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孕前保健背景下的饮食失调:生殖专家的知识、态度及临床实践

Eating disorders in the context of preconception care: fertility specialists' knowledge, attitudes, and clinical practices.

作者信息

Rodino Iolanda S, Byrne Susan M, Sanders Katherine A

机构信息

School of Anatomy, Physiology, and Human Biology, University of Western Australia, Perth, Western Australia, Australia; School of Psychology, University of Western Australia, Perth, Western Australia, Australia.

School of Psychology, University of Western Australia, Perth, Western Australia, Australia; Centre for Clinical Interventions, Perth, Western Australia, Australia.

出版信息

Fertil Steril. 2017 Feb;107(2):494-501. doi: 10.1016/j.fertnstert.2016.10.036. Epub 2016 Nov 23.

Abstract

OBJECTIVE(S): To gauge fertility specialists' knowledge, clinical practices, and training needs in regard to eating disorders.

DESIGN

Cross-sectional study.

SETTINGS

Fertility clinics.

PARTICIPANTS

Eighty Australian and New Zealand fertility specialists who were members of the Fertility Society of Australia.

INTERVENTION(S): None.

MAIN OUTCOME MEASURES(S): Responses to an anonymously completed online questionnaire.

RESULT(S): Approximately 54% of doctors correctly identified the body mass index relevant to anorexia nervosa, and 30% identified menstrual disturbances for anorexia, while 63.8% of doctors incorrectly nominated maladaptive weight control behaviors as a characteristic of binge eating disorder. While clinicians (83.7%) agreed it was important to screen for eating disorders during preconception assessments, 35% routinely screened for eating disorders and 8.8% indicated that their clinics had clinical practice guidelines for management of eating disorders. A minority of participants (13.8%) felt satisfied with their level of university training in eating disorders, 37.5% of doctors felt confident in their ability to recognize symptoms of an eating disorder, and 96.2% indicated a need for further education and clinical guidelines. On most items examined, knowledge and clinical practices regarding eating disorders did not differ according to doctor gender or years of clinical experience working as a fertility specialist.

CONCLUSION(S): Knowledge about eating disorders in the context of fertility treatment is important. This study highlights the uncertainty among fertility specialists in detecting features of eating disorders. The findings point to the importance of further education and training, including the development of clinical guidelines specific to fertility health care providers.

摘要

目的

评估生育专家在饮食失调方面的知识、临床实践及培训需求。

设计

横断面研究。

地点

生育诊所。

参与者

80名澳大利亚和新西兰的生育专家,均为澳大利亚生育协会成员。

干预措施

无。

主要观察指标

对匿名填写的在线问卷的回复。

结果

约54%的医生正确识别出与神经性厌食症相关的体重指数,30%识别出厌食症的月经紊乱情况,而63.8%的医生错误地将适应不良的体重控制行为列为暴饮暴食症的特征。虽然临床医生(83.7%)认同在孕前评估时筛查饮食失调很重要,但35%的医生会常规筛查饮食失调情况,8.8%表示其所在诊所有饮食失调管理的临床实践指南。少数参与者(13.8%)对其在大学期间饮食失调方面的培训水平感到满意,37.5%的医生对自己识别饮食失调症状的能力有信心,96.2%表示需要进一步教育和临床指南。在大多数检查项目上,生育专家在饮食失调方面的知识和临床实践不因医生性别或作为生育专家的临床工作年限而有所不同。

结论

生育治疗中有关饮食失调的知识很重要。本研究凸显了生育专家在检测饮食失调特征方面的不确定性。研究结果表明进一步教育和培训的重要性,包括制定针对生育保健提供者的临床指南。

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