Zaleta Alexandra K, Neff Robert, McCann Georgia A, O'Malley David M, Carpenter Kristen M
Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, 43210, USA.
Department of Obstetrics and Gynecology, Ohio State University, Columbus, OH, 43210, USA.
Support Care Cancer. 2017 May;25(5):1537-1545. doi: 10.1007/s00520-016-3552-0. Epub 2017 Jan 3.
Oncology practice guidelines recommend incorporating weight management efforts throughout survivorship care; however, some oncologists raise concerns about implementing weight management counseling without damaging patient-provider relationships. This study explores cancer survivors' receptivity to weight management counseling and examines whether views of counseling effectiveness are associated with individual characteristics including health-related perceptions or psychological distress.
Patients presenting to a NCI Comprehensive Cancer Center gynecologic oncology ambulatory clinic were asked to complete a survey assessing health and weight history, health perceptions, psychological distress, provider preferences, and weight management counseling perceptions.
Two hundred forty-four gynecologic cancer patients (38% endometrial, 37% ovarian, 16% cervical, 8% other) completed surveys. Mean participant BMI was 31.6 (SD = 9.6); 69% were overweight/obese. Most survivors (≥85%) agreed that oncologists should discuss healthy eating, exercise, and weight loss; only 14% reported receiving weight management counseling from their oncologist. 79% reported being more likely to attempt weight loss if counseled by a physician; 59% reported counseling would not be offensive. Regression results indicated that viewing weight management counseling as effective was associated with fewer depressive symptoms and greater enjoyment of physical activity, while viewing counseling unfavorably was associated with a history of attempting multiple weight loss strategies and an overall view of healthy behaviors as less beneficial (ps < .05).
Most gynecologic cancer survivors want weight management counseling from oncologists and believe counseling is effective rather than deleterious, yet obesity remains inadequately addressed. Results from this study highlight important topics to be incorporated into weight management counseling.
肿瘤学实践指南建议在整个癌症幸存者护理过程中纳入体重管理措施；然而，一些肿瘤学家担心实施体重管理咨询会破坏医患关系。本研究探讨癌症幸存者对体重管理咨询的接受程度，并检验对咨询效果的看法是否与包括健康相关认知或心理困扰在内的个体特征相关。
要求到美国国立癌症研究所综合癌症中心妇科肿瘤门诊就诊的患者完成一项调查，评估健康和体重史、健康认知、心理困扰、对医疗服务提供者的偏好以及对体重管理咨询的认知。
244名妇科癌症患者（38%为子宫内膜癌，37%为卵巢癌，16%为宫颈癌，8%为其他类型）完成了调查。参与者的平均体重指数为31.6（标准差=9.6）；69%超重/肥胖。大多数幸存者（≥85%）同意肿瘤学家应该讨论健康饮食、运动和减肥；只有14%的人报告从他们的肿瘤学家那里接受过体重管理咨询。79%的人报告如果得到医生的建议，更有可能尝试减肥；59%的人报告咨询不会令人反感。回归结果表明，认为体重管理咨询有效的人抑郁症状较少，对体育活动的喜爱程度较高，而对咨询持负面看法的人有尝试多种减肥策略的历史，并且总体认为健康行为益处较小（p值<0.05）。
大多数妇科癌症幸存者希望肿瘤学家提供体重管理咨询，并认为咨询是有效的而非有害的，但肥胖问题仍未得到充分解决。本研究结果突出了纳入体重管理咨询的重要主题。
