Abstract
Objetivo
Describir y comparar los conocimientos y las actitudes de los médicos de familia (MF) europeos con los de los MF españoles en la implantación de actividades preventivas y de promoción de la salud en atención primaria, describir las barreras para su implementación y evaluar la relación entre los estilos de vida propios de los MF y su influencia en las actividades realizadas en sus pacientes.
Diseño
Estudio postal multinacional a través de un cuestionario durante los meses de junio de 2000 a mayo de 2001.
Emplazamiento
Muestra de MF a partir de las bases de datos de las sociedades científicas de cada país europeo participante.
Participantes
En total participaron 2.082 MF de 11 países europeos. En España, el número total de MF participantes fue de 270.
Resultados
Los MF españoles realizaban en un porcentaje superior la mayoría de las actividades de prevención y de promoción de la salud, y realizaban menos aquellas actividades de prevención de escasa o dudosa evidencia científica con respecto al conjunto de MF europeos. El conjunto de MF del estudio consideraba que la excesiva carga de trabajo/escaso tiempo era la primera barrera para el desarrollo de las actividades de prevención y promoción de la salud. Los MF fumadores del conjunto europeo se sienten menos efectivos para ayudar a sus pacientes a reducir o abandonar el consumo de tabaco con respecto a los MF no fumadores (el 39,34 frente al 48,18%; p < 0,01). Los MF europeos que realizan ejercicio se sienten más eficaces para ayudar a sus pacientes a practicar ejercicio regularmente que los MF sedentarios (el 59,14 frente al 49,70%; p < 0,01). No se observaron diferencias significativas al respecto en los MF españoles.
Conclusiones
Globalmente existe aún un vacío en los conocimientos y las actitudes de los MF con relación a las recomendaciones sobre prevención y promoción de la salud. Los MF españoles realizan en mayor porcentaje las actividades de prevención y promoción de la salud por grupos de edad y sexo de mayor evidencia científica.
Palabras clave: Actitudes, Prevención, Promoción de la salud, Práctica clínica, Atención primaria
Abstract
Objective
Disease prevention and health promotion are important tasks in the daily practice of all general practitioners (GPs). The objective of this study was to explore the knowledge and attitudes of European and Spanish GPs in implementing evidence-based health promotion and disease prevention recommendations in primary care, to describe GPs’ perceived barriers to implementing these recommendations, and to assess how GPs’ own health behaviors affect their work with their patients.
Design
A postal multinational survey was carried out from June 2000 to May 2001.
Setting
A random sample of GPs listed from national colleges of each country.
Participants
A total of 2082 GPs from 11 European countries participated in the survey. In Spain a total of 270 GPs participated.
Results
Spanish GPs carried out more frequently most of the health promotion or disease prevention activities than the European GPs. Spanish GPs carried out less often those no evidence-based activities. The most important barrier reported was heavy workload/lack of time. Associations between personal health behaviour and attitudes to health promotion or activities in prevention were found. GPs who smoked felt less effective in helping patients to reduce tobacco consumption than non-smoking GPs (39.34% vs 48.18%; P<.01). GPs who exercised felt that they were more effective in helping patients to practice regular physical exercise than sedentary GPs (59.14% vs 49.70%; P<.01). No differences were observed for Spanish GPs.
Conclusions
Significant gaps between GP's knowledge and practices persist in the use of evidence-based recommendations for health promotion and disease prevention in primary care. Spanish GPs carried out more frequently evidence-base recommendations for health promotion and disease prevention by age and sex.
Key words: Attitudes, Prevention, Health promotion, Clinical practice, Primary care
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