title: Mental health and the relationship between health promotion counseling and health outcomes in chronic conditions: cross-sectional population-based study.
abstract: OBJECTIVE
  To explore the relationship between health promotion counseling (HPC) provided by FPs and health-related quality of life (HRQL) and the use of health care services among patients with chronic conditions, while assessing the effect of mental health on these relationships.
  
  
  METHODS
  Telephone survey using random-digit dialing.
  
  
  METHODS
  Alberta.
  
  
  METHODS
  A total of 1615 participants with chronic conditions.
  
  
  METHODS
  Health promotion counseling provided by FPs, which was assessed using 4 questions; HRQL using the Euro quality of life 5-dimensions (EQ-5D) questionnaire; and the use of health care services assessed with self-reported emergency department (ED) visits and hospitalizations.
  
  
  RESULTS
  Of the 1615 participants with chronic conditions, 55% were female and more than two-thirds were older than age 45 years. Less than two-thirds of participants received HPC from their FPs. In patients without anxiety or depression, those who needed help from their FPs in making changes to prevent illness had a 0.05 lower EQ-5D score than those who did not (P < .001); and those who received diet counseling had a 0.03 higher EQ-5D score than their counterparts did (P = .048). However, these associations were not observed in patients with anxiety or depression. Patients were more likely to have visited EDs if they needed their physicians' help in making changes to prevent illness (odds ratio 1.43, 95% CI 1.08 to 1.89) and less likely to visit EDs if they had been encouraged by their physicians to talk about their health concerns (odds ratio 0.69, 95% CI 0.52 to 0.91). None of the HPC items was associated with hospitalizations.
  
  
  CONCLUSIONS
  Not all patients with chronic conditions are receiving HPC from their FPs. Also, there is an association between HPC and important health outcomes (ie, HRQL and ED visits), but this association is not apparent for those with anxiety or depression.
authors: Department of Public Health Sciences, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, AB T6G 2E1. jeff.johnson@ualberta.ca.
authors: Fatima
authors: F
authors: Al Sayah
authors: Calypse
authors: C
authors: Agborsangaya
authors: Markus
authors: M
authors: Lahtinen
authors: Tim
authors: T
authors: Cooke
authors: Jeffrey A
authors: JA
authors: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000416:Alberta; D001007:Anxiety / Q000523:psychology*; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D003376:Counseling / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003625:Data Collection; D003863:Depression / Q000523:psychology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005194:Family Practice / Q000379:methods*; D005260:Female; D006293:Health Promotion / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D055815:Young Adult