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评估和咨询肥胖患者:提高住院医师肥胖咨询能力。

Assessing and counseling the obese patient: Improving resident obesity counseling competence.

机构信息

Department of Internal Medicine and Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, United States.

Department of Internal Medicine and Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, United States.

出版信息

Obes Res Clin Pract. 2018 Mar-Apr;12(2):242-245. doi: 10.1016/j.orcp.2018.02.007. Epub 2018 Mar 16.

Abstract

OBJECTIVE

To evaluate obesity counseling competence among residents in a primary care training program METHODS: We delivered a 3h obesity curriculum to 28 Primary Care residents and administered a pre-curriculum and post curriculum survey looking specifically at self-assessed obesity counseling competence.

RESULTS

Nineteen residents completed both the pre curriculum survey and the post curriculum survey. The curriculum had a positive impact on residents' ability to ascertain patient's stage of change, use different methods to obtain diet history (including 24h recall, food record or food frequency questionnaire), respond to patient's questions regarding treatment options, assist patients in setting realistic goals for weight loss based on making permanent lifestyle changes, and use of motivational interviewing to change behavior. When looking at the 5As domains, there was a significant improvement in the domains of Assess, Advise, and Assist. The proportion of residents with a lower level of self-assessed obesity counseling competence reduced from 75% before the curriculum to 37.5% (p=0.04) after the curriculum.

CONCLUSION

Our curriculum addressing weight loss counseling using the 5As model increased obesity counseling competence among residents in a primary care internal medicine residency program.

摘要

目的

评估初级保健培训计划中住院医师的肥胖咨询能力

方法

我们向 28 名初级保健住院医师提供了 3 小时的肥胖课程,并在课前和课后进行了调查,专门调查自我评估的肥胖咨询能力。

结果

19 名住院医师完成了课前和课后的调查。该课程对住院医师确定患者改变阶段的能力、使用不同方法获取饮食史(包括 24 小时回顾、饮食记录或食物频率问卷)、回应患者关于治疗选择的问题、帮助患者根据永久性生活方式改变设定现实的减肥目标以及使用动机性访谈来改变行为产生了积极影响。在查看 5A 领域时,评估、建议和协助领域有显著改善。自我评估肥胖咨询能力较低的住院医师比例从课程前的 75%降至课程后的 37.5%(p=0.04)。

结论

我们使用 5A 模型解决减肥咨询的课程提高了初级保健内科住院医师培训计划中肥胖咨询的能力。

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