Harvard T.H. Chan School of Public Health, USA.
Social and Behavioral Research Branch, National Human Genome Research Institute, USA.
Patient Educ Couns. 2019 Sep;102(9):1644-1649. doi: 10.1016/j.pec.2019.04.011. Epub 2019 Apr 6.
This analysis explores the effects of relaying information about the genetic and behavioral causes of obesity (vs. control) on physician trainees' verbal communication behavior with a virtual patient with obesity. Moderation by physician trainees' gender and BMI was also assessed.
119 physician trainees' verbal responses were recorded and coded using a close-ended content analytic approach.
Physician trainees in the behavioral and genetic information conditions were more likely to discuss weight (behavioral: AOR = 5.40; genetic: AOR = 6.58,) and provide lifestyle counseling (behavioral: AOR = 10.92; genetic: AOR = 3.50). Those in the behavioral condition were more likely to make assumptions about the patient's lifestyle behavior (AOR = 5.53) and use stigmatizing language (AOR = 4.69). Heavier physician trainees in the genetic condition had shorter interactions (β = -0.53, p < 0.01).
Emphasizing the genetic causes of overweight offers a potential avenue for encouraging clinical communication with patients with obesity, without also increasing prejudice and bias. Additional efforts may be needed to reap the benefits of genetic information for providers with higher weight.
For providers, considering genetic factors underlying patient body weight and obesity risk may serve to reduce stigmatizing communication with patients.
本分析探讨了向肥胖虚拟患者传达肥胖的遗传和行为原因信息(与对照相比)对医师受训者与患者口头交流行为的影响。还评估了医师受训者的性别和 BMI 是否对此有调节作用。
使用封闭式内容分析方法记录并编码了 119 名医师受训者的口头反应。
接受行为和遗传信息条件的医师受训者更有可能讨论体重(行为:AOR=5.40;遗传:AOR=6.58)和提供生活方式咨询(行为:AOR=10.92;遗传:AOR=3.50)。处于行为条件下的受训者更有可能对患者的生活方式行为做出假设(AOR=5.53)和使用污名化语言(AOR=4.69)。在遗传条件下体重较重的医师受训者的互动时间更短(β=-0.53,p<0.01)。
强调超重的遗传原因可能为鼓励与肥胖患者进行临床沟通提供一种潜在途径,而不会增加偏见和歧视。对于体重较高的提供者,可能需要付出更多努力才能从遗传信息中受益。
对于提供者来说,考虑患者体重和肥胖风险的遗传因素可能有助于减少对患者的污名化沟通。