Department of Health Policy and Management, Baltimore,MD 21205, USA.
Patient Educ Couns. 2010 Jun;79(3):344-50. doi: 10.1016/j.pec.2010.01.020. Epub 2010 Mar 2.
Examine concordance between patient and physician assessments of patient self-reported use of weight-management activities.
Analysis of baseline data from a randomized controlled trial of patient and physician interventions to improve patient-physician communication (41 physicians and 274 of their patients).
A majority of patients reported regular exercise (55.6%) and efforts to lose weight, such as eating less (63.1%) while physicians only perceived one-third of patients as engaging in those activities (exercise, 36.6%; weight loss, 33.3%). Kappa scores indicated small agreement between patient and physician assessments of patient self-reported use of exercise, mean kappa 0.28 (range 0.15 to 0.40) and no agreement between patient and physician assessments of patient self-reported efforts to lose weight, mean kappa -0.14 (range -0.26 to -0.01). Obese patients were more likely than non-obese patients to report trying to lose weight or exercising regularly (p<0.05), but physicians were less likely to perceive obese patients as engaging in those activities (p<0.05).
Primary care physicians differed considerably from their patients, especially obese patients, in their assessments of patient use of weight-management activities.
These results highlight the importance of improving patient-provider communication about weight-management activities, particularly among obese patients.
检查患者和医生对患者自我报告的体重管理活动使用情况评估的一致性。
对一项改善医患沟通的患者和医生干预措施的随机对照试验的基线数据进行分析（41 名医生和 274 名患者）。
大多数患者报告定期锻炼（55.6%）和减肥努力，如少吃（63.1%），而医生只认为三分之一的患者参与这些活动（锻炼，36.6%；减肥，33.3%）。Kappa 评分表明患者和医生对患者自我报告的运动使用情况的评估存在较小的一致性，平均 Kappa 值为 0.28（范围为 0.15 至 0.40），对患者自我报告的减肥努力的评估则没有一致性，平均 Kappa 值为-0.14（范围为-0.26 至-0.01）。肥胖患者比非肥胖患者更有可能报告试图减肥或定期锻炼（p<0.05），但医生更不可能认为肥胖患者参与这些活动（p<0.05）。
初级保健医生与患者对患者使用体重管理活动的评估存在很大差异，尤其是肥胖患者。
这些结果强调了改善医患之间关于体重管理活动的沟通的重要性，特别是在肥胖患者中。
