van Gerwen M, Franc C, Rosman S, Le Vaillant M, Pelletier-Fleury N
Cermes, Villejuif, France.
Obes Rev. 2009 Mar;10(2):227-36. doi: 10.1111/j.1467-789X.2008.00532.x. Epub 2008 Oct 11.
Obesity is an important public health issue with an epidemic spread in adolescents and children, which needs to be tackled. This systematic review of primary care physicians' knowledge, attitudes, beliefs and practices (KABP) regarding childhood obesity will help to implement or adjust the actions necessary to counteract obesity. Eligible studies were identified through a systematic database search for all available years to 2007. Articles were selected if they included data on primary care physicians' KABP regarding childhood obesity: 130 articles were assessed and eventually 11 articles covering the period 1987-2007 and responding to the inclusion criteria were analyzed. The included studies showed that almost all physicians agreed on the necessity to treat childhood obesity but they believed to have a low self-efficacy in the treatment and experienced a negative feeling regarding obesity management. There was a large heterogeneity in the assessment of childhood obesity between the different studies but the awareness of the importance of using body mass index increased over the years among physicians. Almost all studies noted that physicians recommended dietary advice, exercise or referral to a dietician. From this review, it is obvious that there is a need for education of primary care physicians to increase the uniformity of the assessment and to improve physicians' self-efficacy in managing childhood obesity. Multidisciplinary treatment including general practitioners, paediatricians and specialized dieticians appears to be the way to counteract the growing obesity epidemic and thus, primary care physicians have to initiate, coordinate and obviously participate in obesity prevention initiatives.
肥胖是一个重要的公共卫生问题，在青少年和儿童中呈流行趋势，需要加以解决。对基层医疗医生关于儿童肥胖的知识、态度、信念和实践（KABP）进行的这项系统评价，将有助于实施或调整应对肥胖所需的行动。通过对截至2007年所有可用年份的数据库进行系统检索，确定了符合条件的研究。如果文章包含关于基层医疗医生对儿童肥胖的KABP的数据，则予以选取：共评估了130篇文章，最终分析了11篇涵盖1987 - 2007年且符合纳入标准的文章。纳入的研究表明，几乎所有医生都认同治疗儿童肥胖的必要性，但他们认为自己在治疗方面的自我效能较低，并且对肥胖管理有负面感受。不同研究之间对儿童肥胖的评估存在很大差异，但多年来医生对使用体重指数重要性的认识有所提高。几乎所有研究都指出，医生会推荐饮食建议、运动或转介给营养师。从这项综述可以明显看出，需要对基层医疗医生进行教育，以提高评估的一致性，并提高医生管理儿童肥胖的自我效能。包括全科医生（家庭医生）、儿科医生和专业营养师在内的多学科治疗似乎是应对日益严重的肥胖流行的方法，因此，基层医疗医生必须发起、协调并明显参与肥胖预防倡议。
