Blackburn David G
Centers for Nutritional Research Charitable Trust, Wellesley Hills, Massachusetts, USA.
Nutr Clin Care. 2002 May-Jun;5(3):95-102. doi: 10.1046/j.1523-5408.2002.t01-1-00003.x.
This article examines the role of the primary care physician in providing physical activity counseling and proposes a framework for maximizing the effectiveness of this activity. Many studies have been conducted to evaluate the effectiveness of physical activity counseling in the primary care setting. Unfortunately, the results of most of these studies have not been encouraging as there has not been compelling evidence that brief physical activity counseling for the general population results in long-term changes in physical activity behaviors. In contrast, the evidence of health improvements in patients who are successful in achieving levels of physical activity consistent with the Surgeon General's recommendations is compelling and should serve as the source of motivation as we seek more effective paradigms for physical activity counseling. The PACE (Patient-Centered Assessment and Counseling for Exercise and Nutrition) Program is presented as an evidenced-based and effective framework for effective physical activity counseling. By adopting a patient-centered approach to counseling and by tailoring the message to the readiness of the patient to take action, it is possible to engage in physical activity counseling in a cost- and time-effective manner. This article provides specific counseling strategies for addressing patients at various stages of readiness to engage in behavior change regarding physical activity.
本文探讨了初级保健医生在提供体育活动咨询方面的作用，并提出了一个框架，以最大限度地提高这项活动的有效性。已经进行了许多研究来评估在初级保健环境中体育活动咨询的有效性。不幸的是，这些研究中的大多数结果并不令人鼓舞，因为没有令人信服的证据表明针对普通人群的简短体育活动咨询会导致体育活动行为的长期改变。相比之下，成功达到与美国卫生局局长建议相符的体育活动水平的患者健康改善的证据是令人信服的，并且在我们寻求更有效的体育活动咨询范例时应作为动力来源。PACE（以患者为中心的运动与营养评估和咨询）计划被作为一种基于证据且有效的体育活动咨询框架呈现出来。通过采用以患者为中心的咨询方法，并根据患者采取行动的准备程度调整信息，可以以具有成本效益和时间效益的方式进行体育活动咨询。本文提供了具体的咨询策略，以应对患者在准备进行体育活动行为改变的各个阶段的情况。
