Dewhurst Anne, Peters Sarah, Devereux-Fitzgerald Angela, Hart Jo
School of Health Sciences, University of Manchester, Manchester, UK.
School of Health Sciences, University of Manchester, Manchester, UK.
Patient Educ Couns. 2017 May;100(5):897-908. doi: 10.1016/j.pec.2016.12.017. Epub 2016 Dec 21.
To systematically search and synthesise qualitative studies of physicians' views and experiences of discussing weight management within a routine consultation.
A systematic search of four electronic databases identified 11,169 articles of which 16 studies met inclusion criteria. Quality was appraised using the Critical Appraisal Skills Programme tool and a thematic synthesis conducted of extracted data.
Four analytical themes were found: (1) physicians' pessimism about patients' weight loss success (2) physicians' feel hopeless and frustrated (3) the dual nature of the physician-patient relationship (4) who should take responsibility for weight management.
Despite clinical recommendations barriers remain during consultations between physicians and patients about weight management. Many of these barriers are potentially modifiable.
Improving training, providing clearer guidelines and placing a greater emphasis on collaboration within and between clinicians will help reduce barriers for both physicians and patients. In particular, there is an urgent need for more specialised training for physicians about weight management to promote knowledge and skills in behaviour change techniques and ways to broach sensitive topics without damaging patient relationships.
系统检索并综合关于医生在常规会诊中讨论体重管理的观点和经验的定性研究。
对四个电子数据库进行系统检索,共识别出11169篇文章,其中16项研究符合纳入标准。使用批判性评估技能计划工具对质量进行评估,并对提取的数据进行主题综合分析。
发现了四个分析主题:(1)医生对患者减肥成功的悲观态度;(2)医生感到绝望和沮丧;(3)医患关系的双重性质;(4)谁应该对体重管理负责。
尽管有临床建议,但在医生与患者之间关于体重管理的会诊中仍存在障碍。其中许多障碍可能是可以改变的。
改进培训、提供更明确的指导方针以及更加强调临床医生内部和之间的协作,将有助于减少医生和患者双方的障碍。特别是,迫切需要为医生提供更多关于体重管理的专门培训,以提高他们在行为改变技术方面的知识和技能,以及在不损害患者关系的情况下探讨敏感话题的方法。