BARRIERS TO PROVIDING NUTRITION COUNSELING BY PHYSICIANS - A SURVEY OF PRIMARY-CARE PRACTITIONERS
BARRIERS TO PROVIDING NUTRITION COUNSELING BY PHYSICIANS - A SURVEY OF PRIMARY-CARE PRACTITIONERS
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DOI：
10.1006/pmed.1995.1087
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发表时间：
1995-11-01
影响因子：
5.1
通讯作者：
KUSHNER, RF
中科院分区：
文献类型：
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作者：
KUSHNER, RF
背景以前的调查表明，医生对饮食和营养在健康维护和疾病预防中的重要性的信念与实际提供的营养咨询之间存在差距。本研究的主要目的是评估目前的态度，实践行为，并提供营养咨询的初级保健医生的障碍。一份随机抽样邮寄的调查问卷被发送给2,250名初级保健医生，这些医生是从AMA的全科、内科和儿科主文件中选出的，代表了个体经营者、团体、医院和HMO的做法。参与者按年龄、性别、地理区域和目前的就业情况分层。主要的结果指标是确定医生提供营养咨询的时间和患者接受营养咨询的百分比，并确定提供营养咨询的障碍。获得了49%的应答率（n = 1，103）。结果显示了1,030名医生（70%的私人执业）的完整数据。超过三分之二的医生为40%或更少的患者提供饮食咨询，并花费5分钟或更少的时间讨论饮食变化。尽管有这种模式，近四分之三的受访者认为饮食咨询很重要，是医生的责任。饮食咨询的感知障碍依次为时间不足、患者不依从、教材不足、缺乏咨询培训、知识缺乏、报销不足和医生信心不足。这项调查表明，存在多种障碍，阻止初级保健医生提供饮食咨询。改变医生咨询行为需要多方面的方法。(C)出版社：Academic Press
Background. Previous surveys have shown that there is a disparity between physicians' beliefs about the importance of diet and nutrition in health maintenance and disease prevention and the actual delivery of nutrition counseling. The primary objective of this study was to assess the current attitudes, practice behavior, and barriers to the delivery of nutrition counseling by primary care physicians.Methods. A random-sample-mailed questionnaire was sent to 2,250 primary care physicians selected from the AMA masterfile from general practice, internal medicine, and pediatrics, representing self-employed, group, hospital, and HMO practices. Participants were stratified by age, gender, geographical region, and present employment. The main outcome measures were to determine time spent by physicians providing and percentage of patients receiving dietary counseling and to identify barriers to the delivery of nutrition counseling.Results. A 49% response rate (n = 1,103) was obtained. Results are presented for the 1,030 physicians (70% private practice) with complete data. Over two-thirds of physicians provide dietary counseling to 40% or less of patients and spend 5 or fewer min discussing dietary changes. Despite this pattern, nearly three-quarters of respondents feel that dietary counseling is important and is the responsibility of the physician. Ranking of perceived barriers to delivery of dietary counseling were lack of time, patient noncompliance, inadequate teaching materials, lack of counseling training, lack of knowledge, inadequate reimbursement, and low physician confidence.Conclusions. This survey suggests that multiple barriers exist that prevent the primary care practitioner from providing dietary counseling. A multifaceted approach will be needed to change physician counseling behavior. (C) 1995 Academic Press, Inc.