Corsino Leonor, Svetkey Laura P, Ayotte Brian J, Bosworth Hayden B
Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University Medical Center, USA.
N C Med J. 2009 Sep-Oct;70(5):391-8.
Lifestyle behaviors such as reducing weight if overweight or obese, reducing salt intake, exercising, reducing alcohol intake, quitting smoking, and eating a healthy diet are related to the prevention and control of chronic diseases. However the amount of lifestyle advice provided by clinicians has been declining over the last decade.
In 2002, a telephone survey was conducted to assess the quality of preventive care offered by health care providers. The study was a cross-sectional observational study of a randomly selected sample of 516 diverse individuals in Durham County, North Carolina. Information regarding age, sex, race, education, health conditions, and self-reported receipt of lifestyle advice was examined in the study.
The odds of receiving advice to engage in preventive lifestyle behaviors were significantly higher for those with a pre-existing diagnosis of diabetes or hypertension and for participants reporting poor health status. For example, the odds of receiving advice to control or lose weight was 8.32 (95% CI, 2.65, 26.75) among individuals reporting a diagnosis of diabetes. Similarly, the odds of reporting "receiving advice to reduce salt intake" was 6.97 (95% CI, 3.74, 13.00) among subjects reporting a diagnosis of hypertension.
The results are from a cross-sectional study of a sample of individuals in only one county. Additionally, the results are based on patient self-reported information, which could be subject to recall and social desirability bias.
Patients with identified health problems were more likely than others to report being advised to adopt healthy lifestyle recommendations. Future research should examine methods to encourage health care providers to offer lifestyle advice to those without pre-existing illness.
诸如超重或肥胖者减重、减少盐摄入量、锻炼、减少酒精摄入量、戒烟以及健康饮食等生活方式行为与慢性病的预防和控制相关。然而,在过去十年中,临床医生提供的生活方式建议数量一直在下降。
2002年,进行了一项电话调查以评估医疗服务提供者提供的预防保健质量。该研究是对北卡罗来纳州达勒姆县随机抽取的516名不同个体的横断面观察性研究。研究中考察了有关年龄、性别、种族、教育程度、健康状况以及自我报告的生活方式建议接受情况的信息。
对于已确诊患有糖尿病或高血压的患者以及报告健康状况较差的参与者,接受预防性生活方式行为建议的几率显著更高。例如,在报告患有糖尿病的个体中,接受控制体重或减重建议的几率为8.32(95%置信区间,2.65,26.75)。同样,在报告患有高血压的受试者中,报告“接受减少盐摄入量建议”的几率为6.97(95%置信区间,3.74,13.00)。
结果来自仅一个县的个体样本的横断面研究。此外,结果基于患者自我报告的信息,这可能存在回忆偏差和社会期望偏差。
已确诊健康问题的患者比其他人更有可能报告被建议采纳健康的生活方式建议。未来的研究应探讨鼓励医疗服务提供者向未患现有疾病的人提供生活方式建议的方法。