Currin Laura, Waller Glenn, Schmidt Ulrike
King's College London, Institute of Psychiatry, Section of Eating Disorders, London, England.
Int J Eat Disord. 2009 Jul;42(5):453-8. doi: 10.1002/eat.20636.
This study examined the influence of primary care physicians' knowledge of and attitudes to eating disorders on their treatment decisions.
A sample of primary care physicians completed self-report measures on eating disorders and their attitudes towards such patients. They also indicated their diagnosis and treatment decisions in response to case vignettes.
Physicians had substantial gaps in knowledge of the eating disorders. Attitudes to anorexia nervosa clustered differently to those toward patients with bulimia nervosa. However, for both disorders, the factor that explained the most variance was illness duration and consequences. There was no association of knowledge and attitudes, and these variables did not predicted the likelihood of diagnosing an eating disorder. However, those with higher knowledge scores were more likely to ensure that a follow-up appointment took place, particularly when they held the attitude that people with anorexia nervosa had personal control over their problem.
There is a need for greater education of primary care physicians regarding the diagnosis and treatment of the eating disorders, and for that information to be more readily accessible when it is needed. Their clinical actions need to be guided by more objective sources of information and protocols.
本研究探讨初级保健医生对饮食失调症的了解程度和态度对其治疗决策的影响。
抽取一组初级保健医生,让他们完成关于饮食失调症及其对这类患者态度的自我报告测量。他们还针对病例 vignettes 表明了自己的诊断和治疗决策。
医生在饮食失调症知识方面存在很大差距。对神经性厌食症的态度与对神经性贪食症患者的态度聚类不同。然而,对于这两种疾病,解释差异最大的因素是病程和后果。知识与态度之间没有关联,并且这些变量无法预测诊断饮食失调症的可能性。然而,知识得分较高的医生更有可能确保安排后续预约,特别是当他们持有神经性厌食症患者对自己的问题有个人控制权这种态度时。
需要对初级保健医生进行更多关于饮食失调症诊断和治疗的教育,并且在需要时能更方便地获取相关信息。他们的临床行动需要以更客观的信息来源和方案为指导。