医生如何帮助病人改变对心脏有益的生活方式

改变生活方式是一种有效的、被证明有效的预防心脏病的方法. 但是为了让健康的改变坚持下去，人们通常需要一点帮助.

Primary care doctors could offer crucial assistance in connecting patients with counseling that's been shown to make a difference. 但由于沙巴足球体育平台限制或其他障碍，这些医生通常不会这样做.

一份新的报告为如何改变这种状况提供了指导.

The scientific statement, published Thursday in the 美国心脏协会 journal Circulation他总结了显示行为咨询益处的研究. It also offers practical ways for busy health care professionals to help patients get that kind of care – care that goes beyond the typical 15-minute annual appointment.

Deepika Laddu, 谁领导了撰写这份声明的小组, said it's not usually enough for a patient to simply recognize the need to change their eating or exercise habits.

“说‘我要减少饮食中的脂肪量’是一回事.但他们需要支持才能说出来, 我要把这种生活方式保持下去,'" said Laddu, an assistant professor of physical therapy in the College of Applied Health Sciences at the University of Illinois at Chicago.

Such support might involve guidance on planning a healthy diet or setting realistic exercise goals. It also could involve checking in regularly to make sure those plans and goals stay on track.

但“供应商没有沙巴足球体育平台，”拉杜说. “他们可能没有足够的资源. 也有体制相关的因素,“比如转诊政策或报销背后的官僚主义.

The report spells out the importance of overcoming such barriers by summarizing research on programs delivered in primary care or community settings that have been shown to work in people who are middle-aged or older. "We're providing the best-practice approaches of what has been done and what has successfully been shown to improve health behaviors – ­not for a short period of time, 但是很长一段沙巴足球体育平台," Laddu said.

其中一个例子就是糖尿病预防计划，报告的合著者Dr. 马骏是芝加哥伊利诺伊大学的医学教授. It's a well-studied intervention that includes lifestyle coaches who meet regularly with participants. It's been shown to work as well or better than medication at reducing risk factors for heart disease.

But it still tends to be much easier for a physician to write a prescription than to enroll someone in such a program, Ma said. "They do not have the same system or infrastructure to just prescribe a behavioral intervention."

Overworked primary care professionals shouldn't be expected to do all the work themselves, Ma said. "Typical clinicians are not trained to be behavioral counselors or health coaches. 因此，它需要一个基于团队的方法. We need to have people properly trained in behavioral counseling to be on the care team."

为了帮助解决这个问题, the report offers doctors links to lists of community programs – available through the Centers for Disease Control and Prevention, 基督教青年会和其他机构——他们可以用来推荐病人. And it explains how programs might qualify for insurance coverage under the Affordable Care Act.

马说，即使一个实践没有使用行为方法, the statement is written to fit in with the way physicians are trained to guide patients. So, the hope is it systematically makes it easier for doctors to assist patients and arrange care for those who need it.

The report is a starting point for changing the way doctors promote health in light of long-term trends showing an aging population with growing levels of heart disease, Laddu said.

"I don't know if our health care system is going to be equipped for handling the rising burden of heart disease that is expected unless we make a change now," she said, "and unless we help providers understand what tools are available and increase the awareness of what can be done beyond the constraints of their 15-minute window."

当病人准备好改变的时候, Laddu said, 医疗团队也需要承担责任，说, “我需要帮助我的病人改变," whether that's directly helping a patient or "arranging the support system so that their patient can get the care that they need, 当他们需要的时候, 只要他们需要."

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