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肥胖症手术是否为妇科癌症患者的一种选择?检查妇科肿瘤学提供者中减肥咨询的实践和培训。

Is bariatric surgery an option for women with gynecologic cancer? Examining weight loss counseling practices and training among gynecologic oncology providers.

机构信息

Division of Gynecologic Oncology, The Ohio State University, Columbus, OH, United States.

University of Texas Health Sciences at San Antonio, San Antonio, TX, United States.

出版信息

Gynecol Oncol. 2014 Sep;134(3):540-5. doi: 10.1016/j.ygyno.2014.06.006. Epub 2014 Jun 14.

Abstract

OBJECTIVE

The objective of this study was to evaluate gynecologic oncology provider (GOP) practices regarding weight loss (WL) counseling, and to assess their willingness to initiate weight loss interventions, specifically bariatric surgery (WLS).

METHODS

Members of the Society of Gynecologic Oncology were invited to complete an online survey of 49 items assessing knowledge, attitudes, and behaviors related to WL counseling.

RESULTS

A total of 454 participants initiated the survey, yielding a response rate of 30%. The majority of respondents (85%) were practicing GOP or fellows. A majority of responders reported that >50% of their patient population is clinically obese (BMI ≥ 30). Only 10% reported having any formal training in WL counseling, most often in medical school or residency. Providers who feel adequate about WL counseling were more likely to offer multiple WL options to their patients (p<.05). Over 90% of responders believe that WLS is an effective WL option and is more effective than self-directed diet and medical management of obesity. Providers who were more comfortable with WL counseling were significantly more likely to recommend WLS (p<.01). Approximately 75% of respondents expressed interest in clinical trials evaluating WLS in obese cancer survivors.

CONCLUSIONS

The present study suggests that GOP appreciate the importance of WL counseling, but often fail to provide it. Our results demonstrate the paucity of formal obesity training in oncology. Providers seem willing to recommend WLS as an option to their patients but also in clinical trials examining gynecologic cancer outcomes in women treated with BS.

摘要

目的

本研究旨在评估妇科肿瘤医生(GOP)在减肥(WL)咨询方面的实践,并评估他们启动减肥干预措施的意愿,特别是减重手术(WLS)。

方法

邀请妇科肿瘤学会的成员完成一项涉及 49 个项目的在线调查,评估与 WL 咨询相关的知识、态度和行为。

结果

共有 454 名参与者开始了调查,回应率为 30%。大多数受访者(85%)是 GOP 或研究员。大多数回答者报告说,超过 50%的患者群体患有临床肥胖症(BMI≥30)。只有 10%的人报告接受过 WL 咨询的任何正式培训,最常见的是在医学院或住院医师阶段。认为自己在 WL 咨询方面有足够能力的提供者更有可能为他们的患者提供多种 WL 选择(p<.05)。超过 90%的回答者认为 WLS 是一种有效的 WL 选择,比自我指导的饮食和肥胖的医学管理更有效。对 WL 咨询感到更自在的提供者更有可能推荐 WLS(p<.01)。约 75%的受访者对评估肥胖癌症幸存者接受 WLS 的临床试验表示感兴趣。

结论

本研究表明,GOP 认识到 WL 咨询的重要性,但往往未能提供。我们的结果表明,肿瘤学中肥胖培训的正式培训很少。提供者似乎愿意向患者推荐 WLS 作为一种选择,但也愿意在临床试验中研究接受 BS 治疗的女性妇科癌症结局。

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