Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia.
Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia.
Obes Res Clin Pract. 2020 Sep-Oct;14(5):437-442. doi: 10.1016/j.orcp.2020.09.004. Epub 2020 Sep 19.
The prevalence of obesity in Australia is rising. National guidelines for the management of overweight and obesity exist but our previous work demonstrates poor implementation of key elements in general practice. The aim of this study was to describe patient perspectives on the implementation of obesity guidelines in general practice.
Qualitative study of 40 people living with obesity (PwO) who were recruited through general practices in Melbourne, Australia. PwO had a recorded BMI in the overweight range or above (>25), had attended a consultation in the last 6 months and had a diagnosis of at least one of the following: diabetes, kidney disease, hyperlipidemia, hypertension, or cardiovascular disease. Semi-structured telephone interviews were conducted with patients. Interviews were audio-recorded, transcribed verbatim and analysed thematically.
While a strong general practitioner (GP)-patient relationship enabled conversation to occur about weight management there was uncertainty as to whether patients or GPs should broach the topic of weight. Patients described complacency regarding their weight and often being unprepared to take up GP advice. Other health issues were felt to take precedence, and patients described inconsistent provision of information and resources to assist them in tackling their weight problems.
It is imperative to take into account patient perspectives on obesity management in general practice in order to improve health outcomes. This study provides valuable insights into how PwO can be better managed. Interventions should also include strategies to help patients maintain motivation in making lifestyle changes to support healthy weight loss.
澳大利亚的肥胖患病率正在上升。虽然存在针对超重和肥胖管理的国家指南,但我们之前的工作表明,这些指南在全科实践中的关键要素执行情况不佳。本研究旨在描述肥胖患者对全科实践中肥胖指南实施情况的看法。
这是一项在澳大利亚墨尔本的全科诊所进行的 40 名肥胖患者(PwO)的定性研究。PwO 的记录体重指数(BMI)处于超重范围或以上(>25),在过去 6 个月内参加过一次咨询,且至少被诊断出以下一种疾病:糖尿病、肾病、血脂异常、高血压或心血管疾病。对患者进行了半结构化电话访谈。访谈内容被录音、逐字转录并进行主题分析。
虽然强大的全科医生(GP)-患者关系使关于体重管理的对话成为可能,但对于是患者还是 GP 应该提出体重问题存在不确定性。患者对自己的体重感到自满,并且经常不准备接受 GP 的建议。其他健康问题被认为更为重要,患者描述说,他们得到的信息和资源不一致,无法帮助他们解决体重问题。
为了改善健康结果,必须考虑到肥胖患者在全科实践中对肥胖管理的看法。本研究为更好地管理肥胖患者提供了有价值的见解。干预措施还应包括帮助患者保持动力以进行生活方式改变以支持健康减肥的策略。