Epling John W, Morley Christopher P, Ploutz-Snyder Robert
Department of Family Medicine and Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
BMC Res Notes. 2011 Nov 1;4:473. doi: 10.1186/1756-0500-4-473.
Obesity is epidemic in primary care. While family physicians care for the consequences of obesity, they do not generally feel confident managing obesity itself. We examined the barriers to obesity management in a sample of family physicians in a primary care practice-based research network (PBRN).
204 family physicians were invited to respond to a survey on physician beliefs about obese patients and causes of obesity. A total of 75 physicians responded to the survey. Responses were factor analyzed using standard techniques. Comments were sorted into ranked themes by the investigators. The results show systemic barriers to obesity management. Seven general factors were identified, with some discrepancy seen in the role of "psychobehavioral causation" between rural and non-rural physicians. Themes derived from the comments reflected frustration with the resources and structure of current primary care systems to be able to deal with obesity.
Our pilot survey suggests that differences in beliefs regarding the causes of obesity may exist between rural and non-rural physicians. Further research in larger, more diverse samples is necessary to further illuminate practice differences. More comprehensive approaches to obesity management, like the Chronic Care Model, are suggested by these results.
肥胖在初级保健中呈流行趋势。虽然家庭医生负责处理肥胖的后果，但他们通常对管理肥胖本身缺乏信心。我们在一个基于初级保健实践的研究网络（PBRN）中，对一组家庭医生进行了调查，以探究肥胖管理的障碍。
邀请了204名家庭医生回答一份关于医生对肥胖患者及肥胖原因看法的调查问卷。共有75名医生回复了该问卷。使用标准技术对回复进行了因子分析。研究人员将评论整理成了排序主题。结果显示了肥胖管理存在系统性障碍。确定了七个一般因素，农村和非农村医生在“心理行为成因”的作用方面存在一些差异。评论得出的主题反映出对当前初级保健系统处理肥胖的资源和结构感到沮丧。
我们的初步调查表明，农村和非农村医生在肥胖成因的看法上可能存在差异。有必要在更大、更多样化的样本中进行进一步研究，以进一步阐明实践差异。这些结果表明，应采用更全面的肥胖管理方法，如慢性病护理模式。
