家庭醫學專科訓練醫院主治醫師執行運動諮詢之現況調查

Exercise Counseling by Teaching Staff of Family Medicine Specialty Training Hospitals

楊宜青(Yi-Ching Yang) ； 陳淑眉(Shu-Mei Chen) ； 黃盈翔(Ying-Hsiang Huang) ； 胡淑貞(Shu-Chen Hu) ； 吳晉祥(Jin-Shang Wu) ； 盧豐華(Feng-Hwa Lu)

《臺灣家庭醫學研究》 4卷1期 (2006/01) Pp. 26-39

https://doi.org/10.29475/TFMR.200601.0003

摘要

本研究之目的乃是探討國內負責培育家庭醫師的主治醫師們進行病患有氧運動、伸展運動及肌力訓練等三項運動諮詢的情形，包括執行率、諮詢方式、內容、遭遇之障礙，及影響其進行此三項諮詢的相關因素。研究的進行方式是在2004年4月至6月以自填式結構性問卷來收集資料，對象爲當年家庭醫學專科醫師訓練醫院的所有373名家庭醫學科主治醫師。結果顯示有氧運動、伸展運動及肌力訓練三項運動諮詢的執行率分別爲94.4%、79.4%及63.1%，但給予病患上述三項活動建議量達到建議標準之比例則分別是74%, 39%, 31%。諮詢時間大多爲3分鐘以內，且5-7成醫師僅以口頭方式進行運動諮詢。醫師回應缺乏運動諮詢相關衛教資料、沒有足夠的時間及指導經驗不足是主要的諮詢障礙。每年會有2次以上詢問病患身體活動情形者，進行運動諮詢的比例較高，三項運動諮詢的勝算比分別是1.8, 2.5和4.1。雖然國內家庭醫學專科訓練醫院的主治醫師普遍都會進行運動諮詢，但大多醫師僅對不及20%的病患進行諮詢，且對病患會因此去做運動的信心不高，顯示醫師對其運動諮詢的成效並不樂觀，此外醫師如何對所有病患做個別化運動諮詢之相關觀念、衛教材料及教育訓練仍有改善空間。

並列摘要

The purpose of this study was to investigate counseling on aerobic exercise, stretch exercise and weight training practiced by teaching staff in family medicine specialty training hospitals in Taiwan. A structured questionnaire was mailed to all 373 registered staff members of Taiwan Association of Family Medicine between April to June 2004. The results showed that 95%, 85% and 63% of physicians reported to have provided counseling on aerobic exercise, stretch exercise and weight training to their patients, respectively. However, only 74%, 39%, 31% of the physicians respectively had suggested appropriate amount of physical activities which met the criteria recommended by The American College of Sports Medicine. Most physicians made counseling in less than 3 minutes, and mostly by oral instruction only. The major barriers to practice counseling were lack of handy educational materials, insufficient time and insufficient counseling experience in sequence. Those who had inquired patients of physical activity for more than twice a year had highter tendency to practice exercise counseling, the odds ratios for aerobic exercise, stretch exercise and weight training were 1.8, 2.5 and 4.1 respectively. In conclusion, although exercise counseling is a common practice by family physicians, most physicians provide counseling to less than 20% of their patients only, and are not confident of its effectiveness. It indicates that physicians are not satisfied with their exercise counseling practice. Adequate educational materials and enhanced exercise counseling training are needed for improvement.

並列關鍵字

exercise counseling ； aerobic exercise ； stretch exercise ； weight training ； family physicians