Block Jason P, DeSalvo Karen B, Fisher William P
Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.
Prev Med. 2003 Jun;36(6):669-75. doi: 10.1016/s0091-7435(03)00055-0.
To analyze whether internists are suited for their role in treating the growing numbers of obese patients, we surveyed residents about their knowledge and attitudes regarding obesity. Previous assessments have not analyzed familiarity with obesity measurement tools or the correlation between knowledge and attitudes.
We administered a survey to 87 internal medicine residents in two urban, university-based residency programs.
Almost all respondents understood the medical consequences of obesity, but 60% did not know the minimum BMI for diagnosing obesity, 69% did not recognize waist circumference as a reasonable measure of obesity, and 39% incorrectly reported their own BMI. Although nearly all respondents agreed that treating obesity was important, only 30% reported treatment success. Forty-four percent felt qualified to treat obese patients, and 31% reported treatment to be futile. Knowledge and attitudes were not correlated. Rasch analysis of knowledge and attitude subscales showed satisfactory model fit and item reliability of at least 0.96.
Despite solid knowledge of the comorbid conditions associated with obesity, residents have a poor grasp of the tools necessary to identify obesity. They also have negative opinions about their skills for treating obese patients. Residency training not only must improve knowledge of obesity measurement tools but also must address physicians' negative attitudes toward obesity treatment.
为分析内科医生是否适合在治疗日益增多的肥胖患者中发挥作用,我们对住院医师关于肥胖的知识和态度进行了调查。以往评估未分析对肥胖测量工具的熟悉程度或知识与态度之间的相关性。
我们对两个城市大学附属医院住院医师培训项目中的87名内科住院医师进行了一项调查。
几乎所有受访者都了解肥胖的医学后果,但60%的人不知道诊断肥胖的最低体重指数,69%的人不认为腰围是衡量肥胖的合理指标,39%的人错误报告了自己的体重指数。尽管几乎所有受访者都认为治疗肥胖很重要,但只有30%的人报告治疗成功。44%的人觉得有资格治疗肥胖患者,31%的人认为治疗是徒劳的。知识与态度不相关。对知识和态度子量表的拉施分析显示模型拟合良好,项目信度至少为0.96。
尽管住院医师对与肥胖相关的合并症有扎实的知识,但他们对识别肥胖所需的工具掌握不足。他们对自己治疗肥胖患者的技能也持负面看法。住院医师培训不仅必须提高对肥胖测量工具的认识,还必须解决医生对肥胖治疗的负面态度。