McKenna J, Vernon M
Department of Exercise and Health Sciences, University of Bristol, Tyndall Avenue, Bristol BS8 1TP, UK.
Patient Educ Couns. 2004 Jul;54(1):101-6. doi: 10.1016/S0738-3991(03)00192-7.
We investigated how General Practitioners (GPs) promote lifestyle physical activity (PA) ('accumulate 30 min of at least moderate PA on 5 or more days per week': PA30 x 5) to patients in the different stages of change, using a range of counselling strategies. These strategies included six 'A' factors (Ask, Assess, Advise, Assure, Arrange a follow-up, and Applaud). In a postal questionnaire (68% return rate), 47% of GPs from a single UK health district reported regularly promoting PA30 x 5. A stepwise logistic regression identified three counselling strategies that predicted regularly promoting PA30 x 5: (1) arrange follow-ups for patient pre-contemplators (OR=4.93), (2) patient contemplators passed to GP exercise referral scheme (OR=2.34), and (3) asking relapsers about their PA30 x 5 (OR=2.61). GPs who regularly promote PA30 x 5 base their counselling on patients' pre-existing PA behaviour, using 'effortful', 'stage-matched' approaches. Since these are acceptable to GPs, in-service training may build on using these three factors.
我们调查了全科医生(GPs)如何运用一系列咨询策略,向处于不同改变阶段的患者推广生活方式体力活动(PA)(“每周5天或更多天数累积至少30分钟的中等强度PA”:PA30 x 5)。这些策略包括六个“A”因素(询问、评估、建议、保证、安排随访和赞扬)。在一份邮寄问卷(回复率为68%)中,来自英国一个卫生区的47%的全科医生报告称他们经常推广PA30 x 5。逐步逻辑回归确定了三种预测经常推广PA30 x 5的咨询策略:(1)为处于未考虑阶段的患者安排随访(比值比=4.93),(2)将处于考虑阶段的患者转至全科医生运动转诊计划(比值比=2.34),以及(3)询问复发者关于他们的PA30 x 5情况(比值比=2.61)。经常推广PA30 x 5的全科医生基于患者先前的PA行为,采用“费力的”、“阶段匹配的”方法进行咨询。由于这些方法为全科医生所接受,在职培训可以基于使用这三个因素来开展。