Walker Olivia, Strong Mark, Atchinson Rebecca, Saunders Joanna, Abbott Jo
University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
BMC Fam Pract. 2007 Sep 3;8:50. doi: 10.1186/1471-2296-8-50.
The prevalence of childhood obesity is rising and the UK Government have stated a commitment to addressing obesity in general. One method has been to include indicators relating to obesity within the GP pay-for-performance Quality and Outcomes Framework (QOF) contract. This study aimed to explore general practitioners' and practice nurses' views in relation to their role in treating childhood obesity.
We interviewed eighteen practitioners (twelve GPs and six nurses) who worked in general practices contracting with Rotherham Primary Care Trust. Interviews were face to face and semi structured. The transcribed data were analysed using framework analysis.
GPs and practice nurses felt that their role was to raise the issue of a child's weight, but that ultimately obesity was a social and family problem. Time constraint, lack of training and lack of resources were identified as important barriers to addressing childhood obesity. There was concern that the clinician-patient relationship could be adversely affected by discussing what was often seen as a sensitive topic. GPs and practice nurses felt ill-equipped to tackle childhood obesity given the lack of evidence for effective interventions, and were sceptical that providing diet and exercise advice would have any impact upon a child's weight.
GPs and practice nurses felt that their role in obesity management was centred upon raising the issue of a child's weight, and providing basic diet and exercise advice. Clinicians may find it difficult to make a significant impact on childhood obesity while the evidence base for effective management remains poor. Until the lack of effective interventions is addressed, implementing additional targets (for example through the QOF) may not be effective.
儿童肥胖症的患病率正在上升，英国政府已承诺全面应对肥胖问题。其中一种方法是在全科医生绩效薪酬质量与结果框架（QOF）合同中纳入与肥胖相关的指标。本研究旨在探讨全科医生和执业护士对其在治疗儿童肥胖症中所扮演角色的看法。
我们采访了与罗瑟勒姆初级医疗信托机构签约的全科诊所中的18名从业者（12名全科医生和6名护士）。访谈采用面对面和半结构化的方式。对转录的数据进行框架分析。
全科医生和执业护士认为他们的职责是提出儿童体重问题，但最终肥胖是一个社会和家庭问题。时间限制、缺乏培训和资源不足被认为是解决儿童肥胖问题的重要障碍。有人担心讨论这个通常被视为敏感的话题可能会对医患关系产生不利影响。鉴于缺乏有效干预措施的证据，全科医生和执业护士觉得自己没有足够的能力来解决儿童肥胖问题，并且怀疑提供饮食和运动建议对儿童体重是否会有任何影响。
全科医生和执业护士认为他们在肥胖管理中的作用主要是提出儿童体重问题，并提供基本的饮食和运动建议。在有效管理的证据基础仍然薄弱的情况下，临床医生可能会发现很难对儿童肥胖症产生重大影响。在缺乏有效干预措施的问题得到解决之前，实施额外的目标（例如通过QOF）可能不会有效。
