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影响医生就患者生活方式习惯进行咨询的因素:一项队列研究。

Factors influencing doctors' counselling on patients' lifestyle habits: a cohort study.

作者信息

Belfrage Anna Sofia Viktoria, Grotmol Kjersti Støen, Tyssen Reidar, Moum Torbjørn, Finset Arnstein, Isaksson Rø Karin, Lien Lars

机构信息

Psychologist and PhD student, Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.

Psychologist and PhD student, Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway.

出版信息

BJGP Open. 2018 Sep 19;2(3):bjgpopen18X101607. doi: 10.3399/bjgpopen18X101607. eCollection 2018 Oct.

Abstract

BACKGROUND

Lifestyle changes are important for prevention and treatment of many common diseases, and doctors have an important role in the lifestyle counselling of patients. It is important to know more about factors influencing lifestyle counselling.

AIM

To investigate the frequency of counselling about physical activity compared to that about alcohol habits; the impact of doctors' own physical activity and alcohol habits on patient counselling about these lifestyle dimensions; and whether perceived mastery of clinical work or vulnerable personality have a confounding or moderating effect on these associations.

DESIGN & SETTING: In this nationwide cohort survey, a total of 978 doctors in Norway were surveyed by postal questionnaires in 1993/94 and 2014. The response rate was 562/978 (57%).

METHOD

The outcome variables were questions on frequency of asking about alcohol and exercise habits. Explanatory variables were questions on doctors' own exercise habits, drinking habits (using Alcohol Use Disorders Identification Test [AUDIT]), perceived mastery of clinical work, vulnerable personality, and specialty. Associations were studied by linear regression analysis.

RESULTS

Of the 526 responders, 307 (58%) reported asking usually/often about exercise habits, while = 140/524 (27%) usually/often asked about alcohol habits. A doctor's own physical activity level was associated with frequency of asking about physical activity (unstandardised regression coefficient [] = 0.07; 95% confidence intervals [CI] = 0.01 to 0.13). There were no significant associations between doctors' own lifestyle habits and counselling on alcohol habits. Doctors with low levels of vulnerability asked more frequently about physical activity, regardless of their own physical activity habits ( = 2.41, = 0.048).

CONCLUSION

Doctors' own lifestyles influenced their preventive counselling about physical activity, but not about alcohol. Vulnerability moderated these effects, indicating the importance of early interventions to help doctors with a vulnerable personality to handle negative criticism from patients.

摘要

背景

生活方式的改变对许多常见疾病的预防和治疗至关重要,医生在为患者提供生活方式咨询方面发挥着重要作用。了解更多影响生活方式咨询的因素很重要。

目的

调查与饮酒习惯咨询相比,身体活动咨询的频率;医生自身的身体活动和饮酒习惯对患者在这些生活方式方面咨询的影响;以及临床工作的感知掌握程度或易受伤害的人格是否对这些关联有混杂或调节作用。

设计与背景

在这项全国性队列调查中,1993/94年和2014年通过邮政问卷对挪威的978名医生进行了调查。回复率为562/978(57%)。

方法

结果变量是关于询问饮酒和运动习惯频率的问题。解释变量是关于医生自身运动习惯、饮酒习惯(使用酒精使用障碍识别测试[AUDIT])、临床工作的感知掌握程度、易受伤害的人格和专业的问题。通过线性回归分析研究关联。

结果

在526名回复者中,307名(58%)报告通常/经常询问运动习惯,而140/524名(27%)通常/经常询问饮酒习惯。医生自身的身体活动水平与询问身体活动的频率相关(非标准化回归系数[β]=0.07;95%置信区间[CI]=0.01至0.13)。医生自身的生活方式习惯与饮酒习惯咨询之间没有显著关联。易受伤害程度低的医生更频繁地询问身体活动情况,无论他们自身的身体活动习惯如何(β=2.41,P=0.048)。

结论

医生自身的生活方式影响他们对身体活动的预防性咨询,但不影响对饮酒的咨询。易受伤害程度调节了这些影响,表明早期干预对于帮助具有易受伤害人格的医生应对患者的负面批评很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62f3/6202006/513d8d1036e1/bjgpopen-1-607-g001.jpg

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