Dietary counseling of hypercholesterolemic patients by internal medicine residents |
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Authors: | Dr. Mark A. Levine MD Robert S. Grossman MD Paul M. Darden MD Sherron M. Jackson MD James G. Peden MD Alice S. Ammerman DrPH RD Mina L. Levin MD Richard D. Layne MD Laura Q. Rogers MD Charles B. Seelig MD Arthur T. Evans MD MPH Miriam B. Settle PhD Suzanne W. Fletcher MD |
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Affiliation: | (1) the Department of Medicine, the University of North Carolina Faculty Development Program in General Medicine and General Pediatrics, USA;(2) the Area Health Education Center Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;(3) School of Medicine, the Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;(4) the Health Services Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;(5) Department of General Internal Medicine, Geisinger Medical Center, 17822 Danville, PA;(6) the Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina;(7) the Departments of Medicine and Psychiatry, East Carolina University School of Medicine, Greenville, North Carolina;(8) the Department of Medicine, West Virginia University School of Medicine, Morgantown, West Virginia;(9) the Department of Medicine, Medical College of Georgia, Augusta, Georgia |
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Abstract: | Objective:To assess the knowledge, attitudes, and practices of internal medicine residents concerning dietary counseling for hypercholesterolemic patients. Design:Cross-sectional, self-administered questionnaire survey. Setting:Survey conducted August 1989 in seven internal medicine residency programs in four southeastern and middle Atlantic states. Participants:All 130 internal medicine residents who were actively participating in outpatient continuity clinic. Interventions:None. Measurements and main results:Only 32% of the residents felt prepared to provide effective dietary counseling, and only 25% felt successful in helping patients change their diets. Residents had good scientific knowledge, but the degree of practical knowledge about dietary facts varied. Residents reported giving dietary counseling to 58% of their hypercholesterolemic patients and educational materials to only 35%. Residents who felt more self-confident and prepared to counsel reported more frequent use of effective behavior modification techniques in counseling. Forty-three percent of residents had received no training in dietary counseling skills during medical school or residency. Conclusion:Internal medicine residents know much more about the rationale for treatment for hypercholesterolemia than about the practical aspects of dietary therapy, and they feel ineffective and ill-prepared to provide dietary counseling to patients. Presented in part at the annual meeting of the Society of General Internal Medicine, Arlington, Virginia, May 2–4, 1990. Supported by the University of North Carolina Faculty Development Fellowship Program in General Medicine and General Pediatrics (54004-05, Bureau of Health Professions, Washington, DC) and by grants from the Medical Foundation of North Carolina, the Georgia Affiliate of the American Heart Association, and the Geisinger Foundation. |
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Keywords: | Hypercholesterolemia dietary counseling physician counseling internship and residency health promotion |
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