The Physician's Role in Health Promotion — A Survey of Primary-Care Practitioners

Wechsler, Henry; Levine, Sol; Idelson, Roberta K.; Rohman, Mary; Taylor, James O.

doi:10.1056/nejm198301133080211

Cited by 402 publications

(91 citation statements)

References 2 publications

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“…They probably did until specialization and technology, along with rapidly expanding medical information and new economic circumstances, began to crowd these elements out of medical care. Now, even primary care physicians have dif®culty devoting much time, attention, or effort to the education of their patients about behavioral risk factors and ways to modify them (Wechsler et al, 1983;McAlister et al, 1985;Nutting, 1986;Gottlieb et al, 1987;Hiddink et al, 1997). Studies have found large discrepancies among physician initiatives, patient expectations, and published guidelines (Anda et al, 1987;McPhee et al, 1986;Romm et al, 1981;Wells et al, 1986;Woo et al, 1985;Singer et al, 1991).…”

Section: Educational Diagnosis Of Practitioner Behaviormentioning

confidence: 99%

“…Most of these physicians, however, agreed that reducing cigarette smoking is important. This suggests that physicians' attitudes are determined in part by the weight and general acceptance of scienti®c evidence (Wechsler et al, 1983).…”

Section: Predisposing Factorsmentioning

confidence: 99%

“…This is referred to in social cognitive theory as a self-ef®cacy belief. Many physicians apparently feel unprepared to counsel patients about their lifestyles and consequently tend to avoid doing so (Wechsler et al, 1983;Orleans et al, 1985). Nurses' traditional adherence to the medical model has created some of the same barriers to their use of health promotion that physicians face (Jenny, 1993).…”

Section: Predisposing Factorsmentioning

confidence: 99%

See 2 more Smart Citations

What can we generalize from research on patient education and clinical health promotion to physician counseling on diet?

1999

Eur J Clin Nutr

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Section: Educational Diagnosis Of Practitioner Behaviormentioning

confidence: 99%

Section: Predisposing Factorsmentioning

confidence: 99%

Section: Predisposing Factorsmentioning

confidence: 99%

See 1 more Smart Citation

What can we generalize from research on patient education and clinical health promotion to physician counseling on diet?

1999

Eur J Clin Nutr

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“…Specifically, we attempted to answer six basic questions regarding life-style discussions: (1) What is being discussed? (2) How frequently are these discussions occurring?…”

Section: Introductionmentioning

confidence: 99%

Health promotion counseling of chronic-disease patients during primary care visits.

Russell¹,

Roter²

1993

Am J Public Health

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OBJECTIVES. This study was designed to provide an empirical description, based on a review of visit audiotapes, of primary care practice with chronic-disease patients. METHODS. We analyzed 439 interactions between adult patients with chronic disease and 49 physicians. We explored the content, frequency, intensity, and dynamics of health promotion discussion during these routine visits. RESULTS. There was evidence of health promotion discussion in more than half (53%) of the audiotapes reviewed. When life-style topics were discussed, the discussion lasted a mean of 4 1/2 minutes, or 20% of the length of the visit. Diet/weight control was the most frequently discussed topic, followed by exercise, stress, smoking, and alcohol. Stress was by far the most time-consuming topic; stress-related discussion took an average of 6 minutes. CONCLUSIONS. Nearly 60% of the discussion that took place were not merely perfunctory but were attempts to counsel or encourage behavior change in the patient. Physicians used a wide range of behavioral counseling strategies, including providing a rationale for the recommended change and specific instructions to facilitate change. Other strategies noted as "effective" in the literature, however, were used infrequently and indicate obvious areas of weakness in physician performance.

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“…The task perception determinant is defined as the belief that it is the role of the GP to help patients change their health behaviour (38) . Task perception has been included in several studies about nutrition guidance practices (12)(13)(14)18,20,21,39,40) , but only in a few studies about physical activity guidance practices (23,28,41) .…”

mentioning

confidence: 99%

Determinants of Dutch general practitioners’ nutrition and physical activity guidance practices

Dillen

Hiddink

Woerkum

2012

Public Health Nutr.

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Objective: General practitioners (GP) are uniquely placed to guide their patients on nutrition and physical activity. The aims of the present study were to assess: (i) the extent to which GP guide on nutrition and physical activity; (ii) the determinants that cause GP to give guidance on nutrition and physical activity; and (iii) the extent to which these guidance practices have the same determinants. Design: Cross-sectional study, mail questionnaire. Setting: Dutch general practice. Subjects: Four hundred and seventy-two GP in practice for 5-30 years. Results: Our study showed that the majority of GP had similar practices for both nutrition and physical activity guidance. Fair associations were found between nutrition and physical activity guidance practices. More than half of the explained variance in the models of physical activity guidance practices was improved by the inclusion of nutrition guidance practices in the models. Moreover, GP reported higher frequencies of physical activity guidance practices than nutrition guidance practices. Nutrition guidance practices predicted the same physical activity guidance practices. Conclusions: The majority of GP had similar practices for nutrition and physical activity guidance. GP were more inclined to guide their patients on physical activity than on nutrition. Self-efficacy was found to be a determinant in most models for guidance practices. Guidance practices proved to be a mix of prevention and treatment components. Consequently, we advise raising the selfefficacy of GP by training in medical school and in continuing medical education. We also recommend the combination of both nutrition and physical activity guidance in general practice.

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The Physician's Role in Health Promotion — A Survey of Primary-Care Practitioners

Cited by 402 publications

References 2 publications

What can we generalize from research on patient education and clinical health promotion to physician counseling on diet?

What can we generalize from research on patient education and clinical health promotion to physician counseling on diet?

Health promotion counseling of chronic-disease patients during primary care visits.

Determinants of Dutch general practitioners’ nutrition and physical activity guidance practices

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