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本文引用的文献

1
New thoughts on managing obesity.肥胖管理的新思路
Gut. 2004 Jul;53(7):1044-53. doi: 10.1136/gut.2003.021816.
2
Improving management of obesity in primary care: cluster randomised trial.改善基层医疗中肥胖症的管理:整群随机试验。
BMJ. 2003 Nov 8;327(7423):1085. doi: 10.1136/bmj.327.7423.1085.
3
Primary care physicians' attitudes about obesity and its treatment.基层医疗医生对肥胖及其治疗的态度。
Obes Res. 2003 Oct;11(10):1168-77. doi: 10.1038/oby.2003.161.
4
A qualitative study of general practitioners' and practice nurses' attitudes to obesity management in primary care.一项关于全科医生和执业护士对初级保健中肥胖管理态度的定性研究。
Health Bull (Edinb). 2001 Jul;59(4):248-53.
5
Managing obesity: a survey of attitudes and practices among Israeli primary care physicians.肥胖管理:以色列初级保健医生的态度与实践调查
Int J Obes Relat Metab Disord. 2002 Oct;26(10):1393-7. doi: 10.1038/sj.ijo.0802063.
6
The worldwide obesity epidemic.全球肥胖流行。
Obes Res. 2001 Nov;9 Suppl 4:228S-233S. doi: 10.1038/oby.2001.123.
7
General practitioners' and patients' models of obesity: whose problem is it?全科医生和患者对肥胖的认知模式:这是谁的问题?
Patient Educ Couns. 2001 Sep;44(3):227-33. doi: 10.1016/s0738-3991(00)00192-0.
8
Developing, validating and consolidating the doctor-patient relationship: the patients' views of a dynamic process.发展、验证和巩固医患关系:患者对一个动态过程的看法。
Br J Gen Pract. 1998 Jul;48(432):1391-4.
9
Environmental contributions to the obesity epidemic.环境因素对肥胖流行的影响。
Science. 1998 May 29;280(5368):1371-4. doi: 10.1126/science.280.5368.1371.
10
Management of weight problems and obesity: knowledge, attitudes and current practice of general practitioners.体重问题与肥胖症的管理:全科医生的知识、态度及当前实践
Br J Gen Pract. 1991 Apr;41(345):147-50.

关于全科医生对治疗肥胖症看法的定性研究。

A qualitative study of GPs' views of treating obesity.

作者信息

Epstein Laura, Ogden Jane

机构信息

Limehouse General Practice, London.

出版信息

Br J Gen Pract. 2005 Oct;55(519):750-4.

PMID:16212849
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1562352/
Abstract

BACKGROUND

Due to the increased prevalence of obesity GPs now have a key role in managing obese patients.

AIM

To explore GPs' views about treating patients with obesity.

SETTING

An inner London primary care trust.

DESIGN OF STUDY

A qualitative study using semi-structured interviews.

METHOD

Twenty-one GPs working in an inner London primary care trust were interviewed about recent obese patients and obesity in general. An interpretative phenomenological approach was used for data analysis.

RESULTS

GPs primarily believed that obesity was the responsibility of the patient, rather than a medical problem requiring a medical solution. They also believed that in contrast to this, obese patients wanted to hand responsibility over to their doctor. This contradiction created conflict for the GPs, which was exacerbated by a sense that existing treatment options were ineffective. Further, this conflict was perceived as potentially detrimental to the doctor-patient relationship. GPs described a range of strategies that they used to maintain a good relationship including offering anti-obesity drugs, in which they had little faith, as a means of meeting patients' expectations; listening to the patients' problems, despite not having a solution to them; and offering an understanding of the problems associated with being overweight.

CONCLUSION

GPs believe that although patients want them to take responsibility for their weight problems, obesity is not within the GP's professional domain. Until more effective interventions have been developed GPs may remain unconvinced that obesity is a problem requiring their clinical expertise and may continue to resist any government pressure to accept obesity as part of their workload.

摘要

背景

由于肥胖症患病率上升,全科医生在管理肥胖患者方面如今发挥着关键作用。

目的

探讨全科医生对治疗肥胖患者的看法。

地点

伦敦市中心的一个初级医疗信托机构。

研究设计

采用半结构式访谈的定性研究。

方法

对在伦敦市中心一个初级医疗信托机构工作的21名全科医生进行访谈,内容涉及近期的肥胖患者及肥胖症总体情况。数据分析采用解释现象学方法。

结果

全科医生主要认为肥胖是患者自身的责任,而非需要医学解决办法的医学问题。他们还认为,与此相反,肥胖患者希望将责任交给医生。这种矛盾给全科医生带来了冲突,而现有的治疗选择无效这一感觉又加剧了这种冲突。此外,这种冲突被认为可能对医患关系有害。全科医生描述了一系列他们用来维持良好关系的策略,包括提供他们并不看好的抗肥胖药物,以此满足患者的期望;倾听患者的问题,尽管对此没有解决办法;以及表示理解与超重相关的问题。

结论

全科医生认为,尽管患者希望他们对体重问题负责,但肥胖并不在全科医生的专业范围内。在开发出更有效的干预措施之前,全科医生可能仍不相信肥胖是一个需要他们临床专业知识解决的问题,可能会继续抵制政府要求将肥胖纳入其工作量的任何压力。