Phelan S M, Burgess D J, Yeazel M W, Hellerstedt W L, Griffin J M, van Ryn M
Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota, USA.
Obes Rev. 2015 Apr;16(4):319-26. doi: 10.1111/obr.12266. Epub 2015 Mar 5.
The objective of this study was to critically review the empirical evidence from all relevant disciplines regarding obesity stigma in order to (i) determine the implications of obesity stigma for healthcare providers and their patients with obesity and (ii) identify strategies to improve care for patients with obesity. We conducted a search of Medline and PsychInfo for all peer-reviewed papers presenting original empirical data relevant to stigma, bias, discrimination, prejudice and medical care. We then performed a narrative review of the existing empirical evidence regarding the impact of obesity stigma and weight bias for healthcare quality and outcomes. Many healthcare providers hold strong negative attitudes and stereotypes about people with obesity. There is considerable evidence that such attitudes influence person-perceptions, judgment, interpersonal behaviour and decision-making. These attitudes may impact the care they provide. Experiences of or expectations for poor treatment may cause stress and avoidance of care, mistrust of doctors and poor adherence among patients with obesity. Stigma can reduce the quality of care for patients with obesity despite the best intentions of healthcare providers to provide high-quality care. There are several potential intervention strategies that may reduce the impact of obesity stigma on quality of care.
本研究的目的是严格审查来自所有相关学科的关于肥胖污名的实证证据,以便(i)确定肥胖污名对医疗服务提供者及其肥胖患者的影响,以及(ii)确定改善肥胖患者护理的策略。我们在Medline和PsychInfo中搜索了所有呈现与污名、偏见、歧视、成见及医疗护理相关的原始实证数据的同行评审论文。然后,我们对现有的关于肥胖污名和体重偏见对医疗质量及结果影响的实证证据进行了叙述性综述。许多医疗服务提供者对肥胖者持有强烈的负面态度和刻板印象。有大量证据表明,此类态度会影响对人的认知、判断、人际行为和决策。这些态度可能会影响他们提供的护理。对不良治疗的经历或预期可能会导致压力、回避护理、对医生的不信任以及肥胖患者的依从性差。尽管医疗服务提供者有意提供高质量护理,但污名仍会降低肥胖患者的护理质量。有几种潜在的干预策略可能会减少肥胖污名对护理质量的影响。