家庭医生对新西兰绿色处方计划中身体活动咨询的看法和经验。
General practitioners' views and experiences of counselling for physical activity through the New Zealand Green Prescription program.
机构信息
Centre for Physical Activity and Nutrition Research, Auckland University of Technology, Auckland, New Zealand.
出版信息
BMC Fam Pract. 2011 Nov 2;12:119. doi: 10.1186/1471-2296-12-119.
BACKGROUND
Regular physical activity is beneficial in both the prevention and management of chronic health conditions. A large proportion of adult New Zealanders, however, are insufficiently active. To help increase population levels of physical activity in New Zealand the Green Prescription, a primary care physical activity scripting program, was developed. The primary aim of this study was to identify why general practitioners (GPs) counsel for physical activity and administer Green Prescriptions. A secondary aim was to examine GPs' views and experiences of Green Prescription counselling for the management of depression.
METHODS
Individual face-to-face interviews were conducted with 15 GPs. All interviews were audio-taped and transcribed. Data were analysed using an inductive thematic approach.
RESULTS
Several themes and sub-themes emerged from the data. Notably, GPs counselled for physical activity and prescribed Green Prescriptions for both primary preventive (e.g., weight control) and secondary management (e.g., diabetes management) purposes. GPs reported the benefits of the Green Prescription centred around two main themes: (i) a non-medication approach to a healthier lifestyle and (ii) the support benefits of physical activity. Time constraints within the consultation was the only main theme that emerged regarding the barriers GPs perceived to Green Prescription use. Physical activity in general, and physical activity prescribed through the Green Prescription, were also viewed by GPs as beneficial for the management of depression.
CONCLUSIONS
The results of this study suggest that New Zealand GPs view the Green Prescription program as beneficial for their patients with pre-existing conditions and/or weight problems. While this is encouraging, the Green Prescription may also be used to promote physical activity in currently healthy but low-active and sedentary individuals. Such individuals are currently disease free, but are at risk for future health-related problems because of their inactive lifestyle. It is recommended that time constraints of the consultation in regard to administering Green Prescriptions could be dealt with by delegating the more time consuming tasks to the patient support counsellors that support the Green Prescription program, and having practice nurses assist in the administration of Green Prescriptions. Green Prescription counselling in conjunction with antidepressant medication may be beneficial for the management of depression and warrants further research.
背景
定期进行身体活动有益于预防和管理慢性健康问题。然而，新西兰有很大一部分成年人活动量不足。为了帮助提高新西兰的人口身体活动水平，开发了一种初级保健身体活动脚本程序，即绿色处方。这项研究的主要目的是确定全科医生（GP）为何进行身体活动咨询并开具绿色处方。次要目的是检查 GP 对绿色处方咨询管理抑郁症的看法和经验。
方法
对 15 名 GP 进行了单独的面对面访谈。所有访谈均进行了录音和转录。使用归纳主题方法分析数据。
结果
数据中出现了几个主题和子主题。值得注意的是，GP 进行身体活动咨询并开具绿色处方，既用于初级预防（例如，体重控制），也用于二级管理（例如，糖尿病管理）。GP 报告称，绿色处方的好处主要集中在两个主题上：（i）一种非药物的健康生活方式方法和（ii）身体活动的支持益处。时间限制是 GP 认为使用绿色处方的唯一主要障碍。GP 还认为，一般的身体活动，以及通过绿色处方规定的身体活动，对管理抑郁症也有益处。
结论
这项研究的结果表明，新西兰的 GP 认为绿色处方计划对有既往疾病和/或体重问题的患者有益。虽然这是令人鼓舞的，但绿色处方也可用于促进目前健康但活动量低和久坐不动的个体进行身体活动。这些人目前没有疾病，但由于他们的不活跃生活方式，他们有未来健康相关问题的风险。建议可以将咨询中与管理绿色处方相关的时间限制问题委托给支持绿色处方计划的患者支持顾问来处理，并且让执业护士协助管理绿色处方，以解决时间限制问题。绿色处方咨询与抗抑郁药物联合使用可能对管理抑郁症有益，值得进一步研究。
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