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女性体重管理的促进因素与障碍:医生观点

Facilitating Factors and Barriers to Weight Management in Women: Physician Perspectives.

作者信息

Walker Renee E, Kusch Jennifer, Fink Jennifer T, Nelson David A, Morris George, Skalla Jessica, Cisler Ron A

机构信息

Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI.

Center for Urban Population Health, Milwaukee, WI.

出版信息

J Patient Cent Res Rev. 2018 Jan 30;5(1):18-27. doi: 10.17294/2330-0698.1495. eCollection 2018 Winter.

Abstract

PURPOSE

The complexity of addressing overweight and obesity in women has been an ongoing public health and health care challenge. While the mechanism for addressing overweight and obesity in women remains unclear, it has been speculated that disparities in overweight and obesity by race and gender contribute to the complexity. The purpose of the present study was to examine perceptions of primary care physicians when discussing weight management with their patients.

METHODS

We conducted focus group discussions exploring facilitators and barriers to discussing weight management and weight loss among women patients. Participants included 18 family medicine and internal medicine physicians who were recruited using a snowball sampling technique from two large urban institutions. Focus group discussions were transcribed verbatim. Responses were then codified and analyzed in frequency of occurrence using specialized computer software.

RESULTS

Nine themes emerged from group discussions. These recurring themes reflected three overarching critical points: 1) potential utility of the primary care setting to address weight management; 2) the importance of positive patient-provider communication in supporting weight loss efforts; and 3) acknowledgement of motivation as intrinsic or extrinsic, and its role in obesity treatment.

CONCLUSIONS

Physician perceptions of their own lack of education or training and their inability to influence patient behaviors play crucial roles in discussing weight management with patients.

摘要

目的

应对女性超重和肥胖问题的复杂性一直是公共卫生和医疗保健领域持续面临的挑战。虽然应对女性超重和肥胖的机制尚不清楚,但据推测,种族和性别在超重和肥胖方面的差异导致了这种复杂性。本研究的目的是调查初级保健医生在与患者讨论体重管理时的看法。

方法

我们进行了焦点小组讨论,探讨女性患者在讨论体重管理和减肥方面的促进因素和障碍。参与者包括18名家庭医学和内科医生,他们是通过滚雪球抽样技术从两家大型城市机构招募的。焦点小组讨论内容逐字记录。然后使用专门的计算机软件对回复进行编码,并按出现频率进行分析。

结果

小组讨论中出现了九个主题。这些反复出现的主题反映了三个总体关键点:1)初级保健环境在应对体重管理方面的潜在效用;2)积极的医患沟通在支持减肥努力中的重要性;3)认识到动机是内在的还是外在的,及其在肥胖治疗中的作用。

结论

医生对自身缺乏教育或培训以及无法影响患者行为的认知,在与患者讨论体重管理时起着关键作用。

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Facilitating Factors and Barriers to Weight Management in Women: Physician Perspectives.女性体重管理的促进因素与障碍:医生观点
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