Papers by Claudio Del Grande
Les interactions médecin-patient reconsidérées Une analyse sociologique qualitative et séquentiel... more Les interactions médecin-patient reconsidérées Une analyse sociologique qualitative et séquentielle de la communication médecin-patient en pratique généraliste par Claudio Del Grande Département de sociologie Faculté des arts et des sciences Mémoire présenté it la Faculté des études supérieures en vue de l'obtention du grade de maîtrise (M. Sc.
Canadian Family Physician, 2012
To evaluate chronic illness care delivery from the patient's perspective and to examine its m... more To evaluate chronic illness care delivery from the patient's perspective and to examine its main correlates. Cross-sectional, descriptive study using questionnaires and medical chart review. Nine teaching family practices in Quebec. A total of 364 patients with diabetes, hypertension, or chronic obstructive pulmonary disease. Score on the Patient Assessment of Chronic Illness Care (PACIC) questionnaire, which evaluates the patient's perspective on the care received based on the chronic care model (CCM); patients characteristics (sex, level of education, number of chronic illnesses); patient-physician relationship (relational continuity, interpersonal communication assessed from the patient's perspective); and interdisciplinary care and technical quality of care abstracted from patients' medical charts. The mean PACIC score obtained (2.8 out of 5) indicates that, on average, CCM-concordant care "generally did not occur" or occurred only "sometimes"...
Canadian Family Physician, 2014
To gain a deeper understanding of how primary care (PC) practices belonging to different models m... more To gain a deeper understanding of how primary care (PC) practices belonging to different models manage resources to provide high-quality care. Multiple-case study embedded in a cross-sectional study of a random sample of 37 practices. Three regions of Quebec. Health care professionals and staff of 5 PC practices. Five cases showing above-average results on quality-of-care indicators were purposefully selected to contrast on region, practice size, and PC model. Data were collected using an organizational questionnaire; the Team Climate Inventory, which was completed by health care professionals and staff; and 33 individual interviews. Detailed case histories were written and thematic analysis was performed. The core common feature of these practices was their ongoing effort to make trade-offs to deliver services that met their vision of high-quality care. These compromises involved the same 3 areas, but to varying degrees depending on clinic characteristics: developing a shared visio...
Canadian family physician Medecin de famille canadien, 2014
OBJECTIVE To gain a deeper understanding of how primary care (PC) practices belonging to differen... more OBJECTIVE To gain a deeper understanding of how primary care (PC) practices belonging to different models manage resources to provide high-quality care. DESIGN Multiple-case study embedded in a cross-sectional study of a random sample of 37 practices. SETTING Three regions of Quebec. PARTICIPANTS Health care professionals and staff of 5 PC practices. METHODS Five cases showing above-average results on quality-of-care indicators were purposefully selected to contrast on region, practice size, and PC model. Data were collected using an organizational questionnaire; the Team Climate Inventory, which was completed by health care professionals and staff; and 33 individual interviews. Detailed case histories were written and thematic analysis was performed. MAIN FINDINGS The core common feature of these practices was their ongoing effort to make trade-offs to deliver services that met their vision of high-quality care. These compromises involved the same 3 areas, but to varying degrees de...
Health expectations : an international journal of public participation in health care and health policy, 2021
BACKGROUND Patient engagement in care is a priority and a key component of clinical practice. Dif... more BACKGROUND Patient engagement in care is a priority and a key component of clinical practice. Different approaches to care have been introduced to foster patient engagement. There is a lack of a recent review on tools for assessing the main concepts and dimensions related to patient engagement in care. OBJECTIVE Our scoping review sought to map and summarize recently validated tools for assessing various concepts and dimensions of patient engagement in care. SEARCH STRATEGY A scoping review of recent peer-reviewed articles describing tools that assess preferences in and experience with patient engagement in care was conducted in four databases (Ovid Medline, Ovid EMBASE, Cochrane Database of Systematic Reviews, CINAHL-EBSCO). We adopted a broad definition based on the main concepts of patient engagement in care: patient-centredness, empowerment, shared decision-making and partnership in care. MAIN RESULTS Of 2161 articles found, 16, each describing a different tool, were included an...
Research Involvement and Engagement, 2021
Background Patient and public engagement (PPE) in research is growing internationally, and with i... more Background Patient and public engagement (PPE) in research is growing internationally, and with it, the interest for its evaluation. In Canada, the Strategy for Patient-Oriented Research has generated national momentum and opportunities for greater PPE in research and health-system transformation. As is the case with most countries, the Canadian research community lacks a common evaluation framework for PPE, thus limiting our capacity to ensure integrity between principles and practices, learn across projects, identify common areas for improvement, and assess the impacts of engagement. Objective This project aims to build a national adaptable framework for the evaluation of PPE in research, by: 1. Building consensus on common evaluation criteria and indicators for PPE in research; 2. Defining recommendations to implement and adapt the framework to specific populations. Methods Using a collaborative action-research approach, a national coalition of patient-oriented research leaders, ...
Sante publique, 2015
INTRODUCTION This article presents the results of a project conducted by the Institut national d&... more INTRODUCTION This article presents the results of a project conducted by the Institut national d'excellence en santé et en services sociaux of Québec to develop quality of care indicators for the management of six chronic illnesses. METHODS Indicators were identified through literature searches and analysis of clinical practice guidelines (CPGs). Interdisciplinary expert panels assessed their validity and the strength of the evidence on which they were based. Representatives of patients (N = 19) and professionals (N = 29) were consulted on their relevance and acceptability. Indicators were categorized according to the Chronic Care Model (CCM). RESULTS A total of 164 indicators were developed, 126 specific to the illnesses under study and 38 on processes and outcomes generic to the CCM. There was convergence between patients and professionals on the relevance of a majority of indicators. Professionals expressed concerns on the indicators measured by means of patient surveys that ...
Canadian family physician Medecin de famille canadien, 2017
OBJECTIVE To describe the techniques currently used by family physicians in Canada to measure blo... more OBJECTIVE To describe the techniques currently used by family physicians in Canada to measure blood pressure (BP) for screening for, diagnosing, and treating hypertension. DESIGN A Web-based cross-sectional survey distributed by e-mail. SETTING Stratified random sample of family physicians in Canada. PARTICIPANTS Family physician members of the College of Family Physicians of Canada with valid e-mail addresses. MAIN OUTCOME MEASURES Physicians' self-reported routine methods for recording BP in their practices to screen for, diagnose, and manage hypertension. RESULTS A total of 774 valid responses were received, for a response rate of 16.2%. Respondents were similar to nonrespondents except for underrepresentation of male physicians. Of 769 respondents, 417 (54.2%) indicated that they used manual office BP measurement with a mercury or aneroid device and stethoscope as the routine method to screen patients for high BP, while 42.9% (330 of 769) reported using automated office BP (...
Canadian family physician Medecin de famille canadien, 2012
OBJECTIVE To evaluate chronic illness care delivery from the patient's perspective and to exa... more OBJECTIVE To evaluate chronic illness care delivery from the patient's perspective and to examine its main correlates. DESIGN Cross-sectional, descriptive study using questionnaires and medical chart review. SETTING Nine teaching family practices in Quebec. PARTICIPANTS A total of 364 patients with diabetes, hypertension, or chronic obstructive pulmonary disease. MAIN OUTCOMES MEASURES Score on the Patient Assessment of Chronic Illness Care (PACIC) questionnaire, which evaluates the patient's perspective on the care received based on the chronic care model (CCM); patients characteristics (sex, level of education, number of chronic illnesses); patient-physician relationship (relational continuity, interpersonal communication assessed from the patient's perspective); and interdisciplinary care and technical quality of care abstracted from patients' medical charts. RESULTS The mean PACIC score obtained (2.8 out of 5) indicates that, on average, CCM-concordant care "...
Health Expectations
Partnership between patients and health‐care professionals (HCPs) is a concept that needs a valid... more Partnership between patients and health‐care professionals (HCPs) is a concept that needs a valid, practical measure to facilitate its use by patients and HCPs.
Health Expectations
Partnership between patients and health‐care professionals (HCPs) is a concept that needs a valid... more Partnership between patients and health‐care professionals (HCPs) is a concept that needs a valid, practical measure to facilitate its use by patients and HCPs.
Drug and Alcohol Dependence
The Lancet Digital Health
Narrative Inquiry in Bioethics
Narrative Inquiry in Bioethics
Canadian family physician Medecin de famille canadien, 2017
To describe the techniques currently used by family physicians in Canada to measure blood pressur... more To describe the techniques currently used by family physicians in Canada to measure blood pressure (BP) for screening for, diagnosing, and treating hypertension. A Web-based cross-sectional survey distributed by e-mail. Stratified random sample of family physicians in Canada. Family physician members of the College of Family Physicians of Canada with valid e-mail addresses. Physicians' self-reported routine methods for recording BP in their practices to screen for, diagnose, and manage hypertension. A total of 774 valid responses were received, for a response rate of 16.2%. Respondents were similar to nonrespondents except for underrepresentation of male physicians. Of 769 respondents, 417 (54.2%) indicated that they used manual office BP measurement with a mercury or aneroid device and stethoscope as the routine method to screen patients for high BP, while 42.9% (330 of 769) reported using automated office BP (AOBP) measurement. The method most frequently used to make a diagnos...
Canadian Family Physician Medecin De Famille Canadien, Dec 1, 2012
This article has been peer reviewed.
Canadian family physician Médecin de famille canadien, 2014
To gain a deeper understanding of how primary care (PC) practices belonging to different models m... more To gain a deeper understanding of how primary care (PC) practices belonging to different models manage resources to provide high-quality care. Multiple-case study embedded in a cross-sectional study of a random sample of 37 practices. Three regions of Quebec. Health care professionals and staff of 5 PC practices. Five cases showing above-average results on quality-of-care indicators were purposefully selected to contrast on region, practice size, and PC model. Data were collected using an organizational questionnaire; the Team Climate Inventory, which was completed by health care professionals and staff; and 33 individual interviews. Detailed case histories were written and thematic analysis was performed. The core common feature of these practices was their ongoing effort to make trade-offs to deliver services that met their vision of high-quality care. These compromises involved the same 3 areas, but to varying degrees depending on clinic characteristics: developing a shared visio...
Canadian Journal of Bioethics / Revue canadienne de bioéthique, 2018
Engaging patients in research conduct and agenda setting is increasingly considered as an ethical... more Engaging patients in research conduct and agenda setting is increasingly considered as an ethical imperative, and a way to transcend views of patients as passive subjects by fostering their empowerment. However, patient engagement in research (PER) is still an emerging approach with debated definitional and operational frameworks. This song addresses the sometimes difficult encounter and elusive mutual understanding between researchers and patients. “What is PER?” is an impressionistic illustration of the challenges and issues that can be found in the universe of patient engagement in research.
OBJECTIVE: To describe the techniques currently used by family physicians in Canada to measure bl... more OBJECTIVE: To describe the techniques currently used by family physicians in Canada to measure blood pressure
(BP) for screening for, diagnosing, and treating hypertension.
DESIGN: A Web-based cross-sectional survey distributed by e-mail.
SETTING: Stratified random sample of family physicians in Canada.
PARTICIPANTS: Family physician members of the College of Family Physicians of Canada with valid e-mail addresses.
MAIN OUTCOME MEASURES: Physicians’ self-reported routine methods for recording BP in their practices to screen for,
diagnose, and manage hypertension.
RESULTS: A total of 774 valid responses were received, for a response rate of 16.2%. Respondents were similar to
nonrespondents except for underrepresentation of male physicians. Of 769 respondents, 417 (54.2%) indicated
that they used manual office BP measurement with a mercury
or aneroid device and stethoscope as the routine method to
screen patients for high BP, while 42.9% (330 of 769) reported
using automated office BP (AOBP) measurement. The method
most frequently used to make a diagnosis of hypertension was
AOBP measurement (31.1%, 240 of 771), followed by home
BP measurement (22.4%, 173 of 771) and manual office BP
measurement (21.4%, 165 of 771). Ambulatory BP monitoring
(ABPM) was used for diagnosis by 14.4% (111 of 771) of
respondents. The most frequently reported method for ongoing
management was home BP monitoring (68.7%, 528 of 769),
followed by manual office BP measurement (63.6%, 489 of 769)
and AOBP measurement (59.2%, 455 of 769). More than threequarters
(77.8%, 598 of 769) of respondents indicated that ABPM
was readily available for their patients.
CONCLUSION: Canadian family physicians exhibit overall high use
of electronic devices for BP measurement, However, more efforts
are needed to encourage practitioners to follow current Canadian
guidelines, which advocate the use of AOBP measurement for
hypertension screening, ABPM and home BP measurement for
making a diagnosis, and both AOBP and home BP monitoring for
ongoing management.
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Papers by Claudio Del Grande
(BP) for screening for, diagnosing, and treating hypertension.
DESIGN: A Web-based cross-sectional survey distributed by e-mail.
SETTING: Stratified random sample of family physicians in Canada.
PARTICIPANTS: Family physician members of the College of Family Physicians of Canada with valid e-mail addresses.
MAIN OUTCOME MEASURES: Physicians’ self-reported routine methods for recording BP in their practices to screen for,
diagnose, and manage hypertension.
RESULTS: A total of 774 valid responses were received, for a response rate of 16.2%. Respondents were similar to
nonrespondents except for underrepresentation of male physicians. Of 769 respondents, 417 (54.2%) indicated
that they used manual office BP measurement with a mercury
or aneroid device and stethoscope as the routine method to
screen patients for high BP, while 42.9% (330 of 769) reported
using automated office BP (AOBP) measurement. The method
most frequently used to make a diagnosis of hypertension was
AOBP measurement (31.1%, 240 of 771), followed by home
BP measurement (22.4%, 173 of 771) and manual office BP
measurement (21.4%, 165 of 771). Ambulatory BP monitoring
(ABPM) was used for diagnosis by 14.4% (111 of 771) of
respondents. The most frequently reported method for ongoing
management was home BP monitoring (68.7%, 528 of 769),
followed by manual office BP measurement (63.6%, 489 of 769)
and AOBP measurement (59.2%, 455 of 769). More than threequarters
(77.8%, 598 of 769) of respondents indicated that ABPM
was readily available for their patients.
CONCLUSION: Canadian family physicians exhibit overall high use
of electronic devices for BP measurement, However, more efforts
are needed to encourage practitioners to follow current Canadian
guidelines, which advocate the use of AOBP measurement for
hypertension screening, ABPM and home BP measurement for
making a diagnosis, and both AOBP and home BP monitoring for
ongoing management.
(BP) for screening for, diagnosing, and treating hypertension.
DESIGN: A Web-based cross-sectional survey distributed by e-mail.
SETTING: Stratified random sample of family physicians in Canada.
PARTICIPANTS: Family physician members of the College of Family Physicians of Canada with valid e-mail addresses.
MAIN OUTCOME MEASURES: Physicians’ self-reported routine methods for recording BP in their practices to screen for,
diagnose, and manage hypertension.
RESULTS: A total of 774 valid responses were received, for a response rate of 16.2%. Respondents were similar to
nonrespondents except for underrepresentation of male physicians. Of 769 respondents, 417 (54.2%) indicated
that they used manual office BP measurement with a mercury
or aneroid device and stethoscope as the routine method to
screen patients for high BP, while 42.9% (330 of 769) reported
using automated office BP (AOBP) measurement. The method
most frequently used to make a diagnosis of hypertension was
AOBP measurement (31.1%, 240 of 771), followed by home
BP measurement (22.4%, 173 of 771) and manual office BP
measurement (21.4%, 165 of 771). Ambulatory BP monitoring
(ABPM) was used for diagnosis by 14.4% (111 of 771) of
respondents. The most frequently reported method for ongoing
management was home BP monitoring (68.7%, 528 of 769),
followed by manual office BP measurement (63.6%, 489 of 769)
and AOBP measurement (59.2%, 455 of 769). More than threequarters
(77.8%, 598 of 769) of respondents indicated that ABPM
was readily available for their patients.
CONCLUSION: Canadian family physicians exhibit overall high use
of electronic devices for BP measurement, However, more efforts
are needed to encourage practitioners to follow current Canadian
guidelines, which advocate the use of AOBP measurement for
hypertension screening, ABPM and home BP measurement for
making a diagnosis, and both AOBP and home BP monitoring for
ongoing management.