Using doctor-patient communication to affect patients' lifestyles. theoretical and practical implications

Physicians very often do not perceive themselves as being efficient in affecting patients' life style. The aim of this article is to elucidate theoretical constructs and models in health education and their practical implications for individual health counselling in daily work as a guidance for physicians. The current most commonly used strategies are giving information and exhorting people, which have a limited ability to change peoples' behaviour. Derived from current behavioural constructs and models in health education - such as the health belief model, social learning theory, health beliefs, self-efficacy, self-determination theory - principles for successful strategies are described: to use patient-centredness instead of directing, to encourage patients to reflect and decide on their behavior, to find out the patient's readiness to change, to present knowledge as neutral facts instead of valuations, to focus on the actual behaviour instead of information-giving, to highlight patients' health beliefs and to discuss the advantages and disadvantages which the patients experience with their life style. The article concludes with a comprehensive model for individual health counselling in consecutive steps.