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在一家市中心医院对“将预防付之于实践”材料的接受与使用情况。

Acceptance and use of Put Prevention into practice materials at an inner-city hospital.

作者信息

Gemson D H, Dickey L L, Ganz M L, Ashford A R, Francis C K

机构信息

Harlem Center for Health Promotion and Disease Prevention, Columbia University School of Public Health, New York, New York 10032, USA.

出版信息

Am J Prev Med. 1996 Jul-Aug;12(4):233-7.

PMID:8874684
Abstract

Many studies indicate that physicians' prevention practices frequently differ from published guidelines. Put Prevention into Practice (PPIP) consists of a variety of paper-based materials for providers, patients, and the office setting designed to enhance the delivery of clinical preventive services. Prototype PPIP materials were distributed to physicians and patients at the Harlem Hospital medical clinic in conjunction with a series of prevention lectures for physicians. Acceptance and use of these materials were assessed through self-administered questionnaires for physicians and structured interviews for patients. A regression analysis was conducted to assess correlates of physician use of PPIP materials. Physicians reported a high degree of use of and satisfaction with PPIP materials. Multiple regression analysis indicated that the physicians' perceived self-efficacy in their ability to provide preventive counseling to patients at baseline was significantly associated with increased use of PPIP materials. When controlling for baseline physician self-efficacy, physicians whose self-efficacy increased during the study period were more likely to have used the materials. A majority of patients (53%) reported that the main patient-based component of the program-a pocket-sized booklet providing health education information and record-keeping of preventive tests and procedures-was very useful. Results from this study indicate a high degree of acceptance of prototype PPIP materials by physicians and patients at an inner-city hospital. Educational programs for physicians that enhance physician self-efficacy may be more effective in helping practitioners to adopt office-based prevention resources. Medical Subject Headings (MeSH): prevention, primary care, preventive health services, clinical practice patterns.

摘要

许多研究表明,医生的预防措施常常与已发表的指南不同。“将预防付之实践”(PPIP)包括为医疗服务提供者、患者及医疗机构环境设计的各种纸质材料,旨在加强临床预防服务的提供。PPIP的原型材料在哈莱姆医院医疗诊所分发给医生和患者,并同时为医生举办了一系列预防讲座。通过医生自行填写问卷以及对患者进行结构化访谈来评估这些材料的接受和使用情况。进行了回归分析以评估医生使用PPIP材料的相关因素。医生报告对PPIP材料的使用程度很高且满意度也很高。多元回归分析表明,医生在基线时对向患者提供预防性咨询能力的自我效能感与PPIP材料使用的增加显著相关。在控制基线医生自我效能感后,在研究期间自我效能感有所提高的医生更有可能使用这些材料。大多数患者(53%)报告称,该项目以患者为基础的主要组成部分——一本提供健康教育信息以及预防性检查和程序记录的袖珍手册——非常有用。这项研究的结果表明,一家市中心医院的医生和患者对PPIP原型材料的接受程度很高。提高医生自我效能感的医生教育项目可能在帮助从业者采用基于医疗机构的预防资源方面更有效。医学主题词(MeSH):预防、初级保健、预防保健服务、临床实践模式。

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