Institute for General Practice and Family Medicine, Charité Universitätsmedizin, Berlin, Germany.
Patient Educ Couns. 2012 Apr;87(1):62-6. doi: 10.1016/j.pec.2011.07.026. Epub 2011 Aug 27.
The aim of this study was to assess general practitioners' (GP) readiness to involve obese patients in therapy decision making and to determine whether they integrate motivational interviewing techniques.
Fifty-eight preventive Check-up 35 encounters with overweight and obese patients in primary care were audio recorded in 12 GP practices. The use of motivational interviewing techniques was rated with the Behavior Change Counseling Index (BECCI). The involvement in medical decisions was rated with the Observing Patient Involvement Scale (OPTION).
OPTION and BECCI scores were low (means=0.71 and 1.65), indicating minimal implementation of shared decision making and motivational interviewing in preventive encounters with these patients. GPs used more motivational interviewing for patients with a BMI>30 kg/m(2) than for those with a BMI<30 kg/m(2). Female GPs had significantly higher shared decision making scores, indicating that they prefer to involve patients in medical decisions. GPs differed significantly in their use of both approaches.
Shared decision making and motivational interviewing, though known to be successful strategies in lifestyle counseling, are rarely used during obesity encounters in our sample of German GPs.
GPs should be sensitized and trained in the application of these methods.
本研究旨在评估全科医生（GP）准备让肥胖患者参与治疗决策的程度，并确定他们是否整合了动机性访谈技术。
在 12 家全科医生诊所中，对 58 次预防保健 35 次超重和肥胖患者的就诊进行了音频记录。使用行为改变咨询指数（BECCI）来评估动机性访谈技术的使用情况。使用参与患者决策量表（OPTION）来评估在医疗决策中的参与程度。
OPTION 和 BECCI 评分较低（平均值分别为 0.71 和 1.65），表明在这些患者的预防就诊中，共享决策制定和动机性访谈的实施程度很低。与 BMI<30kg/m(2)的患者相比，GP 对 BMI>30kg/m(2)的患者使用了更多的动机性访谈。女性 GP 的共享决策制定得分明显更高，表明她们更倾向于让患者参与医疗决策。GP 在这两种方法的使用上存在显著差异。
尽管共享决策制定和动机性访谈被认为是生活方式咨询的成功策略，但在我们的德国 GP 样本中，肥胖患者就诊时很少使用这些方法。
应提高 GP 对这些方法的应用意识，并对其进行培训。
