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充分应对儿童肥胖问题:初级保健提供者面临的挑战

Adequately Addressing Pediatric Obesity: Challenges Faced by Primary Care Providers.

作者信息

Shreve Marilou, Scott Allison, Vowell Johnson Kelly

机构信息

From the Eleanor Mann School of Nursing, University of Arkansas, Fayetteville, Arkansas.

出版信息

South Med J. 2017 Jul;110(7):486-490. doi: 10.14423/SMJ.0000000000000670.

Abstract

OBJECTIVE

To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese.

METHODS

A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions.

RESULTS

Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity. All providers reported lack of time as a barrier to providing the care needed for obese children. Cultural barriers of both the provider and client were identified as factors, which negatively affect the care and treatment of obese children.

CONCLUSIONS

Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.

摘要

目的

评估基层医疗服务提供者在为确诊为肥胖的儿科患者提供咨询时所面临的挑战。

方法

一项调查评估了阿肯色州西北部为家庭提供医疗服务的提供者在筛查和治疗儿童肥胖方面当前面临的挑战和障碍。该调查包括15个李克特量表问题和4个开放式问题。

结果

提供者报告称,时间、资源、舒适度和文化问题是筛查和治疗儿童肥胖的最大障碍。所有提供者都报告说,时间不足是为肥胖儿童提供所需护理的障碍。提供者和患者的文化障碍都被确定为对肥胖儿童的护理和治疗产生负面影响的因素。

结论

基层医疗服务提供者在处理儿童肥胖问题时仍然面临挑战。在这项研究中,确定缺乏足够的时间来解决肥胖问题是目前最重大的障碍,这可能与医生资源有关。尽管肥胖治疗的报销费用在增加,但报销水平并不支持治疗患者所需的时间和资源。许多提供者报告说,他们患者对肥胖的文化观念影响了他们为患者提供咨询的方式。增加提供者关于体重看法或重视方式差异的知识,可能有助于他们对肥胖儿科患者进行评估和护理。先前研究中确定的挑战在处理肥胖问题时继续限制着提供者。尽管在指南知识方面已经取得了进展,但仍需要持续努力来应对其余的挑战。这将有助于更早地识别和干预,从而改善儿童肥胖的治疗效果。

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