What prevents professional drivers from following physicians' cardiologic advice?
What prevents professional drivers from following physicians' cardiologic advice?
复制标题
DOI：
10.1159/000012285
复制
发表时间：
1998-07-01
影响因子：
22.8
通讯作者：
Cizinsky, S
中科院分区：
文献类型：
--
作者：
Emdad, R;Belkic, K;Cizinsky, S
背景：有一个职业司机（PD）心脏咨询的影响发表的研究稀缺。本研究的目的是：（1）检查两个经典的“驾驶员”风险因素的解释变量-身体质量指数（BMI）和吸烟-并分析戒烟，减肥和与工作有关的生活变化之间的相互关系;（2）评估危险因素辅导六个月后的成效，以及（3）深入了解PD对所需改变的感知与对医生建议的依从性之间可能存在的差异。方法：男性PD分为4组：缺血性心脏病组13例，高血压组12例，临界高血压组10例，血压正常组34例。通过问卷调查评估基线心血管危险因素以及职业和行为数据。咨询的目的是戒烟、减肥和促进闲暇时间的体育活动。定性方法被用来评估PD的看法，工作环境和健康促进。结果：基线吸烟强度是最好的预测职业紧张和吸烟年数的总负担。基线BMI最好通过长时间开车、工作外依恋的低可用性和自我报告的低工作压力来预测。自我戒烟最好的预测是几年的吸烟，低咖啡摄入量和承认在驾驶过程中的恐惧。6个月后体力活动显著增加。减肥与以下因素有关：戒烟或减少吸烟以及做出其他与工作相关的生活改变。没有重度吸烟者在6个月后减少每日吸烟量，尽管在自我生成的陈述中表达了这样做的必要性。结论：暴露于职业压力源，主要是，长时间的工作时间和随之而来的否认工作压力，结合低可用性的工作外的社会依恋，可能有助于维持适应不良行为的PD。这些研究结果可以作为设计标准化干预试验的基础，并建议修改工作环境，与司机的参与，是这种试验的必要组成部分。应特别注意轮班的长度和时间安排。
Background: There is a scarcity of published studies of the effects of cardiac counselling among professional drivers (PD). Aims of the study were: (1) to examine explanatory variables for two classical 'driver' risk factors - body mass index (BMI), and smoking - and to analyse the interrelations among smoking cessation, losing weight and work-related life changes; (2) to assess the effectiveness of risk factor counselling after 6 months, and (3) to gain insight into possible discrepancies between PD perception of needed changes and compliance with the physician's advice. Methods: There were 4 groups of male PD: 13 with ischemic heart disease, 12 hypertensives, 10 borderline hypertensives and 34 normotensives. Baseline cardiovascular risk factors as well as occupational and behavioral data were assessed via questionnaire. The counselling was aimed at smoking cessation, weight loss and promoting leisure-time physical activity. Qualitative methods were used to assess PD perceptions about the work environment and health promotion. Results: Baseline smoking intensity was best predicted by the total burden of occupational stress and number of smoking years. Baseline BMI was best predicted by long work hours behind the wheel, low availability of attachment outside work and low self-reported job strain. Self-initiated smoking cessation was best predicted by few smoking years, low coffee intake and admitting fear during driving. Physical activity was significantly increased after 6 months. Losing weight was associated with: quitting or diminishing smoking and making other, work-related, life changes. None of the heavy smokers decreased their daily number of cigarettes after 6 months, although expressing the need to do so in self-generated statements. Conclusions: Exposure to occupational stressors, mainly, long work hours and the concomitant denial of job strain, in combination with low availability of social attachment outside work, could contribute to maintenance of maladaptive behavior in PD. These findings could serve as a basis for designing standardized intervention trials and suggest that modification of the work environment, with participation of the drivers, is a needed component of such trials. Particular attention should be paid to the length and scheduling of work shifts.