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患者肥胖对医患关系的影响。

Impact of patient obesity on the patient-provider relationship.

机构信息

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Patient Educ Couns. 2011 Dec;85(3):e322-5. doi: 10.1016/j.pec.2011.01.001. Epub 2011 Feb 1.

Abstract

OBJECTIVE

Health professionals' weight bias may impair obese patients' interactions with providers. However, few studies have examined how negative provider attitudes affect the patient-provider relationship for obese patients. We hypothesized that higher patient body mass index (BMI) would be negatively associated with patient-provider relationship quality.

METHODS

We analyzed data from the 2007 Health Tracking Household Survey. BMI was the independent variable, and patient-perceived quality of the patient-provider relationship was the outcome. We performed log-binominal regression analyses accounting for complex survey design to examine the association of BMI with the patient-provider relationship.

RESULTS

Of the 15,197 adult survey respondents, the 6427 who answered the quality of care questions were eligible for analysis. Overall, 29% had a normal range BMI, 34% were overweight, and 37% were obese. We found few differences in ratings of the patient-provider relationship for overweight and obese respondents when compared to respondents with a normal range BMI.

CONCLUSION

These unexpected findings may have occurred due to patients' inability to perceive providers' weight bias, measurement error in questionnaire items, or decreasing weight bias among health professionals.

PRACTICE IMPLICATIONS

Patient's positive perceptions of providers may indicate promise for health professionals acting as motivators of behavior change in obese patients.

摘要

目的

健康专业人员的体重偏见可能会影响肥胖患者与提供者的互动。然而,很少有研究探讨负面的提供者态度如何影响肥胖患者的医患关系。我们假设,较高的患者体重指数(BMI)与患者-提供者关系质量呈负相关。

方法

我们分析了 2007 年健康跟踪家庭调查的数据。BMI 是自变量,患者感知的患者-提供者关系质量是结果。我们进行了对数二项式回归分析,考虑了复杂的调查设计,以检查 BMI 与患者-提供者关系的关联。

结果

在 15197 名成年调查对象中,有 6427 名回答了护理质量问题,符合分析条件。总体而言,29%的人 BMI 在正常范围内,34%超重,37%肥胖。与 BMI 正常范围内的受访者相比,超重和肥胖的受访者对医患关系的评价几乎没有差异。

结论

这些出乎意料的发现可能是由于患者无法感知提供者的体重偏见、问卷项目中的测量误差,或卫生专业人员的体重偏见减少所致。

实践意义

患者对提供者的积极看法可能表明健康专业人员有希望成为肥胖患者行为改变的推动者。

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Quality of care among obese patients.肥胖患者的护理质量。
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