Blekinge Centre of Competence, SE-371 81, Karlskrona, Sweden.
BMC Fam Pract. 2013 Aug 29;14:128. doi: 10.1186/1471-2296-14-128.
Physical activity on prescription (PAP) is a successful intervention for increasing physical activity among patients with a sedentary lifestyle. The method seems to be sparsely used by general practitioners (GPs) and there is limited information about GPs' attitudes to counselling using PAP as a tool. The aim of the study was to explore and understand the meaning of prescribing physical activity from the general practitioner's perspective.
Three focus group interviews were conducted with a purposive sample of 15 Swedish GPs in the south of Sweden. Participants were invited to talk about their experience of using PAP. The interviews were transcribed verbatim, analysed using qualitative content analysis.
The analysis resulted in four categories: The tradition makes it hard to change attitude, Shared responsibility is necessary, PAP has low status and is regarded with distrust and Lack of procedures and clear guidelines. Traditionally GPs talk with patients about the importance of an increased level of physical activity but they do not prescribe physical activity as a treatment. Physician's education focuses on the use of pharmaceuticals. The responsibility for patients' physical activity level is shared with other health professionals, the patient and society. The GPs express reservations about prescribing physical activity. A heavy workload is a source of frustration. PAP is regarded with distrust and considered to be a task of less value and status. Using a prescription to emphasize an increased level is considered to be redundant and the GPs think it should be administered by someone else in the health care system. Scepticism about the result of the method was also expressed.
There is uncertainty about using PAP as a treatment since physicians lack education in non-pharmaceutical methods. The GPs do not regard the written referral as a prioritized task and rather refer to other professionals in the health care system to prescribe PAP. GPs pointed out a need to create routines and arrangements for the method to gain credibility and become everyday practice among GPs.
运动处方（PAP）是一种成功的干预措施，可提高久坐生活方式患者的身体活动水平。这种方法似乎很少被全科医生（GP）使用，而且关于 GP 以 PAP 作为工具进行咨询的态度的信息有限。本研究旨在从全科医生的角度探索和理解开具运动处方的含义。
在瑞典南部，采用目的抽样法对 15 名瑞典全科医生进行了 3 次焦点小组访谈，邀请参与者讨论他们使用 PAP 的经验。访谈逐字记录，采用定性内容分析进行分析。
分析结果得出了四个类别：传统观念难以改变态度、共同责任是必要的、PAP 地位低下且受到不信任、缺乏程序和明确的指导方针。传统上，全科医生会与患者讨论增加身体活动水平的重要性，但他们不会将身体活动作为治疗方法开处方。医生的教育侧重于药物的使用。患者身体活动水平的责任与其他卫生专业人员、患者和社会共同承担。GP 对开运动处方持保留态度。工作量大是挫折感的一个来源。PAP 受到不信任，被认为是价值和地位较低的任务。使用处方来强调增加身体活动被认为是多余的，GP 认为应由医疗保健系统中的其他人来执行。该方法的结果也受到质疑。
由于医生缺乏非药物方法的教育，因此对使用 PAP 作为治疗方法存在不确定性。GP 并不将书面转诊视为优先任务，而是倾向于向医疗保健系统中的其他专业人员转诊 PAP。GP 指出需要为该方法创建常规和安排，以获得可信度并成为 GP 日常实践的一部分。
