Lifestyle Medicine Professionals in Training: A Survey of Behaviors, Knowledge and Needs

Background/Purpose: It is well known that healthy lifestyle habits can influence chronic disease risk and outcomes. The effective practice of Lifestyle Medicine (LM), however, goes beyond general recommendations and has been encapsulated in well-defined clinical competencies. While it has been documented that graduating medical students feel inadequately prepared to counsel patients in nutrition and exercise, the purpose of this study is to explore the perceptions and experiences of Lifestyle Medicine in a group of interdisciplinary healthcare trainees. Methods: A pilot survey of trainees at the 2015 Annual American College of Lifestyle Medicine (ACLM) Conference assessed perspectives on the inclusion of nutrition and exercise in their educational curricula, knowledge of core LM competencies and personal health habits. Results: Of the 37 trainees registered, 22 surveys were completed. Twenty-six percent indicated they were exposed to courses in exercise; sixty-five percent reported having a nutrition block and fifty percent received instruction on counseling about LM behaviors. Relative importance using Likert scale (1-not important, 5-very important) ascribed similar levels of importance to exercise (4.44), nutrition (4.31), and behavioral counseling (4.58) training. Ninety-five percent reported personal engagement in physical activity, however only forty-two percent were familiar with the Lifestyle Medicine core competencies. Ninety-four percent indicated that the current medical model was insufficient in educating trainees to address lifestyle related diseases. Conclusion: In a select multidisciplinary sample of trainees, there is recognition of the importance of Lifestyle Medicine training. Although trainees surveyed practice healthful behaviors, the majority were not familiar with core Lifestyle Medicine competences and express strong interest in increased Lifestyle Medicine in their training experience

Patient knowledge and expectations for functional recovery after stroke

Objective: Understanding the causes and outcomes of stroke is important for stroke survivors and may affect their success in rehabilitation and their risk of recurrent stroke; therefore, this study was performed to assess the knowledge and expectation of functional recovery in stroke patients undergoing acute inpatient rehabilitation. Design:Survey study of 50 consecutive stroke patients undergoing inpatient rehabilitation at a single urban rehabilitation hospital. Results:Forty-six percent of participants were able to correctly identify whether they had sustained a cerebral infarct or hemorrhage. Rehabilitationlength of stay was, on average, 1 wk longer than anticipated by patients. Patients overestimated their functional abilities on initial assessment and at discharge compared with staff assessments, withsome improvement in accuracy for discharge predictions. Ninety-four percent of participants expected to be discharged home, and most achieved this goal. Although no participant anticipated discharge to a nursing home, 10% of patients were discharged to this location. Conclusions: Knowledge of stroke and its treatment was limited, and expectations for recovery tended to exceed actual accomplishments. There are significant areas of opportunity for enhanced educational efforts for stroke patients undergoing inpatient rehabilitation

Family member knowledge and expectations for functional recovery after stroke

Objective: To assess the stroke knowledge and expectations for recovery among the family members of stroke patients in an acute rehabilitation hospital. Design: Survey study of 50 family members of stroke patients under going inpatient rehabilitation at a single urban rehabilitation hospital. Results: Sixty percent of participants were able to identify whether their family member had sustained a cerebral hemorrhage or infarct; 48% were able to identify at least one treatment provided to their family member for his or her stroke. The average length of stay predicted byparticipants closely matched the average patient length of stay. Participants tended to overestimate the functional abilities of their family member with a stroke, both on initial assessment and discharge. This overestimation was more substantial for discharge functional ability than for initial assessment. Participants were able to predict discharge location with substantial accuracy (82% agreement, kappa.41). Conclusions: The knowledge of stroke etiology and functional outcome of family members of individuals undergoing rehabilitation after stroke shows significant limitations. Participants’ ability to predict functional outcome on discharge was worse than their knowledge of current functional status. Participant predictions of length of stay and discharge disposition were areas of relative strength. Further efforts are needed to enhance the knowledge level of family members of patients undergoing rehabilitation after stroke

Compendium of the health and wellness coaching literature

Health and wellness coaching (HWC) for lifestyle behavior change is emerging as a practice, role, and profession, in diverse health care, employee wellness, and community settings. Health care professionals apply HWC as a behavior change methodology for the prevention and treatment of diabetes, hypertension, hyperlipidemia, heart disease, cancer, and other chronic disorders. The purpose of this systematic review was to provide a comprehensive and organized compendium of HWC literature. To date, extant HWC literature remains scattered with no meaningful summary accessible. Lack of comprehensive summary stems from lack of consensus on HWC definition and standards. We applied a recently proposed, standardized definition of HWC to determine compendium inclusion criteria for peer-reviewed, data-based literature from relevant search engines (ie, PubMed, PsychInfo, and CINAHL). A systematic review process was executed and ultimately yielded 219 articles meeting HWC inclusion criteria. Of these, 150 were databased and the remainder were expert opinion or review-style articles. A summary of results generally reveals HWC as a promising intervention for chronic diseases though further research is needed in most categories. The resulting HWC compendium organizes and describes the quantity and quality of available literature for the use and benefit of HWC practitioners and researchers