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全科医生对超重患者营养教育与治疗的任务认知、自我效能、障碍及实践的纵向变化

Longitudinal changes in GPs' task perceptions, self-efficacy, barriers and practices of nutrition education and treatment of overweight.

作者信息

Visser Femke, Hiddink Gerrit, Koelen Maria, van Binsbergen Jaap, Tobi Hilde, van Woerkum Cees

机构信息

Netherlands Institute for Sport and Physical Activity, Bennekom.

出版信息

Fam Pract. 2008 Dec;25 Suppl 1:i105-11. doi: 10.1093/fampra/cmn078.

Abstract

BACKGROUND

GPs play a role in prevention by giving nutrition education and advice on overweight. Over the years, GP's tasks and working environment changed.

OBJECTIVE

To know how task perceptions, perceptions of own ability and perceived barriers regarding nutrition education and treatment of overweight of Dutch GPs have developed from 1992 to 2007.

METHODS

In all, 488 GPs, first included in study in 1992, were asked in 2007 to return the Wageningen PCPs Nutritional Practices Questionnaire. Crohnbach's alphas and sum scores were calculated and differences between 1992 and 2007 were investigated using a paired t-test.

RESULTS

In all, 247 GPs responded (51%). 'Noticing patients overweight and guidance of treatment' did not change in GPs from 1992 to 2007. The task perception about health education and prevention did not change and the perception of daily activities shifted from the curative to the preventive side. Interest in the influence of nutrition on health increased in 2007. GPs less often managed to counsel on nutrition in daily practice. Their perceived capacity to counsel and their self-efficacy regarding overweight management declined over the years. In 2007, more GPs perceived the barriers 'lack of time' to treat overweight and to give nutrition education. The most important barrier in 2007 was lack of patient motivation.

CONCLUSIONS

The GPs perceived overweight and nutrition education as important and were still favourable towards prevention. However, their potential to give nutrition education or guide in treatment of overweight was not fully utilized because of decreased self-efficacy factors and perceived barriers.

摘要

背景

全科医生通过提供营养教育和关于超重问题的建议来发挥预防作用。多年来,全科医生的任务和工作环境发生了变化。

目的

了解1992年至2007年期间,荷兰全科医生在营养教育和超重治疗方面的任务认知、自我能力认知以及感知到的障碍是如何发展的。

方法

共有488名全科医生于1992年首次纳入研究,2007年被要求返还瓦赫宁根初级保健医生营养实践调查问卷。计算克朗巴赫系数和总分,并使用配对t检验研究1992年和2007年之间的差异。

结果

共有247名全科医生做出回应(51%)。从1992年到2007年,全科医生“注意到患者超重并指导治疗”的情况没有变化。关于健康教育和预防的任务认知没有改变,日常活动的认知从治疗转向了预防。2007年,对营养对健康影响的兴趣增加。全科医生在日常实践中就营养问题提供咨询的情况减少。多年来,他们认为自己提供咨询的能力以及在超重管理方面的自我效能有所下降。2007年,更多的全科医生认为“缺乏时间”是治疗超重和提供营养教育的障碍。2007年最重要的障碍是患者缺乏动力。

结论

全科医生认为超重和营养教育很重要,并且仍然支持预防。然而,由于自我效能因素下降和感知到的障碍,他们提供营养教育或指导超重治疗的潜力没有得到充分利用。

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