Glenister Kristen M, Malatzky Christina Ar, Wright Julian
Aust Fam Physician. 2017 Oct;46(10):769-773.
General practitioners (GPs) have a crucial role to play in engaging patients in discussions about overweight and obesity. However, such discussions are currently uncommon. The aim of this study was to examine how GPs in rural areas talk about overweight and obesity with their patients, specifically to identify key barriers to effective conversations.
This study used a qualitative methodology. Semi-structured interviews were conducted with GPs (n = 7) and patients (n = 7) across two rural areas.
Key barriers to effective conversations between GPs and patients about overweight and/or obesity include: uncertainty about appropriate language; lack of time; concerns about compromising mutual trust and rapport; concerns about patient readiness; concerns about patients' mental health and how this may be impacted by discussing a potentially upsetting and stigmatising topic; and lack of effective and individualised treatment and/or referral options.
The findings suggest that responses to overweight and obesity need to be localised and tailored. Structural-level change is required to enable better responses to overweight and obesity, including multidisciplinary team approaches.
全科医生在促使患者参与有关超重和肥胖问题的讨论方面起着关键作用。然而，目前此类讨论并不常见。本研究的目的是考察农村地区的全科医生如何与患者谈论超重和肥胖问题，特别是确定有效沟通的关键障碍。
本研究采用定性研究方法。对两个农村地区的全科医生（n = 7）和患者（n = 7）进行了半结构化访谈。
全科医生与患者之间就超重和/或肥胖问题进行有效沟通的关键障碍包括：对恰当措辞不确定；时间不足；担心损害相互信任和融洽关系；担心患者是否做好准备；担心患者的心理健康以及讨论这一可能令人不安和带来污名化的话题会如何影响其心理健康；缺乏有效且个性化的治疗和/或转诊选择。
研究结果表明，对超重和肥胖问题的应对需要因地制宜、量身定制。需要进行结构性变革，以更好地应对超重和肥胖问题，包括采用多学科团队方法。
