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What Do Family Practice Residents Do in Prevention and Counselling?

By Michael Klein, Robert Bluman and David Tannenbaum


A study was undertaken to measure what family practice residents do in prevention and counselling during routine check-ups on adults. A series of Health Monitoring and Promotion (HMP) measures were used to assess the content of the check-up. The residents were given a sheet of guidelines in an attempt to augment performance of the HMP measures. Using one-way glass, 353 patient encounters were observed. Analysis of 171 encounters before and 182 encounters after the introduction of the guidelines showed that the guidelines positively influenced the residents' behavior by increasing the number of HMP measures performed. Preventive items of a physical nature were carried out 61.2% of the time before the introduction of the guidelines and 69.7% after, with more pronounced improvement when dealing with the 18-39 age group and among men. Similar changes occurred on historical items of a preventive type, but history-taking from women was more positively influenced. Preventive counselling was carried out 20% of the time and was uninfluenced by the guidelines. There was a high level of breast and testicle examination, but a low level of teaching self-examination. Counselling on retirement, lifestyle, ‘passages’ and similar issues was uninfluenced by the instrument

Topics: Academic Commentary
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