Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3168, Australia.
Nutrients. 2019 May 7;11(5):1024. doi: 10.3390/nu11051024.
Weight and lifestyle management is advocated as the first-line treatment for polycystic ovary syndrome (PCOS) by evidence-based guidelines. Current literature describes both systems- and individual-related challenges that general practitioners (GPs) face when attempting to implement guideline recommendations for lifestyle management into clinical practice for the general population. The GPs' perspective in relation to weight and lifestyle advice for PCOS has not been captured.
Fifteen GPs were recruited to take part in semi-structured interviews. NVIVO software was used for qualitative analysis.
We report that GPs unanimously acknowledge the importance of weight and lifestyle management in PCOS. Practice was influenced by both systems-related and individual-related facilitators and barriers. Individual-related barriers include perceived lack of patient motivation for weight loss, time pressures, lack of financial reimbursement, and weight management being professionally unrewarding. System-related barriers include costs of accessing allied health professionals and unavailability of allied health professionals in certain locations. Individual-related facilitators include motivated patient subgroups such as those trying to get pregnant and specific communication techniques such as motivational interviewing. System-related facilitators include the GP's role in chronic disease management.
This study contributes to the understanding of barriers and facilitators that could be addressed to optimize weight and lifestyle management in women with PCOS in primary care.
基于循证指南，提倡将体重和生活方式管理作为多囊卵巢综合征（PCOS）的一线治疗方法。目前的文献描述了全科医生（GP）在尝试将生活方式管理的指南建议纳入普通人群的临床实践时所面临的系统相关和个体相关的挑战。尚未捕捉到 GP 对 PCOS 体重和生活方式建议的观点。
招募了 15 名全科医生参加半结构化访谈。使用 NVIVO 软件进行定性分析。
我们报告说，全科医生一致认为 PCOS 中体重和生活方式管理很重要。实践受到系统相关和个体相关的促进因素和障碍的影响。个体相关的障碍包括患者减肥动机不足、时间压力、缺乏经济补偿，以及体重管理在专业上没有回报。系统相关的障碍包括获得专门医疗保健专业人员的费用和某些地区缺乏专门医疗保健专业人员。个体相关的促进因素包括有动力的患者亚组，如那些试图怀孕的患者，以及特定的沟通技巧，如动机访谈。系统相关的促进因素包括 GP 在慢性病管理中的作用。
本研究有助于了解可解决的障碍和促进因素，以优化初级保健中多囊卵巢综合征妇女的体重和生活方式管理。
