Wiesemann Armin, Ludt Sabine, Szecsenyi Joachim, Scheuermann Wolfgang, Scheidt Reginald
Department of General Practice and Health Services Research, University of Heidelberg, Heidelberg, Im Neuenheimer Feld 347, Heidelberg D-69120, Germany.
Patient Educ Couns. 2004 Oct;55(1):40-7. doi: 10.1016/j.pec.2003.07.002.
This paper explores the motivation of patients towards a healthy life-style in a small community with a special general practice and community-based health education program in order to identify reasons for different motivations and barriers and to improve preventive measures and outcome. The last of six standardised health surveys carried out over 9 years in the five general practices was therefore combined with a questionnaire to explore the attitudes of a sample of patients from these practices (N = 1044) and all attendees of 11 health education courses (N = 153). In addition to the cardiovascular risk factors, data were collected on sociodemographic factors and motivations for health promotion. The results show that, over time, the risk factors of hypertension (P < 0.001) and smoking (P < 0.005) had decreased. Health-promoting activities were not associated with cardiovascular risk factors; the motivations "duty" and "staying young" correlated with gender (P < 0.05). Patients with good health and white collar professions were more active. About 20% specified specific barriers to health-related activities. As expected, the participants of an educational program were more highly motivated by "fun", "fitness" and "meaningfulness". This group was mainly female. Future preventive measures should take into account that motivation for health promotion depends more on psychosocial factors than on risk factors; frequent obstacles should be noticed in the community.
本文探讨了在一个小型社区中,患者对健康生活方式的动机,该社区设有特殊的全科医疗和社区健康教育项目,目的是确定不同动机和障碍的原因,并改进预防措施和结果。因此,将在9年时间里在5家全科诊所进行的6次标准化健康调查中的最后一次,与一份问卷相结合,以探究这些诊所的部分患者样本(N = 1044)以及11次健康教育课程的所有参与者(N = 153)的态度。除了心血管危险因素外,还收集了社会人口学因素和健康促进动机的数据。结果显示,随着时间的推移,高血压(P < 0.001)和吸烟(P < 0.005)的危险因素有所下降。健康促进活动与心血管危险因素无关;“责任”和“保持年轻”的动机与性别相关(P < 0.05)。健康状况良好且从事白领职业的患者更为积极。约20%的人指出了与健康相关活动的具体障碍。正如预期的那样,教育项目的参与者更容易受到“乐趣”、“健身”和“有意义”的激励。这一群体主要为女性。未来的预防措施应考虑到,健康促进的动机更多地取决于社会心理因素而非危险因素;应关注社区中常见的障碍。