Bocquier Aurélie, Verger Pierre, Basdevant Arnaud, Andreotti Gérard, Baretge Jean, Villani Patrick, Paraponaris Alain
Southeastern France Regional Center for Disease control, Marseilles, France.
Obes Res. 2005 Apr;13(4):787-95. doi: 10.1038/oby.2005.89.
To describe the current knowledge, attitudes, and practices of French general practitioners (GPs) in the field of adult overweight and obesity management.
A cross-sectional telephone survey interviewed a sample of 600 GPs, representative of the private GPs in southeastern France. A four-part questionnaire assessed personal and professional characteristics, attitudes and opinions about overweight and obesity, relevant knowledge and training, and practices (diagnostic methods, clinical assessments, weight loss objectives, types of counseling).
Most GPs knew that weight problems are health-threatening, and 79% agreed that managing these problems is part of their role. Nevertheless, 58% did not feel they perform this role effectively, and one-third did not find it professionally gratifying. Approximately 30% had negative attitudes toward overweight and obese patients; 57% were pessimistic about patients' ability to lose weight; 64% often set weight loss objectives more demanding than guidelines call for; and neither food diaries nor nutritional education were used systematically. GPs' feelings of effectiveness and attitudes toward obese patients were associated with some professional (training) and personal (BMI, personal diet experience) characteristics.
GPs' feelings of ineffectiveness may stem from an underlying conflict between practitioners' and patients' representations of weight problems and the relationship problems this causes. Inadequate practices and health care system organization may also play a role.
描述法国全科医生在成人超重和肥胖管理领域的现有知识、态度及实践情况。
一项横断面电话调查对600名全科医生进行了访谈,这些医生代表了法国东南部的私人全科医生。一份由四部分组成的问卷评估了个人及专业特征、对超重和肥胖的态度与看法、相关知识和培训以及实践情况(诊断方法、临床评估、减肥目标、咨询类型)。
大多数全科医生知道体重问题对健康构成威胁,79%的人认为管理这些问题是他们职责的一部分。然而,58%的人觉得自己没有有效地履行这一职责,三分之一的人认为这一职责无法带来职业满足感。约30%的人对超重和肥胖患者持消极态度;57%的人对患者减肥的能力持悲观态度;64%的人设定的减肥目标往往比指南要求的更苛刻;食物日记和营养教育都没有被系统地采用。全科医生的效能感以及对肥胖患者的态度与一些专业(培训)和个人(体重指数、个人饮食经历)特征有关。
全科医生的效能感低下可能源于从业者和患者对体重问题的认知之间潜在的冲突以及由此引发 的关系问题。实践不足和医疗保健系统组织不完善也可能起了作用。