Cancer Prevention, Detection and Control Research Program, Duke University Medical Center, Durham, NC 27705, USA.
Fam Pract. 2012 Oct;29(5):553-60. doi: 10.1093/fampra/cms004. Epub 2012 Feb 7.
Physician counselling may help patients increase physical activity, improve nutrition and lose weight. However, physicians have low outcome expectations that patients will change. The aims are to describe the accuracy of physicians' outcome expectations about whether patients will follow weight loss, nutrition and physical activity recommendations. The relationships between physician outcome expectations and patient motivation and confidence also are assessed.
This was an observational study that audio recorded encounters between 40 primary care physicians and 461 of their overweight or obese patients. We surveyed physicians to assess outcome expectations that patients will lose weight, improve nutrition and increase physical activity after counselling. We assessed actual patient change in behaviours from baseline to 3 months after the encounter and changes in motivation and confidence from baseline to immediately post-encounter.
Right after the visit, ~55% of the time physicians were optimistic that their individual patients would improve. Physicians were not very accurate about which patients actually would improve weight, nutrition and physical activity. More patients had higher confidence to lose weight when physicians thought that patients would be likely to follow their weight loss recommendations.
Physicians are moderately optimistic that patients will follow their weight loss, nutrition and physical activity recommendations. Patients might perceive physicians' confidence in them and thus feel more confident themselves. Physicians, however, are not very accurate in predicting which patients will or will not change behaviours. Their optimism, although helpful for patient confidence, might make physicians less receptive to learning effective counselling techniques.
医生的咨询可以帮助患者增加身体活动、改善营养状况和减轻体重。然而，医生对患者改变的预期结果较低。本研究旨在描述医生对患者是否遵循减肥、营养和身体活动建议的预期结果的准确性。还评估了医生的预期结果与患者的动机和信心之间的关系。
这是一项观察性研究，对 40 名初级保健医生和 461 名超重或肥胖患者的医患互动进行了音频记录。我们调查了医生，以评估他们对患者在咨询后减肥、改善营养和增加身体活动的预期结果。我们评估了患者在接触后 3 个月内行为的实际变化以及从基线到接触后即刻的动机和信心的变化。
在就诊后不久，约 55%的时间里，医生对个别患者的改善持乐观态度。医生对哪些患者实际上会改善体重、营养和身体活动的预期结果并不十分准确。当医生认为患者可能会遵循他们的减肥建议时，更多的患者对减肥更有信心。
医生对患者遵循减肥、营养和身体活动建议的可能性持适度乐观态度。患者可能会感知到医生对他们的信心，从而增强自己的信心。然而，医生在预测哪些患者会或不会改变行为方面并不十分准确。尽管他们的乐观态度对患者的信心有帮助，但可能会使医生对学习有效的咨询技巧不太感兴趣。
