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医生的 BMI 如何影响患者的信任和感知耻辱?

How does physician BMI impact patient trust and perceived stigma?

机构信息

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

出版信息

Prev Med. 2013 Aug;57(2):120-4. doi: 10.1016/j.ypmed.2013.05.005. Epub 2013 Jun 4.

Abstract

OBJECTIVE

The objective is to evaluate whether physician body mass index (BMI) impacts their patients' trust or perceptions of weight-related stigma.

METHODS

We used a national cross-sectional survey of 600 non-pregnant overweight and obese patients conducted between April 5 and April 13, 2012. The outcome variables were patient trust (overall and by type of advice) and patient perceptions of weight-related stigma. The independent variable of interest was primary care physician (PCP) BMI. We conducted multivariate regression analyses to determine whether trust or perceived stigma differed by physician BMI, adjusting for covariates.

RESULTS

Patients reported high levels of trust in their PCPs, regardless of the PCPs body weight (normal BMI=8.6; overweight=8.3; obese=8.2; where 10 is the highest). Trust in diet advice was significantly higher among patients seeing overweight PCPs as compared to normal BMI PCPs (87% vs. 77%, p=0.04). Reports of feeling judged by their PCP were significantly higher among patients seeing obese PCPs (32%; 95% confidence interval (CI): 23-41) as compared to patients seeing normal BMI PCPs (14%; 95% CI: 7-20).

CONCLUSION

Overweight and obese patients generally trust their PCP, but they more strongly trust diet advice from overweight PCPs as compared to normal BMI PCPs.

摘要

目的

评估医生的体重指数(BMI)是否会影响患者对与体重相关的耻辱感的信任或看法。

方法

我们使用了一项全国性的横断面调查,调查了 2012 年 4 月 5 日至 4 月 13 日期间的 600 名非孕妇超重和肥胖患者。结果变量是患者的信任(总体和按建议类型)和患者对与体重相关的耻辱感的看法。主要关注的自变量是初级保健医生(PCP)的 BMI。我们进行了多变量回归分析,以确定信任或感知的耻辱感是否因医生的 BMI 而有所不同,同时调整了协变量。

结果

无论医生的体重(正常 BMI=8.6;超重=8.3;肥胖=8.2;其中 10 是最高值)如何,患者对其 PCP 的信任度都很高。与正常 BMI 的 PCP 相比,超重的 PCP 提供的饮食建议更受患者信任(87%对 77%,p=0.04)。与正常 BMI 的 PCP 相比,肥胖的 PCP 让患者感到被评判的比例明显更高(32%;95%置信区间(CI):23-41)。

结论

超重和肥胖患者通常信任他们的 PCP,但与正常 BMI 的 PCP 相比,他们更信任超重 PCP 提供的饮食建议。

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