Faculty of Public Health, Academy of Medicine, Lithuanian University of Health Sciences, Tilzes 18, Kaunas, Lithuania.
BMC Fam Pract. 2019 Sep 7;20(1):125. doi: 10.1186/s12875-019-1022-8.
Primary health care plays a crucial role in providing recommendations on a healthy diet and physical activity to assist patients in weight management. The study aimed to evaluate health behaviour counselling provided by general practitioners (GPs) for adults with overweight and obesity in Lithuania between 2000 and 2014.
Eight biennial postal surveys to independent nationally representative random samples of Lithuanians aged 20-64 were conducted. Response rates varied from 41.1 to 74%, with a decreasing trend over time. The data of 5867 participants who visited a GP at least once during the last year and had BMI of ≥25.0 kg/m were analysed. Respondents were asked about GP advice on nutrition and physical activity and changes in their health behaviour during the last year.
The proportion of persons with overweight who reported GP advice on nutrition increased from 23.6% in 2000 to 37.5% in 2010 and advice on physical activity from 11.9 to 17.2% respectively; however, later both proportions decreased slightly. The likelihood of reporting was higher in respondents with higher BMI, more chronic conditions and frequent contact with a GP. Respondents who were living in cities, older and highly educated women were all more likely to report being advised on physical activity. Men and women who received advice from a GP more often reported changes in health behaviour as compared with non-advised individuals.
Despite increasing trends, the rate of GP advice on nutrition and physical activity reported by patients with overweight and obesity remains low in Lithuania. GP advice appears to have a significant impact on attempts by patients to change behaviour related to weight control. Therefore, there is an obvious need to make additional efforts to increase the frequency of GP counselling and to identify and address barriers to advising patients with overweight.
初级卫生保健在提供健康饮食和身体活动建议方面发挥着至关重要的作用，以帮助患者进行体重管理。本研究旨在评估 2000 年至 2014 年期间立陶宛全科医生（GP）为超重和肥胖成年人提供的健康行为咨询情况。
对独立的、具有全国代表性的 20-64 岁立陶宛人进行了 8 次两年一次的邮政调查。回应率从 41.1%到 74%不等，呈下降趋势。对过去一年至少看过一次全科医生且 BMI≥25.0kg/m2 的 5867 名参与者的数据进行了分析。受访者被问及 GP 关于营养和身体活动的建议以及过去一年他们健康行为的变化情况。
超重者中报告 GP 提供营养建议的比例从 2000 年的 23.6%增加到 2010 年的 37.5%，提供身体活动建议的比例从 11.9%增加到 17.2%；然而，后来这两个比例都略有下降。BMI 较高、患有更多慢性病且经常与 GP 接触的受访者报告称更有可能获得建议。居住在城市、年龄较大和受教育程度较高的女性更有可能报告接受过 GP 的身体活动建议。与未接受建议的个体相比，经常从 GP 处获得建议的男性和女性更有可能报告健康行为的变化。
尽管呈上升趋势，但立陶宛超重和肥胖患者报告的 GP 营养和身体活动咨询率仍然很低。GP 建议似乎对患者改变与体重控制相关的行为有显著影响。因此，显然需要做出更多努力来增加 GP 咨询的频率，并发现和解决对超重患者进行咨询的障碍。
