Department of Surgery, McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Ontario, Canada L8N 3Z5.
J Pediatr Surg. 2013 May;48(5):1012-9. doi: 10.1016/j.jpedsurg.2013.02.019.
This qualitative study aims to understand academic physicians' attitudes towards the treatment of pediatric obesity in Canada.
A stratified sample of 24 participants (surgeons, pediatricians, family practitioners) were recruited from 4 Canadian regions. Semi-structured interviews were conducted and transcribed. A codebook was developed through iterative data reduction and conceptual saturation ensured. Validity was ensured through triangulation, audit trail, and member-checking.
This study revealed 45 themes with regional, specialty, and experiential differences. Quebec and Ontario emphasized education of physicians and parents to improve treatment and favored surgical intervention. Half of surgeons felt surgery was the only successful treatment option, while non-surgeons favored behavioral interventions. Experienced physicians in Western Canada desired more evidence to improve patient care, while inexperienced physicians focused on early detection and home environments. Across Canada participants advocated for program development and system change. Respondents expressed family involvement as integral to treatment success and shifting away from blame and moving towards a healthy lifestyles approach.
Canadian regional differences in physicians' attitudes towards pediatric obesity treatment exist, influenced by experience and specialty. We will understand how themes identified in this study influence real life clinical decision making by applying these results to create a discrete choice-based conjoint survey.
本定性研究旨在了解加拿大学术医师对儿科肥胖治疗的态度。
从加拿大 4 个地区抽取了 24 名参与者（外科医生、儿科医生、家庭医生）作为分层样本。进行了半结构化访谈并进行了转录。通过迭代数据缩减开发了一个代码本，并确保了概念饱和。通过三角测量、审核跟踪和成员检查确保了有效性。
本研究揭示了 45 个主题，具有区域、专业和经验差异。魁北克和安大略省强调对医生和家长进行教育以改善治疗效果，并赞成手术干预。一半的外科医生认为手术是唯一成功的治疗选择，而非外科医生则赞成行为干预。来自加拿大西部的经验丰富的医生希望有更多的证据来改善患者的护理，而缺乏经验的医生则专注于早期发现和家庭环境。整个加拿大的参与者都倡导制定计划和进行系统变革。受访者表示，家庭参与是治疗成功的关键，从指责转向健康生活方式的方法。
加拿大医生对儿科肥胖治疗的态度存在区域差异，这受到经验和专业的影响。我们将通过应用这些结果创建离散选择式联合调查来了解本研究中确定的主题如何影响现实生活中的临床决策。
