Family physician's roles in health promotion, what patients want

BACKGROUND: Family physicians are interested in health promotion for maintaining one's sound health. But there is little information on what patients think about the practice of health promotion by family physicians. Therefore, we found out whether patients think that it is appropriate for family physicians to be concerned about problems relating to four health risk factors, and the patients' perception both of their own health problems and of the concern actually shown by their family physicians. METHODS: Patients who had visited our two family medicine offices from March to August 1998 was asked to complete a self administered questionnaire. Questions on attitudes to wards and perceptions of family physicians' interest in weight, smoking, drinking, and fitness problems were included. 586 questionnaires with adequate response were analyzed using chi square test and Mantel Haenszel's linear trend test. RESULTS: A total of 586 respondents consisted of 230 men and 356 women. Of the respondents, the proportion of people who thought that family physicians should be concerned about the health risk factors ranged from 83.6% in the case of smoking to 86.5% of fitness, but 76.6% thought their family physicians had in fact been interested in smoking and 72.2% thought so about fitness. There was a significant age group trend in the case of attitudes towards family physician concern for smoking with larger proportions of older patients (p<0.01). Significantly more women than men thought that their family physicians seemed interested in health risk factor with 62.2% to 70.0% in men and 78.6% to 80.9% in women (p<0.001). There were significant age group differences in proportions who thought that their family physicians seemed interested in weight (p<0.001), smoking (p<0.001), and drinking (p<0.05) problems except for fitness problem. 31.6% of the respondents thought that they had a weight problem, 20.5% smoking problem, 14.0% drinking problem, and 28.2% fitness problem. CONCLUSION: These results suggest that many patients thought that most of their family physicians seemed interested in health promotion, but felt the need that they should be come more interested.

The relationship between nutrient intake and bone mineral density by use of a semiquantitative food frequency questionnaire

BACKGROUND: To determine the relationship between nutrient intake and bone mineral density(BMD), we have investigated this issue by the use of a semiquantitative food-frequency questionnaire. METHODS: A total of 312 women aged 33-77 was divided into two groups, 187 premenopausal and 125 postmenopausal women. Dietary intake was assessed with a food-frequency questionnaire. DMD was assessed with dual-energy X-ray absorptiometry at the lumbar spine (lumbar vertebrae 2-4). Pearson correlation and partial correlation coefficients were calculated for each nutrient at the lumbar spine BMD. RESULTS: The mean age of the 312 participants was 48 years, and their mean body mass index (BMI) was 23.7+/-2.8 Kg/m2. Forty percent of the women were in postmenopausal state. The mean lumbar BMD was 1.117g/cm2. Age was negatively correlated with BMD in premenopausal and postmenopausal women, BMI was positively correlated with BMD in postmenopausal women, but smoking and exercise were not correlated with BMD. In premenopausal women, nutrient intakes were not associated with BMD. A significant association was found between intakes of fat, iron, vitamin A, vitamin C and BMD in postmenopausal women, but after adjusting for age, body mass index, energy intake, smoking, exercise, and use of hormone replacement therapy, there was no association. CONCLUSION: There was no significant association between nutrient intakes and BMD of the lumbar spine.

The effect of urine-holding on blood pressure

BACKGROUND: For diagnosis of hypertension, prompt blood pressure measurement is necessary. In a clinical setting, increased blood pressure is often recorded during urine-holding. The aim of this study was to assess the effect of urine-holding on blood pressure. METHODS: We analyzed 172 subjets who visited a hospital in Pusan for examinafion of pelvic ultrasonography. We measured urine holding time, blood pressure in a urine-holding state, and blood pressure immediately after urination when pelvic ultrasonography was examined. Paired t-test was performed to compare the pre-voiding blood pressure. The relationship between urineholding time and difference in blood pressure were assessed by Pearsons's correlatian coefficients. RESULTS: In subjects who held urine for no less than 3 hours, mean pre-voiding systolic blood pressure was 124.2+/-20.8 mmHg, mean pre-voiding diastolic blood pressure was 78.3+/-13.3 mmHg, post-voiding systolic blood pressure was 120.0+/-21.0 mmHg, and post-voiding diastolic blood pressure was 75.4+/-12.3 mmHg. Mean difference in systolic bload pressure was 4.2+/-10.7mmHg, and mean difference in diastolic blood pressure was 2.8+/-7.7 mmHg(p0.05) CONCLUSION: Urine-holding for no less than 3 hours made systolic and diastolic blood pressure rise. However, the rise in blood pressure was not proportianal to urine-holding time.