Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Patient Educ Couns. 2012 Oct;89(1):152-7. doi: 10.1016/j.pec.2012.06.033. Epub 2012 Jul 21.
Primary care providers (PCPs) are encouraged to counsel their obese patients about weight loss. We used focus groups to explore how PCPs communicate with patients about weight management.
During the summer of 2010, we conducted five focus groups of community-based PCPs who had patients enrolled in a practice-based, randomized controlled weight loss trial in Maryland. Focus groups were audio-recorded and transcribed verbatim. Two investigators independently coded transcripts for thematic content using editing style analysis.
Twenty-six PCPs from six different practices participated. Mean years in practice were 16.4 (SD 11.7) and 77% practiced internal medicine. We identified three communication-based themes about weight loss counseling: (1) motivating patients to lose weight, (2) partnering with the patient to achieve weight loss, and (3) handling challenges that arise during weight counseling.
PCPs use a variety of strategies to communicate with their patients about weight loss. Some PCPs already use patient-centered approaches to communicate with their patients about weight loss, suggesting that future weight counseling interventions should be tailored to build upon this strength.
PCPs' weight loss counseling may be improved by using techniques with demonstrated behavior change effectiveness such as the 5A's or motivational interviewing.
鼓励初级保健提供者(PCP)就减肥问题为肥胖患者提供咨询。我们采用焦点小组的方法来探索 PCP 如何与患者就体重管理进行沟通。
2010 年夏,我们对马里兰州一项基于实践的、随机对照减肥试验中登记患者的六位社区 PCP 进行了五次焦点小组讨论。对小组讨论进行了录音和逐字转录。两位调查员使用编辑风格分析独立对抄本进行主题内容编码。
来自六家不同诊所的 26 名 PCP 参与了研究。平均从业年限为 16.4 年(标准差为 11.7 年),其中 77%从事内科。我们确定了关于减肥咨询的三个基于沟通的主题:(1)激励患者减肥,(2)与患者合作实现减肥,以及(3)处理减肥咨询过程中出现的挑战。
PCP 采用多种策略与患者就减肥进行沟通。一些 PCP 已经使用以患者为中心的方法与患者就减肥进行沟通,这表明未来的减肥咨询干预措施应该针对这一优势进行定制。
通过使用已证明对行为改变有效的技术,如 5A's 或动机性访谈,可以改善 PCP 的减肥咨询。