McKenna J, Naylor P J, McDowell N
Exercise and Health Research Unit, University of Bristol, United Kingdom.
Br J Sports Med. 1998 Sep;32(3):242-7. doi: 10.1136/bjsm.32.3.242.
To examine the promotion of physical activity by general practitioners (GPs) and practice nurses (PNs).
A questionnaire that examined the types of barriers and the levels of their influence as well as stage of change for activity promotion and for personal behaviour was mailed to 846 subjects.
The return rate exceeded 70% in each group with a high proportion (69%) of GPs and PNs reporting that they regularly promote physical activity with their patients. GPs were less likely to regularly promote physical activity with their patients if they indicated lack of time as a barrier (odds ratio (OR) = 0.73, 95% confidence interval (CI) 0.58 to 0.93) or lack of incentives (OR = 0.74, 95% CI 0.59 to 0.94), and more likely to promote exercise if they themselves were regular exercisers (OR = 3.19, 95% CI 1.96 to 5.18). However, for PNs longer consultation times (by 1.5 to 2 minutes) had a higher likelihood of producing regular promotion of activity (OR = 1.61, 95% CI 1.02 to 1.62). For PNs personal physical activity stage was the strongest significant predictor of promotion level, but with a stronger effect (OR = 4.77, 95% CI 1.48 to 15.35) than in the GPs.
The main finding is that GPs in the action or maintenance stage of changing their own physical activity are three times more likely to regularly promote the same behaviour in their patients than those in the other stages; for PNs the same difference quadruples the likelihood of them promoting physical activity. Professional readiness to change is influenced by known system barriers in GPs, and not in PNs, but is more strongly predicted by personal physical activity behaviour in both groups.
研究全科医生(GPs)和执业护士(PNs)对身体活动的促进情况。
向846名受试者邮寄了一份调查问卷,该问卷调查了障碍类型及其影响程度以及活动促进和个人行为的改变阶段。
每组的回复率均超过70%,有高比例(69%)的全科医生和执业护士报告称他们经常与患者一起促进身体活动。如果全科医生表示时间不足是障碍(比值比(OR)=0.73,95%置信区间(CI)为0.58至0.93)或缺乏激励措施(OR = 0.74,95% CI为0.59至0.94),则他们不太可能经常与患者一起促进身体活动;而如果他们自己是经常锻炼的人,则更有可能促进锻炼(OR = 3.19,95% CI为1.96至5.18)。然而,对于执业护士来说,更长的咨询时间(延长1.5至2分钟)更有可能促使他们经常促进身体活动(OR = 1.61,95% CI为1.02至1.62)。对于执业护士而言,个人身体活动阶段是促进水平的最强显著预测因素,但其影响比全科医生更强(OR = 4.77,95% CI为1.48至15.35)。
主要发现是,处于改变自身身体活动的行动或维持阶段的全科医生,定期向患者推广相同行为的可能性是其他阶段医生的三倍;对于执业护士而言,同样的差异使他们促进身体活动的可能性增加四倍。专业人员改变的意愿受到全科医生已知系统障碍的影响,而执业护士则不受此影响,但两组的个人身体活动行为对其预测作用更强。