Leeds Institute of Health Sciences, Charles Thackrah Building, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, UK.
BMC Fam Pract. 2013 Nov 14;14:172. doi: 10.1186/1471-2296-14-172.
The UK Department of Health introduced the National Health Service (NHS) Health Check Programme in April 2009 in an attempt to improve primary and secondary prevention of cardiovascular disease in the UK population and to reduce health inequalities. Healthcare professionals' attitudes towards giving lifestyle advice will influence how they interact with patients during consultations. We therefore sought to identify the attitudes of primary care healthcare professionals towards the delivery of lifestyle advice in the context of the NHS Health Check Programme.
Fifty-two primary care healthcare professionals undertook a Q sort with 36 statements that represented a range of viewpoints about the importance of lifestyle change, medication, giving lifestyle advice in the primary care setting, and the individual, social and material factors that might impact on lifestyle related behaviour change. Sorts were analysed by-person using principal components analysis and varimax rotation.
Five statistically independent factors (accounts) reflected distinct views on the topic. Account 1 was supportive of initiatives like the NHS Health Check, and emphasised the importance of professionals working collaboratively with patients to facilitate lifestyle change. Account 2 expressed views on the potential overuse of statin medication and placed responsibility for lifestyle change with the patient. Account 3 viewed the healthcare professional role to be one of educator, emphasising the provision of information. Account 4 perceived lifestyle change to be difficult for patients and emphasised the need for healthcare professionals to be role models. Account 5 was inconsistent about the value of lifestyle change, or the role of healthcare professionals in promoting it, a finding that may be due to ambivalence about the health check or to lack of engagement with the Q sort task. We found no strong associations between any of the factors and, gender, role, age or ethnicity.
Our findings suggest that healthcare professionals hold viewpoints that may influence how they interact with patients during health checks. When implementing programmes like the NHS Health Check, it would be useful to take healthcare professionals' views into account. Attitudes and beliefs could be explored during training sessions, for example.
英国卫生部于 2009 年 4 月推出了国民保健制度（NHS）健康检查计划，试图改善英国人口的一级和二级心血管疾病预防，并减少健康不平等。医疗保健专业人员对提供生活方式建议的态度将影响他们在咨询期间与患者的互动方式。因此，我们试图确定初级保健医疗保健专业人员在 NHS 健康检查计划背景下提供生活方式建议的态度。
52 名初级保健医疗保健专业人员对 36 个陈述进行了 Q 分类，这些陈述代表了对生活方式改变的重要性、药物治疗、在初级保健环境中提供生活方式建议以及可能影响与生活方式相关的行为改变的个人、社会和物质因素的一系列观点。通过个人进行分类分析，使用主成分分析和方差极大旋转。
五个统计学独立的因素（账户）反映了对该主题的不同看法。账户 1 支持 NHS 健康检查等计划，并强调专业人员与患者合作促进生活方式改变的重要性。账户 2 对他汀类药物的潜在过度使用表达了看法，并将生活方式改变的责任归咎于患者。账户 3 将医疗保健专业人员的角色视为教育者，强调提供信息。账户 4 认为患者改变生活方式很困难，并强调医疗保健专业人员需要成为榜样。账户 5 对生活方式改变的价值或医疗保健专业人员在促进生活方式改变方面的作用持不确定态度，这一发现可能是由于对健康检查持矛盾态度或对 Q 分类任务缺乏参与。我们没有发现任何因素与性别、角色、年龄或种族之间存在强烈关联。
我们的研究结果表明，医疗保健专业人员持有可能影响他们在健康检查期间与患者互动的观点。在实施 NHS 健康检查等计划时，考虑医疗保健专业人员的观点将是有益的。例如，可以在培训课程中探讨态度和信念。
