Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD 20892, USA.
Int J Obes (Lond). 2011 May;35(5):728-35. doi: 10.1038/ijo.2010.173. Epub 2010 Sep 7.
This study examined the independent effect of a patient's weight on medical students' attitudes, beliefs and interpersonal behavior toward the patient, in addition to the clinical recommendations they make for her care.
A total of 76 clinical-level medical students were randomly assigned to interact with a digital, virtual female patient who was visibly either obese or non-obese.
Interactions with the patient took place in an immersive virtual (virtual reality) clinical environment that allowed standardization of all patient behaviors and characteristics except for weight. Visual contact behavior was automatically recorded during the interaction. Afterward, participants filled out a battery of self-report questionnaires.
Analyses revealed more negative stereotyping, less anticipated patient adherence, worse perceived health, more responsibility attributed for potentially weight-related presenting complaints and less visual contact directed toward the obese version of a virtual patient than the non-obese version of the patient. In contrast, there was no clear evidence of bias in clinical recommendations made for the patient's care.
Biases in attitudes, beliefs and interpersonal behavior have important implications because they can influence the tone of clinical encounters and rapport in the patient-provider relationship, which can have important downstream consequences. Gaining a clear understanding of the nature and source of weight bias in the clinical encounter is an important first step toward the development of strategies to address it.
本研究考察了患者体重对医学生对患者的态度、信念和人际行为的独立影响，以及他们对患者护理的临床建议。
共有 76 名临床水平的医学生被随机分配与一位可见肥胖或非肥胖的数字化虚拟女性患者进行互动。
在沉浸式虚拟（虚拟现实）临床环境中与患者进行互动，除了体重之外，该环境允许对所有患者行为和特征进行标准化。在互动过程中自动记录目光接触行为。之后，参与者填写了一系列自我报告问卷。
分析显示，对肥胖虚拟患者的刻板印象更负面、对患者依从性的预期更低、对健康的感知更差、对可能与体重相关的主诉的责任归因更多、目光接触指向肥胖虚拟患者的次数更少，而非肥胖虚拟患者。相比之下，对患者护理的临床建议没有明显的偏见证据。
态度、信念和人际行为的偏见具有重要影响，因为它们会影响医患关系中的临床接触和融洽程度，从而产生重要的下游后果。清楚地了解临床接触中体重偏见的性质和来源是制定解决体重偏见策略的重要第一步。
