1. Variation in the psychosocial determinants of the intention to prescribe hormone therapy prior to the release of the Women's Health Initiative trial: a survey of general practitioners and gynaecologists in France and Quebec
- Author
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France Legare, Gaston Godin, Virginie Ringa, Sylvie Dodin, Lucile Turcot, Joanna Norton, Centre de Recherche, CHUQ-Hôpital Saint-François d'Assise [CHU Québec] (HSFA), CHU de Québec–Université Laval, Université Laval [Québec] (ULaval)-Université Laval [Québec] (ULaval)-CHU de Québec–Université Laval, Université Laval [Québec] (ULaval)-Université Laval [Québec] (ULaval), Canada Research Chair on Behaviour and Health, Université Laval [Québec] (ULaval)-Faculty of Nursing, Recherches épidémiologiques en santé périnatale et santé des femmes, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), This research was supported by an unrestricted grant from Fournier Pharma and peer-reviewed by a scientific committee from the Fonds de la recherche du Quebec (FRSQ). Dr. Legare is a new clinical scientist who is supported by the FRSQ. Dr. Godin is Tier 1 Canada Research Chair in Health Related Behaviour, Université Laval. Dr Dodin holds the Chaire Andree et Lucie Chagnon pour une approche integrée en santé, Université Laval., and Maylin, Françoise
- Subjects
Male ,medicine.medical_treatment ,MESH: Logistic Models ,Intention ,Health informatics ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,Medicine ,030212 general & internal medicine ,MESH: Drug Utilization ,Practice Patterns, Physicians' ,Estrogen replacement therapy ,MESH: Middle Aged ,030219 obstetrics & reproductive medicine ,Health Policy ,Women's Health Initiative ,Estrogen Replacement Therapy ,Quebec ,Theory of planned behavior ,MESH: Comparative Study ,Middle Aged ,humanities ,Computer Science Applications ,lcsh:R858-859.7 ,Female ,France ,Family Practice ,Psychosocial ,Research Article ,Adult ,medicine.medical_specialty ,Attitude of Health Personnel ,MESH: Attitude of Health Personnel ,education ,MEDLINE ,Health Informatics ,[SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics ,lcsh:Computer applications to medicine. Medical informatics ,03 medical and health sciences ,Nursing ,Humans ,Medical prescription ,MESH: Physician's Practice Patterns ,Physician's Role ,MESH: Family Practice ,Paternal Behavior ,MESH: Humans ,business.industry ,MESH: Adult ,MESH: Intention ,MESH: Estrogen Replacement Therapy ,MESH: Male ,Drug Utilization ,MESH: Paternal Behavior ,MESH: France ,[SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics ,Logistic Models ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Gynecology ,Family medicine ,MESH: P ,Women's Health ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Hormone therapy ,MESH: Gynecology ,business ,MESH: Female - Abstract
Background Theory-based approaches are advocated to improve our understanding of prescription behaviour. This study is an application of the theory of planned behaviour (TPB) with additional variables. It was designed to assess which variables were associated with the intention to prescribe hormone therapy (HT). In addition, variations in the measures across medical specialities (GPs and gynaecologists) and across countries (France and Quebec) were investigated. Methods A survey among 2,000 doctors from France and 1,044 doctors from Quebec was conducted. Data were collected by means of a self-administered questionnaire. A clinical vignette was used to elicit doctors' opinions. The following TPB variables were assessed: attitude, subjective norm, perceived behavioural control, attitudinal beliefs, normative beliefs and power of control beliefs. Additional variables (role belief, moral norm and practice pattern-related factors) were also assessed. A stepwise logistic regression was used to assess which variables were associated with the intention to prescribe HT. GPs and gynaecologists were compared to each other within countries and the two countries were compared within the specialties. Results Overall, 1,085 doctors from France returned their questionnaire and 516 doctors from Quebec (response rate = 54% and 49%, respectively). In the overall regression model, power of control beliefs, moral norm and role belief were significantly associated with intention (all at p < 0.0001). The models by specialty and country were: for GPs in Quebec, power of control beliefs (p < 0.0001), moral norm (p < 0.01) and cytology and hormonal dosage (both at p < 0.05); for GPs in France, power of control beliefs and role belief (both at p < 0.0001) and perception of behavioural control (p < 0.05) and cessation of menses (p < 0.01); for gynaecologists in Quebec, moral norm and power of control beliefs (both at p = 0.01); and for gynaecologists in France, power of control beliefs (p < 0.0001), and moral norm, role belief and lipid profile (all at p < 0.05). Conclusion In both countries, compared with GPs, intention to prescribe HT was higher for gynaecologists. Psychosocial determinants of doctors' intention to prescribe HT varied according to the specialty and the country thus, suggesting an influence of contextual factors on these determinants.
- Published
- 2005
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