Amar S, Tiben N, Karkabi K, Hermoni D
Dept. of Family Medicine, Faculty of Medicine, Technion, Haifa.
Harefuah. 2001 Aug;140(8):689-93, 808, 807.
Previous data on the importance of promoting cessation of smoking, physical activity and a healthy diet exists in the literature. However, there is insufficient evidence that counseling healthy patients to change their life-styles will indeed have a positive effect on their behavior. In this study we examined whether a single doctor-patient appointment dedicated to preventive medicine can have a positive effect on cessation of smoking, promoting physical activity and weight control.
Eighty-eight patients from the "French Carmel" Clinic, aged 25-50, were summoned to a doctor-patient appointment lasting 20 minutes. The patients filled out a questionnaire and their weight and height were measured. The doctor counseled the patients to cease smoking, increase their physical activity and lose weight. The counseling was patient-oriented. Six to twelve months later the patients were interviewed by telephone and data was collected. The data was processed on a windows-based SPSS program.
Of the 25 smoking patients, 2 (8%) stopped smoking, another 5 (20%) reduced their cigarette smoking. None of the non-smokers began smoking during the study, and there was no increase in the number of cigarettes smoked among the smokers. There was an increase in the number of patients who engaged in physical activity on a regular basis after the intervention: 56.1% as compared to 42.7% prior to the consultation. This increase was found to be statistically significant (p < 0.001). Among overweight (BMI 25-26.9) and obese (BMI > 27) patients there was a decrease in BMI following the intervention which was found to be statistically significant (p < 0.01). Among patients with normal weight (BMI 20-24.9) and underweight (BMI < 20) there was a decrease in BMI which was not statistically significant.
In an era when economic considerations challenge the everyday work of the physician, we have showed in our study that a 20-minute doctor-patient appointment could influence the patient's life-style and thus promote healthy living.
文献中已有关于促进戒烟、体育锻炼和健康饮食重要性的先前数据。然而，尚无充分证据表明建议健康患者改变生活方式确实会对其行为产生积极影响。在本研究中，我们调查了一次专门用于预防医学的医患预约是否会对戒烟、促进体育锻炼和体重控制产生积极影响。
来自“法国卡梅尔”诊所的88名年龄在25至50岁之间的患者被召集参加一次持续20分钟的医患预约。患者填写了一份问卷，并测量了体重和身高。医生建议患者戒烟、增加体育锻炼并减肥。咨询是以患者为导向的。六至十二个月后，通过电话对患者进行访谈并收集数据。数据在基于Windows的SPSS程序上进行处理。
在25名吸烟患者中，2人（8%）戒烟，另外5人（20%）减少了吸烟量。在研究期间，没有非吸烟者开始吸烟，吸烟者的吸烟量也没有增加。干预后，定期进行体育锻炼的患者数量有所增加：从咨询前的42.7%增加到56.1%。这一增加具有统计学意义（p < 0.001）。在超重（BMI 25 - 26.9）和肥胖（BMI > 27）患者中，干预后BMI有所下降，具有统计学意义（p < 0.01）。在体重正常（BMI 20 - 24.9）和体重过轻（BMI < 20）的患者中，BMI有所下降，但无统计学意义。
在一个经济因素对医生日常工作构成挑战的时代，我们在研究中表明，一次20分钟的医患预约可以影响患者的生活方式，从而促进健康生活。
