Spurrier Nicola J, Magarey Anthea, Wong Catherine
Department of Paediatrics and Child Health, Flinders University, Bedford Park, SA, Australia.
J Paediatr Child Health. 2006 Jul-Aug;42(7-8):411-8. doi: 10.1111/j.1440-1754.2006.00890.x.
(i) To determine the ability of general practitioners (GPs) and paediatricians to correctly identify children as overweight or obese by visual cues alone; (ii) to describe the current management practices of overweight and obese children by these practitioners; and (iii) to compare these with National Health and Medical Research Council (NHMRC) Clinical Practice Guidelines.
Forty-four GPs and 29 paediatricians participated in the study. Respondents completed a questionnaire based on a series of body images, rating the size of the child as acceptable weight, overweight or obese and indicating the likelihood of carrying out a series of management options.
There was considerable variation in ability to rate images correctly with the total number of correct responses being 72% and 68%, respectively, for GPs and paediatricians. There were statistically significant differences in management between GPs and paediatricians in terms of conducting appropriate anthropometry and screening for co-morbidities, with paediatricians performing closer to the NHMRC Clinical Practice Guidelines.
GPs and paediatricians have the opportunity to screen children for overweight and obesity during their everyday practice. Accurate determination of weight status cannot be performed by visualisation alone and all children should have height and weight measured and correctly interpreted. Some areas of current GP and paediatrician management of overweight and obese children fall short of the NHMRC clinical guidelines and areas for improvement are highlighted in this paper.
(i)确定全科医生(GP)和儿科医生仅通过视觉线索正确识别超重或肥胖儿童的能力;(ii)描述这些医生对超重和肥胖儿童的当前管理做法;(iii)将这些做法与澳大利亚国家健康与医学研究委员会(NHMRC)临床实践指南进行比较。
44名全科医生和29名儿科医生参与了该研究。受访者根据一系列身体图像完成一份问卷,将儿童的体型评为正常体重、超重或肥胖,并表明采取一系列管理措施的可能性。
正确评估图像的能力存在相当大的差异,全科医生和儿科医生的正确回答总数分别为72%和68%。在进行适当人体测量和筛查合并症方面,全科医生和儿科医生在管理上存在统计学显著差异,儿科医生的做法更接近NHMRC临床实践指南。
全科医生和儿科医生在日常诊疗过程中有机会对儿童进行超重和肥胖筛查。仅通过观察无法准确确定体重状况,所有儿童都应测量身高和体重并进行正确解读。全科医生和儿科医生目前对超重和肥胖儿童的管理在某些方面未达到NHMRC临床指南的要求,本文强调了需要改进的方面。