Fasser C E, Mullen P D, Holcomb J D
Physician Assistant Program, Baylor College of Medicine, Houston, TX 77030.
Am J Prev Med. 1988 Jul-Aug;4(4):208-15.
Concern has been expressed over how the volume and effectiveness of physicians' practices relative to prevention can be increased. While a review of the health care services provided by physician assistants in medical practices indicated an emphasis on health education and patient counseling, there has existed an absence of data regarding their beliefs and practices in the area of health promotion. Based upon an analysis of self-reported data from 256 respondents (89%) of a random sample (n = 289) of the 870 physician assistants in Texas, it appears that physician assistants perceive themselves as having a role in health promotion, are generally satisfied with their preventive health care role, view health promotion activities as being more important in the future, and disagree with the idea that health promotion would not be well received by patients. They routinely gather information on health behaviors and discuss or recommend ways to reduce at-risk behavior. Furthermore, while expressing certainty about their knowledge and skills to educate and influence individuals to change certain risk behaviors, physician assistants indicate less certainty about patient follow-through when it relates to such activities as smoking, drinking, and the use of illicit drugs. Considering the perceived challenge and the view that health promotion will become an even larger component of the physician assistant's future role, these findings suggest a need for additional skills training to better assist patients to modify their more complex health risk behaviors.
人们对如何提高医生在预防方面的业务量和效果表示担忧。虽然对医生助理在医疗实践中提供的医疗服务进行的一项审查表明,重点在于健康教育和患者咨询,但在健康促进领域,关于他们的信念和实践的数据却一直缺失。基于对得克萨斯州870名医生助理的随机样本(n = 289)中256名受访者(89%)的自我报告数据进行的分析,医生助理似乎认为自己在健康促进中发挥着作用,总体上对自己的预防保健角色感到满意,认为健康促进活动在未来更重要,并且不同意健康促进不会受到患者欢迎的观点。他们经常收集有关健康行为的信息,并讨论或推荐减少危险行为的方法。此外,虽然医生助理对自己教育和影响个人改变某些危险行为的知识和技能表示确定,但在涉及吸烟、饮酒和使用非法药物等活动时,他们对患者后续行动的确定性较低。考虑到所察觉到的挑战以及健康促进将成为医生助理未来角色中更大组成部分的观点,这些发现表明需要额外的技能培训,以更好地帮助患者改变他们更复杂的健康风险行为。