Aboueid Stephanie, Jasinska Monika, Bourgeault Ivy, Giroux Isabelle
1 Telfer School of Management, , Ottawa, Ontario, Canada.
2 School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
Can J Nurs Res. 2018 Dec;50(4):169-178. doi: 10.1177/0844562118769229. Epub 2018 Apr 17.
Obesity management in primary care has been suboptimal due to lack of access to allied health professionals, time, and resources.
To understand the weight management approaches used by primary care providers working in team-based settings and how they assess the most suitable approach for a patient.
A total of 20 primary care providers (13 nurse practitioners and 7 family physicians) working in 6 multidisciplinary clinics in Ontario were interviewed. All interviews were recorded, transcribed verbatim, and coded using NVivo qualitative software. Conventional content analysis was used to inductively elucidate codes, which were then clustered into categories.
A referral to on-site programming was the most frequent weight management approach used. The pharmacological approach was underutilized due to adverse side effects and cost to patients. Primary care providers assessed the most suitable weight management approach based on patients': preference, level of motivation, income status and access to resources, body mass index and comorbidities, and previous weight loss attempts. Primary care providers perceived that referring to health professionals and educational resources were the approaches preferred by patients.
The team-based nature of these clinics allowed for referrals to various on-site professionals and/or programs. Some barriers to pursuing weight management avenues with patients were patient dependent.
由于难以获得专职医疗人员的支持、时间和资源，初级保健中的肥胖管理一直未达到最佳效果。
了解在团队协作环境中工作的初级保健提供者所采用的体重管理方法，以及他们如何为患者评估最合适的方法。
对安大略省6家多学科诊所的20名初级保健提供者（13名执业护士和7名家庭医生）进行了访谈。所有访谈均进行了录音、逐字转录，并使用NVivo定性软件进行编码。采用常规内容分析法归纳阐释编码，然后将其归类。
转介至现场项目是最常用的体重管理方法。由于药物副作用和患者费用问题，药物治疗方法未得到充分利用。初级保健提供者根据患者的偏好、动机水平、收入状况和资源获取情况、体重指数和合并症以及以往的减肥尝试来评估最合适的体重管理方法。初级保健提供者认为，转介至健康专业人员和教育资源是患者偏爱的方法。
这些诊所的团队协作性质使得能够转介至各种现场专业人员和/或项目。与患者一起寻求体重管理途径的一些障碍取决于患者自身。
