Auspitz Mark, Cleghorn Michelle C, Azin Arash, Sockalingam Sanjeev, Quereshy Fayez A, Okrainec Allan, Jackson Timothy D
Division of General Surgery, University Health Network-Toronto Western Hospital, 399 Bathurst Street, Room 8MP-322, Toronto, Ontario, M5T 2S8, Canada.
Department of Psychiatry, University Health Network, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada.
Obes Surg. 2016 Sep;26(9):2022-2028. doi: 10.1007/s11695-016-2055-x.
The primary objective of this study was to identify Ontario family physicians' knowledge and perceptions of bariatric surgery.
The study population included all physicians practicing family medicine in Ontario who were listed in the Canadian Medical Directory. A self-administered questionnaire consisting of 28 questions was developed and validated using a focus group of seven primary care physicians. The questionnaire was distributed to 1328 physicians.
One hundred sixty-five surveys were completed. 8.8 % of physicians did not have any bariatric surgical patients, and 71.3 % had no more than five in their practice. 70.2 % referred no more than 5 % of their morbidly obese patients for surgery. Only 32.1 % had the appropriate equipment and resources to manage obese patients. 92.5 % of physicians would like to receive more education about bariatric surgery. Physicians with no history of referral (n = 21) were earlier into their practices and had less morbidly obese patients than physicians with previous referrals (n = 141). They were also less likely to discuss bariatric surgery with their patients (30 vs. 79.3 %; p < 0.001) and less likely to feel comfortable explaining procedure options (5.6 vs. 33.9 %; p = 0.013) and providing postoperative care (26.7 vs. 64.2 %; p = 0.005). 55.6 % would refer a family member for surgery, compared to 85.4 % of physicians with previous referrals; p = 0.002.
There appears to be a knowledge gap in understanding the role of bariatric surgery in the treatment of obesity. There is an opportunity to improve education and available resources for primary care physicians surrounding patient selection and follow-up care. This may improve access to treatment.
本研究的主要目的是确定安大略省家庭医生对减肥手术的了解和看法。
研究人群包括加拿大医学名录中列出的安大略省所有从事家庭医学的医生。通过由7名初级保健医生组成的焦点小组开发并验证了一份包含28个问题的自填式问卷。该问卷被分发给1328名医生。
共完成了165份调查问卷。8.8%的医生没有任何减肥手术患者，71.3%的医生在其执业中此类患者不超过5例。70.2%的医生将不超过5%的病态肥胖患者转诊进行手术。只有32.1%的医生拥有管理肥胖患者的适当设备和资源。92.5%的医生希望接受更多关于减肥手术的教育。没有转诊史的医生（n = 21）比有转诊史的医生（n = 141）更早开始执业，且病态肥胖患者更少。他们也不太可能与患者讨论减肥手术（30%对79.3%；p < 0.001），不太可能自在地解释手术选择（5.6%对33.9%；p = 0.013）以及提供术后护理（26.7%对64.2%；p = 0.005）。55.6%的医生会将家庭成员转诊进行手术，而有转诊史的医生这一比例为85.4%；p = 0.002。
在理解减肥手术在肥胖治疗中的作用方面似乎存在知识差距。有机会改善针对初级保健医生在患者选择和后续护理方面的教育及可用资源。这可能会改善治疗的可及性。
