Barriers to Providing Nutrition Counseling Cited by Physicians: A Survey of Primary Care Practitioners
Barriers to Providing Nutrition Counseling Cited by Physicians: A Survey of Primary Care Practitioners
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DOI：
10.1177/0884533610380057
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发表时间：
2010-10-01
影响因子：
3.1
通讯作者：
Rickett, Katherine
中科院分区：
文献类型：
--
作者：
Kolasa, Kathryn M.;Rickett, Katherine
在1995年的一项关键研究中，库什纳描述了初级保健医生提供营养咨询的态度、实践行为和障碍。这篇文章承认营养和饮食咨询是初级保健医生提供预防服务的关键组成部分。库什纳呼吁采取多方面的方法来改变医生的咨询实践。今天普遍的看法是，几乎没有什么变化。《2010年健康人》和美国预防工作小组指出，医生需要与患者一起解决营养问题。2010年的目标是将包括为诊断为心血管疾病、糖尿病或高血压的患者订购或提供饮食咨询的办公室就诊比例提高到75%。在中期审查时，这一比例实际上从42%下降到40%。初级保健医生仍然认为提供营养咨询是他们的职责范围。然而，医生认为可以从营养咨询中受益的患者比例与从初级保健医生那里获得营养咨询或转介给营养师和其他医疗保健专业人员的患者比例之间仍然存在差距。近年来提到的障碍仍然是库什纳列出的障碍：缺乏时间和报酬，以及在较小程度上缺乏知识和资源。2010年卫生局局长的“健康和健美国家愿景”和第一夫人奥巴马的“让我们动起来”运动都强调了在饮食和体育活动方面为成人和儿童提供咨询的必要性。（中华临床医学杂志，2010;25:50 02-509）
In a 1995 pivotal study, Kushner described the attitudes, practice behaviors, and barriers to the delivery of nutrition counseling by primary care physicians. This article recognized nutrition and dietary counseling as key components in the delivery of preventive services by primary care physicians. Kushner called for a multifaceted approach to change physicians' counseling practices. The prevailing belief today is that little has changed. Healthy People 2010 and the U.S. Preventive Task Force identify the need for physicians to address nutrition with patients. The 2010 objective was to increase to 75% the proportion of office visits that included ordering or providing diet counseling for patients with a diagnosis of cardiovascular disease, diabetes, or hypertension. At the midcourse review, the proportion actually declined from 42% to 40%. Primary care physicians continue to believe that providing nutrition counseling is within their realm of responsibility. Yet the gap remains between the proportion of patients who physicians believe would benefit from nutrition counseling and those who receive it from their primary care physician or are referred to dietitians and other healthcare professionals. The barriers cited in recent years continue to be those listed by Kushner: lack of time and compensation and, to a lesser extent, lack of knowledge and resources. The 2010 Surgeon General's Vision for a Healthy and Fit Nation and First Lady Obama's "Let's Move Campaign" spotlight the need for counseling adults and children on diet and physical activity. (Nutr Clin Pract. 2010; 25:502-509)