Lifestyle counseling in hypertension-related visits--analysis of video-taped general practice visits.
Lifestyle counseling in hypertension-related visits--analysis of video-taped general practice visits.
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DOI：
10.1186/1471-2296-9-58
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发表时间：
2008-10-14
影响因子：
2.9
通讯作者：
Bemelmans WJ
中科院分区：
文献类型：
--
作者：
Milder IE;Blokstra A;de Groot J;van Dulmen S;Bemelmans WJ
全科医生（GP）在促进健康生活方式方面可发挥重要作用，这对于因高血压而心血管疾病风险升高的人群尤为重要。因此，本研究的目的是确定全科医生在高血压相关诊疗中关于减肥、营养、体育活动和吸烟的生活方式咨询的频率和内容。对生活方式的评估（收集信息或测量体重或腰围）和给予生活方式建议（给出改变患者行为的具体建议或让患者参考其他信息来源或其他卫生专业人员）进行了区分。
在这项研究中，我们观察了2000/2001年第二次荷兰全科医学全国调查中收集的212份高血压相关诊疗的视频记录。
诊疗的平均时长为9.8分钟（范围从2.5分钟到30分钟）。在40%的诊疗中讨论了生活方式（n = 84），但在这些诊疗中，81%的讨论持续时间短于诊疗时长的四分之一。在77次诊疗（36%）中对生活方式进行了评估，最常见的是关于体重和营养。在大多数情况下，患者发起关于营养和体育活动的讨论，而体重和吸烟状况的评估大多由全科医生发起。在35次诊疗（17%）中全科医生给出了生活方式建议，但在这些诊疗中只有五分之一评估了患者改变行为的动机或感知到的障碍。支持因素完全没有被讨论。
在40%的高血压相关诊疗中讨论了生活方式主题。然而，生活方式建议的频率和质量都有待提高。
The general practitioner (GP) can play an important role in promoting a healthy lifestyle, which is especially relevant in people with an elevated risk of cardiovascular diseases due to hypertension. Therefore, the aim of this study was to determine the frequency and content of lifestyle counseling about weight loss, nutrition, physical activity, and smoking by GPs in hypertension-related visits. A distinction was made between the assessment of lifestyle (gathering information or measuring weight or waist circumference) and giving lifestyle advice (giving a specific advice to change the patient's behavior or referring the patient to other sources of information or other health professionals). For this study, we observed 212 video recordings of hypertension-related visits collected within the Second Dutch National Survey of General Practice in 2000/2001. The mean duration of visits was 9.8 minutes (range 2.5 to 30 minutes). In 40% of the visits lifestyle was discussed (n = 84), but in 81% of these visits this discussion lasted shorter than a quarter of the visit. An assessment of lifestyle was made in 77 visits (36%), most commonly regarding body weight and nutrition. In most cases the patient initiated the discussion about nutrition and physical activity, whereas the assessment of weight and smoking status was mostly initiated by the GP. In 35 visits (17%) the GP gave lifestyle advice, but in only one fifth of these visits the patient's motivation or perceived barriers for changing behavior were assessed. Supporting factors were not discussed at all. In 40% of the hypertension-related visits lifestyle topics were discussed. However, both the frequency and quality of lifestyle advice can be improved.
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影响因子：
2.9
作者：
Bensing JM;Tromp F;van Dulmen S;van den Brink-Muinen A;Verheul W;Schellevis FG
通讯作者：
Schellevis FG
影响因子：
4.4
作者：
Geleijnse, JM;Kok, FJ;Grobbee, DE
通讯作者：
Grobbee, DE
DOI：
10.1001/archfami.9.7.631
发表时间：
2000-07-01
期刊：
ARCHIVES OF FAMILY MEDICINE
影响因子：
--
作者：
Stafford, RS;Farhat, JH;Schoenfeld, DA
通讯作者：
Schoenfeld, DA
影响因子：
4.5
作者：
Douglas, Flora;Torrance, Nicola;Kerr, Ann
通讯作者：
Kerr, Ann
影响因子：
7.1
作者：
Brotons, C;Ciurana, R;Sammut, MR
通讯作者：
Sammut, MR