Training physicians in behavioural change counseling: A systematic review.

Autor: Dragomir AI; Department of Psychology, Université du Québec à Montréal, Canada; Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Canada., Julien CA; Department of Psychology, Université du Québec à Montréal, Canada; Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Canada., Bacon SL; Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Canada; Department of Health, Kinesiology and Applied Physiology, Concordia University, Canada., Boucher VG; Department of Psychology, Université du Québec à Montréal, Canada; Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Canada., Lavoie KL; Department of Psychology, Université du Québec à Montréal, Canada; Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Canada. Electronic address: lavoie.kim@uqam.ca.
Jazyk: angličtina
Zdroj: Patient education and counseling [Patient Educ Couns] 2019 Jan; Vol. 102 (1), pp. 12-24. Date of Electronic Publication: 2018 Aug 19.
DOI: 10.1016/j.pec.2018.08.025
Abstrakt: Background: Poor health behaviours (e.g., smoking, physical inactivity) represent major underlying causes of non-communicable chronic diseases (NCDs). Prescriptive behaviour change interventions employed by physicians show limited effectiveness. Physician training in evidence-based behaviour change counselling (BCC) may improve behavioural risk factor management, but the efficacy and feasibility of current programs remains unclear.
Objective: (1) To systematically review the efficacy of BCC training programs for physicians, and (2) to describe program content, dose and structure, informing better design and dissemination.
Methods: Using PRISMA guidelines, a database search up to January 2018, yielded 1889 unique articles, screened by 2 authors; 9 studies met inclusion criteria and were retained for analysis.
Results: 100% of studies reported significant improvements in BCC skills among physicians, most programs targeting provider-patient collaboration, supporting patient autonomy, and use of open questions to elicit "change-talk". Limitation included: poor reporting quality, high program heterogeneity, small sample sizes, 78% of studies having no comparison group, and less than 30% of skills taught being formally assessed.
Conclusion: Training programs were efficacious, but methodological weaknesses limit the ability to determine content and delivery. Caution is necessary when interpreting the results.
Practice Implications: Further research emphasizing rigorous training program development and testing is warranted.
(Copyright © 2018. Published by Elsevier B.V.)
Databáze: MEDLINE
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