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英国初级保健咨询中的生活方式建议:医生使用条件式建议形式。

Lifestyle advice in UK Primary Care consultations: Doctors' use of conditional forms of advice.

机构信息

Birmingham City University, Curzon Building, Birmingham B4 7BD, UK.

出版信息

Patient Educ Couns. 2021 Nov;104(11):2706-2715. doi: 10.1016/j.pec.2021.03.033. Epub 2021 Mar 31.

Abstract

OBJECTIVE

To investigate how doctors deliver lifestyle advice to patients in ordinary general practice consultations.

METHOD

A secondary analysis of audio/video recorded primary care consultations between doctors and patients. Instances of lifestyle related talk were identified and analysed according to the methods of Conversation Analysis.

RESULTS

The most frequently used format for delivering advice was found to be if-conditional forms. Conditional forms work to convey how advice is relevant to the individual's health circumstances 1) topicalising the problematic risk to the patient, 2) informing and warning the patient of reoccurring or future health risks, and 3) offering changes in lifestyle in addition to or as a replacement for medication.

CONCLUSION

The results show that doctors use if-conditional constructions to navigate anticipated or actual difficulties evidenced through misalignment in delivering lifestyle advice, by conveying the importance of the advice to the individual patient.

PRACTICE IMPLICATIONS

Using if-conditional constructions when talking with patients regarding their problematic risk factors provides a technique enabling doctors to navigate the sensitivities associated with giving advice, whilst delivering personalised and preventative medicine.

摘要

目的

调查医生在普通全科诊疗中如何向患者提供生活方式建议。

方法

对医生和患者之间的音频/视频记录的初级保健咨询进行二次分析。根据会话分析的方法,确定并分析与生活方式相关的谈话实例。

结果

发现传递建议最常用的格式是条件句形式。条件句的作用是将建议与个人的健康状况相关联:1)将有问题的风险主题化;2)告知并警告患者重复或未来的健康风险;3)除药物治疗外,提供生活方式的改变。

结论

结果表明,医生使用条件句结构来解决在提供生活方式建议时出现的预期或实际困难,通过向个体患者传达建议的重要性。

实践意义

在与患者讨论其有问题的风险因素时使用条件句结构,为医生提供了一种技术,使他们能够在提供建议时解决相关的敏感性问题,同时提供个性化和预防医学。

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