Health Promotion Counseling Research Articles

Family Practice Physicians’ Perceptions and Practices Regarding Health Promotion for the Elderly

This study assessed 321 family practice physicians' perceptions and practices regarding health promotion in the elderly; specifically, whether health promotion is perceived to be beneficial for this segment of the population. A random sample of 250 male and 250 female members of the American Academy of Family Physicians was surveyed. The internal reliability of the questionnaire was assessed, yielding a Cronbach alpha of .84. Respondents were 46% male and 54% female, and 67% of them had completed a residency program. Three-fourths (77%) of the respondents were between 25 and 50 years of age. The majority believed that health promotion counseling is of value to patients of all ages (88%) and that medical schools should devote more attention to preventive medicine (69%). These physicians identified lack of third-party payment, lack of sufficient staff, lack of competence in prescribing prevention programs for the elderly, and finding counseling the elderly about preventive health issues not professionally gratifying as barriers to health promotion of the elderly. All health promotion practices but one listed on the questionnaire were perceived as important by at least half the physicians. Until compensation for health promotion is available and physicians perceive themselves as competent concerning health promotion in the elderly, it is likely their clinical practices and recommendations will lag behind their favorable attitudes toward the topic.

Clinical implications of population-based studies in Europe

The cross-fertilization of epidemiology and clinical medicine is a continuous process. The impressive progress in cardiovascular disease (CVD) epidemiology of the last 30 years was substantially reinforced by large population-based intervention studies in the last decade. As a result, guidelines for prevention are emerging with relatively clear implications for clinical medicine in general. Two such guidelines were recently published by the Royal College of General Practitioners (2, 5). However, the application of these general principles in day-today doctor-patient interaction is not easy. General health promotion counseling in the family, conscientious case findings, and regular follow-up are the main points of agreement between epidemiologists and progressive clinicians. Preventive treatment with drugs, however, needs to be decided in each case individually. The ever-increasing new epidemiological knowledge, the intimate knowledge of the individual and his family, and the careful balancing of potential benefits and possible side effects of treatment coupled with the art of the clinician are helping physicians to make these difficult decisions correctly. In order to maximally diminish the current need for such difficult decision making, when the patient's risk is already high, generally adopted, sound, and safe health promotion efforts should be pursued by clinicians in their everyday activities. WHO will continue to encourage the accumulation of sound knowledge in prevention of CVD and other chronic diseases. The future calls for comprehensive health promotion policies focused on the individual and on the community, not only in regard to single diseases.