Speechly Catherine, Bridges-Webb Charles, McKenzie Suzanne, Zurynski Yvonne, Lucas Alison
Projects, Research and Development Unit, RACGP NSW and ACT Faculty, 12 Mount Street, North Sydney, NSW 2060, Australia.
Aust J Prim Health. 2010;16(2):154-8. doi: 10.1071/py09011.
Patients with coronary heart disease often engage in unhealthy lifestyle behaviours. We explored patients' and general practitioners' (GPs') perceptions about the effectiveness of healthy behaviours and medications for the prevention of further cardiovascular disease. This exploratory study used semi-structured interviews with eight Sydney GPs and 13 of their patients with coronary heart disease. Patients perceived medications to be more effective than healthy behaviours in improving specific aspects of cardiovascular health, such as angina symptoms, cholesterol and blood pressure, whilst GPs perceived that medications were more effective in patients they considered at highest cardiovascular risk, patients with uncontrolled risk factors, or where adherence to healthy behaviours was poor. Among patients we found a negative perception of the effort required to adhere to healthy behaviours and possible underestimation of their future cardiovascular risk. Patients valued support from peers and family. This study opens up avenues for investigation in further research, including whether patient adherence to healthy behaviours may be enhanced by the exploration oftheir perceptions about behaviour effectiveness, barriers and cardiovascular risk and by GP facilitation of practical supports.
冠心病患者常常有不健康的生活方式行为。我们探讨了患者和全科医生（GP）对于健康行为及药物预防进一步心血管疾病有效性的看法。这项探索性研究采用了对8名悉尼全科医生及其13名冠心病患者进行半结构化访谈的方法。患者认为在改善心血管健康的特定方面，如心绞痛症状、胆固醇和血压方面，药物比健康行为更有效，而全科医生认为在他们认为心血管风险最高的患者、危险因素未得到控制的患者或健康行为依从性差的患者中，药物更有效。在患者中，我们发现他们对坚持健康行为所需的努力持负面看法，并且可能低估了他们未来的心血管风险。患者重视来自同伴和家人的支持。这项研究为进一步研究开辟了调查途径，包括探索患者对行为有效性、障碍和心血管风险的看法以及全科医生提供实际支持是否可以提高患者对健康行为的依从性。
