The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71302

Viviane Leaune, MSc, Gilles Paradis, MD, MSc, FRCPC, Lise Renaud, PhD, Sara La Tour, MSc, and Sylvie Chevalier, MSc. Institut national de santé publique, Direction de santé publique de Montréal-centre, 1301, Sherbrooke est, Montréal, QC H2L 1M3, Canada, (514)528-2400 #3380, vleaune@santepub-mtl.qc.ca

Although patients value health professional (HP) counseling regarding prevention, little is known about differences between nurses and physicians regarding counseling practices and between patients and HP perspectives on counseling. As part of the baseline assessment for a community-based trial, we conducted telephone interviews with 3 802 patients aged 18 to 74 years (response rate (RR): 70%) from 20 local community clinics (LCC) in Quebec. Self-administered questionnaires were completed by 177 nurses (RR: 75%) and 83 physicians (RR: 58%). Significantly (p<0,05) more nurses than physicians felt they had little or no counseling preparation for smoking cessation (49% vs 4%), and for physical activity (42% vs 29%), but similar proportions felt ill-prepared for dietary counseling (39% vs 37%). Significantly (p<0,05) more physicians (76%) than nurses (5%) gave cessation counseling to all or almost all smokers during visits with appointment compared to 27% and 3% respectively in walk-in clinics. Although 63% of patients reported that their blood pressure (BP) was measured at their last visit, only 44% of those who had ever been told they were hypertensive had ever received counseling to reduce their BP. Fifty-one percent of smokers had never received cessation counseling and only 26% and 18% of patients had ever received dietary or physical activity recommendations respectively. These data suggest that much prevention opportunities are unused by primary care HP. The lower frequency of preventive counseling practices among nurses may be related to lack of training and the definition of their role in LCC.

Learning Objectives:

• 3. Identify differences in preventive practices of physicians and nurses.
  7. Identify gaps in cardiovascular preventive counseling practices.
  11. Understand how the context of consultations influence counseling practices.

Keywords: Evaluation, Counseling

Related Web page: www.inspq.qc.ca/aucoeurdelavie

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.