[Effects of a health-education approach on health behavior, consultation satisfaction and psychological well being]

Abstract

78 patients were recruited from a local occupational health clinic service and from general practices. They were allocated randomly to either an intervention group (40 patients) for a patient-centred approach to health care, or to a control group (38 patients) for conventional care. The patients were free to express their attitudes to health-related behaviour and to suggest behaviour changes. Emphasis was placed on the doctor being an active listener, with an understanding and sympathetic approach to the patient. 27 of the 40 patients in the intervention group suggested initiating change. After six weeks 24 patients reported having accomplished changes. There was a more significant reduction in the use of tobacco in the intervention group (p = 0.05) than in the control group. The patients' evaluation of the two approaches was the same, except for four patients in the intervention group, who felt provoked. Psychological well-being was measured using the Goldberg General Health Questionnaire, 28 item version (GHQ-28). In the control group there was a significant improvement in the GHQ-28 score (p = 0.022) after six weeks; the intervention group showed a near-significant improvement (p = 0.068) after 12 weeks. There was no significant difference in the change in GHQ-28 score between the groups. A patient-centred approach to health care may have potential for changing attitudes to health-related behaviour and bringing about actual behaviour changes. Further research with more extensive material is needed to confirm both this, and the effects on psychological well-being.