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为肥胖和行动不便的患者提供便利:医生的观察。

Accommodating patients with obesity and mobility difficulties: Observations from physicians.

机构信息

Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, United States.

Institute for Healthcare Delivery and Population Science and Department of Medicine, Baystate Health, Springfield, MA, United States; University of Massachusetts Medical School, United States.

出版信息

Disabil Health J. 2021 Jan;14(1):100951. doi: 10.1016/j.dhjo.2020.100951. Epub 2020 Jun 26.

Abstract

BACKGROUND

Given the growing population of U.S. adults with obesity and mobility disability, physicians will need to accommodate these patients.

OBJECTIVE

To explore attitudes and practices of US physicians related to caring for patients with obesity and mobility disability.

METHODS

Three open-ended, semi-structured, web-based focus group interviews with practicing physicians in selected specialties, which reached data saturation. Interviews were video recorded and transcribed for qualitative, conventional content analysis. Measurements included commonly expressed themes around caring for patients with obesity.

RESULTS

Physicians recognized obesity as a disability that poses challenges to high quality, safe, and efficient patient care. Observations coalesced around four themes: (1) difficulty routinely tracking weight; (2) reluctance to transfer obese patients to exam tables; (3) barriers to diagnostic testing; and (4) weight stigma. Physicians described difficulties accurately assessing weight, performing complete physical examinations, arranging diagnostic imaging, and providing prenatal care for obese patients. Lack of accessible medical diagnostic equipment impeded care for patients with obesity. Other participants did not contest comments of individual participants' that suggested weight stigma.

CONCLUSIONS

Our findings suggest that important gaps may remain in providing equitable access to care for patients with obesity, requiring additional training and accessible medical diagnostic equipment to safely accommodate these patients.

摘要

背景

鉴于美国肥胖和行动障碍的成年人数量不断增加,医生将需要照顾这些患者。

目的

探讨美国医生在照顾肥胖和行动障碍患者方面的态度和做法。

方法

在选定的专业中,对执业医师进行了三次基于网络的开放性、半结构式焦点小组访谈,直至达到数据饱和。访谈进行了视频录制和转录,以便进行定性的常规内容分析。测量包括围绕照顾肥胖患者的常见主题。

结果

医生将肥胖视为一种残疾,会给高质量、安全和高效的患者护理带来挑战。观察结果集中在四个主题上:(1)难以常规跟踪体重;(2)不愿将肥胖患者转移到检查台上;(3)诊断测试的障碍;(4)体重耻辱。医生描述了在准确评估体重、进行全面体检、安排诊断成像以及为肥胖患者提供产前护理方面的困难。缺乏可及的医疗诊断设备阻碍了对肥胖患者的护理。其他参与者没有对个别参与者的评论提出异议,这些评论表明存在体重耻辱。

结论

我们的研究结果表明,为肥胖患者提供公平的护理机会方面可能仍然存在重要差距,需要额外的培训和可及的医疗诊断设备,以安全地照顾这些患者。

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