Burke Lora E, Fair Joan
University of Pittsburgh, Pa 15261, USA.
J Cardiovasc Nurs. 2003 Sep-Oct;18(4):256-66. doi: 10.1097/00005082-200309000-00004.
Preventive therapies have been shown to reduce morbidity and mortality from cardiovascular disease. However, health care providers are not addressing prevention and not treating patients according to evidence-based guidelines. Reasons frequently cited for not delivering health promotion/disease prevention oriented care is lack of training or skills to provide counseling, and a lack of confidence in health care provider skills. This article outlines the skills and attributes considered essential for a health care provider to promote behavioral change and risk reduction. The skills and attributes of the health care provider, such as expertise and knowledge, skills for assessing readiness for behavior change, relationship building skills, and skill in considering the patient's attitudes and beliefs about the disease or treatment are discussed. Principles of communication to guide the patient-provider encounter, key behavioral change strategies, and use of technology are reviewed and resources available to support prevention goals are presented.
预防性治疗已被证明可降低心血管疾病的发病率和死亡率。然而,医疗保健提供者并未重视预防工作,也未按照循证指南对患者进行治疗。经常被提及的未提供以健康促进/疾病预防为导向的护理的原因包括缺乏提供咨询的培训或技能,以及对医疗保健提供者技能缺乏信心。本文概述了医疗保健提供者为促进行为改变和降低风险所必需的技能和特质。讨论了医疗保健提供者的技能和特质,如专业知识、评估行为改变准备情况的技能、建立关系的技能以及考虑患者对疾病或治疗的态度和信念的技能。回顾了指导医患交流的沟通原则、关键行为改变策略以及技术的使用,并介绍了支持预防目标的可用资源。