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Aim To evaluate clinical practice of primary care physicians with respect of preventing behavioral risk factors in patients as well as objective and subjective factors that influence their motivation for taking preventive measures. Material and methods This study was a cross-sectional survey. The questionnaire was anonymous and included closed questions and multiple-choice questions. Based on the obtained results, prevalence of modifiable risk factors for chronic noninfectious diseases (CNID) was comprehensively evaluated in the survey population. Also, a special quantitative variable was introduced, the Index of Behavioral Risk Factors. that reflected the burden of risk factors. This composite index included the degree of risk factor in a specific respondent, for example, obesity degree, number of cigarettes smoked per day, severity of hypodynamia. Physicians’ knowledge and beliefs about the effect of physical activity (PA) on certain diseases were evaluated. Result 623 physicians (mean age 40 years (31-52), 85.5 % women) participated in the survey. The respondents included general practitioners (7.5%), cardiologists (2.9 %), preventive care physicians (4.8 %), internists (25.4 %), and other specialists (59.4 %). 70.8 % of respondents never smoked, 17.5 % were current smokers. 38.5% (240) of the surveyed had a normal body weight index (BWI); 41.7 % (260) were overweight; 11.6 % (72) had degree 1 obesity; 3.7 % (23) had degree 2 obesity; and 0.8 % had degree 3 obesity. A very low PA level was noticed; most of the surveyed exercised not more than once a week (median, 1 (0-3) time). More than 90 % had behavioral risk factors, low PA and excessive body weight. The physicians with a higher index of behavioral risk factors 50% less frequently checked the body weight of patients (odds ratio (OR), 0.541; 95 % confidence interval (CI): 0.388–0.753, p<0.05); 33% less frequently asked whether the patient smoked (OR, 0.675; 95 % CI: 0.465–0.978, p=0.037); 50% less frequently asked the patients about his/her level of PA (OR, 0.482; 95 % CI: 0.343–0.678, p<0.001); and 60% less frequently recommended increasing the PA (OR, 0.408; 95 % CI: 0.292–0.570, p<0.001).Conclusion Most of the surveyed were aware of the benefits of PA for prevention and treatment of CNID, however, they related the mechanism of this effect only with weight loss. The most frequently mentioned barriers to behavioral risk counseling were uncertainty about whether such counseling was within the physician's professional competence, lack of time, lack of confidence in the provision of advice and the effectiveness of interventions, and lack of patients’ compliance.
Aim To evaluate clinical practice of primary care physicians with respect of preventing behavioral risk factors in patients as well as objective and subjective factors that influence their motivation for taking preventive measures. Material and methods This study was a cross-sectional survey. The questionnaire was anonymous and included closed questions and multiple-choice questions. Based on the obtained results, prevalence of modifiable risk factors for chronic noninfectious diseases (CNID) was comprehensively evaluated in the survey population. Also, a special quantitative variable was introduced, the Index of Behavioral Risk Factors. that reflected the burden of risk factors. This composite index included the degree of risk factor in a specific respondent, for example, obesity degree, number of cigarettes smoked per day, severity of hypodynamia. Physicians’ knowledge and beliefs about the effect of physical activity (PA) on certain diseases were evaluated. Result 623 physicians (mean age 40 years (31-52), 85.5 % women) participated in the survey. The respondents included general practitioners (7.5%), cardiologists (2.9 %), preventive care physicians (4.8 %), internists (25.4 %), and other specialists (59.4 %). 70.8 % of respondents never smoked, 17.5 % were current smokers. 38.5% (240) of the surveyed had a normal body weight index (BWI); 41.7 % (260) were overweight; 11.6 % (72) had degree 1 obesity; 3.7 % (23) had degree 2 obesity; and 0.8 % had degree 3 obesity. A very low PA level was noticed; most of the surveyed exercised not more than once a week (median, 1 (0-3) time). More than 90 % had behavioral risk factors, low PA and excessive body weight. The physicians with a higher index of behavioral risk factors 50% less frequently checked the body weight of patients (odds ratio (OR), 0.541; 95 % confidence interval (CI): 0.388–0.753, p<0.05); 33% less frequently asked whether the patient smoked (OR, 0.675; 95 % CI: 0.465–0.978, p=0.037); 50% less frequently asked the patients about his/her level of PA (OR, 0.482; 95 % CI: 0.343–0.678, p<0.001); and 60% less frequently recommended increasing the PA (OR, 0.408; 95 % CI: 0.292–0.570, p<0.001).Conclusion Most of the surveyed were aware of the benefits of PA for prevention and treatment of CNID, however, they related the mechanism of this effect only with weight loss. The most frequently mentioned barriers to behavioral risk counseling were uncertainty about whether such counseling was within the physician's professional competence, lack of time, lack of confidence in the provision of advice and the effectiveness of interventions, and lack of patients’ compliance.
Relevance. Assessment of the cardiovascular risk factors (RF) knowledge is important for the development of disease preventive programs. It is shown that awareness of the RF does not guarantee readiness for their correction, and there is a potential gap between intention and behavior. Ample evidence suggests that a physician’s commitment to a healthier lifestyle and RF control increases patient confi in his recommendations. Assessment of the subjective attitude to RF for the development of cardiovascular diseases (CVD) and the readiness for their correction not only in patients, but also in doctors is an important task both for the health of the doctors themselves and indirectly for their future and current patients.Objective. To assess the subjective attitude to RF for the development of CVD and the readiness for their correction in doctors and patients of one medical organization.Design and methods. The study included 58 doctors and 55 patients who were consecutively hospitalized in different departments of the Medical Research and Education Center of Moscow State University named after M. V. Lomonosov. Doctors and patients of the cardiology department were not included in the study. All questions about CVD RF were open. The number of answers was not limited.Results. The analysis included 58 questionnaires of doctors and 52 questionnaires of patients. The median age of physicians was 37 [31; 48] years, among them 40 % were men. The median age of patients was 61 [49; 71] years, men — 42 %. Physicians expectedly showed higher awareness of various RF for CVD. They called an average of 4,9 ± 2,0 RF, and patients — 3,9 ± 1,6, but the difference was not significant. Physicians were more aware of carbohydrate metabolism disorders, malnutrition, physical inactivity, sleep disturbances, and stress as CVD RF (all p < 0,001), with more frequent patients, than physicians indicated smoking (67,3 % and 27,6 %, respectively, p < 0,001). Female physicians were statistically significantly less likely to report obesity (4,3 % and 25,7 %, respectively, p = 0,013). At the same time, they indicated hypertension more often than men (13,0 % and 2,6 %, respectively, p = 0,018). Physicians named one RF that threatened their own health more (p < 0,001). At the same time, physicians were willing to try to change less than half of these factors, while inpatients were determined to change two-thirds of the factors (45,9 % and 66,1 %, p = 0,012). Conclusions. The level of physicians’ awareness of CVD RF and readiness for change remains relatively low. To combat the growing burden of CVD in Russia, it is necessary to maximize the potential of not only cardiologists, but also doctors of other specialties, as channels of reliable information about health, develop and implement measures to increase awareness of the circumstances that contribute to the development of CVD, as well as tools for self-management of risks, not only among patients, but also among medical workers.
The paper reports the issues of the medical assistance of students attending secondary medical educational institutions in Volgograd and the Volgograd region. It has been found that the regional regulatory documents contain no unified requirements related to students’ health protection. Primary medical care provision to students is ensured by pediatric (under the age of 18 years) and adult outpatient clinics (over the age of 18 years) of Volgograd and the Volgograd region in accordance with the concluded contracts. Furthermore, the students have a mandatory medical check-up before the beginning of practical training in accordance with the Order № 29N of the Ministry of Health of the Russian Federation dated January 28, 2021. At the same time, there is no dynamic monitoring of the students’ health status during the educational process. It has been shown that none of the secondary medical educational institutions of Volgograd and the Volgograd region conducts assessment and monitoring of occulational risk factors corresponding to the studied specialty. It is necessary to develop the system for informational communication of medical professional with medical institutions conducting preventive medical examinations and routine check-ups of students. Furthermore, it is important to consider the features of the chosen profession taking into account potential risk factors of the learning process and future professional activity.
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