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Discussing patient's lifestyle choices in the consulting room: analysis of GP-patient consultations between 1975 and 2008

机译：在咨询室讨论患者的生活方式选择：1975年至2008年之间的GP-患者咨询分析

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Background The increasing prevalence of chronic diseases and the growing understanding that lifestyle behaviour plays an essential role in improving overall health suggest a need for increased attention to lifestyle choices in the consulting room. This study aims to examine whether or not healthy and unhealthy lifestyle choices of patients are currently being discussed more often in primary care consultations than in former decades. Furthermore, we are interested in GPs' approach to lifestyle behaviour during consultations. Lastly, we examine whether lifestyle behaviour is discussed more with certain patients during consultations, depending on gender, age and educational background. Method We analysed video-recordings of medical consultations, collected between 1975 and 2008 in Dutch GP practices. Data were analysed using logistic regression. Results This study shows that discussion of smoking behaviour and physical activity has increased somewhat over time. A change in discussion of nutrition and alcohol is, however, less clear. Overall, alcohol use is the least discussed and physical activity the most discussed during consultations. GPs mainly refer to lifestyle when it is relevant to the patient's complaints (symptom approach). GPs' approach to lifestyle behaviour did not change over time. In general, lifestyle behaviour is discussed more with older, male patients (except for nutrition). GPs talk about lifestyle behaviour with patients from different educational backgrounds equally (except for physical activity). Conclusion In recent years there is greater awareness of a healthy lifestyle, which is reflected to a limited extent in this study. Still, lifestyle behaviour is discussed in only a minority of consultations. GPs do not refer to lifestyle behaviour as a routine procedure, i.e. do not include it in primary prevention. This highlights the importance of the introduction of prevention consultations, where GPs can discuss lifestyle issues with patients who do not (yet) have risk symptoms.
机译：背景技术慢性病的流行率不断提高，人们越来越认识到生活方式对改善整体健康起着至关重要的作用，这表明需要在诊疗室中更加关注生活方式的选择。这项研究旨在检查与过去几十年相比，目前在初级保健咨询中是否更经常讨论患者健康和不健康的生活方式选择。此外，我们对全科医生在咨询过程中的生活方式行为感兴趣。最后，我们根据性别，年龄和教育背景，检查是否在咨询过程中与某些患者就生活方式行为进行了更多讨论。方法我们分析了1975年至2008年之间在荷兰全科医生实践中收集的医疗咨询的录像。使用逻辑回归分析数据。结果这项研究表明，吸烟行为和体育锻炼的讨论随着时间的推移有所增加。然而，关于营养和酒精的讨论的变化尚不清楚。总体而言，在咨询期间，饮酒是讨论最少的活动，而体育锻炼是讨论最多的活动。全科医生主要指与患者抱怨相关的生活方式（症状方法）。全科医生对生活方式的态度并没有随着时间而改变。通常，与老年男性患者（营养除外）讨论的生活方式更多。全科医生与来自不同教育背景的患者平等地谈论生活方式（运动除外）。结论近年来，人们对健康生活方式有了更多的认识，这项研究在一定程度上反映了这一点。尽管如此，只有少数咨询会讨论了生活方式。全科医生不将生活方式作为常规程序，即不将其包括在一级预防中。这突出了引入预防咨询的重要性，在该咨询中，GP可以与尚未（尚未）有风险症状的患者讨论生活方式问题。

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