STRENGTHS AND WEAKNESSES IN HEALTH COUNSELING IN FINNISH PRIMARY HEALTH-CARE

Representative samples of Finnish health centres and of their physicia ns, nurses and physiotherapists were selected for a comprehensive surv ey on the professionals':work characteristics, health education attitu des and counseling practices. The main objectives of the study were to study the degree of implementation of patient counseling, with specia l reference to the national goals in health policy and to analyze the determinants of counseling practices in terms of predisposing, enablin g and reinforcing factors. Broadly defined patient counseling was freq uent in the contacts with all 3 professional groups and no differences in counseling frequency were found between different sizes of health centres. However, the objective of implementing counseling in every pa tient contact, with the incorporation of guidance regarding healthy li ving habits in it, recommended in the national health policy goals, wa s only partially realized. There were distinct differences between the 3 professional groups in counseling attitudes, topics, methods and pu rposes. These differences reflect, to a great extent, the differences in the professional tasks and the basic training between the 3 groups and also differences in the characteristics of patient contacts. These findings indicate a need for further in-service training in the metho ds of patients counseling, as well as restructuring the health care de livery system to allow more time for counseling, better continuity bet ween contacts and more co-work between the members of primary care tea ms.