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肥胖患者的多学科生活方式干预:对患者对疾病、食物和体育锻炼的感知的影响。

Multidisciplinary lifestyle intervention in the obese: its impact on patients' perception of the disease, food and physical exercise.

机构信息

Healthy Lifestyle Institute, (C.U.R.I.A.MO.: Centro Universitario di Ricerca Interdipartimentale Attività Motoria), University of Perugia, CURIAMO, Via G. Bambagioni 19, 06126 Perugia, Italy.

出版信息

Nutr Metab Cardiovasc Dis. 2013 Apr;23(4):337-43. doi: 10.1016/j.numecd.2011.12.008. Epub 2012 Apr 11.

Abstract

BACKGROUND AND AIMS

To be successful, lifestyle intervention in obesity must take into account patients' views. The aim of the present study, conducted using a narrative-autobiographical approach, was to report on the perception of disease, food and physical exercise in a group of 80 obese patients during a structured multidisciplinary lifestyle intervention.

METHODS AND RESULTS

Patients underwent lifestyle intervention, of three months' duration, structured in the following steps: 1) an initial medical examination; 2) an interview by a psychologist; 3) an assessment by a dietician, 4) a physical examination by a specialist in sports medicine; 5) an individualized program consisting of 24 sessions (two per week) of structured indoor exercise 6) eight sessions of group therapeutic education; 7) Nordic walking activity combined with walking excursions during weekends. All the narrative autobiographic texts obtained during the lifestyle intervention were submitted for content analysis; data were analysed according to the ''grounded theory'' method. According to patients' descriptions at the end of the intervention, lifestyle intervention resulted in enhanced self-efficacy and a reduction in their dependency on food and people; their fear of change was also diminished because, by undergoing intervention, they had experienced change.

CONCLUSION

The findings made in the present qualitative analysis suggest that whenever multidisciplinary lifestyle intervention is planned for patients with obesity, it is of the utmost importance to tailor the approach while taking the following key aspects into account: motivation, barriers and/or facilitators in lifestyle change, patients' perceptions of obesity and relationship with food, diet and exercise.

摘要

背景和目的

生活方式干预在肥胖症中取得成功,必须考虑到患者的观点。本研究采用叙述自传体方法,旨在报告一组 80 名肥胖患者在结构化多学科生活方式干预期间对疾病、食物和体育锻炼的看法。

方法和结果

患者接受了为期三个月的生活方式干预,分为以下步骤:1)初步体检;2)心理学家访谈;3)营养师评估;4)运动医学专家体检;5)由 24 节结构化室内运动组成的个体化方案(每周两次);6)八节小组治疗性教育课程;7)北欧式步行活动与周末徒步旅行相结合。在生活方式干预过程中获得的所有叙述自传体文本均进行内容分析;根据“扎根理论”方法分析数据。根据患者在干预结束时的描述,生活方式干预增强了他们的自我效能感,减少了对食物和人的依赖;他们对变化的恐惧也减少了,因为通过干预,他们经历了变化。

结论

本定性分析的结果表明,每当为肥胖患者计划多学科生活方式干预时,至关重要的是要量身定制方法,同时考虑以下关键方面:动机、生活方式改变的障碍和/或促进因素、患者对肥胖的看法以及与食物、饮食和运动的关系。

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