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医患性别一致性与肥胖患者的体重相关咨询。

Patient-physician gender concordance and weight-related counseling of obese patients.

机构信息

Department of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19027, USA.

出版信息

Am J Prev Med. 2011 Jun;40(6):616-9. doi: 10.1016/j.amepre.2011.02.020.

Abstract

BACKGROUND

Obesity affects approximately one third of Americans. Patient and provider characteristics such as gender may influence obesity care. Gender concordance has been associated with clinical practice patterns in chronic conditions such as hypertension and diabetes, but its role in obesity care is unknown.

PURPOSE

The purpose of this study was to investigate the association of patient-physician gender concordance with weight-related counseling among obese adults.

METHODS

A cross-sectional study using the 2005-2007 National Ambulatory Medical Care Survey was conducted in 2010. Postvisit data from the clinical encounters of 5667 obese individuals and their physicians were analyzed to determine the association between patient-physician gender concordance (categorized using patient gender as the reference point as female gender-concordant, male gender-concordant, male gender-discordant, and female gender-discordant) and three types of weight-related counseling (diet/nutrition, exercise, and weight reduction).

RESULTS

Diet/nutrition, exercise, and weight reduction counseling was provided to 30%, 23%, and 20% of obese patients, respectively. Patients in male gender-concordant patient-physician pairs had significantly higher adjusted odds of receiving diet/nutrition (OR=1.58, 95% CI=1.05, 2.40) and exercise counseling (OR=1.76, 95% CI=1.13, 2.74) than female gender-concordant pairs. There were no significant differences in any form of weight-related counseling between female gender-concordant and gender-discordant pairs.

CONCLUSIONS

The findings of this study suggest that male patient-physician gender concordance is positively associated with diet/nutrition and exercise counseling.

摘要

背景

肥胖影响了大约三分之一的美国人。患者和医生的特征,如性别,可能会影响肥胖的治疗。在高血压和糖尿病等慢性疾病中,性别一致性与临床实践模式有关,但在肥胖治疗中的作用尚不清楚。

目的

本研究旨在调查肥胖成年人中患者-医生性别一致性与体重相关咨询的关系。

方法

本研究于 2010 年使用 2005-2007 年全国门诊医疗调查进行了一项横断面研究。对 5667 名肥胖患者及其医生的就诊后数据进行分析,以确定患者-医生性别一致性(以患者性别为参照点,分为女性性别一致、男性性别一致、男性性别不一致和女性性别不一致)与三种体重相关咨询(饮食/营养、运动和体重减轻)之间的关系。

结果

分别有 30%、23%和 20%的肥胖患者接受了饮食/营养、运动和体重减轻咨询。在男性性别一致的患者-医生配对中,接受饮食/营养(OR=1.58,95%CI=1.05,2.40)和运动咨询(OR=1.76,95%CI=1.13,2.74)的调整后优势比明显高于女性性别一致的配对。在任何形式的体重相关咨询中,女性性别一致和性别不一致的配对之间均无显著差异。

结论

本研究结果表明,男性患者-医生性别一致性与饮食/营养和运动咨询呈正相关。

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