Health Habit Counseling Amidst Competing Demands
| Autor: | Andrew B. Lanto, Scott E. Sherman, Lisa V. Rubenstein, Bruce A. Chernof, Elizabeth M. Yano, Martin Lee |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Counseling
Male media_common.quotation_subject Health Behavior Primary care California Doctor patient communication Cohort Studies CONSECUTIVE SAMPLE Habits Nursing Surveys and Questionnaires Odds Ratio Humans Medicine Longitudinal Studies Aged media_common Health Services Needs and Demand Likelihood Functions Primary Health Care business.industry Public Health Environmental and Occupational Health Middle Aged United States United States Department of Veterans Affairs Logistic Models Health promotion Habit business Health habits Health care quality |
| Zdroj: | Medical Care. 37:738-747 |
| ISSN: | 0025-7079 |
| DOI: | 10.1097/00005650-199908000-00004 |
| Popis: | This study assesses the effects of competing demands, such as poor health habits or new medical problems, on health-habit counseling during a primary care visit.We surveyed a consecutive sample of 1,259 patients visiting primary care clinicians at an academic VA medical center. Before the visit, patients reported their health status, health habits, and sociodemographics; immediately after the visit, patients reported reasons for the visit and whether they had been counseled about specific health habits. We scored visit acuity ranging from visits for unscheduled walk-in care or new medical problems to scheduled visits for check-ups or old problems. We defined counseling "triggers" as clinical indications for counseling about particular health habits (e.g., smoking). We developed a logistic model predicting primary care provider counseling during a visit.Over two-thirds of patients (68.9%) received some health habit counseling. Controlling for other independent variables, patients with more triggers were more likely to report being counseled. Counseling rates went up as visit acuity went down; patients with the lowest visit acuity having 67% greater odds of being counseled than patients with the highest visit acuity.Physicians set priorities for health-habit counseling during a visit based on patients' health habit problems or triggers; whether the visit is scheduled or walk-in; and whether the patient has new or acute problems. Future research about primary care performance of health habit counseling should account for these patient and visit characteristics, and prevention-oriented health care organizations should ensure access to scheduled "check-up" visits. |
| Databáze: | OpenAIRE |
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