Evaluation of Internal Medicine Residents as Exercise Role Models and Associations With Self-Reported Counseling Behavior, Confidence, and Perceived Success

Rogers, Laura Q.; Gutin, Bernard; Humphries, Matthew C.; Lemmon, Christian R.; Waller, Jennifer L.; Baranowski, Tom; Saunders, Ruth P.

doi:10.1207/s15328015tlm1803_5

Cited by 58 publications

(64 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…11 Literature review confirmed low counseling rates of patients at risk for CVD in our program 6 and in other residency programs [12][13][14] and documented studies on reported barriers to physician counseling. [15][16][17] We then conducted a targeted needs assessment defined in step two of Kern's six-step approach as "assessing the needs of one's targeted group of learners and their medical institution/ learning environment, which may be different from the needs of learners and medical institutions in general." At study initiation in 2006, faculty preceptors perceived nutrition and exercise counseling rates remained low in resident clinics.…”

Section: Methodsmentioning

confidence: 99%

“…To assess professional attitudes toward counseling, we developed open and closed ended questions regarding potential barriers based on published barriers to counseling. [12][13][14][15][16][17] We then developed questions on resident practices in physical activity and nutrition counseling. The self-administered KAP survey used multiple choice questions for the knowledge and practices portions and 5-point Likert scale questions for the attitudes portion.…”

Section: Kap Questionnairementioning

confidence: 99%

See 1 more Smart Citation

Incorporating Performance Improvement Methods into a Needs Assessment: Experience with a Nutrition and Exercise Curriculum

et al. 2010

View full text Add to dashboard Cite

BACKGROUND: Clinical guidelines recommend that physicians counsel patients on diet and exercise; however, physician counseling remains suboptimal. OBJECTIVES: To determine if incorporating performance improvement (PI) methodologies into a needs assessment for an internal medicine (IM) residency curriculum on nutrition and exercise counseling was feasible and enhanced our understanding of the curricular needs. DESIGN AND PARTICIPANTS: One hundred and fiftyeight IM residents completed a questionnaire to assess their knowledge, attitudes, and practices (KAP) about nutrition and exercise counseling for hypertensive patients. Residents' baseline nutrition and exercise counseling rates were also obtained using chart abstraction. Fishbone diagrams were created by the residents to delineate perceived barriers to diet and exercise counseling. MAIN MEASURES: The KAP questionnaire was analyzed using descriptive statistics. Chart abstraction data was plotted on run charts and average counseling rates were calculated. Pareto charts were developed from the fishbone diagrams depicting the number of times each barrier was reported. KEY RESULTS: Almost 90% of the residents reported counseling their hypertensive patients about diet and exercise more than 20% of the time on the KAP questionnaire. In contrast, chart abstraction revealed average counseling rates of 3% and 4% for nutrition and exercise, respectively. The KAP questionnaire exposed a clinical knowledge deficit, lack of familiarity with the national guidelines, and low self-efficacy. In contrast, the fishbone analysis highlighted patient apathy, patient co-morbidities, and time pressure as the major perceived barriers. CONCLUSIONS: We found that incorporating PI methods into a needs assessment for an IM residency curriculum on nutrition and exercise counseling for patients at risk of cardiovascular disease was feasible, provided additional information not obtained through other means, and provided the opportunity to pilot the use of PI techniques as an educational strategy and means of measuring outcomes. Our findings suggest that utilization of PI principles provides a useful framework for developing and implementing a medical education curriculum and measuring its effectiveness.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Kap Questionnairementioning

confidence: 99%

Incorporating Performance Improvement Methods into a Needs Assessment: Experience with a Nutrition and Exercise Curriculum

et al. 2010

View full text Add to dashboard Cite

show abstract

“…16,35,36 This sample of oncology nurses did not exercise at the level recommended by the CDC. 30 Personal experience with exercise was not related to the exercise benefits beliefs nor the exercise barriers beliefs of nurses, suggesting that personal experience with exercise may not be an important contextual factor that affects nurses' beliefs in exercise as a treatment for women with breast cancer experiencing CRF.…”

Section: Discussionmentioning

confidence: 99%

“…1,15,16 According to the ONS, about 10% of patients with breast cancer received recommendation to exercise in order to reduce their fatigue.…”

Section: Background and Conceptual Frameworkmentioning

confidence: 99%

See 1 more Smart Citation

Factors Related to Oncology Nurses’ Exercise Counseling for Management of Fatigue of Women during Treatment for Breast Cancer

Shing¹

2017

NCOAJ

View full text Add to dashboard Cite

Purpose: To identify and explore the predictors of nurses' exercise counseling for the management of fatigue of women during treatment for breast cancer.Design: Descriptive correlational. Setting:Registered nurses who were current members of the Oncology Nursing Society.Sample: 115 nurses working in oncology settings, providing direct care to adult women receiving treatment for breast cancer.Methods: Nurses completed a demographic questionnaire, an Exercise Questionnaire, two Exercise Beliefs, and one Exercise Counseling Behaviors Scales. Main research variables:personal experience with exercise, exercise barriers beliefs, exercise benefits beliefs, exercise counseling behaviors.Findings: Exercise barriers beliefs, the nurse's current position nurse, and knowledge about National Comprehensive Cancer Network (NCCN) guidelines predicted exercise counseling behaviors. Conclusion:Nurses' beliefs about exercise barriers are most important to their exercise counseling for women with breast cancer and cancer-related fatigue (CRF). Implications for nursing:Educational programs are needed to improve nurses' knowledge about standards of care for the treatment of CRF. Strategies need to be developed to assist patients to overcome barriers and promote nurses' exercise counseling behaviors.Knowledge Translation i. Nurses who believe in the benefits of exercise, but also have strong beliefs that women with breast cancer experiencing CRF have many barriers to exercise, tend not to counsel them to exercise.ii. Nurses may need to explore strategies to increase their exercise counseling behaviors in the presence of their personal beliefs about exercise barriers.iii. Nurse leaders could mentor staff nurses to alter the impact of exercise barriers beliefs.Keywords: exercise beliefs, fatigue, counseling, knowledge, behaviors, nurse leaders, cancerNursing & Care Open Access Journal Research ArticleOpen Access Factors related to oncology nurses' exercise counseling for management of fatigue of women during treatment for breast cancer 78Copyright: ©2017 Shing Citation: Shing DH. Factors related to oncology nurses' exercise counseling for management of fatigue of women during treatment for breast cancer. Nurse Care Open Acces J. 2017;2(3):77-83. DOI: 10.15406/ncoaj.2017.02.00037and counseling during treatment to motivate women with breast cancer to exercise, thus minimizing their fatigue. The Oncology Nursing Society Foundation came to the same conclusion after supporting the development of the Breast Cancer Care Quality Measure's set. One of the Quality measures was to ascertain the percentage of patients beginning chemotherapy who received counseling about exercise as an intervention to combat fatigue. 14 Background and conceptual frameworkCurrently, nurses' management of fatigue is inconsistent with national treatment guidelines, which recommend that exercise counseling includes encouraging patients with CRF to exercise. 1,15,16 According to the ONS, about 10% of patients with breast cancer received recommendation to exercise...

show abstract

Perceived Quality of Care and Lifestyle Counseling Among Patients With Heart Disease

Jackson

Krishnan

Meccone

et al. 2010

Clinical Cardiology

View full text Add to dashboard Cite

Background: To examine patients' perceived quality of care and reported receipt of information on diet and exercise related to cardiovascular disease prevention. Methods: Patients admitted with acute coronary syndromes or elective cardiac catheterization were eligible for enrollment. Baseline medical information was collected through medical-record review. Patients completed surveys at the time of hospitalization that included items on perceived quality of care and whether they had received information from a healthcare provider on diet and exercise as related to their heart. Perceived quality of care was grouped into 3 categories: (1) poor to fair, (2) good, and (3) very good to excellent. Results: Among the 182 cardiac patients who completed the survey, those who reported poor to fair quality of care were more likely to report that they had received no advice regarding diet as compared with those who perceived their quality of care as good or very good to excellent (61%, 59%, and 26%, respectively, P < 0.0001). A similar pattern was observed for exercise (71%, 74%, and 36%, respectively, P < 0.0001). Conclusions: Patients with low perceived quality of care were less likely to have discussed diet and exercise habits with healthcare providers. Improving receipt of lifestyle counseling is warranted given the central role that diet and exercise play in secondary prevention.

show abstract

Evaluation of Internal Medicine Residents as Exercise Role Models and Associations With Self-Reported Counseling Behavior, Confidence, and Perceived Success

Cited by 58 publications

References 21 publications

Incorporating Performance Improvement Methods into a Needs Assessment: Experience with a Nutrition and Exercise Curriculum

Incorporating Performance Improvement Methods into a Needs Assessment: Experience with a Nutrition and Exercise Curriculum

Factors Related to Oncology Nurses’ Exercise Counseling for Management of Fatigue of Women during Treatment for Breast Cancer

Perceived Quality of Care and Lifestyle Counseling Among Patients With Heart Disease

Contact Info

Product

Resources

About