Division of Endocrinology, Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, J1H 5N4, Canada.
Nursing school, Université de Sherbrooke, Sherbrooke, Québec, J1H 5N4, Canada.
BMC Med Educ. 2020 Oct 14;20(1):361. doi: 10.1186/s12909-020-02248-5.
Primary care providers' (PCPs) attitude toward obesity is often negative, and their confidence level for helping patients manage their weight is low. Continuing professional development (CPD) on the subject of obesity is often based on a single activity using a traditional passive approach such as lectures known to have little effect on performance or patient outcomes. The aim of this study was to evaluate the impact of an educational intervention for obesity management on PCPs' attitude, self-efficacy, practice changes and patient-related outcomes.
Prospective interventional study with 12 months follow-up. A two-day clinical obesity preceptorship was offered where participants were actively involved in competence building using real-life situations, in addition to electronic networking tools, including a discussion forum and interactive monthly webinars. Thirty-five participants (12 nurses and 23 physicians) from seven Family medicine groups were enrolled. Questionnaires were used to evaluate the impact on primary care nurses' and physicians' attitudes and self-efficacy for obesity management. Practice changes and patient outcomes were evaluated using clinical vignettes, de-identified electronic patient records and qualitative analyses from group interviews.
Physicians' general attitude towards patients with obesity was improved (61 ± 22 mm vs 85 ± 17 mm, p < 0.001). Self-efficacy for obesity management and lifestyle counselling were also improved immediately and 1 year after the intervention (all Ps < 0.05). De-identified patient records and clinical vignettes both showed improvement in recording of weight, waist circumference and evaluation of readiness to change lifestyle (all Ps < 0.05) that was confirmed by group interviews. Also, 15% of patients who were prospectively registered for weight management had lost more than 5% of their initial weight at the time of their last visit (P < 0.0001, median follow-up of 152 days).
A multimodal educational intervention for obesity management can improve PCPs'attitude and self-efficacy for obesity management and lifestyle counselling. This translates into beneficial practice changes and patient-related outcomes.
clinicaltrials.gov Identifier: NCT01385397 . Retrospectively registered, 28 June 2011.
初级保健提供者（PCP）对肥胖的态度往往是负面的，他们帮助患者管理体重的信心水平较低。关于肥胖的继续教育（CPD）通常基于单一活动，采用传统的被动方法，如讲座，已知对绩效或患者结果几乎没有影响。本研究旨在评估肥胖管理教育干预对 PCP 态度、自我效能、实践改变和患者相关结果的影响。
前瞻性干预研究，随访 12 个月。提供为期两天的临床肥胖指导，参与者积极参与能力建设，使用现实生活中的情况，以及电子网络工具，包括讨论论坛和互动每月网络研讨会。招募了来自七个家庭医学小组的 35 名参与者（12 名护士和 23 名医生）。使用问卷评估肥胖管理对初级保健护士和医生态度和自我效能的影响。使用临床病例、匿名电子患者记录和小组访谈的定性分析评估实践改变和患者结果。
医生对肥胖患者的总体态度得到改善（61±22mm 与 85±17mm，p<0.001）。肥胖管理和生活方式咨询的自我效能也在干预后立即和 1 年得到改善（所有 p<0.05）。匿名患者记录和临床病例均显示体重、腰围记录和生活方式改变准备情况的改善（所有 p<0.05），小组访谈也证实了这一点。此外，有 15%的前瞻性登记参加体重管理的患者在最后一次就诊时体重减轻了初始体重的 5%以上（p<0.0001，中位数随访 152 天）。
肥胖管理的多模式教育干预可以改善 PCP 对肥胖管理和生活方式咨询的态度和自我效能。这转化为有益的实践改变和患者相关结果。
clinicaltrials.gov 标识符：NCT01385397。回顾性注册，2011 年 6 月 28 日。
