aims: This thesis explored Japanese patients’ preference for Patient-centered medicine, which was one of the core principles of family medicine, and its association with the satisfaction of patients with their family physicians.

Method: A cross-sectional study was conducted to examine Japanese patients’ preference for 3 factors of Patient-centered medicine and their satisfaction with the practice by family physicians, using patient questionnaires pre and post consultation.

Findings: The majority of Japanese patients preferred all 3 of the factors of Patient-centered medicine: Communication, Partnership and Health Promotion. The more vulnerable the patients, the more their expressed preference. A high proportion of patients …

Measuring Multimorbidity, Eng Sing E S Lee

Electronic Thesis and Dissertation Repository

Multimorbidity is common. The gaps in multimorbidity research are in the measurement of the prevalence, the levels of multimorbidity and its associated outcomes.

This thesis aimed to provide a uniform definition for multimorbidity, identify instruments for measuring the level of multimorbidity, and describe patient-reported outcomes for different levels of multimorbidity.

Three studies were conducted. The first determined the prevalence rates of multimorbidity and explored whether there were differences among the different age, gender and ethnic groups in the primary care population. Common dyads and triads of conditions were described. The systematic review updated the list of instruments for measuring the …

Family Physician's Clinical Inertia In The Management Of Hypoglycemia, Caroline V. Martignoni Rebicki

Electronic Thesis and Dissertation Repository

Though the management of diabetes is widely documented in scientific literature, little is published about how hypoglycemia is managed by family physicians. The objective of this study was to create a measurement for family physician clinical inertia in managing hypoglycemia, and to determine family physicians’ characteristics associated with clinical inertia. The design was a secondary analysis of the data provided by 162 family physicians from the Canadian InHypo-DM Study. The outcome for this thesis was a score for physician clinical inertia. The methods applied were exploratory factor analysis, bivariate analysis and multiple linear regression. Results showed no statistically significant differences …

A National Perspective On Childhood Obesity Medical Education: Do Medical Students In Canada Perceive That They Are Prepared To Treat Children With Obesity?, Dr. Dalia Hasan

Electronic Thesis and Dissertation Repository

The purposes of this survey-based, mixed-methods study were to investigate medical students’ perceptions of: (1) the overall level of medical school training acquired in relation to childhood obesity treatment; (2) the medical school training acquired in relation to specific competencies associated with the treatment of children with obesity and their caregiver(s); and (3) additional training needed. Results showed that of the 507 students who provided complete data, approximately 60% (n = 303) disagreed or strongly disagreed that their medical training related to childhood obesity was adequate. With regard to specific competencies and additional training needed, quantitative and qualitative data revealed …

Multimorbidity Among Adult Primary Health Care Patients In Canada: Examining Multiple Chronic Diseases Using An Electronic Medical Record Database, Kathryn Nicholson

Electronic Thesis and Dissertation Repository

Introduction: The coexistence of multiple chronic diseases within an individual, also known as multimorbidity, is an ongoing challenge for patients, caregivers and primary health care (PHC) providers. An enhanced understanding of the burden of multimorbidity in Canada is needed.

Objectives: This research had two main objectives. Objective One aimed to understand the prevalence of multimorbidity among adult PHC patients, as well as the patterns of unordered and ordered clusters of multiple chronic diseases. Objective Two aimed to determine the natural progression of multimorbidity over time, as well as the patient-, provider- and practice-level predictors of progressing into more complex clinical …

An Evaluation Of The Determinants Of Job Satisfaction In Canadian Family Physicians, Jana L. Malhotra

Electronic Thesis and Dissertation Repository

Physicians as a group appear to be satisfied with their work. However, there are some gaps in our current understanding of the determinants that impact the job satisfaction of Canadian family physicians. This thesis examined determinants of family physician job satisfaction using in-depth interviews with family physicians to achieve a broad perspective on their job satisfaction. This was complemented by a multivariate analysis that examined the professional and work-life balance satisfaction of physicians across this country. The findings from this research confirm the significance of a number of factors to the professional and work-life balance satisfaction of family physicians. Novel …

"A Family Doctor Can Do That!" Is There A Role For A Formalized Referral Network For Office Procedures In Family Practices Of Newfoundland And Labrador?, Annabeth J. Loveys

Electronic Thesis and Dissertation Repository

Office procedures are an important part of the comprehensive care package provided by family physicians. Every family physician cannot feasibly perform every office procedure. A cadre of family physicians drawing upon each other’s procedural skills has the potential to improve patient care and enhance physician satisfaction. A mixed methods approach was used to explore potential clinical and educational roles of a formalized referral networkfor office procedures in Newfoundland and Labrador, Canada. In a quantitative study, using a self-administered survey, family physicians identified that while there are procedures being performed in family practice, there is a discrepancy between the demand for, …