DIETARY COUNSELING OF HYPERCHOLESTEROLEMIC PATIENTS BY INTERNAL-MEDICINE RESIDENTS

被引：6

作者：

LEVINE, MA

GROSSMAN, RS

DARDEN, PM

JACKSON, SM

PEDEN, JG

AMMERMAN, AS

LEVIN, ML

LAYNE, RD

ROGERS, LQ

SEELIG, CB

EVANS, AT

SETTLE, MB

FLETCHER, SW

机构：

[1] Department of General Internal Medicine, Geisinger Medical Center, Danville, 17822, PA

[2] the Department of Medicine, the University of North Carolina Faculty Development Program in General Medicine, and General Pediatrics

[3] the Area Health Education Center Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

[4] the Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina

[5] the Departments of Medicine and Psychiatry, East Carolina University School of Medicine, Greenville, North Carolina

[6] School of Medicine, the Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

[7] the Department of Medicine, West Virginia University School of Medicine, Morgantown, West Virginia

[8] the Department of Medicine, Medical College of Georgia, Augusta, Georgia

[9] the Health Services Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

来源：

JOURNAL OF GENERAL INTERNAL MEDICINE | 1992年 / 7卷 / 05期

关键词：

HYPERCHOLESTEROLEMIA; DIETARY COUNSELING; PHYSICIAN COUNSELING; INTERNSHIP AND RESIDENCY; HEALTH PROMOTION;

D O I：

10.1007/BF02599455

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objective: To assess the knowledge, attitudes, and practices of internal medicine residents concerning dietary counseling for hypercholesterolemic patients. Design: Cross-sectional, self-administered questionnaire survey. Setting: Survey conducted August 1989 in seven internal medicine residency programs in four southeastern and middle Atlantic states. Participants: All 130 internal medicine residents who were actively participating in outpatient continuity clinic. Interventions: None. Measurements and main results: Only 32% of the residents felt prepared to provide effective dietary counseling, and only 25% felt successful in helping patients change their diets. Residents had good scientific knowledge, but the degree of practical knowledge about dietary facts varied. Residents reported giving dietary counseling to 58% of their hypercholesterolemic patients and educational materials to only 35%. Residents who felt more self-confident and prepared to counsel reported more frequent use of effective behavior modification techniques in counseling. Forty-three percent of residents had received no training in dietary counseling skills during medical school or residency. Conclusion: Internal medicine residents know much more about the rationale for treatment for hypercholesterolemia than about the practical aspects of dietary therapy, and they feel ineffective and ill-prepared to provide dietary counseling to patients.

引用

页码：511 / 516

页数：6

共 13 条

[1]

Goodman D.S., Hulley S.B., Clark L.T., Et al., Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Publication #88-2925, (1988)

[2]

Schucker B., Wittes J.T., Cutler J.A., Et al., Change in physician perspective on cholesterol and heart disease, JAMA, 258, pp. 3521-6, (1987)

[3]

Madlon-Kay D.J., Family physician recognition and treatment of severe hypercholesterolemia, J Fam Pract, 24, pp. 54-6, (1987)

[4]

McPhee S.J., Richard R.J., Solkowitz S.N., Performance of cancer screening in a university general internal medicine practice: comparison with the 1980 American Cancer Society guidelines, J Gen Intern Med, 1, pp. 275-81, (1986)

[5]

Woo B., Woo B., Cook F., Weisberg M., Goldman L., Screening procedures in the asymptomatic adult: comparison of physicians’ recommendations, patients’ desires, published guidelines, and actual practice, JAMA, 254, pp. 1480-4, (1985)

[6]

Bell M.M., Dippe S.E., Recognition and treatment of hypercholesterolemia in a family practice center, J Fam Pract, 26, pp. 507-13, (1988)

[7]

Madlon-Kay D.J., Improvement in family physician recognition and treatment of hypercholesterolemia, Arch Intern Med, 149, pp. 1754-5, (1989)

[8]

McBride P.E., Pacala J.T., Dean J., Plane M.B., Primary care residents and the management of hypercholesterolemia, Am J Prev Med, 6, 2, pp. 71-6, (1990)

[9]

Hoppe R.B., Farquhar L.J., Henry R., Stoffelmayr B., Residents’ attitudes towards and skills in counseling: Using undetected standardized patients, J Gen Intern Med, 5, pp. 415-20, (1990)

[10]

Wechsler H., Levine S., Idelson R.K., Rohman M., Taylor J.O., The physician’s role in health promotion. A survey of primary care practitioners, N Engl J Med, 308, pp. 97-100, (1983)

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