Research Centre for the Prevention of Overweight, VU University Amsterdam/Windesheim University of Applied Sciences Zwolle, Zwolle, The Netherlands.
Fam Pract. 2012 Apr;29 Suppl 1:i177-i184. doi: 10.1093/fampra/cmr072.
Recent guidelines on obesity management promote integrated care. There is little knowledge about local opportunities and barriers, faced by health care professionals and patients, that affect implementation of an integrated national health care standard in a local setting. Our aim is to understand experiences and expectations of health care professionals and patients as part of the local implementation process.
Eight focus groups and two interviews have been conducted among 24 patients (60+) and 29 professionals from seven different care disciplines.
Both patients and professionals have identified serious barriers to implement the national standard: older adults do not feel taken seriously and experience lacking support from professionals. Professionals give contradictory advice and recommendations do not match needs of older adults. Professionals actually feel reluctant to discuss weight-related topics due to several reasons: they do not consider obesity being a chronic disease, lack of qualifications to support self-management and perceived lack of awareness and motivation among patients.
Focus groups have proven their value to ascertain the opportunities and barriers older adults and professionals foresee while improving obesity care in order to meet the standards as required in a national guideline. Our research provides an emerging picture of health care professionals and patients having contradictory views and expectations about 'the others' role and their notions on the capability to intervene on patient's weight problems. Without this emerging picture, we would have missed important information on barriers to overcome. The likelihood of successful implementation would then have been small.
最近关于肥胖管理的指南提倡综合护理。对于影响在当地环境中实施国家综合卫生保健标准的卫生保健专业人员和患者所面临的当地机会和障碍，我们知之甚少。我们的目的是了解卫生保健专业人员和患者的经验和期望，这是当地实施过程的一部分。
在七个不同护理学科中，对 24 名 60 岁以上的患者和 29 名专业人员进行了 8 次焦点小组和 2 次访谈。
患者和专业人员都发现实施国家标准存在严重障碍：老年人感觉没有受到重视，缺乏专业人员的支持。专业人员提供相互矛盾的建议，建议与老年人的需求不匹配。由于多种原因，专业人员实际上不愿意讨论与体重相关的话题：他们不认为肥胖是一种慢性病，缺乏支持自我管理的资格，并且认为患者缺乏意识和动力。
焦点小组证明了它们的价值，有助于确定老年人和专业人员在改善肥胖护理方面预见的机会和障碍，以满足国家指南要求的标准。我们的研究提供了一幅关于卫生保健专业人员和患者对“他人”角色的看法和期望以及他们对干预患者体重问题能力的看法存在矛盾的新兴图景。如果没有这个新兴的图景，我们就会错过克服障碍的重要信息。成功实施的可能性就会很小。
