NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Patient Educ Couns. 2012 Nov;89(2):227-44. doi: 10.1016/j.pec.2012.07.006. Epub 2012 Aug 9.
To systematically review the literature on the relative effectiveness of face-to-face communication-related behavior change techniques (BCTs) provided in primary care by either physicians or nurses to intervene on patients' lifestyle behavior.
PubMed, EMBASE, PsychINFO, CINAHL and The Cochrane Library were searched for studies published before October 2010. Fifty studies were included and assessed on methodological quality.
Twenty-eight studies reported significantly favorable health outcomes following communication-related BCTs. In these studies, 'behavioral counseling' was most frequently used (15 times), followed by motivational interviewing (eight times), education and advice (both seven times). Physicians and nurses seem equally capable of providing face-to-face communication-related BCTs in primary care.
Behavioral counseling, motivational interviewing, education and advice all seem effective communication-related BCTs. However, BCTs were also found in less successful studies. Furthermore, based on existing literature, one primary care profession does not seem better equipped than the other to provide face-to-face communication-related BCTs.
There is evidence that behavioral counseling, motivational interviewing, education and advice can be used as effective communication-related BCTs by physicians and nurses. However, further research is needed to examine the underlying working mechanisms of communication-related BCTs, and whether they meet the requirements of patients and primary care providers.
系统评价初级保健中医师或护士对患者生活方式行为进行干预时,面对面交流相关行为改变技术(BCT)的相对有效性的文献。
检索了 PubMed、EMBASE、PsychINFO、CINAHL 和 The Cochrane Library 中截至 2010 年 10 月前发表的研究。纳入了 50 项研究,并对其方法学质量进行了评估。
28 项研究报告了在接受交流相关 BCT 后出现显著有利的健康结果。在这些研究中,“行为咨询”使用最频繁(15 次),其次是动机性访谈(8 次)、教育和建议(均为 7 次)。医师和护士似乎都有能力在初级保健中提供面对面交流相关的 BCT。
行为咨询、动机性访谈、教育和建议似乎都是有效的交流相关 BCT。然而,在不太成功的研究中也发现了 BCT。此外,基于现有文献,一种初级保健专业人员似乎并不比另一种更有能力提供面对面交流相关的 BCT。
有证据表明,行为咨询、动机性访谈、教育和建议可以被医师和护士用作有效的交流相关 BCT。然而,需要进一步研究来检验交流相关 BCT 的潜在作用机制,以及它们是否符合患者和初级保健提供者的要求。