Gudzune Kimberly A, Bennett Wendy L, Cooper Lisa A, Bleich Sara N
Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Prev Med. 2014 May;62:103-7. doi: 10.1016/j.ypmed.2014.02.001. Epub 2014 Feb 9.
To examine the association between patient-perceived judgments about weight by primary care providers (PCPs) and self-reported weight loss.
We conducted a national internet-based survey of 600 adults engaged in primary care with a body mass index (BMI)≥25 kg/m(2) in 2012. Our weight loss outcomes included attempted weight loss and achieved ≥10% weight loss in the last 12 months. Our independent variable was "feeling judged about my weight by my PCP." We created an interaction between perceiving judgment and PCP discussing weight loss as an independent variable. We conducted a multivariate logistic regression model adjusted for patient and PCP factors using survey weights.
Overall, 21% perceived that their PCP judged them about their weight. Respondents who perceived judgment were significantly more likely to attempt weight loss [odds ratios (OR) 4.67, 95% confidence interval (CI) 1.96-11.14]. They were not more likely to achieve ≥10% weight loss [OR 0.87, 95%CI 0.42-1.76]. Among patients whose PCPs discussed weight loss, 20.1% achieved ≥10% weight loss if they did not perceive judgment by their PCP as compared to 13.5% who perceived judgment.
Weight loss discussions between patients and PCPs may lead to greater weight loss in relationships where patients do not perceive judgment about their weight.
探讨初级保健提供者（PCP）对患者体重的判断与患者自我报告的体重减轻之间的关联。
2012年，我们对600名体重指数（BMI）≥25kg/m²且接受初级保健的成年人进行了一项基于互联网的全国性调查。我们的体重减轻结果包括尝试减肥以及在过去12个月内体重减轻≥10%。我们的自变量是“感觉我的初级保健提供者对我的体重进行了评判”。我们将感知到的评判与初级保健提供者讨论减肥作为一个自变量进行交互分析。我们使用调查权重对患者和初级保健提供者因素进行调整后，进行了多变量逻辑回归模型分析。
总体而言，21%的人认为他们的初级保健提供者对他们的体重进行了评判。感知到评判的受访者尝试减肥的可能性显著更高[优势比（OR）为4.67，95%置信区间（CI）为1.96 - 11.14]。他们体重减轻≥10%的可能性并没有更高[OR为0.87，95%CI为0.42 - 1.76]。在初级保健提供者讨论过减肥的患者中，未感知到初级保健提供者评判的患者中有20.1%体重减轻≥10%，而感知到评判的患者中这一比例为13.5%。
在患者未感知到对其体重的评判的医患关系中，患者与初级保健提供者之间关于减肥的讨论可能会带来更多的体重减轻。
