The process and methods of health counseling by primary health care personnel in Finland: a national survey.

A stratified random sample of 53 Finnish health centers was selected, and representative samples of their physicians, nurses and physiotherapists were surveyed by questionnaire on the frequency of their use of health education methods in health counseling and their perception of the ease vs. difficulty of implementing the stages of the process of lifestyle counseling. Overall, the assessment of the enabling and reinforcing factors in client health behavior (social relationships and physical environment), the translation of these factors into a behavior change program and the evaluation of such programs were seen as difficult by all three categories of health care professionals. The implementation stage of lifestyle counseling was, however, generally rated as easy, although quite a limited selection of education methods and self-evident motivational prompts were used. The physiotherapists regarded the process of lifestyle counseling in their specialty, exercise counseling, as easier to conduct and they used a more varied selection of methods than the other health care personnel groups. The findings indicate a need for further in-service education for Finnish health center professionals on health education methods as well as a need for the restructuring of the care system to allow better opportunities for the full realization of the process of health counseling.