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加拿大“运动即良药”工作坊培训提高了加拿大各地医生的身体活动水平,与初始信心水平无关。

Exercise is Medicine Canada workshop training improves physical activity practices of physicians across Canada, independent of initial confidence level.

作者信息

O'Brien Myles W, Shields Chris A, Solmundson Kara, Fowles Jonathon R

机构信息

School of Kinesiology, Acadia University, Nova Scotia, Canada.

Nova Scotia Health Authority, Nova Scotia, Canada.

出版信息

Can Med Educ J. 2020 Sep 23;11(5):e5-e15. doi: 10.36834/cmej.68376. eCollection 2020 Sep.

Abstract

BACKGROUND

Educational workshops help physicians (MDs) include physical activity and exercise (PAE) content in more patient appointments. It is unclear if MDs with varying degrees of confidence discussing PAE with their patients equally benefit from such training. We evaluated whether MDs' initial confidence affects the impact of an educational PAE workshop.

METHODS

MDs ( 63) across Canada completed self-reflection questionnaires initially and 3-months following a PAE workshop. MDs were divided into low-confidence [confidence score (out of 100%): <40%; 21], medium-confidence (40-60%; 19) and high-confidence (>60%; 23).

RESULTS

PAE counselling confidence increased in all groups (relative increase: Low=40%, Medium=20%, High=10%). Training increased the low-confidence group's knowledge, awareness of guidance/resources and perception of their patients' interest in lifestyle management (30% change; all 0.001). Compared to baseline, a greater proportion (all 0.001) of MDs reported prescribing exercise at 3-month follow-up in each of the low-confidence (10% to 62%) medium-confidence (16% to 89%) and high-confidence (57% to 87%) groups.

CONCLUSION

PAE training favorably improved MDs' confidence, perceived impact of many barriers and the proportion of MDs prescribing exercise, at each level of confidence. An educational workshop particularly assisted MDs with low-confidence (i.e., those who needed it the most) integrate PAE into their practice.

摘要

背景

教育研讨会有助于医生在更多患者预约中纳入身体活动与锻炼(PAE)相关内容。尚不清楚与患者讨论PAE时信心程度不同的医生是否能同样从此类培训中受益。我们评估了医生的初始信心是否会影响PAE教育研讨会的效果。

方法

加拿大各地的63名医生在PAE研讨会开始时及之后3个月完成了自我反思问卷。医生被分为低信心组[信心得分(满分100%):<40%;21人]、中等信心组(40 - 60%;19人)和高信心组(>60%;23人)。

结果

所有组的PAE咨询信心均有所提高(相对增幅:低信心组约40%,中等信心组约20%,高信心组约10%)。培训提高了低信心组的知识水平、对指导/资源的认知以及对患者生活方式管理兴趣的认知(变化约30%;均P<0.001)。与基线相比,低信心组(从10%增至62%)、中等信心组(从16%增至89%)和高信心组(从57%增至87%)中,在3个月随访时有更多比例的医生报告开具了运动处方(均P<0.001)。

结论

PAE培训在各个信心水平上都有利地提高了医生的信心、对诸多障碍的感知影响以及开具运动处方的医生比例。教育研讨会尤其帮助了低信心的医生(即那些最需要帮助的医生)将PAE纳入他们的临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ef5/7522882/ea2a8ca48a72/CMEJ-11-e005-g001.jpg

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