School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, United States.
Julia Jones Matthews Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, United States.
Front Public Health. 2022 Feb 24;10:821150. doi: 10.3389/fpubh.2022.821150. eCollection 2022.
Approximately half of adult Americans suffer from musculoskeletal disorders (MSD). Significant risk factors for musculoskeletal disorders include poor diet, obesity, and insufficient physical activity. Studies show that lifestyle change education and interventions reduce MSD risk factors. However, little is known about the relationship between physician advice for behavior change and reported behavior change by MSD patients. This study explored the association between physician advice for lifestyle change and reported change in MSD patients, as well as the effects that patient education levels have on compliance.
This study used data from the 2017 National Health Interview Survey, a nationally representative cross-sectional survey of non-institutionalized US adults. The research team limited analysis to adults who reported a limitation due to musculoskeletal problems ( = 2,672). Outcomes included physician recommendations to increase physical activity, reduce fat/calories, or lose weight, and whether they enacted these behavioral changes. Adjusted logistic regression models examined whether compliance with doctor's instructions differed by education level.
Adjusted models show patients advised to change physical activity, diet, and weight were more likely to report attempted behavior change. Education was positively associated with likelihood of complying with physician advice to increase physical activity. Among patients not advised to change behaviors by a physician, education was positively associated with current behavior change attempts.
This study suggests that physician recommendations are relevant predictors of reported behavior change in individuals with MSD. Although education plays an important role in this association, the relationship is complex and multifaceted. Future studies should explore how compliance may be impacted by other factors, such as physician message type.
约有一半的美国成年人患有肌肉骨骼疾病（MSD）。肌肉骨骼疾病的主要危险因素包括不良饮食、肥胖和缺乏身体活动。研究表明，生活方式改变教育和干预措施可降低 MSD 风险因素。然而，对于医生关于行为改变的建议与 MSD 患者报告的行为改变之间的关系知之甚少。本研究探讨了医生对生活方式改变的建议与 MSD 患者报告的改变之间的关联，以及患者教育程度对依从性的影响。
本研究使用了 2017 年全国健康访谈调查的数据，这是一项对美国非机构化成年人进行的全国代表性横断面调查。研究小组将分析仅限于报告因肌肉骨骼问题导致活动受限的成年人（=2672）。结果包括医生建议增加体力活动、减少脂肪/卡路里或减肥，以及他们是否采取了这些行为改变。调整后的逻辑回归模型检查了教育水平是否会影响对医生建议的依从性。
调整后的模型显示，被建议改变体力活动、饮食和体重的患者更有可能报告尝试进行行为改变。教育程度与遵医嘱增加体力活动的可能性呈正相关。在未被医生建议改变行为的患者中，教育程度与当前行为改变尝试呈正相关。
本研究表明，医生的建议是 MSD 个体报告行为改变的重要预测因素。尽管教育在这种关联中起着重要作用，但这种关系是复杂和多方面的。未来的研究应探讨依从性可能如何受到其他因素（如医生信息类型）的影响。
