Spencer Elsa H, Frank Erica, Elon Lisa K, Hertzberg Vicki S, Serdula Mary K, Galuska Deborah A
School of Medicine and the School of Public Health, Biostatistics, Emory University, Atlanta, GA, USA.
Am J Clin Nutr. 2006 Sep;84(3):655-62. doi: 10.1093/ajcn/84.3.655.
Nutrition counseling by physicians can improve patients' dietary behaviors and is affected by physicians' nutrition practices and attitudes, such as the perceived relevance of nutrition counseling.
The objective was to provide data on medical students' perceived relevance of nutrition counseling, reported frequency of nutrition counseling, and frequency of fruit and vegetable intakes.
Students (n = 2316) at 16 US medical schools were surveyed and tracked at freshmen orientation, at the time of orientation to wards, and in their senior year.
Freshmen students were more likely (72%) to find nutrition counseling highly relevant than were students at the time of ward orientation (61%) or during their senior year (46%; P for trend = 0.0003). Those intending to subspecialize had lower and declining perceptions of counseling relevance (P for trend = 0.0009), whereas the perceived relevance of counseling by primary care specialists remained high (P for trend = 0.5). Students were significantly more likely to find nutrition counseling highly relevant if they were female, consumed more fruit and vegetables, believed in primary prevention, had personal physicians who encouraged disease prevention, or intended to specialize in primary care. Only 19% of students believed that they had been extensively trained in nutrition counseling, and 17% of seniors reported that they frequently counseled their patients about nutrition. Students who consumed more fruit and vegetables, believed that they would be more credible if they ate a healthy diet, were not Asian or white, or intended to specialize in primary care counseled patients about nutrition more frequently. Medical students consumed an average of 3.0 fruit and vegetable servings/d, which declined over time.
The perceived relevance of nutrition counseling by US medical students declined throughout medical school, and students infrequently counseled their patients about nutrition. Interventions may be warranted to improve the professional nutritional practices of medical students.
医生提供的营养咨询可改善患者的饮食行为，且受医生的营养实践和态度影响，如对营养咨询相关性的认知。
旨在提供关于医学生对营养咨询相关性的认知、报告的营养咨询频率以及水果和蔬菜摄入量频率的数据。
对美国16所医学院校的2316名学生在新生入学迎新时、进入病房实习时以及大四时进行了调查和跟踪。
新生比病房实习时（61%）或大四时（46%）的学生更有可能（72%）认为营养咨询高度相关（趋势P值 = 0.0003）。打算从事专科的学生对咨询相关性的认知较低且呈下降趋势（趋势P值 = 0.0009），而初级保健专科医生对咨询相关性的认知仍较高（趋势P值 = 0.5）。如果学生为女性、水果和蔬菜摄入量更多、相信一级预防、有鼓励疾病预防的私人医生或打算从事初级保健专科，他们更有可能认为营养咨询高度相关。只有19%的学生认为他们接受过广泛的营养咨询培训，17%的大四学生报告称他们经常就营养问题向患者提供咨询。水果和蔬菜摄入量更多、认为健康饮食会使自己更有可信度、非亚裔或白人或打算从事初级保健专科的学生更频繁地就营养问题向患者提供咨询。医学生平均每天食用3.0份水果和蔬菜，且随着时间推移呈下降趋势。
美国医学生对营养咨询相关性的认知在整个医学院学习期间呈下降趋势，且学生很少就营养问题向患者提供咨询。可能需要采取干预措施来改善医学生的专业营养实践。
