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丹麦二级保健提供者对肥胖症手术转诊的态度和知识:一项全国性调查。

Attitudes and knowledge regarding referrals for bariatric surgery among Danish secondary healthcare providers: A national survey.

机构信息

Department of Medicine, Section of Endocrinology, Southwest Jutland Hospital, Esbjerg, Denmark.

Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Clin Obes. 2020 Aug;10(4):e12369. doi: 10.1111/cob.12369. Epub 2020 May 26.

Abstract

Bariatric surgery induces significant and sustained weight loss and subsequently reduces obesity-related comorbidities. However, only a small percentage of patients with severe obesity undergo bariatric surgery in Denmark. There is limited knowledge about the experiences with and possible reservations to bariatric surgery among secondary healthcare providers. The aim of this cross-sectional study was to investigate referral patterns and knowledge regarding the criteria for bariatric surgery among Danish secondary healthcare providers, treating obesity-related diseases. A questionnaire regarding experiences with and reservations to referring patients for consideration for bariatric surgery, along with thoughts to specific patient cases were sent to several specialists: endocrinologists, obstetricians and gynaecologists, orthopaedic surgeons and otorhinolaryngologists. Most questions required responses on a 5-point Likert scale and frequency distributions were calculated. A total of 345 (44%) specialists responded to the questionnaires. Good knowledge of the criteria for referral to bariatric surgery varied among the specialist from 6% to 68%. One of the main issues was a concern about the medical and surgical postoperative complications, which was a barrier to and influenced referral decisions. Furthermore, specialists were more likely to refer patients to bariatric surgery when patients requested this. Except for endocrinologists, the Danish secondary healthcare specialists interviewed have limited knowledge about bariatric surgery, which results in a reluctance in referring patients. Our results indicate that there is a need to improve knowledge among specialists, regarding the indications, criteria and outcomes for bariatric surgery to establish a more pro-active, specialist led approach to referrals.

摘要

减重手术可显著且持续地减轻体重,进而降低肥胖相关的合并症。然而,在丹麦,只有一小部分重度肥胖患者接受减重手术。对于二级保健提供者而言,他们对减重手术的经验和可能的保留意见知之甚少。本横断面研究旨在调查丹麦二级保健提供者(治疗肥胖相关疾病)对减重手术的转介模式和相关知识,以及对特定患者病例的看法。我们向几位专家(内分泌学家、妇产科医生、骨科医生和耳鼻喉科医生)发送了一份关于将患者转介以考虑进行减重手术的经验和保留意见以及特定患者病例的想法的问卷。大多数问题要求在 5 点李克特量表上作答,并计算了频率分布。共有 345 名(44%)专家对问卷做出了回应。专家对减重手术转介标准的了解程度差异很大,从 6%到 68%不等。主要问题之一是对医疗和手术术后并发症的担忧,这是转诊决策的障碍,并影响了转诊决策。此外,当患者提出要求时,专家更有可能将患者转介到减重手术。除了内分泌学家,接受采访的丹麦二级保健专家对减重手术的了解有限,这导致他们不愿意转介患者。我们的研究结果表明,需要提高专家对减重手术的适应症、标准和结果的认识,以建立更积极主动的、由专家主导的转介方法。

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