CHANGING PHYSICIAN BEHAVIOR TO IMPROVE DISEASE PREVENTION
CHANGING PHYSICIAN BEHAVIOR TO IMPROVE DISEASE PREVENTION
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DOI：
10.1006/pmed.1994.1040
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发表时间：
1994-05-01
影响因子：
5.1
通讯作者：
GOSSELINK, CA
中科院分区：
文献类型：
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作者：
COHEN, SJ;HALVORSON, HW;GOSSELINK, CA
医生经常不能为他们的病人提供国家推荐的预防服务。为了解决这个问题，我们回顾了一些关于使用“变革准备”跨理论模型的组织结构改变医生行为的文献。这个模型表明，行为的进化经历了从预观、到观、到准备、到开始、到维持变化的几个阶段。传统的继续医学教育可能会影响知识和信仰，但很少导致行为改变。然而，诸如实践反馈报告和有影响力的同伴等激励策略可以促进阶段变化。针对准备改变的医生的成功干预经常使用一种不仅针对医生，而且针对办公室工作人员和患者的办公室系统方法。为了说明准备改变模式如何指导干预措施的设计和实施，我们描述了在全州范围内的随机对照试验中使用的策略，以改善初级保健医生的癌症预防咨询和早期检测。预防合作伙伴的多阶段干预措施包括提供医疗责任承运者、激励录像带、任务界定的办公室手册、图表流程图、患者激活表、实践反馈报告、在每个实践中指定一名预防协调员以及项目工作人员的定期电话和办公室访问。(C) 1994学术出版社，Inc.
Physicians often fail to provide nationally recommended preventive services for their patients. Addressing this, we have reviewed selected literature on changing physician behavior using the organizational construct of the ''readiness for change'' transtheoretical model. This model suggests that behavior evolves through stages from precontemplation, to contemplation, to preparation, to initiation, and to maintenance of change. Traditional continuing medical education may affect knowledge and beliefs, but rarely results in behavior change. However, motivational strategies such as practice feedback reports and influential peers can foster stage change. Successful interventions aimed at physicians preparing for change frequently use an office-system approach that targets not only physicians, but office staff and patients as well. Illustrating how the readiness to change model can guide the design and implementation of interventions, we describe strategies being used in a statewide randomized controlled trial to improve cancer prevention counseling and early detection by primary care physicians. The multistage interventions of Partners for Prevention include support from a medical liability carrier, a motivational videotape, a task-delineated office manual, chart flowsheets, patient activation forms, practice feedback reports, a designated prevention coordinator within each practice and regular telephone calls and office visits by project staff. (C) 1994 Academic Press, Inc.