Jones Kay M, Dixon Maureen E, Dixon John B
Monash University, Department of General Practice, 270 Ferntree Gully Road, Notting Hill, Victoria, Australia.
Monash University, Department of General Practice, 270 Ferntree Gully Road, Notting Hill, Victoria, Australia.
Obes Res Clin Pract. 2014 Mar-Apr;8(2):e140-8. doi: 10.1016/j.orcp.2013.02.001.
Childhood obesity has a high risk of becoming a chronic disease requiring life-long weight management. Evidence based guidelines were developed and distributed to GPs throughout Australia by the NHMRC, but current application falls short. Measuring height and weight, and calculating BMI for children appears to be rare. Some general practitioners (GPs) perceive significant barriers to managing this patient cohort, and patients report not having confidence in their GPs.
To explore perceptions and experiences of treating childhood obesity of (i) GPs, (ii) families involved in a childhood obesity study in general practiceâ?? and (iii) families not involved in the project, but who had concerns about childhood obesity.
Supported by the literature, a semi-structured schedule was developed to address the aims. Ten GPs and eight families involved, and four families previously not involved in the project participated in interviews in 2009. All family interviews were audio-taped and transcribed verbatim. Data were thematically analyzed.
Five themes emerged: (1) raising the topic, (2) frustrations experienced by GPs and families, (3) support available for GPs to provide to families and/or anticipated by families, (4) successes from involvement in the project and (5) sustaining improvements â?? the GPsâ?? and family's perspectives.
All acknowledged that childhood obesity is a sensitive issue with both GPs and parents preferring the other to raise the topic. GPs reported successes in practice and patient management such as improved patient records. For families, the GPs dedication and support were major factors sought.
儿童肥胖有很高的风险发展为需要终身体重管理的慢性疾病。澳大利亚国家健康与医学研究理事会（NHMRC）制定了循证指南并分发给全澳的全科医生（GP），但目前这些指南的应用情况并不理想。测量儿童的身高和体重并计算体重指数（BMI）的情况似乎很少见。一些全科医生认为管理这一患者群体存在重大障碍，而患者也表示对他们的全科医生缺乏信心。
探讨（i）全科医生、（ii）参与全科医疗中儿童肥胖研究的家庭以及（iii）未参与该项目但对儿童肥胖有所担忧的家庭在治疗儿童肥胖方面的看法和经历。
在文献支持下，制定了一份半结构化的访谈提纲以实现研究目的。2009年，10名全科医生、8个参与研究的家庭以及4个之前未参与该项目的家庭参与了访谈。所有家庭访谈都进行了录音并逐字转录。对数据进行了主题分析。
出现了五个主题：（1）提出话题；（2）全科医生和家庭所经历的挫折；（3）全科医生可提供给家庭的支持和/或家庭期望得到的支持；（4）参与项目所取得的成功；（5）持续改进——全科医生和家庭的观点。
所有人都承认儿童肥胖是一个敏感问题，全科医生和家长都希望对方提出这个话题。全科医生报告了在实践和患者管理方面的成功，如改善患者记录。对于家庭来说，全科医生的奉献和支持是他们所寻求的主要因素。
