Bocquier Aurélie, Paraponaris Alain, Gourheux Jean-Claude, Lussault Pierre-Yves, Basdevant Arnaud, Verger Pierre
Observatoire régional de la santé de la region, Provence-Alpes-Côte d'Azur, Marseille.
Presse Med. 2005 Jun 18;34(11):769-75. doi: 10.1016/s0755-4982(05)84039-4.
To describe the current knowledge, attitudes, and practices of French general practitioners (GPs) in the field of child and adult overweight and obesity management.
A cross-sectional telephone survey interviewed a sample of 600 GPs, representative of the population of private GPs in southeastern France. A three-part questionnaire assessed attitudes and opinions about overweight and obesity, knowledge and training in this field, and practices (diagnostic methods, standard weight loss objectives, types of counseling).
Most GPs (90.2%) regarded obesity as a disease requiring long-term management (99.5%), and 79% agreed that managing these problems is part of their role. Nevertheless, 58 and 66% did not feel they perform this role effectively for their adult patients and for children and teenagers, respectively. Approximately 30% had negative attitudes towards overweight and obese patients. Most practices followed the guidelines relatively closely. Nevertheless, 60% often set weight loss objectives more demanding than guidelines call for; neither food diaries nor nutritional education were used systematically; 55% often forbade children and teenagers to eat specific foods.
These results, which were based on GPs' declarations, revealed the existence of a gap between theory and practice in the field of obesity management: GPs felt responsible for but ineffective in this management. Their feelings of ineffectiveness may be furthered by the underlying disagreement in the attitudes of practitioner and patient towards weight problems and the ensuing difficulties in their relationship.
描述法国全科医生在儿童及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访问了600名全科医生样本,这些样本代表了法国东南部私人全科医生群体。一份由三部分组成的问卷评估了对超重和肥胖的态度与看法、该领域的知识及培训情况,以及实践情况(诊断方法、标准减重目标、咨询类型)。
大多数全科医生(90.2%)将肥胖视为一种需要长期管理的疾病(99.5%),79%的人认同管理这些问题是他们职责的一部分。然而,分别有58%和66%的人认为自己在对成年患者以及儿童和青少年的这一管理职责履行上效果不佳。约30%的人对超重和肥胖患者持负面态度。大多数实践相对严格地遵循了指南。然而,60%的人常常设定比指南要求更苛刻的减重目标;既未系统使用饮食日记,也未进行营养教育;55%的人常常禁止儿童和青少年食用特定食物。
这些基于全科医生自述的结果揭示了肥胖管理领域理论与实践之间存在差距:全科医生觉得自己对此负有责任,但成效不佳。从业者和患者对体重问题态度上的潜在分歧以及随之而来的医患关系困难,可能会加剧他们的这种无力感。