Yeager K K, Donehoo R S, Macera C A, Croft J B, Heath G W, Lane M J
Public Health Practice Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA.
Am J Prev Med. 1996 Jul-Aug;12(4):238-41.
Personal belief concerning both the validity of health promotion and the physician's ability to influence patient behavior may affect how much effort a physician spends on health promotion strategies. We assessed these beliefs through a mail survey to physicians practicing in a predominantly rural southern state in 1987 (n = 83) and 1991 (n = 96). Response rates in both studies exceeded 75%. The instrument was obtained from similar studies conducted in Massachusetts in 1981 and Maryland in 1983. Between 1987 and 1991 we found slight improvements in the perceived importance of many health behaviors, but significant improvement was observed in the importance of reducing intake of dietary saturated fat (66% in 1987 to 80% in 1991; P < .05). Less than 10% of the physicians thought they could be "very successful" in modifying patients' behaviors. However, in 1991 physicians perceived that their ability to be "very successful" in helping patients to modify their behavior would increase threefold (8%-24% for exercise; 4%-18% for smoking) if given appropriate support. Although the type of appropriate support was not identified, the credibility of physician's advice in promoting health changes is important. These results suggest that efforts should be made to provide support to physicians who are inclined to discuss health behavior changes with their patients. Medical Subject Headings (MeSH): dietary fats, exercise, patient education, physician's practice patterns, smoking.
关于健康促进的有效性以及医生影响患者行为能力的个人信念,可能会影响医生在健康促进策略上投入的精力。我们于1987年(n = 83)和1991年(n = 96)通过邮件调查,对在一个以农村为主的南方州执业的医生进行了这些信念的评估。两项研究的回复率均超过75%。该调查工具取自1981年在马萨诸塞州和1983年在马里兰州进行的类似研究。在1987年至1991年期间,我们发现许多健康行为的感知重要性略有提高,但在减少膳食饱和脂肪摄入量的重要性方面观察到显著改善(1987年为66%,1991年为80%;P <.05)。不到10%的医生认为他们在改变患者行为方面会“非常成功”。然而,在1991年,医生们认为,如果得到适当支持,他们在帮助患者改变行为方面“非常成功”的能力将提高三倍(运动方面从8%提高到24%;吸烟方面从4%提高到18%)。尽管未明确适当支持的类型,但医生建议在促进健康改变方面的可信度很重要。这些结果表明,应该努力为倾向于与患者讨论健康行为改变的医生提供支持。医学主题词(MeSH):膳食脂肪、运动、患者教育、医生执业模式、吸烟。