Direct observation and patient recall of health behavior advice
Direct observation and patient recall of health behavior advice
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DOI：
10.1016/j.ypmed.2003.11.004
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发表时间：
2004-03-01
影响因子：
5.1
通讯作者：
Stange, KC
中科院分区：
文献类型：
--
作者：
Flocke, SA;Stange, KC
背景患者与医生讨论健康行为改变的回忆是遵守建议和随后行为改变的重要中间结局。本研究报告了患者在门诊访视期间对健康行为讨论的回忆，并测试了与回忆相关的患者和访视特征。在一项横断面研究中，2670名成年门诊患者访问了84个实践中的138名家庭医生，通过直接观察来衡量健康行为建议的提供。通过患者调查评估患者对每个健康行为主题讨论的回忆。患者回忆率从11%的物质使用评估到75%的吸烟者回忆戒烟建议。患者人口统计学与回忆无关。在多变量模型中，患者回忆饮食和运动建议的最强预测因素是建议的持续时间。在良好的护理访问期间提供的建议是更有可能被召回的患者比在疾病访问期间，但存在的健康行为相关的诊断在疾病访问期间与患者召回的2倍增加。病人回忆健康行为的建议，提高了较长的持续时间的建议，并通过链接的建议，代表可教的时刻访问上下文。(C)2003年癌症预防研究所和爱思唯尔公司。All rights reserved.
Background. Patient recall of health behavior change discussions with physicians is an important intermediate outcome to adherence with recommendations and subsequent behavior change. This study reports patient recall of health behavior discussions during outpatient visits and tests patient and visit characteristics associated with recall.Method. In a cross-sectional study of 2670 adult outpatients visiting 138 family physicians in 84 practices, provision of health behavior advice was measured by direct observation. Patient recall of discussion of each health behavior topic was assessed by patient survey.Results. Patient recall rates ranged from 11% for substance use assessment to 75% of smokers recalling smoking cessation advice. Patient demographics were not associated with recall. In multivariable models, the strongest predictor of patient recall of diet and exercise advice was the duration of the advice. Advice provided during well care visits was more likely to be recalled by patients than during illness visits, but presence of a health behavior-relevant diagnosis during an illness visit was associated with a 2-fold increase in patient recall.Conclusions. Patient recall of health behavior advice is enhanced by longer duration of advice and by linking advice to visit contexts that represent teachable moments. (C) 2003 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.