Torti Jacqueline, Luig Thea, Borowitz Michelle, Johnson Jeffrey A, Sharma Arya M, Campbell-Scherer Denise L
Department of Family Medicine, University of Alberta, Clinical Research Unit, Edmonton, AB, Canada, T6G 2E1.
School of Public Health, University of Alberta, Edmonton, AB, Canada, T6G 2E3.
BMC Fam Pract. 2017 Feb 8;18(1):19. doi: 10.1186/s12875-017-0596-2.
Over 60% of people have overweight or obesity, but only a third report receiving counselling from primary care providers. We explored patients' perspectives on the role of primary care in obesity management and their experience with existing resources, with a view to develop an improved understanding of this perspective, and more effective management strategies.
Qualitative study employing semi-structured interviews and thematic analysis, with a sample of 28 patients from a cohort of 255 patients living with obesity and receiving care to support their weight management in a large Primary Care Network of family practices in Alberta.
Four illustrative themes emerged: (1) the patient-physician relationship plays an important role in the adequacy of obesity management; (2) patients have clear expectations of substantive conversations with their primary care team; (3) complex conditions affect weight and patients require assistance tailored to individual obesity drivers; (4) current services provide support in important ways (accessibility, availability, accountability, affordability, consistency of messaging), but are not yet meeting patient needs for individual plans, advanced education, and follow-up opportunities.
Patients have clear expectations that their primary care physician asks them about weight within a supportive therapeutic relationship. They see obesity as a complex phenomenon with multiple drivers. They want their healthcare providers to assess and address their root causes - not simplistic advice to "eat less, move more". Patients felt that the current services were positive resources, but expressed needs for tailored weight management plans, and longer-term follow-up.
超过60%的人超重或肥胖，但只有三分之一的人报告接受过初级保健提供者的咨询。我们探讨了患者对初级保健在肥胖管理中的作用的看法以及他们对现有资源的体验，以期更好地理解这一观点，并制定更有效的管理策略。
采用半结构化访谈和主题分析的定性研究，样本来自艾伯塔省一个大型初级保健网络中255名肥胖患者队列中的28名患者，这些患者正在接受支持其体重管理的护理服务。
出现了四个具有代表性的主题：（1）医患关系在肥胖管理的充分性方面起着重要作用；（2）患者对与初级保健团队进行实质性对话有明确期望；（3）复杂情况会影响体重，患者需要针对个体肥胖驱动因素量身定制的帮助；（4）当前服务在重要方面（可及性、可用性、问责制、可承受性、信息一致性）提供支持，但尚未满足患者对个性化计划、进阶教育和随访机会的需求。
患者明确期望他们的初级保健医生在支持性治疗关系中询问他们的体重情况。他们将肥胖视为一个由多种驱动因素导致的复杂现象。他们希望医疗保健提供者评估并解决其根本原因，而不是简单地建议“少吃多动”。患者认为当前服务是积极的资源，但表示需要量身定制的体重管理计划和长期随访。
