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儿科初级保健中体重管理实践的认知与记录

Perception and documentation of weight management practices in pediatric primary care.

作者信息

Chelvakumar Gaya, Levin Laura, Polfuss Michele, Hovis Susan, Donohoue Patricia, Kotowski Amanda

出版信息

WMJ. 2014 Aug;113(4):149-53; quiz 154.

Abstract

BACKGROUND

Pediatric obesity is a significant problem in the United States. The Childhood Obesity Action Network (COAN) published expert recommendations in 2007 for pediatric obesity prevention and assessment at well-child visits. The purpose of this study was to assess pediatric providers' perception and documentation of their adherence to the 2007 COAN guidelines.

METHODS

This was a 2-part cross sectional research study. A 36-item questionnaire about screening and management of obesity was sent to 69 providers from 16 pediatric practice sites in Southeastern Wisconsin. A retrospective chart review of well-child visits performed in June 2012 was conducted.

RESULTS

Discrepancies were found between what providers reported and documented for their obesity screening management and anticipatory guidance that they provided. In addition, the majority of providers reported inadequacy and lack of comfort when working with overweight or obese patients. Patient compliance and motivation were reported as barriers to obesity management.

CONCLUSION

Discrepancies exist between providers' self-report and documentation of obesity screening and management. In addition, providers report discomfort in managing obesity. Tools to improve documentation and continued education to improve provider comfort in managing obesity are imperative steps in optimizing care.

摘要

背景

儿童肥胖在美国是一个重大问题。儿童肥胖行动网络(COAN)于2007年发布了关于在儿童健康检查中预防和评估儿童肥胖的专家建议。本研究的目的是评估儿科医疗服务提供者对其遵循2007年COAN指南情况的认知和记录。

方法

这是一项分为两部分的横断面研究。一份关于肥胖筛查和管理的36项问卷被发送给来自威斯康星州东南部16个儿科诊所的69名医疗服务提供者。对2012年6月进行的儿童健康检查进行了回顾性病历审查。

结果

在医疗服务提供者报告的肥胖筛查管理及提供的预期指导与其记录之间发现了差异。此外,大多数医疗服务提供者表示在为超重或肥胖患者提供服务时感到不足且缺乏信心。患者的依从性和积极性被报告为肥胖管理的障碍。

结论

医疗服务提供者在肥胖筛查和管理的自我报告与记录之间存在差异。此外,医疗服务提供者表示在管理肥胖方面感到不自在。改善记录的工具以及持续教育以提高医疗服务提供者管理肥胖的信心是优化护理的必要步骤。

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