Steeves Jeremy A, Liu Benmei, Willis Gordon, Lee Richard, Smith Ashley Wilder
Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
Obes Res Clin Pract. 2015 May-Jun;9(3):243-55. doi: 10.1016/j.orcp.2014.08.002. Epub 2014 Aug 28.
Overweight and obesity are major health risks in the United States (US) and primary care physicians (PCPs) are uniquely positioned to address them. However, their personal beliefs about weight-related care may influence their delivery of care.
A nationally representative sample of 2022 physicians completed the National Survey of Energy Balance-Related Care among Primary Care Physicians. Physicians responded to questions regarding their beliefs and clinical practices associated with weight control including assessment, counselling, referral and follow-up for diet, physical activity, and weight. Multivariate logistic regression was used to examine associations between physician characteristics and personal beliefs, and associations between personal beliefs and care delivery, adjusting for specialty, age, gender, race, region, urban/rural location, and patient population.
Most physicians feel a responsibility (97%) to promote weight-related care, but over half (53%) have concerns about their effectiveness and almost two-thirds feel they lack effective strategies to help patients (63%). Demographics and medical specialty were associated with beliefs (female, Asian-American, Midwest and Southern location, and internal medicine physicians were more likely to have stronger positive beliefs about weight-related care). Personal beliefs about weight-related care were associated with the likelihood of its delivery. However, two practices, regular BMI assessment and referring patients for further evaluation and management, were less related to PCP beliefs than were other care practices.
PCPs' beliefs may be important to their practice of weight-related care. Training in behavioural counselling, and providing physician's tools and resources may help to address their concerns about helping patients with weight-related care.
超重和肥胖是美国的主要健康风险，初级保健医生在解决这些问题方面具有独特的地位。然而，他们对体重相关护理的个人信念可能会影响他们提供护理的方式。
一个由2022名医生组成的具有全国代表性的样本完成了初级保健医生能量平衡相关护理全国调查。医生们回答了关于他们与体重控制相关的信念和临床实践的问题，包括饮食、身体活动和体重的评估、咨询、转诊和随访。使用多变量逻辑回归来检验医生特征与个人信念之间的关联，以及个人信念与护理提供之间的关联，并对专业、年龄、性别、种族、地区、城乡位置和患者群体进行了调整。
大多数医生（97%）认为有责任促进体重相关护理，但超过一半（53%）的医生担心其有效性，近三分之二（63%）的医生觉得他们缺乏帮助患者的有效策略。人口统计学和医学专业与信念相关（女性、亚裔美国人、中西部和南部地区以及内科医生对体重相关护理更可能有更强的积极信念）。关于体重相关护理的个人信念与其提供的可能性相关。然而，与其他护理实践相比，定期进行体重指数评估以及将患者转诊进行进一步评估和管理这两种做法与初级保健医生的信念关联较小。
初级保健医生的信念可能对其体重相关护理实践很重要。行为咨询培训以及提供医生工具和资源可能有助于解决他们在帮助患者进行体重相关护理方面的担忧。
