Michie Susan
Psychology, University College London, London, UK.
Psychol Health Med. 2007 Oct;12(5):521-5. doi: 10.1080/13548500701203441.
Evidence-based guidance recommends that primary care health practitioners should deliver brief interventions to their patients to change behaviours to reduce overweight and obesity. This cross-sectional study investigates UK general practitioners' (GPs) and practice nurses' communication about overweight with their overweight and obese patients. Forty general practitioners and 47 practice nurses in two inner-London primary care organizations completed a questionnaire about past practice and concerns. When there was no identified medical problem, 38% of GPs and 14% of practice nurses reported raising the issue on less than 50% of occasions. Practice nurses were more likely than GPs to raise the issue of weight, both when there was no medical problem and when there was a medical problem. When they did raise the issue of overweight, only 9% did so in the context of presenting possible solutions to weight loss or in discussions about health promotion. Fifty two per cent of GPs and 28% of practice nurses had concerns about raising the issue of overweight; the most common being that patients would react emotionally to the message. These results suggest that there is considerable room for improvement in the frequency with which primary care practitioners address the questions of weight in their overweight patients, especially amongst doctors. Training to increase skills and confidence in communicating about weight is recommended.
循证指南建议，基层医疗保健从业者应向患者提供简短干预措施，以改变行为，减少超重和肥胖。这项横断面研究调查了英国全科医生（GP）和执业护士与超重及肥胖患者就超重问题进行的沟通情况。伦敦市中心两个基层医疗保健机构的40名全科医生和47名执业护士完成了一份关于既往做法和担忧的问卷。当未发现医疗问题时，38%的全科医生和14%的执业护士报告称，在不到50%的情况下会提及该问题。无论是在没有医疗问题还是有医疗问题时，执业护士比全科医生更有可能提及体重问题。当他们确实提及超重问题时，只有9%的人是在提出可能的减肥解决方案或在关于健康促进的讨论中提及的。52%的全科医生和28%的执业护士对提及超重问题存在担忧；最常见的是患者会对该信息产生情绪反应。这些结果表明，基层医疗从业者在超重患者中提及体重问题的频率有很大的改进空间，尤其是在医生当中。建议进行培训，以提高在体重沟通方面的技能和信心。
