Johansson Kjell, Bendtsen Preben, Akerlind Ingemar
Department of Health and Society, Linköping University, Linköping, Sweden.
Eur J Public Health. 2005 Dec;15(6):615-20. doi: 10.1093/eurpub/cki046. Epub 2005 Aug 10.
Lifestyle advice given by general practitioners (GPs) may be a cost-effective means of health promotion; however, it is not fully put into routine practice. The aim of this study was to explore to what extent GPs' patients expect and receive advice concerning alcohol, tobacco, exercise and diet in relation to sociodemographic characteristics, type of visit and patient satisfaction.
A postal questionnaire was sent to a representative sample (n = 9750) of patients who had consulted GPs in a county in Sweden. The response rate was 69% (n = 6734).
Exercise was the most (16%) and alcohol the least (5%) common type of advice. The patients received advice more often than they expected in all areas except alcohol. The patients reported the highest rate of unfulfilled advice expectation and the lowest rate of unexpected advice in the case of alcohol. Male gender, poorer self-rated health and scheduled appointment were independent predictors of all types of advice. Continuity of GP contact was only favourable for exercise and diet advice. The patients who received advice were more satisfied with their visit to the doctor.
A tertiary preventive perspective guides GPs' practice of giving advice. Male patients with advanced illnesses are given priority. Women and patients with long-term risk habits are more neglected. The GPs tend to misjudge the expectations and needs of their patients and are too restrained in their counselling practice. Alcohol is the most disregarded area of advice in proportion to the patients' expectations and needs.
全科医生（GP）提供的生活方式建议可能是一种具有成本效益的健康促进手段；然而，它并未完全纳入常规实践。本研究的目的是探讨全科医生的患者在多大程度上期望并接受关于酒精、烟草、运动和饮食的建议，以及这些建议与社会人口学特征、就诊类型和患者满意度之间的关系。
向瑞典一个县咨询过全科医生的患者代表性样本（n = 9750）发送了邮政问卷。回复率为69%（n = 6734）。
运动是最常见的建议类型（16%），酒精是最不常见的（5%）。除酒精外，患者在所有领域接受建议的频率都高于他们的期望。患者报告在酒精方面未实现的建议期望率最高，意外建议率最低。男性、自我健康评分较差和预约就诊是所有类型建议的独立预测因素。全科医生联系的连续性仅有利于运动和饮食建议。接受建议的患者对就诊更满意。
三级预防视角指导全科医生的建议实践。患有晚期疾病的男性患者被给予优先考虑。女性和有长期风险习惯的患者更被忽视。全科医生往往误判患者的期望和需求，并且在咨询实践中过于保守。与患者的期望和需求相比，酒精是最被忽视的建议领域。
