ABSTRACT
BACKGROUND: There is increasing focus on hospitals to provide health promotion (HP) to patients who smoke, misuse alcohol, are obese or physically inactive, yet there is little published literature on assessment and HP in English hospitals. METHODS: Thirty hospitals participated in national audits, both in 2009 and 2011, to assess HP in hospitalized patients. Random samples of 100 patients were selected per hospital per year. RESULTS: Between the 2009 and 2011 audit, assessment rates increased for smoking (82 versus 86%; P < 0.001) and obesity (38 versus 53%; P < 0.001), alcohol assessments remained similar (71 versus 73%; P = 0.123) and physical activity assessments decreased (34 versus 28%; P < 0.001). Provision of HP was similar in both audits for smoking (22 versus 26%; P = 0.17), alcohol misuse (47 versus 44%; P = 0.12) and physical inactivity (43 versus 44%; P = 0.865), but fell for obesity (26 versus 14%; P < 0.001). Few hospitals met the standards for assessment and HP for each risk factor. CONCLUSIONS: Whilst patients are being assessed for most lifestyle risk factors, and despite an increased policy focus, there remains little evidence of HP practice in English hospitals. There is potential for health gain across England that could be exploited through wider provision of HP for hospitalized patients.
Subject(s)
Health Promotion/methods , Health Promotion/statistics & numerical data , Hospitals/standards , Adult , Aged , Alcohol Drinking/epidemiology , Alcohol Drinking/prevention & control , England/epidemiology , Female , Health Policy , Hospitals/statistics & numerical data , Humans , Male , Medical Audit , Medical Records , Middle Aged , Motor Activity , Obesity/epidemiology , Obesity/prevention & control , Public Health Practice/statistics & numerical data , Risk Factors , Smoking/epidemiology , Smoking Prevention , State MedicineABSTRACT
The musculoskeletal function of vitamin D has been well defined, prompting the population to supplement with vitamin D and calcium to maximise bone growth. However the role of vitamin D in pregnancy has not been systematically studied and is permeated with continuing controversy regarding the cause and effect relationship of vitamin D and pregnancy outcomes. Although further research is needed, the National Institute of Health and Clinical Excellence (NICE) (2008) recommend that all pregnant and breastfeeding women supplement with 10 microgrammes of vitamin D daily. Furthermore midwives and health visitors are asked to educate women about the importance of vitamin D supplementation, at booking and throughout antenatal care. Each appointment presents an opportunity to address concerns and explore options to increase levels through diet and supplementation and address any difficulties in obtaining supplements.
