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全科医生培训实践中对肥胖治疗的态度:一项焦点小组研究。

Attitudes towards obesity treatment in GP training practices: a focus group study.

机构信息

Department of General Practice/Family Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.

出版信息

Fam Pract. 2011 Aug;28(4):422-9. doi: 10.1093/fampra/cmq110. Epub 2011 Jan 27.

Abstract

BACKGROUND

Both patients and government expect the GP to treat obesity. Previous studies reported a negative attitude of GPs towards this task. Little is known about the attitude of GP trainees.

OBJECTIVES

To assess the attitude and other factors that influence the willingness and ability of GP trainees to provide lifestyle interventions for overweight patients.

METHODS

A qualitative study was performed using focus groups, consisting of first- and third-year trainees, GP trainers and teachers. Two researchers analysed the data independently.

RESULTS

First-year trainees lack knowledge and a positive attitude. Third-year trainees, although trained in motivational interviewing techniques, lack specific knowledge and feel cheated when discussing eating habits. Trainers are despondent as they rarely observe long-lasting results. Teachers warn the trainees not to have high hopes. The trainers and trainees fear ruining the relationship with their patient, and all make a request for evidence-based multidisciplinary treatment programmes, joint responsibility and an image change in society to stop the epidemic.

CONCLUSIONS

Trainees do not feel more competent in treating overweight patients successfully over the course of their GP specialty training and GP trainers are not convinced of the success of the treatment of overweight patients. Therefore, it could be equally important to reflect on the GP trainer as a role model as to concentrate on the education of the trainee. Both need a revived attitude and evidence-based treatment programmes, help from policy makers and an attitude change in society are desired.

摘要

背景

患者和政府都期望全科医生能够治疗肥胖症。先前的研究报告称,全科医生对这项任务持消极态度。然而,对于全科医生培训生的态度,我们知之甚少。

目的

评估全科医生培训生对为超重患者提供生活方式干预的意愿和能力的态度,以及影响这种意愿和能力的其他因素。

方法

采用焦点小组的定性研究方法,参与者包括一年级和三年级的培训生、全科医生培训师和教师。两位研究人员独立分析数据。

结果

一年级培训生缺乏知识且态度消极。尽管三年级培训生接受过动机性访谈技巧的培训,但他们缺乏具体的知识,在讨论饮食习惯时感到被欺骗。培训师感到沮丧,因为他们很少观察到持久的结果。教师警告培训生不要抱有过高的期望。培训师和培训生担心破坏与患者的关系,所有人都呼吁制定基于证据的多学科治疗计划、共同承担责任和改变社会形象以阻止肥胖症的流行。

结论

在全科医生专业培训过程中,培训生并没有感到自己在成功治疗超重患者方面更有能力,而全科医生培训师也不相信治疗超重患者的效果。因此,反思全科医生培训师作为榜样的角色,以及专注于培训生的教育,可能同样重要。两者都需要重新树立态度,需要基于证据的治疗计划,需要政策制定者的帮助和社会态度的改变。

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