医生沟通技巧与成年人减肥：CHAT 项目。
Physician communication techniques and weight loss in adults: Project CHAT.
机构信息
Cancer Prevention, Detection and Control Research Program, Duke University Medical Center, Durham, North Carolina, USA.
出版信息
Am J Prev Med. 2010 Oct;39(4):321-8. doi: 10.1016/j.amepre.2010.06.005.
BACKGROUND
Physicians are encouraged to counsel overweight and obese patients to lose weight.
PURPOSE
It was examined whether discussing weight and use of motivational interviewing techniques (e.g., collaborating, reflective listening) while discussing weight predicted weight loss 3 months after the encounter.
METHODS
Forty primary care physicians and 461 of their overweight or obese patient visits were audio recorded between December 2006 and June 2008. Patient actual weight at the encounter and 3 months after the encounter (n=426); whether weight was discussed; physicians' use of motivational interviewing techniques; and patient, physician, and visit covariates (e.g., race, age, specialty) were assessed. This was an observational study and data were analyzed in April 2009.
RESULTS
No differences in weight loss were found between patients whose physicians discussed weight or did not. Patients whose physicians used motivational interviewing-consistent techniques during weight-related discussions lost weight 3 months post-encounter; those whose physician used motivational interviewing-inconsistent techniques gained or maintained weight. The estimated difference in weight change between patients whose physician had a higher global motivational interviewing-Spirit score (e.g., collaborated with patient) and those whose physician had a lower score was 1.6 kg (95% CI=-2.9, -0.3, p=0.02). The same was true for patients whose physician used reflective statements: 0.9 kg (95% CI=-1.8, -0.1, p=0.03). Similarly, patients whose physicians expressed only motivational interviewing-consistent behaviors had a difference in weight change of 1.1 kg (95% CI=-2.3, 0.1, p=0.07) compared to those whose physician expressed only motivational interviewing-inconsistent behaviors (e.g., judging, confronting).
CONCLUSIONS
In this observational study, use of motivational interviewing techniques during weight loss discussions predicted patient weight loss.
背景
鼓励医生对超重和肥胖患者进行体重管理。
目的
探讨在讨论体重时，讨论体重和使用动机性访谈技术（如合作、反映性倾听）是否能预测在就诊后 3 个月时的体重减轻。
方法
2006 年 12 月至 2008 年 6 月间，40 名初级保健医生及其 461 名超重或肥胖患者的就诊被录音。评估患者在就诊时和就诊后 3 个月时的实际体重（n=426）；是否讨论了体重；医生使用的动机性访谈技术；以及患者、医生和就诊的协变量（如种族、年龄、专业）。这是一项观察性研究，数据于 2009 年 4 月进行分析。
结果
未发现医生讨论或不讨论体重的患者之间的体重减轻有差异。在与体重相关的讨论中，医生使用动机性访谈一致技术的患者在就诊后 3 个月时体重减轻；而医生使用动机性访谈不一致技术的患者体重增加或保持不变。医生的整体动机性访谈-精神评分较高（如与患者合作）的患者与评分较低的患者在体重变化方面的估计差异为 1.6 公斤（95%CI=-2.9，-0.3，p=0.02）。对于医生使用反映性陈述的患者也是如此：0.9 公斤（95%CI=-1.8，-0.1，p=0.03）。同样，与医生仅表达动机性访谈一致行为的患者相比，医生仅表达动机性访谈不一致行为（如评判、对抗）的患者体重变化差异为 1.1 公斤（95%CI=-2.3，0.1，p=0.07）。
结论
在这项观察性研究中，在讨论体重减轻时使用动机性访谈技术预测了患者的体重减轻。
Zotero 插件