RESUMEN
OBJECTIVE: A pilot study to determine health belief factors associated with osteoporosis prevention behaviors in peri-and postmenopausal women. DESIGN: We administered a survey to a convenience sample of 60 women aged 40-95 years old in an urban family practice center and an associated retirement community. The self-reported questionnaire addressed demographics, osteoporosis risk factors, current preventive behaviors for osteoporosis, and health beliefs. RESULTS: The majority of women (89%) believed that osteoporosis is a serious condition, but only 29% perceived a personal susceptibility. Women were less concerned about osteoporosis when compared with cancer, cardiovascular disease, and neurologic disorders. Only 40% of women were taking active measures to prevent osteoporosis. There was no significant relationship between active osteoporosis prevention behaviors and five health belief factors (motivation, barrier, active participant in health care, frustration, and benefit) (p >or= 0.43). However, active behaviors to prevent osteoporosis were found to correlate with the single item "I am worried about developing osteoporosis" (p = 0.03). Most women surveyed would be willing to exercise and take calcium and a multivitamin to prevent osteoporosis. CONCLUSION: Few women are taking active measures to prevent osteoporosis despite their belief that it is a serious condition. Our data suggest that most women do not perceive a personal susceptibility to the disease. Only women who reported actively worrying about developing osteoporosis were more likely to be engaged in significant osteoporosis preventive behaviors.
Asunto(s)
Actitud , Conductas Relacionadas con la Salud , Osteoporosis Posmenopáusica/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Encuestas Epidemiológicas , Humanos , Persona de Mediana Edad , Proyectos PilotoRESUMEN
Patients who provide care to family members or friends with dementia are likely to be in a family physician's practice. The caregiver role can be stressful, and identifying these patients can give the family physician opportunities to help patients cope with the challenges of the caregiver role. Family physicians have a systematic approach for assessing the degree of caregiver burden in these patients. Because caregivers are at increased risk for depression and anxiety, screening should be done to exclude the presence of either disorder. The caregiver's skill in managing behavioral problems in the family member with dementia should be assessed. If there are problems, family physicians should provide practical counseling about common caregiving stresses and about resources that benefit caregivers. Helping the caregiver learn strategies for coping with difficulties may help reduce some of the stress the caregiver is experiencing.
Asunto(s)
Adaptación Psicológica , Cuidadores/psicología , Demencia/enfermería , Medicina Familiar y Comunitaria , Atención Domiciliaria de Salud/psicología , Rol del Médico , Estrés Psicológico/etiología , Estrés Psicológico/terapia , Costo de Enfermedad , Directorios como Asunto , Humanos , Visita a Consultorio Médico , Educación del Paciente como Asunto , Cuidados Intermitentes , Apoyo Social , Materiales de Enseñanza , Estados UnidosRESUMEN
The advance directive has been acknowledged widely by patients and physicians as a desirable tool to promote patient autonomy at the end of life. Rates of completion of advance directives, however, remain low among all segments of the population. Significant patient and physician barriers to completion of advance directives are considered. Legal and ethical principles of advance directives, as well as some practical means of overcoming barriers to these important discussions, are reviewed.
Asunto(s)
Directivas Anticipadas , Atención Primaria de Salud , Directivas Anticipadas/legislación & jurisprudencia , Actitud del Personal de Salud , Actitud Frente a la Salud , Humanos , Participación del Paciente/legislación & jurisprudencia , Relaciones Médico-Paciente , Cuidado Terminal/economía , Cuidado Terminal/legislación & jurisprudencia , Estados UnidosRESUMEN
Nutritional information and support for the elderly are available from many sources. Yet many older adults still remain at risk for malnutrition. This study examined the nutritional status of homebound elderly in a physician-monitored population, with access to health and social services. Older adult patients from the Home Visit Program of the Department of Family Medicine were visited, and an assessment was administered. All patients had primary care physicians who visited patients in their homes, on average, every 3 months. For this survey, the Nutritional Risk Index, the Nutritional Screening Initiative Checklist, an ADL (Activities of Daily Living) assessment, and general history questions were asked. In order to evaluate content of diet, food frequency and a 24-hour diet history were used. Questions on basic nutritional knowledge were asked, and a kitchen survey was used to examine purchasing behavior. Most patients were found to be at high nutritional risk with an average Nutritional Screening Initiative Risk score of 7, but for reasons that varied among patients. Most patients claimed to have a good appetite and enough money for food. The 24-hour diet analysis showed that many individuals did not meet 70% of RDA for major energy sources and fiber. Patient knowledge of the four basic food groups was poor. Since none of the patients shopped for themselves and many did not cook, the nutritional knowledge and food preparation behaviors of caregivers may be important for the nutritional well-being of the patient. An educational program for this population should include the caregiver as well as the patient.