Petrella Robert J, Lattanzio Chastity N, Overend Tom J
Canadian Centre for Activity and Aging, Department of Family Medicine, Schulich School of Medicine, University of Western Ontario, 801 Commissioners Rd, Room 3002, London, ON N6G 2M3, Canada.
Arch Intern Med. 2007 Sep 10;167(16):1774-81. doi: 10.1001/archinte.167.16.1774.
Primary care physicians are ideally positioned to affect a large population at risk for epidemics of sedentary lifestyle; however, it is unclear what type of counseling they provide.
A questionnaire was used to obtain information on primary care physicians' behaviors with respect to counseling and prescribing physical activity, physician demographics, and practice characteristics. Registered primary care physicians in Canada were contacted in all 10 provinces and 2 territories.
Of 27 980 primary care physicians, 14 319 returned usable questionnaires and 13 166 were eligible for study participation (response rate, 51.2%). Respondents were predominantly male (61.1%), practiced in private office/clinic settings (73.4%), and had graduated from medical school more than 22 years earlier. Eighty-five percent of respondents reported asking patients about their physical activity levels, whereas only 26.2% assessed patient fitness as part of a physical examination or through a fitness test and only 10.9% referred patients to others for fitness assessment or appraisal. Most physicians (69.8%) reported using verbal counseling to promote physical activity, whereas only 15.8% used written prescriptions for a physical activity promotion program. Male and female physicians responded differently. Men more frequently assessed fitness than did women, whereas women more frequently asked and provided verbal and written directions.
This large sample of Canadian primary care physicians regularly asked patients about physical activity levels and advised them using verbal counseling. Few respondents provided written prescriptions, performed fitness assessments, or referred patients. These results suggest possible opportunities to improve physicians' counseling and prescription efforts.
基层医疗医生在影响大量面临久坐生活方式流行风险的人群方面具有理想的地位；然而，他们提供何种类型的咨询尚不清楚。
使用问卷调查来获取有关基层医疗医生在咨询和开具体育活动处方方面的行为、医生人口统计学特征和执业特点的信息。联系了加拿大所有10个省和2个地区的注册基层医疗医生。
在27980名基层医疗医生中，14319人返回了可用问卷，13166人符合研究参与条件（回复率为51.2%）。受访者主要为男性（61.1%），在私人办公室/诊所执业（73.4%），且毕业于医学院超过22年。85%的受访者报告会询问患者的体育活动水平，而只有26.2%的人将评估患者健康状况作为体格检查的一部分或通过健康测试进行评估，只有10.9%的人将患者转介给其他人进行健康评估。大多数医生（69.8%）报告使用口头咨询来促进体育活动，而只有15.8%的人使用书面处方来推行体育活动促进计划。男性和女性医生的反应有所不同。男性比女性更频繁地评估健康状况，而女性更频繁地询问并提供口头和书面指导。
这一样本量较大的加拿大基层医疗医生经常询问患者的体育活动水平，并通过口头咨询为他们提供建议。很少有受访者提供书面处方、进行健康评估或转介患者。这些结果表明在改善医生的咨询和处方工作方面可能存在机会。
