当前位置： SCI文献检索 > BMC Family Practice期刊下所有文献 > Primary prevention in general practice - views of German general practitioners: a mixed-methods study.

Primary prevention in general practice - views of German general practitioners: a mixed-methods study.

Abstract：

BACKGROUND:Policy efforts focus on a reorientation of health care systems towards primary prevention. To guide such efforts, we analyzed the role of primary prevention in general practice and general practitioners' (GPs) attitudes toward primary prevention. METHODS:Mixed-method study including a cross-sectional survey of all community-based GPs and focus groups in a sample of GPs who collaborated with the Institute of General Practice in Berlin, Germany in 2011. Of 1168 GPs 474 returned the mail survey. Fifteen GPs participated in focus group discussions. Survey and interview guidelines were developed and tested to assess and discuss beliefs, attitudes, and practices regarding primary prevention. RESULTS:Most respondents considered primary prevention within their realm of responsibility (70%). Primary prevention, especially physical activity, healthy eating, and smoking cessation, was part of the GPs' health care recommendations if they thought it was indicated. Still a quarter of survey respondents discussed reduction of alcohol consumption with their patients infrequently even when they thought it was indicated. Similarly 18% claimed that they discuss smoking cessation only sometimes. The focus groups revealed that GPs were concerned about the detrimental effects an uninvited health behavior suggestion could have on patients and were hesitant to take on the role of "health policing". GPs saw primary prevention as the responsibility of multiple actors in a network of societal and municipal institutions. CONCLUSIONS:The mixed-method study showed that primary prevention approaches such as lifestyle counseling is not well established in primary care. GPs used a selective approach to offer preventive advice based upon indication. GPs had a strong sense that a universal prevention approach carried the potential to destroy a good patient-physician relationship. Other approaches to public health may be warranted such as a multisectoral approach to population health. This type of restructuring of the health care sector may benefit patients who are unable to afford specific prevention programmes and who have competing demands that hinder their ability to focus on behavior change.

journal_name

BMC Fam Pract

journal_title

BMC family practice

authors

Holmberg C,Sarganas G,Mittring N,Braun V,Dini L,Heintze C,Rieckmann N,Muckelbauer R,Müller-Nordhorn J

doi

10.1186/1471-2296-15-103

subject

Has Abstract

pub_date

2014-05-25 00:00:00

pages

103

issn

1471-2296

pii

1471-2296-15-103

journal_volume

pub_type

杂志文章

在线工具

Primary prevention in general practice - views of German general practitioners: a mixed-methods study.