Farnesi B C, Ball G D C, Newton A S
Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
Pediatr Obes. 2012 Jun;7(3):175-86. doi: 10.1111/j.2047-6310.2012.00029.x. Epub 2012 Apr 10.
In this integrative review, we examined contemporary literature in pediatric weight management to identify characteristics that contribute to the relationship between families and health professionals and describe how these qualities can inform healthcare practices for obese children and families receiving weight management care. We searched literature published from 1980 to 2010 in three electronic databases (MEDLINE, PsycINFO and CINAHL). Twenty-four articles identified family-health professional relationships were influenced by the following: health professionals' weight-related discussions and approaches to care; and parents' preferences regarding weight-related terminology and expectations of healthcare delivery. There was considerable methodological heterogeneity in the types of reports (i.e. qualitative studies, review articles, commentaries) included in this review. Overall, the findings have implications for establishing a positive clinical relationship between families and health professionals, which include being sensitive when discussing weight-related issues, using euphemisms when talking about obesity, demonstrating a non-judgmental and supportive attitude and including the family (children and parents) in healthcare interactions. Experimental research, clinical interventions and longitudinal studies are needed to build on the current evidence to determine how best to establish a collaborative partnership between families and health professionals and whether such a partnership improves treatment adherence, reduces intervention attrition and enhances pediatric weight management success.
在这篇综合性综述中,我们研究了儿科体重管理方面的当代文献,以确定有助于家庭与健康专业人员之间关系的特征,并描述这些特质如何为接受体重管理护理的肥胖儿童及其家庭的医疗实践提供信息。我们在三个电子数据库(MEDLINE、PsycINFO和CINAHL)中检索了1980年至2010年发表的文献。24篇确定家庭与健康专业人员关系受到以下因素影响的文章:健康专业人员与体重相关的讨论及护理方法;以及父母对与体重相关术语的偏好和对医疗服务的期望。本综述纳入的报告类型(即定性研究、综述文章、评论)存在相当大的方法学异质性。总体而言,这些发现对在家庭与健康专业人员之间建立积极的临床关系具有启示意义,包括在讨论与体重相关问题时保持敏感、在谈论肥胖时使用委婉语、表现出无偏见和支持的态度以及让家庭(儿童和父母)参与医疗互动。需要进行实验研究、临床干预和纵向研究,以基于当前证据确定如何最好地在家庭与健康专业人员之间建立合作关系,以及这种合作关系是否能提高治疗依从性、减少干预流失并提高儿科体重管理的成功率。